Cannabis for Medicinal Use

Ceisteanna (255, 331, 336, 337, 338, 343, 344, 387)

Joan Collins

Ceist:

255. Deputy Joan Collins asked the Minister for Health when products of a company (details supplied) will be dispensed through general practitioners or pharmacies here in order to avoid persons having to travel abroad every three months and in some instances monthly to collect the medication. [11985/19]

Amharc ar fhreagra

Michael Healy-Rae

Ceist:

331. Deputy Michael Healy-Rae asked the Minister for Health his views on a matter regarding medical distribution (details supplied); and if he will make a statement on the matter. [11697/19]

Amharc ar fhreagra

Willie O'Dea

Ceist:

336. Deputy Willie O'Dea asked the Minister for Health his plans to have the medication CBD produced by a company (details supplied) dispensed to pharmacies here rather than persons having to travel abroad to collect this medication; and if he will make a statement on the matter. [11707/19]

Amharc ar fhreagra

Thomas P. Broughan

Ceist:

337. Deputy Thomas P. Broughan asked the Minister for Health if he will report on accessibility for medicinal cannabis; if patients prescribed medicinal cannabis through the compassionate access programme will have their medication delivered to, and dispensed from their local chemists; the measures he will take in this regard; and if he will make a statement on the matter. [11711/19]

Amharc ar fhreagra

Thomas P. Broughan

Ceist:

338. Deputy Thomas P. Broughan asked the Minister for Health if all forms of medicinal cannabis will be available to patients from their local chemists; the way in which the dispensing of medicinal cannabis will be undertaken here; and if he will make a statement on the matter. [11712/19]

Amharc ar fhreagra

Louise O'Reilly

Ceist:

343. Deputy Louise O'Reilly asked the Minister for Health if his attention has been drawn to cases in the Northern Ireland and Britain in which a distribution company is facilitating the direct importation of distribution to pharmacies of medication by a company (details supplied); the reason the same process has not been afforded to the 16 patients who have been granted licences here for the medication; if these patients will be facilitated delivery of their mediation to pharmacies here in view of rolling out the compassionate access programme; and if not, the reason therefor. [11718/19]

Amharc ar fhreagra

Louise O'Reilly

Ceist:

344. Deputy Louise O'Reilly asked the Minister for Health further to Parliamentary Questions Nos. 341 and 342 of 19 February 2019, the reason patients who have been prescribed medicinal cannabis for their health needs still need to leave the State and travel to another state to acquire the medication; the reason a process has not been put in place to import the medication to chemists and pharmacies here under the supervision of the health service to be provided to patients; and his plans to put processes in place to ensure that such medication will be imported and distributed through chemists and pharmacies here. [11719/19]

Amharc ar fhreagra

Clare Daly

Ceist:

387. Deputy Clare Daly asked the Minister for Health the progress made on the granting of importation licences for medicinal cannabis and the sourcing of an adequate distribution company to ensure supply of medication to pharmacies here; and if he will make a statement on the matter. [11950/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 255, 331, 336 to 338, inclusive, 343, 344 and 387 together.

My Department is working towards the introduction shortly of a Cannabis for Medical Use Access Programme.

While the arrangements that will enable this programme to begin are being finalised, it is open to a registered medical practitioner to apply for a Ministerial Licence under the Misuse of Drugs Act 1977. Such a licence, if granted, enables them to legally prescribe medical cannabis for a named patient. It is important to note that the decision to prescribe such treatment is a clinical decision for the prescribing doctor.

Until acceptable medical cannabis products are available for use in Ireland, patients who are the subject of a Licence are obtaining their cannabis products from a pharmacy in the Netherlands.

Under Netherlands government policy, cannabis oil products are not permitted to be commercially exported.

Notwithstanding the fact that such cannabis products might eventually be listed as products that could be accessed under the Programme, unless the Dutch export barrier is removed, anyone who is prescribed these products will have to travel to the Netherlands to obtain them.

We are aware that a UK company may provide a service which involves it collecting cannabis products from the Netherlands for persons authorised to use it under the UK medical cannabis regime.

While this company can import medical cannabis products into the UK from the Netherlands, the UK authorities do not currently allow re-export from the UK to other countries, which includes Ireland.

I have been informed that this UK company may be acting as the patient’s “nominated representative” in the collection of their personally prescribed medical cannabis products. No similar Irish entity is known to provide this service, but it is certainly open to any patient to engage a representative on their behalf in this regard.

Background information

1. What is the Cannabis Access Programme?

(i) The purpose of the Cannabis for Medical Use Access Programme is to facilitate access to cannabis-based products or preparations that are of a standardised quality and which meet an acceptable level of quality assurance during the manufacturing process, for three specified medical conditions:

- Spasticity associated with multiple sclerosis;

- Intractable nausea and vomiting associated with chemotherapy;

- Severe, refractory (treatment-resistant) epilepsy.

(ii) The Cannabis Access Programme was initiated after the publication of:

(a) The Health Products Regulatory Authority scientific review.

(b) Detailed clinical guidelines produced by an Expert Reference Group on medical cannabis.

Both reports may be found on the Department of Health’s web site.

2. When will the Cannabis Access Programme be introduced?

(a) Good progress has been made on the introduction of the Cannabis Access Programme. This work is well advanced. It is hoped to introduce the programme in the coming months.

3. What is a Ministerial Licence for the prescribing of cannabis?

(a) Pending full operation of the Cannabis Access Programme, clinicians may utilise the Ministerial licensing route to prescribe medical cannabis for their patients.

(b) This is provided by Section 14 of the Misuse of Drugs Act.

(c) Ministerial licences are time limited. The initial licence is valid for a period of 3 months and subsequent licenses in respect of the same patient are valid for 6 months.

4. Why do patients have to travel to the Netherlands for their medical cannabis products once a ministerial licence has been granted?

(a) Until suitable medical cannabis products are made available in Ireland under the medical cannabis access programme, prescribers and their patients are sourcing the prescribed products from a pharmacy in The Netherlands, on foot of their medical prescription.

(b) The Netherland medical cannabis product is sold under the trade name Bedrocan.

(c) Due to current Netherlands government policy, Bedrocan products, sold as cannabis oil formulations, are not currently permitted to be commercially exported from the Netherlands, but are only supplied in the Netherlands on foot of a valid medical prescription when presented to the appropriate pharmacy.

(d) This Netherlands pharmacy has confirmed to the Department of Health recently that there are no issues with the supply of THC and CBD products to Irish patients, who are in possession of a valid prescription, and that a three-month supply can be obtained.

(e) Notwithstanding the fact that Bedrocan products might ultimately be listed as products that could be accessed under the CAP, until the export barrier is removed by the Netherlands government, anyone who is prescribed Bedrocan oils under the Cannabis Access Programme, or a Ministerial Licence will have to travel to the Hague to access it.

5. Further information

(a) It is intended that the Ministerial licence application scheme will continue to operate in parallel with the Cannabis for Medical Use Access Programme, after the programme becomes operational, for exceptional cases, only where there is an unmet clinical need, or the Cannabis Access programme is not suitable for a patient.

6. Where can information on Cannabis Access Programme and the Ministerial Licence be found?

(a) The Department of Health website contains detailed 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. This information can be found at: health.gov.ie/blog/publications/cannabis-for-medical-use.

Services for People with Disabilities

Ceisteanna (256, 257)

Kate O'Connell

Ceist:

256. Deputy Kate O'Connell asked the Minister for Health if an audit of children or adults in long-term residential care has been carried out; the costs associated with the care and stay of such persons during their lives from entry to when they leave; and if he will make a statement on the matter. [12179/19]

Amharc ar fhreagra

Kate O'Connell

Ceist:

257. Deputy Kate O'Connell asked the Minister for Health the cost of long-term residential care for a person with special needs under the care of the State and-or privately in tabular form; the person or body who provides such long-term residential care in terms of governance, ethos and management; if a list of the organisations will be provided; the details in relation to inheritance of assets by the organisations should a service user die while in care; and if same will be provided. [12180/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 256 and 257 together.

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 questions relate to service matters, I have arranged for the questions to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Hospital Waiting Lists

Ceisteanna (258)

Niamh Smyth

Ceist:

258. Deputy Niamh Smyth asked the Minister for Health if a hospital appointment will be expedited for a person (details supplied); if they can be placed on a cancellation list; and if he will make a statement on the matter. [11464/19]

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.

Assisted Human Reproduction Legislation

Ceisteanna (259)

Niamh Smyth

Ceist:

259. Deputy Niamh Smyth asked the Minister for Health the way in which private sector IVF is regulated; his plans in place in this area; and if he will make a statement on the matter. [11465/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Currently there is no specific legislation in Ireland governing assisted human reproduction (AHR). There is limited existing regulation relating to the use of gametes and embryos under SI No. 158 of 2006 (Quality and Safety of Human Tissues and Cells) Regulations, which governs the quality and safety standards in the donation, procurement, testing, processing, preservation, storage and distribution of human tissues and cells, including gametes and embryos. These regulations empower the Health Products Regulatory Authority (HPRA) to authorise and monitor tissue establishments, which include some fertility clinics.

In addition, the Children and Family Relationships Act 2015, reforms and updates family law to address the needs of children living in diverse family types. Parts 2 & 3 of that Act, which are the responsibility of the Minister for Health, contain provisions relating to the regulation of donor-assisted human reproduction (DAHR) procedures carried out in the State, including dealing with the rights of children born as a result of those procedures. It is intended that Parts 2 & 3 of the Children and Family Relationships Act 2015 will be commenced as soon as possible.

In October 2017, the Government approved the drafting of a Bill on assisted human reproduction (AHR) and associated areas of research, based on the published General Scheme of the Assisted Human Reproduction Bill 2017. The General Scheme encompasses the regulation of a range of practices, including: gamete (sperm or egg) and embryo donation for AHR and research; surrogacy; pre-implantation genetic diagnosis (PGD) of embryos; posthumous assisted reproduction; and embryo and stem cell research. The General Scheme also provides for the establishment of an independent regulatory authority for AHR.

The process of drafting this Bill will be completed in conjunction with the Office of the Attorney General. As part of this drafting process officials in my Department will ensure that there is coherent interaction between the AHR Bill and Parts 2 & 3 of the Children and Family Relationships Act 2015.

In addition, the Joint Committee on Health is currently conducting a review of the General Scheme of the Assisted Human Reproduction Bill 2017 as part of the pre-legislative scrutiny process, which began in January of last year. The review is ongoing and the Joint Committee intends to report thereon before the summer recess. However, it is not possible at this time to give a definitive timeline for the completion of the draft Bill and its subsequent passage through the Houses of the Oireachtas.

The provisions outlined within the Scheme, including the establishment of the AHR Regulatory Authority, will ensure that AHR practices and related areas of research are conducted in a more consistent and standardised way and with the necessary oversight.

The aim of the AHR legislation is to promote and ensure the health and safety of parents, others involved in the process (such as donors and surrogate mothers) and, most importantly, the children who will be born as a result of AHR. Consideration of the welfare and best interests of children born through AHR is a key principle underpinning the Scheme.

Healthcare Infrastructure Provision

Ceisteanna (260)

Stephen Donnelly

Ceist:

260. Deputy Stephen Donnelly asked the Minister for Health the status of the replacement and refurbishment of 90 community nursing units nationally announced on 26 January 2016, in tabular form; the funding allocated to each project in 2019; and the expected completion date for each. [11466/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As the Health Service Executive is responsible for the delivery of healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.

Neuro-Rehabilitation Policy

Ceisteanna (261)

Margaret Murphy O'Mahony

Ceist:

261. Deputy Margaret Murphy O'Mahony asked the Minister for Health the funding made available in 2019 to support the implementation of the national neurorehabilitation strategy following publication of the implementation plan 2019 to 2021 by the HSE on 20 February 2019. [11474/19]

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 a service issue, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Ministerial Meetings

Ceisteanna (262)

Stephen Donnelly

Ceist:

262. Deputy Stephen Donnelly asked the Minister for Health the number of times he met with a person (details supplied); the issues discussed; if his officials attended the meeting; and if he will make a statement on the matter. [11476/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I have not met with the person identified by the Deputy, in my role as Minister for Health.

Services for People with Disabilities

Ceisteanna (263)

Jack Chambers

Ceist:

263. Deputy Jack Chambers asked the Minister for Health the reason no funding is available to transport young adults with disabilities to day care services; and if he will make a statement on the matter. [11490/19]

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.

Assisted Human Reproduction Services Provision

Ceisteanna (264, 473)

Niamh Smyth

Ceist:

264. Deputy Niamh Smyth asked the Minister for Health the way in which the public IVF scheme operates; the way in which it is regulated; the criteria for accessing the scheme; his plans in this regard; and if he will make a statement on the matter. [11494/19]

Amharc ar fhreagra

Niall Collins

Ceist:

473. Deputy Niall Collins asked the Minister for Health when the funding set aside for IVF will be available to couples; the criteria to avail of same; the way in which couples register their interest; and if he will make a statement on the matter. [12419/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 264 and 473 together.

In October 2017, the Government approved the drafting of a Bill on assisted human reproduction (AHR) and associated areas of research, based on the published General Scheme. The process of drafting this Bill will be completed in conjunction with the Office of the Attorney General. In addition, the Joint Committee on Health is currently conducting a review of the General Scheme of the Assisted Human Reproduction Bill 2017 as part of the pre-legislative scrutiny process, which began in January of last year. The review is ongoing and the Joint Committee intends to report thereon before the summer recess. However, it is not possible at this time to give a definitive timeline for the completion of the draft Bill and its subsequent passage through the Houses of the Oireachtas.

Interlinked with the legislation, officials in the Department of Health in conjunction with the HSE are developing a model of care for infertility and an associated public fund for AHR. This work includes developing proposals on the allocation approved by Government for a €1 million fund for use in relation to providing public AHR treatment during 2019.

The development of a model of care for infertility will help to ensure the provision of safe, effective and accessible services through the public health system as part of the full range of services available in obstetrics and gynaecology. Once the funding proposals have been submitted and approved by the Minister for Health, there will be an announcement regarding the commencement of this fund.

Cancer Screening Programmes

Ceisteanna (265)

Stephen Donnelly

Ceist:

265. Deputy Stephen Donnelly asked the Minister for Health further to Parliamentary Question No. 363 of 26 February 2019, the details of interactions including dates, substance of advice and position taken by CervicalCheck between his Department and the organisation (details supplied); and if he will make a statement on the matter. [11495/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As set out in the response to Parliamentary Question No. 363 of 26 February 2019, 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.

Neither I nor my officials received advice that recommended against these tests in advance of the decision.  Subsequent to the decision, on foot of telephone contact by the Department, the National Screening Service raised a number of concerns verbally. Following the announcement, the Screening Service set out concerns in an email to my Department, which related to uncertainty about costs, volume, impact on turnaround times, impact on perceptions of the programme's accuracy, challenges with processing GP payments, and the potential difficulty in ceasing the arrangements in due course. 

However, as I have previously  stated, the concerns failed to recognise the circumstances of the unfolding crisis in the programme against which such considerations required to be balanced. 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. A fee to provide for the free repeat smear, and for a GP consultation, was subsequently agreed with the Irish Medical Organisation, and welcomed by TDs across the Dáil and by GP representative bodies. 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.

HSE Staff Data

Ceisteanna (266)

Stephen Donnelly

Ceist:

266. Deputy Stephen Donnelly asked the Minister for Health the number of staff at national director level, assistant national director level, general manager level and grade VIII level in the HSE on 1 March 2019 or the latest date available. [11499/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

General Practitioner Data

Ceisteanna (267)

Stephen Donnelly

Ceist:

267. Deputy Stephen Donnelly asked the Minister for Health the number of general practitioner vacancies in each local health area in tabular form. [11500/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this question relates to service matters, I have arranged for it to be referred to the HSE for direct reply to the Deputy.

Hospital Staff Recruitment

Ceisteanna (268)

Peter Burke

Ceist:

268. Deputy Peter Burke asked the Minister for Health the status of the position to be filled at the Midlands Regional Hospital, Mullingar, which has been with the health business services division for advertising and recruitment since 2018 (details supplied); and if he will make a statement on the matter. [11508/19]

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 (269)

Eugene Murphy

Ceist:

269. Deputy Eugene Murphy asked the Minister for Health if a general practitioner surgery (details supplied) will be excluded from panel appointments going forward due to the fact that the surgery is operating at full capacity and has experienced difficulties in recruiting staff; and if he will make a statement on the matter. [11509/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this question relates to service matters, I have arranged for it to be referred to the HSE for direct reply to the Deputy.

National Treatment Purchase Fund Waiting Times

Ceisteanna (270, 271)

Alan Kelly

Ceist:

270. Deputy Alan Kelly asked the Minister for Health the criteria for treatment under the NTPF for public patients seeking wisdom tooth removal or impacted teeth removal; and if he will make a statement on the matter. [11511/19]

Amharc ar fhreagra

Alan Kelly

Ceist:

271. Deputy Alan Kelly asked the Minister for Health the waiting times under the NTPF for patient access to wisdom tooth removal or impacted teeth removal; his views on whether the exclusion of accredited specialists from providing this service is causing another significant delay for this cohort of patients (details supplied); and if he will make a statement on the matter. [11512/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 270 and 271 together.

I am conscious that waiting times are often unacceptably long and of the burden that this places on patients and their families. In this regard, I committed to improving waiting times for hospital appointments and procedures.

I published the joint Department of Health, Health Service Executive (HSE) and National Treatment Purchase Fund (NTPF) Scheduled Care Access Plan earlier this week. This Plan sets out a number of commitments aimed at improving access for patients waiting for hospital operations or procedures as well as patients waiting for a first Outpatient appointment.

The role of the NTPF is to authorise public hospitals to offer outsourced treatment to clinically suitable long waiting patients who are on an inpatient/day case waiting list for surgery, having been referred on to such a list following clinical assessment by a consultant/specialist at an outpatient clinic. NTPF authorisations are made in respect of the longest waiting patients first.

The information regarding waiting times for Wisdom Tooth Removal requested by the Deputy is currently being collated by officials in my Department and will be provided to the Deputy directly as soon as it becomes available.

With regard to the matter the exclusion of accredited specialists from providing wisdom tooth removal or impacted teeth removal service, I have asked the HSE to respond to the Deputy directly.

HSE Properties

Ceisteanna (272)

Michael McGrath

Ceist:

272. Deputy Michael McGrath asked the Minister for Health the intended use of a building (details supplied) acquired by the HSE in County Cork; and if he will make a statement on the matter. [11536/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As the Health Service Executive is responsible for the management of the healthcare property estate and the provision of services, I have asked the HSE to respond directly to you in relation to this matter.

Services for People with Disabilities

Ceisteanna (273)

Clare Daly

Ceist:

273. Deputy Clare Daly asked the Minister for Health his plans to relocate 33 persons from a home (details supplied); if those persons will be relocated together to a complex; if they will be dispersed to other locations; and if he will make a statement on the matter. [11545/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Report “Time to Move on from Congregated Settings – A Strategy for Community Inclusion” proposes a new model of support in the community, moving people from Congregated settings to the community in line with Government policy.

The Programme for Partnership Government contains a commitment to continue to move people with disabilities out of congregated settings, to enable them to live independently and to be included in the community. The objective is to reduce this figure by one-third by 2021 and ultimately, to eliminate all congregated settings.

By the end of this year, it is expected that under 2,100 people with a disability will remain living in congregated settings. I want to emphasise that the appropriate supports and resources are being put in place to ensure that people are supported as they move out of residential centres. The model of care for individuals will be based on a person centred plan (PCP). The PCP may change over time in line with an individual’s needs and circumstances and the model of service delivery applicable at a particular time.

In the context of residents in St Joseph’s House, Stillorgan - the Deaf Village Ireland, any opportunity for residents to live in smaller settings in the community will come after considerable planning and discussion with those residents and their families. It will be on the basis that it will enhance their life, and anyone who moves will continue to access the services they require.

As the HSE is responsible for leading out on the recommendations on "Time to Move on from Congregated Settings - A Strategy for Community Inclusion", I have arranged for the Deputy's question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Obesity Strategy

Ceisteanna (274, 275, 276, 278, 279, 280)

Denise Mitchell

Ceist:

274. Deputy Denise Mitchell asked the Minister for Health the research which has been undertaken on evidence-based fiscal measures to support healthy eating and lifestyles as per action point 1.8 of A Healthy Weight for Ireland: Obesity Policy and Action Plan 2016-2025; and if he will make a statement on the matter. [11552/19]

Amharc ar fhreagra

Denise Mitchell

Ceist:

275. Deputy Denise Mitchell asked the Minister for Health the review of evidence which has taken place for fiscal measures on products that are high in fat, sugar and salt to reduce their consumption as per action point 1.10 of A Healthy Weight for Ireland: Obesity Policy and Action Plan 2016-2025; and if he will make a statement on the matter. [11553/19]

Amharc ar fhreagra

Denise Mitchell

Ceist:

276. Deputy Denise Mitchell asked the Minister for Health the status of step 9 of the ten steps forward of A Healthy Weight for Ireland: Obesity Policy and Action Plan 2016-2025 in respect of the first 1,000 days of life; and if he will make a statement on the matter. [11556/19]

Amharc ar fhreagra

Denise Mitchell

Ceist:

278. Deputy Denise Mitchell asked the Minister for Health the status of each of the recommendations of A Healthy Weight for Ireland: Obesity Policy and Action Plan 2016-2025; and if he will make a statement on the matter. [11558/19]

Amharc ar fhreagra

Denise Mitchell

Ceist:

279. Deputy Denise Mitchell asked the Minister for Health the status of action point 1.4 of A Healthy Weight for Ireland: Obesity Policy and Action Plan 2016-2025; and if he will make a statement on the matter. [11567/19]

Amharc ar fhreagra

Denise Mitchell

Ceist:

280. Deputy Denise Mitchell asked the Minister for Health the community based programmes with a focus on disadvantaged areas funded by his Department that focus on healthy eating and active living; and if he will make a statement on the matter. [11573/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 274 to 276, inclusive, and 278 to 280, inclusive, together.

A Healthy Weight for Ireland’, the Obesity Policy and Action Plan (OPAP), was launched in September 2016 under the auspices of the Healthy Ireland agenda.

The OPAP covers a ten year period up to 2025 and aims to reverse obesity trends, prevent health complications and reduce the overall burden for individuals, families, the health system, and the wider society and economy. Indeed it must be emphasised that every sector of our society has a role in reducing the burden of obesity and the OPAP clearly acknowledges this.

The OPAP policy prescribed 'Ten Steps Forward' that would be taken to prevent overweight and obesity. A new Obesity Policy Implementation Oversight Group (OPIOG) was established in October 2017 and a progress report on each recommendation in the OPAP is currently being finalised under the aegis of the OPIOG.

In the meantime, I am pleased to advise the Deputy of the current position with implementing the Ten Steps Forward as follows:

1. Embed multi-sectoral actions on obesity prevention with the support of government departments and public sector agencies

An Obesity Policy Implementation Oversight Group (OPIOG) has been established under the Chair of the Department of Health. It is comprised of representatives from the following Departments and Agencies: Department of Agriculture, Food and the Marine; Department of Children and Youth Affairs; Department of Employment Affairs and Social Protection; Department of Education and Skills; Department of Housing, Planning and Local Government; University College Cork; the Food Safety Authority of Ireland; the Health Service Executive (HSE) - including the National Clinical Lead for Obesity; and Safefood. The OPIOG held its inaugural meeting in October 2017 with further meetings arranged at agreed intervals for the purposes of providing oversight to the implementation of the national Obesity Policy & Action Plan (OPAP).

The OPAP recommended that proposals be developed relating to the rollout of evidence based fiscal measures, including a levy on sugar-sweetened drinks, in support of healthy eating. An internal working paper was published by the Department to inform consideration of a sugar sweetened drinks levy from a health perspective. This was entitled Introducing a Tax on Sugar Sweetened Drinks: Health Rationale, Options and Recommendations with a policy objective to reduce rates of childhood and adult obesity in Ireland by reducing the consumption of sugar sweetened drinks (SSDs) as a contributor to health and dental deterioration, particularly among young people.

As the Deputy is aware the Sugar-Sweetened Drinks Tax commenced on 1 May 2018. It represents a positive step in our national policy to deal with the problem of obesity. The question of considering further fiscal measures similar to the Sugar Sweetened Drinks Tax is being kept under review by the OPIOG during this early implementation phase of the Sugar Tax.

On the issue of Step 1 Action 1.4 of the OPAP, the Department of Education and Skills (DES) has advised that in relation to school buildings (primary and post-primary), the Department of Education and Skills (DES) provides tap drinking water system as a matter of routine. In existing buildings if a school has concerns about the quality of its drinking water, the matter can be addressed by the relevant local authority and Irish Water. If any quality issues are identified as a result of a test, the DES provides funding to address the issue. If a school does not have a tap drinking water supply, the DES will provide funding to address this.

2. Regulate for a healthier environment

The development of legislation for calorie posting to support people to make healthy choices is underway by the Department of Health. A behaviour study on how best to make the posting of calories meaningful to customers and more likely to impact on their behaviours has been published by the ESRI.

A number of Government policies aim to support the design and development of built environments that enhance health, wellbeing and quality of life for all. The National Physical Activity Plan (NPAP) and OPAP both require that joint action is taken to promote the importance of physical activity and to reduce the obesogenic nature of the built environment.

In line with Actions 31 of the NPAP and 2.1 of the OPAP, which commit to developing guidelines and support materials for those working in developing the built environment in order to promote the importance of physical activity, and Action 59 of the NPAP which commits to developing a programme of on-going stakeholder communication and engagement, a Stakeholder Forum was held on 21 November last.

The event was planned in partnership, with substantial input from three Government Departments, (Health; Transport, Tourism and Sport; and Housing, Planning and Local Government). Work will progress in 2019 taking account of the outcomes of the forum's discussions.

3. Secure appropriate support from the commercial sector to play its part in obesity prevention

At its inaugural meeting, the OPIOG agreed to establish two sub-groups for Reformulation and Healthy Eating. Both sub-groups have met on a number of occasions since being established and agreed their Terms of Reference.

The Reformulation sub-group is technical in its work programme. The work of the sub-group will primarily set targets on reformulation of food and drink. It will also make recommendations on addressing reduction of portion sizes and on monitoring and validation procedures.

One of the priority actions under Step 3 of the OPAP was to ‘Establish a forum for meaningful engagement with industry on best practice initiatives towards a healthy food environment’. It is intended to progress this action under the auspices of the OPIOG. And in this regard, workshops between the Reformulation sub-group of the OPIOG and Food Sector Stakeholders on reformulation took place last September and again in February this year. These workshops provided an opportunity for detailed engagement with key Food Sector Stakeholders on the challenges and opportunities of reformulation in the interest of promoting the health and wellbeing of the population.

A code of practice for food and beverages promotion, marketing and sponsorship has also been developed involving representatives from the food industry, advertising sector, statutory agencies, and various Government Departments. It was chaired by the former CEO of the statutory Food Safety Authority of Ireland, and published in 2018. Work on the implementation of the Codes of Practice is continuing.

4. Implement a strategic and sustained communications strategy that empowers individuals, communities and service providers to become obesity aware and equipped to change, with a particular focus on families with children in the early years

The Healthy Ireland 2018 communications and citizen engagement campaign sought to encourage people to make small, healthy changes under the themes of Healthy Eating, Physical Activity and Mental Wellbeing, and to link them with partner organisations and initiatives providing information and support. This campaign will continue in 2019.

In addition, under Healthy Ireland, the Department, safe food and the HSE run a campaign called START which aims to inspire, empower and support parents to start building and persist with healthy lifestyle habits in the family to prevent childhood obesity.

5. The Department of Health, through Healthy Ireland, will provide leadership, engage and co-ordinate multi-sectoral action and implement best practice in the governance of the Obesity Policy and Action Plan

As referred to at step 1 above, an Obesity Policy Implementation Oversight Group was established to oversee implementation. New Healthy Eating Guidelines, Food Pyramid and supporting resources have already been published, disseminated and communicated in 2017, including dissemination of the new Guidelines to all primary and post-primary schools.

Work has also commenced on developing Healthy Eating Guidelines for the 1-5 year old age group. As a first step in this work, the Scientific Committee of the Food Safety Authority of Ireland (FSAI) is currently developing scientific recommendations for food based dietary guidelines for 1 to 5 year olds.

New Nutrition Standards for schools, with an initial focus on school meal programmes funded by the Department of Employment Affairs and Social Protection, have also been developed. These Nutrition Standards were published in September 2017. The Nutrition Standards were developed by the Department of Health with the assistance of safe food and the Health Service Executive, in cooperation with the members of the School Meals Programme in the Department of Employment Affairs and Social Protection and the Department of Education and Skills.

6. Mobilise the health services to better prevent and address overweight and obesity through effective community-based health promotion programmes, training and skills development and through enhanced systems for detection and referrals of overweight and obese patients at primary care level

A Healthy Eating, Active Living Programme has been established as a Policy Priority Programme within the HSE and a three-year plan for the programme has been finalised. The GP contract for the provision of free care to children under 6 years, already provides that the medical practitioner shall take an active approach toward promoting health and preventing disease through the provision of periodic assessments to child patients.

The HSE is also implementing a Breastfeeding Action Plan and a new Making Every Contact Count brief intervention framework which aims to capitalise on the opportunities that occur every day within the health service to support people to make healthy lifestyle choices.

On the issue of nutrition in hospitals, the HSE, in conjunction with the Department of Health and Healthy Ireland, is to roll out a new Food, Nutrition and Hydration Policy for patients in acute hospitals in the coming months. A team working at national level, composed of all relevant staff including catering, (managers and chefs), dietitians, management, medical, nursing , occupational therapy and speech and language have worked together to develop the policy. Support and guidance to aid implementation of the policy will be provided in an accompanying toolkit. The policy and toolkit are due for publication and implementation in the near future.

7. Develop a service model for specialist care for children and adults

A National Clinical Lead for Obesity was appointed in 2017. This appointment is important in further advancing the implementation of many of the recommendations in the OPAP including the development of a national integrated service model for the health and social care of overweight and obese people and for developing quality assurance guidance for obesity services.

8. Acknowledge the key role of physical activity in the prevention of overweight and obesity

'Get Ireland Active! The National Physical Activity Plan for Ireland' (NPAP) is one of the key developments arising from Healthy Ireland, and implementation of that Plan is well underway in collaboration with the Department of Transport, Tourism and Sport and a range of other stakeholders. An updated progress report on the implementation of the NPAP will be published in Q1 2019.

9. Allocate resources according to need, in particular to those population groups most in need of support in the prevention and management of obesity, with particular emphasis on families and children during the first 1,000 days of life

The implementation of the Healthy Eating and Active Living Plan within the HSE is supporting work in the education sector, as well as with parents, families and communities in delivering a more co-ordinated approach to prevention and early intervention in child obesity.

In addition, the Healthy Ireland fund was established in 2017 with an allocation of €5 million and with additional allocations of €5 million in 2018 and 2019. The first round of the Fund was distributed through Local Community Development Committees, Children and Young Person’s Services Committees and statutory organisations. The aim of the Fund is to support innovative, cross sectoral, evidence-based projects, programmes and initiatives that support the implementation of key national policies in areas such as Obesity, Smoking Alcohol, Physical Activity and Sexual Health.

The Fund has been effective at targeting population groups that experience health inequalities. In Round 1 (2017/18), there was a focus on specific groups experiencing health inequalities, including people living in areas of social disadvantage (71% of actions), people with disabilities (45%), people from new communities including refugees and asylum seekers (39%) and members of the Traveller community (36%). Furthermore, of the local actions that were implemented in Round 1, 61% related to physical activity and 32% were related to food, nutrition and weight management. Round 2 of the Fund is currently being implemented.

10. Develop a multi-annual research programme that is closely allied to policy actions, invest in surveillance and evaluate progress on an annual basis.

The development of an annual bulletin or score card to evaluate progress in relation to the national Obesity Plan and dissemination of results, has also been initiated. Finally, a progress report on implementation of the OPAP is currently being finalised under the aegis of the OPIOG.

Finally, there are a number of relevant commitments in the First 5 whole-of-government strategy for babies, young children and their families, which will be taken forward by the relevant Departments, agencies and other partners.

Maternity Services

Ceisteanna (277)

Denise Mitchell

Ceist:

277. Deputy Denise Mitchell asked the Minister for Health the status of the implementation of the breastfeeding action plan; and if he will make a statement on the matter. [11557/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As the question relates to service matters it has been referred to the HSE for direct reply to the Deputy.