Tuesday, 15 Jan 2019

Written Answers Nos. 530-549

Dental Services Provision

Ceisteanna (530)

Michael Healy-Rae

Ceist:

530. Deputy Michael Healy-Rae asked the Minister for Health if the HSE covers children (details supplied) with a condition; and if he will make a statement on the matter. [54076/18]

Freagraí scríofa

Minister for Health

As this is a service matter it has been referred to the HSE for direct reply to the Deputy.

Medical Qualifications

Ceisteanna (531)

Eamon Scanlon

Ceist:

531. Deputy Eamon Scanlon asked the Minister for Health the reason doctoral level training is required to qualify as a professional psychologist compared to others that work in the mental health sector qualified at degree level; and if he will make a statement on the matter. [54142/18]

Freagraí scríofa

Minister for Health

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

Hospital Investigations

Ceisteanna (532, 533)

Catherine Connolly

Ceist:

532. Deputy Catherine Connolly asked the Minister for Health the policy on the funding of external and-or internal reviews and-or investigations of patient care in hospitals; the cost of such reviews or investigations in each of the past ten years; and if he will make a statement on the matter. [54325/18]

Catherine Connolly

Ceist:

533. Deputy Catherine Connolly asked the Minister for Health the policy on the funding of external and-or internal reviews and-or investigations of patient care in hospitals; the cost of such reviews or investigations at Galway University Hospital in each of the past ten years; and if he will make a statement on the matter. [54326/18]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 532 and 533 together.

As the Deputy's questions refer to service matters, I have referred the questions to the HSE for direct reply.

Mental Health Services Provision

Ceisteanna (534)

Fiona O'Loughlin

Ceist:

534. Deputy Fiona O'Loughlin asked the Minister for Health further to Parliamentary Question No. 440 of 27 November 2018, the timeframe for a new design team to be appointed; and if he will make a statement on the matter. [54397/18]

Freagraí scríofa

Minister of State at the Department of Health

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

Long-Term Illness Scheme Coverage

Ceisteanna (535)

Jack Chambers

Ceist:

535. Deputy Jack Chambers asked the Minister for Health if persons with exocrine pancreatic insufficiency will be allowed access to a medication (details supplied) on the long-term illness scheme; and if he will make a statement on the matter. [54035/18]

Freagraí scríofa

Minister for Health

Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Mental Health Services

Ceisteanna (536)

John Brassil

Ceist:

536. Deputy John Brassil asked the Minister for Health if he will request Kerry community services to provide a full-time security person at the Sliabh Mish unit, UHK, in view of the ongoing security issues; and if he will make a statement on the matter. [54038/18]

Freagraí scríofa

Minister of State at the Department of Health

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

Patient Transfers

Ceisteanna (537)

Michael Fitzmaurice

Ceist:

537. Deputy Michael Fitzmaurice asked the Minister for Health his plans to move a resident of a unit (details supplied) who requires one-to-one specialist care to a nursing home in which the standard of care they are receiving will not be attainable; and if he will make a statement on the matter. [54041/18]

Freagraí scríofa

Minister of State at the Department of Health

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

Hospital Appointments Status

Ceisteanna (538)

Niamh Smyth

Ceist:

538. Deputy Niamh Smyth asked the Minister for Health further to Parliamentary Question No. 390 of 27 November 2018, the reason a person (details supplied) was told they had an appointment in March 2019 and has now been informed they are not on a waiting list; and if he will make a statement on the matter. [54042/18]

Freagraí scríofa

Minister for Health

Under 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.

Hospitals Data

Ceisteanna (539)

Niamh Smyth

Ceist:

539. Deputy Niamh Smyth asked the Minister for Health the number of attendances at a facility (details supplied) in each of the years 2010 to 2018 and to date in 2019; and if he will make a statement on the matter. [54050/18]

Freagraí scríofa

Minister for Health

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

Hospital Facilities

Ceisteanna (540)

Niamh Smyth

Ceist:

540. Deputy Niamh Smyth asked the Minister for Health the status of a review of an injury unit (details supplied); the detail of the review; when it will be concluded; and if he will make a statement on the matter. [54051/18]

Freagraí scríofa

Minister for Health

The establishment of Hospital Groups has enabled a better configuration of hospital services with benefits relating to safety, quality, access, cost and sustainable medical staffing. Hospitals working together in a group can support each other, providing a stronger role for smaller hospitals in delivering less complex care, and ensuring that those who require emergency or complex planned care are managed safely in larger hospitals.

The Smaller Hospitals Framework focuses on the future role of smaller hospitals and outlines the wide range of services that can be provided within these smaller hospitals. Medical Assessment Units, Urgent Care Centres and Minor Injuries Clinics provide a safe and local alternative to EDs and work has begun in my Department on a review of these, as committed to in the Programme for a Partnership Government 2016.

As a Model 2 hospital, in line with the Smaller Hospitals Framework, Monaghan Hospital has a Minor Injuries Unit located on site which provides an important service to the local community. I recently met with the RCSI Hospitals Group, which includes Monaghan Hospital, to discuss how all hospitals within the group can develop and contribute to improvements in both scheduled and unscheduled care for patients.

I am committed to securing and further developing the role of our smaller hospitals with the expansion of services delivered in these hospitals, especially in services such as day surgery; ambulatory care; medical services and diagnostics.

Hospital Appointments Status

Ceisteanna (541)

Michael Healy-Rae

Ceist:

541. 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. [54052/18]

Freagraí scríofa

Minister for Health

Under 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.

National Children's Hospital Expenditure

Ceisteanna (542, 578, 600)

Alan Kelly

Ceist:

542. Deputy Alan Kelly asked the Minister for Health the projected final cost for the new national children’s hospital; and if he will make a statement on the matter. [54053/18]

Thomas P. Broughan

Ceist:

578. Deputy Thomas P. Broughan asked the Minister for Health if he will report on the rising costs of the children’s hospital; the way in which the projected costs are accumulating; and if he will make a statement on the matter. [54237/18]

Mattie McGrath

Ceist:

600. Deputy Mattie McGrath asked the Minister for Health the reason given for the significant levels of additional extra funding required for the national children’s hospital at St. James's Hospital; the measures he is taking to prevent further increases; and if he will make a statement on the matter. [54314/18]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 542, 578 and 600 together.

The children’s hospital is one of the most complex and important public capital projects that this country has ever embarked upon. The hospital will facilitate the implementation of a new model of care that will have a profound impact on all paediatric services once the new hospital is open.

Considerable work has been undertaken on the project since April 2017 when Government gave the green light for the construction of the hospital. Enabling works on the main hospital site are complete and Phase A construction works (substructure works on the main site), which commenced in October 2017, are also now nearing completion. The Phase B 7-storey above ground works will begin early this year. Development is also well advanced on the paediatric outpatients and urgent care centres. Works at Connolly are on target for practical completion of the building in the Spring with the opening scheduled for July 2019. Works at Tallaght are underway with a target hand-over date of July 2020, and the construction of the main hospital to be completed in 2022.

At an early stage in the process, it was determined that the traditional method of procurement was not suitable or realistic for a project of this size and complexity. Accordingly, the contract is subject to a two-stage process with stage one consisting of a scope refinement and value engineering process, based upon tendered rates, to finalise the Phase B works (above ground). This approach allowed the early phases of work to commence on site while also allowing for the detail of later phases to be finalised and agreed. This approach brings issues on cost to the fore much earlier in the life of the project than is the case where traditional procurement approaches are deployed.

Following the completion of the second stage of the two-stage tender procurement process, the final cost of the design, build and equipment programme for which the National Paediatric Hospital Development Board is responsible is now at €1,433 million, €450m more than advised to Government in April 2017. €319m of the additional cost relates to construction costs, and the balance of €131m, which includes €50m in VAT, relates to costs associated with staff, consultants, planning, design team fees, risk/contingency, and Management Equipment Service.

As I have already stated the increased cost is a matter of great concern and I have made it clear that Phase B of the construction project must be delivered within budget and timescale. Accordingly, there will be an independent review, commencing in January, of the escalation in cost in determining the adjusted contract sum, the contributory factors and associated responsibilities so that any potential weaknesses are identified and comprehensively and speedily resolved in the interests of the successful completion of the project and the effective management of public funds. The National Paediatric Hospital Development Board will be required to provide on-going assurance to the HSE, Department of Health and Government that Phase B of the project is being delivered within budget and timescale.

Hospital Facilities

Ceisteanna (543)

Alan Kelly

Ceist:

543. Deputy Alan Kelly asked the Minister for Health the reason the proposed second radiology room in Our Lady of Lourdes Hospital, Drogheda, was not provided as part of the new expanded accident and emergency department; and if he will make a statement on the matter. [54060/18]

Freagraí scríofa

Minister for Health

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

Nursing Homes Support Scheme Administration

Ceisteanna (544)

Noel Grealish

Ceist:

544. Deputy Noel Grealish asked the Minister for Health if consideration will be given to changing the rules of the fair deal scheme to enable families and persons who are in nursing homes under the fair deal scheme to sell or rent their houses without financial penalty to help increase the number of properties available for purchase and rent and therefore help to alleviate the housing crisis; and if he will make a statement on the matter. [54062/18]

Freagraí scríofa

Minister of State at the Department of Health

The Nursing Homes Support Scheme (NHSS), commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.

Participants in the Scheme contribute up to 80% of their assessable income, such as their pension and a maximum of 7.5% per annum of the value of assets held, such as their principal private residence or cash assets. The first €36,000 of an individual’s assets is not counted at all in the financial assessment. The capital value of an individual’s principal private residence is only included in the financial assessment for the first three years of their time in care. This is known as the three year cap. No participant will pay more that the actual cost of care.

Under NHSS rental income is considered income for the purpose of the financial assessment, and is assessed at 80% less any allowable deductions.

Action 17 of the Strategy for the Rental Sector commits the Department of Housing, Planning, and Local Government (DHPLG) to examine the treatment under the Nursing Homes Support Scheme's financial assessment of income from the rental of a person's principal private residence where they move into long term residential care. The Department of Health is currently engaging with the DHPLG in this regard.

It also is worth noting that the decision to rent out a home resides with the home-owner, therefore creating the possibility of older people in nursing homes becoming landlords and taking on the many responsibilities associated with that role. This would involve the consideration of many practicalities. As such, there are significant complexities in examining changes to the NHSS, particularly to ensure the ongoing fair, equitable and sustainable operation of the scheme. As a result there are competing interests and issues that must be fully considered.

Medicinal Products Reimbursement

Ceisteanna (545, 604, 654)

Noel Grealish

Ceist:

545. Deputy Noel Grealish asked the Minister for Health if Spinraza will be made available to children with SMA to prevent permanent deterioration in their condition; the timeframe for the introduction of this drug to the children in this regard; and if he will make a statement on the matter. [54065/18]

Gino Kenny

Ceist:

604. Deputy Gino Kenny asked the Minister for Health if his attention has been drawn to the distress the parents of children with SMA are experiencing due to the delay in making the drug Spinraza available (details supplied); the steps he will take to ensure that this matter is resolved at the drugs meeting in January 2019; and if he will make a statement on the matter. [54321/18]

James Browne

Ceist:

654. Deputy James Browne asked the Minister for Health the position regarding the provision of a drug (details supplied) to persons with SMA; and if he will make a statement on the matter. [54491/18]

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 545, 604 and 654 together.

The 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.

Nusinersen (Spinraza) is indicated for the treatment of 5q spinal muscular atrophy (SMA), a disorder characterised by progressive muscle atrophy and weakness.

An application for Nusinersen is currently undergoing assessment by the HSE.

The statutory assessment process involves a Health Technology Assessment followed by detailed consideration by the HSE expert groups on new Drug therapies, including the Technology Review Group for Rare Diseases and the HSE Drugs Committee.

The assessment focus is twofold and particularly centred on reviewing the evidence of the clinical effectiveness of this new drug therapy i.e. the benefits for patients undergoing clinical trials; and on the cost effectiveness of the product in view of the prices being charged for the drug.

The application is currently going through the final stages of assessment, and the various reports are due to be considered shortly by the HSE Leadership Team, following which the final decision will be notified.

Health Insurance Cover

Ceisteanna (546)

Noel Rock

Ceist:

546. Deputy Noel Rock asked the Minister for Health his views on the fact that athletic therapy and training is not recognised by a company (details supplied); if representations will be made to the company to include this in the future; and if he will make a statement on the matter. [54073/18]

Freagraí scríofa

Minister for Health

Health insurance providers operate in a competitive market and are free to impose certain terms and conditions on their policies, providing they comply with the Health Insurance Act, 1994 (Minimum Benefit) Regulations, 1996. The regulations ensure that all consumers obtain a minimum level of health insurance cover regardless of what plan they purchase and that every plan available is inclusive of a minimum suite of benefits/procedures.

As the Minister for Health, I have no role to play in the commercial decisions of any health insurer and am therefore not in a position to determine or direct insurers to provide cover for any particular procedure or service, other than those outlined in the regulations.

Emergency Departments

Ceisteanna (547)

Willie O'Dea

Ceist:

547. Deputy Willie O'Dea asked the Minister for Health if his attention has been drawn to the fact that when persons attend emergency departments with mental health problems, including suicide ideation, there is no help available for them, they are simply sent back out into the streets; and if he will make a statement on the matter. [54074/18]

Freagraí scríofa

Minister of State at the Department of Health

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

Services for People with Disabilities

Ceisteanna (548)

Seán Sherlock

Ceist:

548. Deputy Sean Sherlock asked the Minister for Health if full care day service and respite care will be sanctioned for a person (details supplied). [54078/18]

Freagraí scríofa

Minister of State at the Department of Health

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.

The Programme for Partnership Government states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability.

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.

Medical Card Applications

Ceisteanna (549)

Charlie McConalogue

Ceist:

549. Deputy Charlie McConalogue asked the Minister for Health when a decision will be made on a medical card application by a person (details supplied) in County Donegal; and if he will make a statement on the matter. [54082/18]

Freagraí scríofa

Minister for Health

As this is a service matter it has been sent to the Health Service Executive for direct reply to the Deputy.