Written Answers Nos. 877-901
877. Deputy Michael McGrath asked the Minister for Health the status of plans for a primary care centre at a location (details supplied); when the primary care centre will be developed; if a location for same has been confirmed; and if he will make a statement on the matter. [19381/19]
Amharc ar fhreagraAs 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.
878. Deputy Eoin Ó Broin asked the Minister for Health if the HSE drugs group met to consider the revised pricing proposal from the manufacturer of Spinraza; if so, the recommendation of the HSE leadership team; and when the leadership team will make a final decision on the reimbursement of the drug. [19385/19]
Amharc ar fhreagraThe HSE has statutory responsibility for medicine pricing and reimbursement, 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. As Minister for Health I have no role or powers in this regard.
I am advised by the HSE that, following detailed consideration of an application for the reimbursement of Nusinersen (Spinraza) and lengthy engagement with the company, the HSE decided that it was unable to reimburse Nusinersen (Spinraza). The HSE concluded that the evidence for clinical effectiveness was still quite limited and that the price proposed by the manufacturer was not a cost-effective use of resources.
On the 21 February 2019, the HSE wrote to the manufacturer 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 had 28 days to respond or make representations to the HSE’s proposed decision.
I am advised by the HSE that the manufacturer submitted additional information which was considered by the HSE Drugs Group at their meeting on 16th April 2019. This information is scheduled for consideration at a HSE Leadership Team meeting on 14th May 2019.
879. Deputy John Brassil asked the Minister for Health the dedicated nursing support services available for persons with Parkinson's disease; the locations of same; his plans to expand services for persons in counties Cork and Kerry; and if he will make a statement on the matter. [19392/19]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
880. Deputy Robert Troy asked the Minister for Health the reason nurses who have trained in the United States must have regency of practice in order to register in the general division of nursing (details supplied). [19396/19]
Amharc ar fhreagraI would like to advise the Deputy that the regulations regarding the registration of a nurse or midwife is a matter for the Nursing and Midwifery Board of Ireland (NMBI).
I have asked the NMBI to reply directly to the Deputy in relation to this matter.
881. Deputy Michael Healy-Rae asked the Minister for Health if funding will be provided for a bus for a day care centre (details supplied); and if he will make a statement on the matter. [19397/19]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
882. Deputy John McGuinness asked the Minister for Health if speech and language therapy and occupational therapy services will be provided for a person (details supplied); the reason for the delay; and the timeframe for the delivery of the services to the person. [19401/19]
Amharc ar fhreagraThe 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 of 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.
883. Deputy John McGuinness asked the Minister for Health the number of patients on the waiting lists for cataract operations at University Hospital Waterford; his plans to ensure that this type of operation is provided for patients without undue delay; when a date for an operation will be arranged in the case of a person (details supplied) in view of the fact that their case has been deemed urgent by their general practitioner; and if he will make a statement on the matter. [19404/19]
Amharc ar fhreagraI 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 am committed to improving waiting times for hospital appointments and procedures.
Cataract surgery is one of the most common surgical procedures carried out in the Ophthalmology specialty and is one of the targeted high-volume procedures of the Scheduled Care Access Plan for both 2018 and 2019.
Waiting List figures published by the National Treatment Purchase Fund (NTPF) for the end of March show the total number of patients waiting for a cataract procedure fell from 10,024 in July 2017 to under 6,300, a reduction of almost 38%. The numbers waiting more than 3 months halved in the same period, down from 8,000 to just over 4,000, while those waiting more than 9 months fell from 4,371 to 531, a reduction of 88%.
Last year also saw the establishment of a dedicated Cataract Centre at Nenagh Hospital. This is a stand-alone high-volume consultant-led cataract theatre facility which, at full capacity, is expected to deliver approximately 2,000 cataract procedures.
Budget 2019 announced that the Government had further increased investment in tackling waiting lists, with funding to the NTPF increasing from €55 million in 2018 to €75 million in 2019.
The joint Department of Health/HSE/NTPF Scheduled Care Access Plan 2019 was published in March and sets out measures to improve care for patients waiting for scheduled care in 2019 by reducing waiting times for inpatient, day case and outpatient appointments. The plan places a strong focus on ten high-volume procedures, including cataracts. When combined with HSE activity it is projected that the NTPF will be in a position to offer treatment to all clinically suitable patients waiting more than 6 months for one of these procedures.
The information requested by the Deputy on cataract waiting times at University Hospital Waterford was provided to my Department by the NTPF and is outlined in the table below. The data shows that there are 1,202 patients on the cataract waiting list at UHW. Of these, over 83% are waiting 9 months or less.
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 patient query, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
Waiting list figures for cataract operations in UHW
|
0-3 mths |
3-6 mths |
6-9 mths |
9-12 mths |
12-15 mths |
15-18 mths |
18+ mths |
Grand Total |
|
333 |
329 |
341 |
122 |
33 |
12 |
32 |
1,202 |
884. Deputy John McGuinness asked the Minister for Health if a cataract operation will be provided for a person (details supplied) at University Hospital Waterford; and if they qualify for the cross-border scheme in view of the fact that they were referred in 2017. [19406/19]
Amharc ar fhreagraReducing waiting time for patients for hospital operations and procedures is a key priority for Government. Budget 2019 announced that the Government has further increased investment in tackling waiting lists, with funding to the National Treatment Purchase Fund (NTPF) increasing from €55 million in 2018 to €75 million in 2019.
The joint Department of Health/HSE/NTPF Scheduled Care Access Plan 2019 was published recently and sets out measures to improve care for patients waiting for scheduled care in 2019 by reducing wait times for inpatient/day case treatment and outpatient appointments. The plan will place a strong focus on a number of high-volume procedures, including cataracts. When combined with HSE activity, it is projected that the NTPF will be in a position to offer treatment to all clinically suitable patients waiting more than 6 months for one of these procedures.
The HSE operates the Cross Border Directive (CBD) in Ireland. Under the terms of the Directive, patients of an EU/EEA Member State who meet the necessary criteria may opt to avail of healthcare provided under the legislation of their Member State of affiliation in another EU/EEA Member State and be reimbursed the lesser of the cost of receiving the treatment abroad, or the cost in their own Member State. The HSE provides information for patients on the CBD on its website which can be accessed at http://www.hse.ie/eng/services/list/1/schemes and also by phone at 056 7784551.
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.
885. Deputy Tony McLoughlin asked the Minister for Health the status of the development of the proposed CSSD sterilisation unit at Sligo University Hospital; the reason it has not been developed to date; and if he will make a statement on the matter. [19411/19]
Amharc ar fhreagraAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond directly to the Deputy in relation to this matter.
886. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) will receive an appointment. [19415/19]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
887. Deputy Charlie McConalogue asked the Minister for Health the status of the reopening of a ward (details supplied); when the ward will reach full capacity; the efforts being made to reopen it as soon as possible; and if he will make a statement on the matter. [19417/19]
Amharc ar fhreagraAs Minister for Health, I recognise that hospitals are increasingly operating at or above capacity, with year-round demand pressures that are further challenged over the winter months.
It is against this background that the Health Service Capacity Review 2018 recommended an increase in acute hospital beds of over 2,600 by 2031 to support the projected increase in demand for services in the years ahead. The National Development Plan 2018-2027 provides for the full 2,600 beds over its lifetime.
The HSE Winter Plan included funding for the opening of 5 acute inpatient beds in Letterkenny University Hospital.
In relation to the particular query raised, as this is an operational matter, I have asked the HSE to respond to the Deputy directly.
888. Deputy Gerry Adams asked the Minister for Health the progress of the recruitment competition initiated by St. Vincent's University Hospital to fill the post vacated in 2018 by a person (details supplied); and if he will make a statement on the matter. [19418/19]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
889. Deputy Timmy Dooley asked the Minister for Health when a person (details supplied) in County Clare will receive an appointment from the urology department at University Hospital Limerick; and if he will make a statement on the matter. [19419/19]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
890. Deputy Gerry Adams asked the Minister for Health the progress made on, and the planning permission status of, the €9 million 50-bed facility for St. Joseph's Hospital, Ardee, County Louth, as listed in the HSE capital plan, which expires in 2021; and if he will make a statement on the matter. [19423/19]
Amharc ar fhreagra891. Deputy Gerry Adams asked the Minister for Health the status of the proposed additional nursing home beds at St. Mary's Hospital, Drogheda, County Louth; and if he will make a statement on the matter. [19433/19]
Amharc ar fhreagraI propose to take Questions Nos. 890 and 891 together.
As the Health Service Executive is responsible for the delivery of public healthcare services and infrastructure projects, I have asked the HSE to respond directly to the Deputy in relation to this matter.
892. Deputy Michael Healy-Rae asked the Minister for Health the status of a hip operation in University Hospital Kerry for a person (details supplied); and if he will make a statement on the matter. [19439/19]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
893. Deputy Dara Calleary asked the Minister for Health if Versatis patches will be reinstated on the medical card scheme. [19443/19]
Amharc ar fhreagraMedicines play a vital role in improving the health of Irish patients. Securing access to existing and new and innovative medicines is a key health service objective. However, the challenge is to do this in a safe and sustainable manner. Treatment must be appropriate and proportionate and clinical decision-making, such as prescribing, should be based on both patient needs and sound medical evidence.
Lidocaine 5% medicated plasters are licensed for localised relief of post-shingles pain in adults. This is the patch's only licensed use in Ireland. It has been reimbursed in the community drug schemes since 2010.
Clinical concern arose as usage increased significantly, to the point where more plasters were being used in Ireland than in the entire UK National Health Service. In such situations, it is important and appropriate for clinicians to review usage and, in 2016, the HSE Medicines Management Programme (MMP) reviewed the use of the plasters. The review estimated that only 5-10% of prescribing was for the licensed indication.
From September 2017, following the clinical review, the HSE introduced a new reimbursement approval system for the patches, to support appropriate use and patient care. Under these arrangements, the patient's GP or consultant applies to the MMP for reimbursement approval on behalf of the patient. If an application is refused, the clinician may submit an appeal to the MMP, making a clear clinical case for the patient. Information for patients and practitioners is on the HSE MMP website at: hse.ie/yourmedicines.
The outcome of an application or an appeal for reimbursement of lidocaine patches is a matter between the MMP and the treating clinician. The Deputy will appreciate that, as Minister for Health, I cannot intervene in individual cases.
The decision to introduce a new reimbursement approval process for a particular treatment is a matter for the HSE. I fully support the objectives of the HSE Medicines Management Programme.
894. Deputy Peter Burke asked the Minister for Health if discretion can be shown in respect of a late registration payment (details supplied); and if he will make a statement on the matter. [19447/19]
Amharc ar fhreagraI would like to advise the Deputy that the removal of a nurse or midwife from the register and his or her restoration to the register are matters for the Nursing and Midwifery Board of Ireland (NMBI).
I have asked the NMBI to reply directly to the Deputy in relation to this matter.
895. Deputy Kevin O'Keeffe asked the Minister for Health if a person (details supplied) will receive a hospital appointment for an orthopaedic procedure. [19455/19]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
896. Deputy Thomas Byrne asked the Minister for Health if Crohn's disease is covered under the long-term illness scheme. [19457/19]
Amharc ar fhreagraThe 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 the LTI Scheme will be included as part of a review of the current eligibility framework, including the basis for existing hospital and medication charges, to be carried out under commitments given in the Sláintecare Implementation Strategy.
For people who are not eligible for the LTI Scheme, there are other arrangements which protect them from excessive medicine costs.
Under the Drug Payment Scheme, no individual or family pays more than €124 a month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. In the assessment process, the HSE can take into account medical costs incurred by an individual or a family.
People who are not eligible for a medical card may still be able to avail of a GP visit card, which covers the cost of GP consultations.
897. Deputy Gerry Adams asked the Minister for Health the reason a person (details supplied) has been denied access to the compassionate access programme; if persons have a right to access the programme when they request same; the options available to a person in circumstances in which they are denied access; and if he will make a statement on the matter. [19460/19]
Amharc ar fhreagraThe Medical Cannabis Access Programme is not yet operational.
In the meantime it is open to a medical practitioner wishing to prescribe cannabis for medical purposes for an individual patient under their care to apply to the Minister for Health for a licence, under Section 14 of The Misuse of Drugs Acts 1977 to 2016 and the Regulations made thereunder.
It should be noted that it is the decision of the clinician, in consultation with their patient, to prescribe or not prescribe a particular treatment for a patient under their care. As Minister for Health I have no role in the clinical decision making process.
In line with the Chief Medical Officer's advice, the granting of a licence for cannabis for medical purposes must be premised on an appropriate application being submitted to the Department of Health, which is endorsed by a consultant who is responsible for the management of the patient and who is prepared to monitor the effects of the treatment over time.
To date licences have been issued in respect of twenty individual patients under this provision of the Act.
The Medical Cannabis Access Programme
The Health Products Regulatory Authority’s (HPRA) report ‘Cannabis for Medical Use – A Scientific Review’ recommended that if access to cannabis is to be permitted for medical purposes, its use should only be initiated as part of a structured process of formal ongoing clinical evaluation, in a limited number of clearly defined medical conditions, which have failed to respond to all other previous treatments, and where there is at least modest evidence that cannabis may be effective.
All such patients should be under the direct supervision of an appropriately trained and experienced medical consultant. The specified medical conditions (medical indications) are:
- Spasticity associated with multiple sclerosis;
- Intractable nausea and vomiting associated with chemotherapy;
- Severe, refractory (treatment-resistant) epilepsy.
The purpose of the Medical Cannabis 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.
The Medical Cannabis Access Programme has not yet been established but good progress is being made:
1. clinical guidelines have been drawn up and published,
2. secondary legislation is being drafted to underpin the Programme,
3. cannabis products for use under the Programme, once reviewed as suitable for medical use, will be published on an ‘approved list’.
Department officials are working intensively on finding solutions to the supply of appropriate products for Irish patients.
Department of Health Website
The Department of Health website contains detailed information on medical cannabis, including clinical guidance on the use of medical cannabis. It is updated in the event of new developments on the issue.
898. Deputy Mattie McGrath asked the Minister for Health the number of claims initiated against him and the HSE in respect of vaccine administration since 2011; the vaccine concerned in each case; and if he will make a statement on the matter. [19461/19]
Amharc ar fhreagraWhile I cannot comment on individual cases or matters that are the subject of litigation, one of which is a case managed by the High Court concerning the issue of Discovery, I can clarify matters that are already in the public domain.
As of 1 May 2019, the State Claims Agency has been notified of potential claims being initiated against the Minister for Health, the Health Services Executive and GlaxoSmithKline Biological SA by one hundred and nine (109) individuals and in 70 of these cases formal legal proceedings have been issued. The plaintiffs allege personal injury in which they claim the development of narcolepsy resulted from the administration of the H1N1 pandemic vaccine.
The management of these cases transferred to the State Claims Agency on 15 October 2013 when the Taoiseach signed the National Treasury Management Agency (Delegation of Claims Management Functions) (Amendment) Order 2013.
My main priority as Minister for Health is that individuals and families affected receive appropriate health and social care supports. My Department continues to engage with the Health Service Executive, the Department of Education and Skills, and the Department of Employment Affairs and Social Protection to ensure the provision of a wide range of services and supports on an ex-gratia basis for those who have received a diagnosis of narcolepsy following administration of the H1N1 pandemic vaccine. The HSE’s Advocacy Unit acts as liaison with other service providers and Government Departments to facilitate access to required services. It is in regular contact with the individuals affected and their families, and regional co-ordinators have been appointed to assist by providing advice, information and access to local services. These supports include discretionary medical cards, reimbursement of expenses associated with diagnosis and treatment, home tuition and learning supports.
899. Deputy Sean Sherlock asked the Minister for Health when a child (details supplied) will receive a further dental examination. [19466/19]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for reply to the Deputy.
900. Deputy John McGuinness asked the Minister for Health if an early appointment for a cataract operation will be arranged for a person (details supplied); and the reason they were not called as promised at the time of their assessment. [19476/19]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
901. Deputy Aengus Ó Snodaigh asked the Minister for Health the status of the purchase of medical equipment for home carers by CHO; the budget over the past five years by CHO; the amount spent in the past five years; if there is a priority list for home care medical equipment; if so, the number on the priority list and other waiting lists for home care medical equipment; and the criteria to qualify for this medical equipment. [19477/19]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for reply to the Deputy.
