Air Quality

Ceisteanna (140)

Alan Kelly

Ceist:

140. Deputy Alan Kelly asked the Minister for Health if an analysis has been performed on the health risks associated with air quality; and if he will make a statement on the matter. [11327/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I wish to advise the Deputy that policy responsibility with regard to air quality is a matter for the Department of Communications, Climate Action and the Environment.

Air Quality

Ceisteanna (141)

Alan Kelly

Ceist:

141. Deputy Alan Kelly asked the Minister for Health if he has met with officials from the Department of Communications, Climate Action and Environment to discuss the issue of sub par air quality here (details supplied); and if he will make a statement on the matter. [11328/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I have not met with officials from the Department of Communications, Climate and the Environment regarding the issue of air quality referred to in the report cited by the Deputy.

Medicinal Products Availability

Ceisteanna (142)

Charlie McConalogue

Ceist:

142. Deputy Charlie McConalogue asked the Minister for Health further to Parliamentary Question No. 468 of 22 January 2019, if the shortage of the drug has now been addressed; and if he will make a statement on the matter. [11334/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Health Products Regulatory Authority (HPRA) is the competent authority for the regulation of medicines in Ireland. The HPRA leads the co-ordination of efforts by national agencies and stakeholders to manage medicine shortages.  

The HPRA has advised me that the supply of Hydrocortisone 10 mg tablets has resumed to normal supply as of 19 February 2019. However some local issues may persist for a period of time as stock levels return to normal throughout the system. If a patient has any concerns regarding their treatment with this or any other medication, they should discuss this directly with their doctor or pharmacist.

The HPRA welcomes and encourages reports of medicine shortages from all stakeholders, including healthcare professionals and patients via its website, which also includes information on expected return dates of medicines and resolved shortages. 

HPRA website: www.hpra.ie/homepage/medicines/medicines-information/medicines-shortages.

Grant Payments

Ceisteanna (143)

Michael Healy-Rae

Ceist:

143. Deputy Michael Healy-Rae asked the Minister for Health the status of an application for an injury grant by a person (details supplied); and if he will make a statement on the matter. [11337/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Respite Care Services Provision

Ceisteanna (144)

Martin Ferris

Ceist:

144. Deputy Martin Ferris asked the Minister for Health his plans to ensure a person (details supplied) receives respite care while their fair deal application is being processed; and if he will make a statement on the matter. [11338/19]

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.

Hospital Appointments Status

Ceisteanna (145)

Timmy Dooley

Ceist:

145. Deputy Timmy Dooley asked the Minister for Health when a person (details supplied) in County Clare will have cataract surgery; and if he will make a statement on the matter. [11340/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar 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.

Treatment Abroad Scheme

Ceisteanna (146)

Jackie Cahill

Ceist:

146. Deputy Jackie Cahill asked the Minister for Health if a person (details supplied) can have a tonsillectomy carried out under the treatment abroad fund or another scheme if they are referred by a general practitioner; and if he will make a statement on the matter. [11341/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The HSE currently operates two schemes that facilitate patients accessing treatment abroad.

The Treatment Abroad Scheme (TAS) allows public patients to be referred to another EU/EEA Member State for treatment, in their public healthcare system, that is not available in Ireland, subject to qualifying criteria. A patient's Irish based consultant is responsible for referring the patient abroad under the terms of the TAS, after having exhausted all treatment options including tertiary care within Ireland. The HSE provides information for patients on the TAS on its website. 

An alternative where the treatment is available in Ireland is the Cross Border Directive (CBD), which the HSE operates in Ireland. Under the terms of the CBD patients in Ireland can be reimbursed for medical treatment, that is available in the public health service in Ireland, but received in another EU\EEA Member State. The patient may access the overseas service in either the public or private health sector of the other Member State they choose to receive the service in. The patient pays for the treatment and claims reimbursement from the HSE at the cost of that treatment in Ireland or the cost of it abroad, whichever is the lesser. 

Referral for care under the CBD may be made by a GP, a hospital consultant and certain other clinicians. The HSE through the National Contact Point (NCP) provides information for patients on the operation of the CBD. 

The patient should contact the HSE TAS/CBD office for advice on making an application for treatment abroad under the most appropriate scheme. They can be contacted in writing at HSE TAS/CBD Office, St Canices, Laken, Dublin Road, Kilkenny, R95 P231 or by phone on 056 778 4551.  Information is also available on the HSE's TAS and CBD websites.

Primary Care Centres Provision

Ceisteanna (147)

Alan Farrell

Ceist:

147. Deputy Alan Farrell asked the Minister for Health the potential to deliver a primary care centre for Swords, County Dublin; and if he will make a statement on the matter. [11344/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

Cancer Screening Programmes

Ceisteanna (148)

Micheál Martin

Ceist:

148. Deputy Micheál Martin asked the Minister for Health if he received written or verbal advice, directly or indirectly, on free smear tests before he announced same; and if he will make a statement on the matter. [11348/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

On 28 April 2018, I made the decision to provide for a free out of cycle smear test for any woman who was concerned, where her GP felt she should have a further test as part of her reassurance. My Department's advice in this regard was reflected in the press statement issued on the 28 April which said that, “for any woman who has had a CervicalCheck smear test and where her GP feels she should have a further test as part of her reassurance, the Minister has asked CervicalCheck to make the necessary arrangements, including payment provision. These arrangements will be confirmed next week."

A fee to provide for this free repeat smear was subsequently agreed with the Irish Medical Organisation, and welcomed by TDs across the Dáil and by GP representative bodies. Neither I nor my officials received advice that recommended against these tests in advance of the decision.  I understand that, subsequent to the decision, concerns were raised verbally by the National Screening Service on foot of contact by my Department, but these failed to recognise the circumstances of the unfolding crisis in the programme. Were it not for these circumstances, it would never have been necessary to contemplate such a step in the ordinary course of the operation of the screening programme. The decision cannot be separated from the reality that general practitioners, in difficult circumstances, were dealing with large numbers of worried patients as a result of the issues which came into the public domain over the course of Thursday and Friday, 26th and 27th of April. It was important that GPs be supported while they awaited supporting information to be developed and disseminated by CervicalCheck. The alternative, i.e. that the State failed to recognise the reality of patients presenting in this way to GPs or the State refused to pay for such smears, would have been untenable in the circumstances.

Pharmacy Regulations

Ceisteanna (149)

Louise O'Reilly

Ceist:

149. Deputy Louise O'Reilly asked the Minister for Health his plans to delay the signing of statutory instruments regarding the rules of an organisation (details supplied) until the Oireachtas Joint Committee on Health has had the opportunity to engage with officials from his Department and representatives of the organisation on the impact the rules will have on pharmaceutical assistants. [11350/19]

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.

Following a period of public consultation, the Council of the PSI considered the proposed draft Pharmaceutical Society of Ireland (Temporary Absence of Pharmacist from Pharmacy) Rules 2018 at its meeting of 20 September 2018, where the Council approved the draft rules without amendment. Following this, the PSI undertook to redraft the Rules in relation to what may or not be done by a registered pharmaceutical assistant when acting on behalf of a registered pharmacist.

On 6 December, the Council of the PSI approved a revised draft of the Pharmaceutical Society of Ireland (Temporary Absence of Pharmacist from Pharmacy) Rules 2018 for issuance for public consultation. This public consultation commenced on 13 December 2018 and ran until 11 January 2019, affording 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 14 February 2019.

My role in relation to this process is limited to the consideration of any such Rules once submitted for my consent. I must consider any Rules presented to me from a fair and impartial perspective, without prejudice or prejudgment. No Rules have as yet been submitted to me by the PSI.

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.

Services for People with Disabilities

Ceisteanna (150)

John Brassil

Ceist:

150. Deputy John Brassil asked the Minister for Health if approval will be given for the hours and contract of the nursing support for a school (details supplied); and if he will make a statement on the matter. [11355/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar 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. 

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.

Respite Care Services Funding

Ceisteanna (151)

Éamon Ó Cuív

Ceist:

151. Deputy Éamon Ó Cuív asked the Minister for Health his plans to provide extra funding in 2019 for respite care for those with an intellectual disability; when funding will be allocated to service providers; and if he will make a statement on the matter. [11361/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar 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. 

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.

Medicinal Products Prices

Ceisteanna (152)

Thomas P. Broughan

Ceist:

152. Deputy Thomas P. Broughan asked the Minister for Health the price the BeNeLuxa countries are paying for Spinraza; the reason Ireland cannot access the same deal in view of the fact that this price was finalised prior to Ireland joining the BeNeLuxa initiative; and if he will make a statement on the matter. [11366/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

In July 2018, two members of the Beneluxa Initiative on Pharmaceutical Policy (Belgium and the Netherlands) completed a joint negotiation for the reimbursement of Spinraza.  However, this joint negotiation process commenced when Ireland had only opened negotiations with Belgium, the Netherlands, Austria and Luxembourg, with a view to joining the existing collaboration between these four countries.

The Deputy will appreciate that as a candidate country, Ireland was not notified, due to confidentiality arrangements that negotiations were occurring for the reimbursement of Spinraza and we were not party to the details of the negotiations, or indeed the final agreed price which was agreed between these parties as part of a commercially confidential arrangement. 

There is no transparency around final agreed prices in Ireland and in Europe due to Industry’s insistence on commercial confidentiality which means that countries have neither certainty nor predictability on prices.   

Despite lengthy engagement with the manufacturer, the HSE was unable to come to an agreement with the company for the reimbursement of Spinraza at a price that is viable.

The HSE has written to the company involved and informed them of the proposal to refuse reimbursement at the current price offering. Under the requirements of the Health (Pricing and Supply of Medical Goods) Act 2013 the company now has 28 days to respond or make representations to the HSE’s proposed decision.

The HSE remains open to considering any new evidence or information which emerges regarding the clinical effectiveness or price of this medicine.

Medicinal Products Licensing

Ceisteanna (153)

Thomas P. Broughan

Ceist:

153. Deputy Thomas P. Broughan asked the Minister for Health the work his officials are undertaking to improve the drug approval process; and if he will make a statement on the matter. [11367/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The HSE has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013 which specifies the criteria for decisions on the reimbursement of medicines.

After receiving market authorisation and in line with the 2013 Act, a company which would like a medicine to be reimbursed by the HSE must submit an application for reimbursement to have the 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.

Within the confines of the 2013 Health Act, there has been engagement between the Department, the HSE and the NCPE over the last number of months, which has resulted in a number of key changes to the assessment process.

In June 2018, the HSE leadership appointed a Technology Review Committee for Rare Diseases, which is responsible for:

1. Reviewing proposals received from industry or expert groups in Ireland for funding of new products for rare diseases or expanded indications for existing products for rare diseases and making recommendations on the implementation of the relevant recommendations from the National Rare Diseases Plan 2011-2018; and

2. Contributing to the development of clinical guidelines for relevant orphan medicinal products (OMPs) and supporting the implementation of guidelines with the National Drugs Management Programme Office where applicable.

The Committee’s recommendations for reimbursement of OMPs are not intended to replace any part of the existing medicines appraisal process, but rather to complement it.

The composition of the HSE Drugs Group has also recently been expanded to include two representatives from the National Patients Forum and more clinical expertise in the area of rare diseases.   These changes are intended to provide greater balance and transparency to the assessment process as a whole.

The challenge of securing affordable access to innovative medicines is not unique to Ireland. Over the past two years, my officials and I have been engaging with a number of EU forums in an effort to identify solutions to issues of medicine pricing, sustainability and supply. 

In June 2018, I signed the Beneluxa Initiative on Pharmaceutical Policy with Austria, Belgium, the Netherlands and Luxembourg. This Agreement is in line with my objective to work with other European countries to identify workable solutions, in an increasingly challenging environment, to secure timely access for  patients to new medicines in an affordable and sustainable way. 

My Department has completed a tender process for a review of the HSE reimbursement and pricing decision-making process and are in the process of appointing a consultancy firm to complete this review.

HSE Staff Data

Ceisteanna (154)

Thomas P. Broughan

Ceist:

154. Deputy Thomas P. Broughan asked the Minister for Health the number of staff in the HSE corporate pharmaceutical unit in tabular form; the role of each in the organisation in each year since 2009 to date in 2019; and if he will make a statement on the matter. [11369/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Medicinal Products Data

Ceisteanna (155)

Thomas P. Broughan

Ceist:

155. Deputy Thomas P. Broughan asked the Minister for Health the number of drug treatments and medicines assessed by the National Centre For Pharmacoeconomics and the HSE corporate pharmaceutical unit in each year since 2009 to date in 2019, in tabular form; the numbers approved and denied each year, respectively; and if he will make a statement on the matter. [11370/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Disability Diagnoses

Ceisteanna (156)

Thomas P. Broughan

Ceist:

156. Deputy Thomas P. Broughan asked the Minister for Health the number of children born with SMA, spinal muscular atrophy, or diagnosed in childhood each year since 2009 to date in 2019; and if he will make a statement on the matter. [11371/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Mental Health Services Staff

Ceisteanna (157)

James Browne

Ceist:

157. Deputy James Browne asked the Minister for Health the number of mental health whole-time equivalents who need to be recruited for the full implementation of A Vision for Change taking account of demographic changes by CHO; the teams and specialties in which the additional staff are required; and the full year cost of such recruitment. [11372/19]

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.

Psychological Services Waiting Lists

Ceisteanna (158)

James Browne

Ceist:

158. Deputy James Browne asked the Minister for Health the number of persons in each local health office area waiting for a psychology appointment in primary care; and the number waiting zero to 12, 12 to 26, 26 to 52 and more than 52 weeks, respectively. [11373/19]

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.

Child and Adolescent Mental Health Services Data

Ceisteanna (159)

James Browne

Ceist:

159. Deputy James Browne asked the Minister for Health the number of persons in each local health office area waiting for a child and adolescent mental health services appointment; and the number waiting 0 to 12, 12 to 26, 26 to 52 and more than 52 weeks, respectively. [11374/19]

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.

Long-Term Illness Scheme Eligibility

Ceisteanna (160)

Jan O'Sullivan

Ceist:

160. Deputy Jan O'Sullivan asked the Minister for Health his plans to update the long-term illness scheme to include other illnesses; and if he will make a statement on the matter. [11377/19]

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 at this time.

However, I wish to inform the Deputy that it is proposed that the LTI Scheme would be included as part of a review of the basis for existing hospital and medication charges, to be carried out under commitments given in the Sláintecare Implementation Strategy.

Health Services Staff Remuneration

Ceisteanna (161)

Barry Cowen

Ceist:

161. Deputy Barry Cowen asked the Minister for Health the progress on restoring pay for section 39 health workers; the role he is playing in the process; when the process will be completed; and if he will make a statement on the matter. [5767/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

In February 2018, an agreement was reached at the Workplace Relations Commission (WRC) between the Department, the HSE and health sector Trade Unions in relation to a process aimed at resolving the pay restoration issue for staff employed by section 39 bodies in 50 pilot organisations.  The 50 organisations which were included were agreed at the WRC.

Following a data gathering exercise and the compilation of an interim report in June, the parties attended for conciliation talks at the WRC in July 2018.  Following a reconvening of talks, an agreement was reached on 2 October 2018 between the parties. For those employed by the 50 organisations involved in the pilot, the following will apply: 

- Pay restoration will commence in April 2019 with an annual pay increase of up to €1,000;

- 50% of the outstanding restoration due will be paid on 1 October 2020;

- The remaining 50% will be paid on 1 October 2021.

Based on the information available, it appears that almost 90% of these staff who received a pay cut will have on average, 75% of it restored next month.

The above payments will be made based on the following criteria:

- This is pay restoration and not pay progression;

- The intention is to restore pay reductions made, no more;

- Only the 50 organisations in the pilot are eligible at this time;

- Payment will be subject to a verification and validation process.

It is recognised that some of the remaining organisations will have pay restoration issues also.  A process of engagement to address this will commence in 2019.

Nursing Staff Remuneration

Ceisteanna (162)

Barry Cowen

Ceist:

162. Deputy Barry Cowen asked the Minister for Health the developments involving his Department since the Labour Court recommendation on the dispute with the nurses; the changes to be made with contracts; and if he will make a statement on the matter. [10676/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Representatives of my Department, the HSE and the Department of Public Expenditure and Reform have met with representatives of the INMO, SIPTU and the PNA to consider the recent Labour Court recommendations which issued in relation to the nursing dispute.  As engagement is ongoing, it would not be possible to respond in detail at this juncture.

Nursing Staff Remuneration

Ceisteanna (163, 164)

Mattie McGrath

Ceist:

163. Deputy Mattie McGrath asked the Minister for Health if the demand by a union (details supplied) for parity of pay for its members within the flexibility available to him under the terms of the public sector pay agreement will be reconsidered; and if he will make a statement on the matter. [7515/19]

Amharc ar fhreagra

Mattie McGrath

Ceist:

164. Deputy Mattie McGrath asked the Minister for Health if he will reconsider the demand of a union (details supplied) for parity of pay for its members within the flexibility available to him under the terms of the Public Sector Pay Agreement; and if he will make a statement on the matter. [7365/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 163 and 164 together.

The recent Labour Court Recommendations issued on foot of industrial action taken by members of the INMO are still under consideration by the parties. As engagement is still ongoing, it would be unhelpful to comment further at this time.