John Brassil
Ceist:41. Deputy John Brassil asked the Minister for Health if the drug ocrelizumab will be available for persons with multiple sclerosis; and if he will make a statement on the matter. [20812/19]
Amharc ar fhreagraMedicinal Products Reimbursement
Ceisteanna (41)
Freagraí scríofa
The HSE has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. The Act specifies the criteria for decisions on the reimbursement of medicines.
The NCPE completed a health technology assessment on 29 August 2018 for Ocrelizumab (Ocrevus) for the treatment of adult patients with relapsing forms of multiple sclerosis (RMS). They recommended that Ocrelizumab (Ocrevus) not be considered for reimbursement unless cost-effectiveness can be improved relative to existing treatments.
On 4 October 2018 the NCPE completed their assessment for Ocrelizumab (Ocrevus) indicated for the treatment of adult patients with early primary progressive multiple sclerosis (PPMS). They did not recommend that Ocrelizumab (Ocrevus) be reimbursed for this indication.
The HSE is the statutory decision-making body for medicine reimbursement. It will make the final decision on whether Ocrelizumab (Ocrevus) will be reimbursed for each of these indications, taking into consideration the statutory criteria contained in the 2013 Health Act.
I am advised by the HSE that there has been considerable engagement between the HSE and the manufacturer over the past number of months and that commercial discussions are ongoing.
Question No. 42 answered with Question No. 29.
HSE Planning
Ceisteanna (43)
Louise O'Reilly
Ceist:43. Deputy Louise O'Reilly asked the Minister for Health the status of the future of trauma care here; the position regarding the decision for level 1 trauma centres for Cork and Dublin; and when a decision on the location for Dublin will be made [20836/19]
Amharc ar fhreagraFreagraí scríofa
The Report of the Trauma Steering Group was approved by Government in February 2018. An interim implementation group has been established by the HSE, as recommended in the report, and is progressing the four immediate actions (recruitment of National Clinical Lead, orthopaedic bypass protocols, selection of Major Trauma Centre for Dublin, and detailed implementation planning).
The report, A Trauma System for Ireland, recommends the introduction of an inclusive trauma system for Ireland with one Major Trauma Centre to be based in Dublin servicing the Central Trauma Network, and another to be based in Cork University Hospital servicing the South Trauma Network. Each of these Major Trauma Centres will be linked to a number of Trauma Units. The Report provided that the HSE should designate Cork University Hospital as the Major Trauma Centre for the South Trauma Network, contingent on it meeting the recommended designation criteria. This will require an enhancement of some specialties before Cork University Hospital can be formally designated as a Major Trauma Centre.
In order to progress the designation of the Major Trauma Centre for the Central Trauma Network and the Dublin Trauma Unit(s), a consultation on the service specifications and the approach and process for designation took place between 21 December and 14 February 2019.
The findings of the public consultation have been analysed and it is expected that the formal designation process will commence in May 2019 with each of the Dublin Hospital Groups (Ireland East Hospital Group, Dublin Midlands Hospital Group and RCSI Hospital Group) invited to make submissions for hospitals within their Group to be designated as the Major Trauma Centre or as a Trauma Unit for the Central Trauma Network.
An Independent Assessment Panel comprised of local and international experts will review and score the written proposals in line with the service specifications and assessment criteria, will conduct site visits to the hospital sites and will meet with Hospital Group management and other key representatives as part of the assessment process. It is expected that a final recommendation to the Department will be made in the Autumn.
Health Services Provision
Ceisteanna (44, 61)
Richard Boyd Barrett
Ceist:44. Deputy Richard Boyd Barrett asked the Minister for Health if each CHO has enough funding to provide the home and respite care packages necessary for all those in need nationally; and if he will make a statement on the matter. [20884/19]
Amharc ar fhreagraRichard Boyd Barrett
Ceist:61. Deputy Richard Boyd Barrett asked the Minister for Health if he is satisfied that the process for allocating home care packages and respite care is fit for purpose and provides the care needed to the most vulnerable persons; and if he will make a statement on the matter. [20883/19]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 44 and 61 together.
As these are a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Trade Union Recognition
Ceisteanna (45)
Stephen Donnelly
Ceist:45. Deputy Stephen Donnelly asked the Minister for Health the action he is taking regarding the ongoing industrial dispute in the ambulance service; and if he will make a statement on the matter. [20745/19]
Amharc ar fhreagraFreagraí scríofa
As you are aware, a branch of the Psychiatric Nurses Association called the National Ambulance Service Representative Association (NASRA) has been engaged in industrial action. The Psychiatric Nurses Association state that their industrial action is in connection with two substantive issues. The first is the automated deduction of union subscriptions. The second is the refusal by the HSE to engage in negotiations with the PNA or to recognise the PNA as representing ambulance personnel.
To be clear, NASRA, which is affiliated with the PNA, is a group which is not recognised by the HSE and, therefore, does not have negotiating rights. The PNA does not have negotiating rights for ambulance personnel.
It should be noted that the HSE deducts subscriptions at source for those ambulance staff that are members of a number of unions. These are SIPTU, FORSA and UNITE. The deduction of subscriptions is not a legal right but rather a concession granted to recognised unions.
While it is regrettable that the PNA has taken this industrial action, it is not possible to negotiate with a union which is not recognised as having negotiating rights for ambulance grades. Officials from the Department have met with representatives of the HSE and the management of the National Ambulance Service to explore possible options. However, this is a complex, challenging situation.
Industrial relations policy has had a long standing objective of avoiding fragmentation in worker representation in public sector employments, and the trade union movement generally, so as to facilitate the orderly conduct of bargaining and other aspects of industrial relations.
Hospital Waiting Lists Action Plans
Ceisteanna (46)
Catherine Connolly
Ceist:46. Deputy Catherine Connolly asked the Minister for Health when funding will be provided to allow for the development of an extra procedure room in endoscopy at University Hospital Galway; the number of persons and duration by month on the waiting list for GI endoscopy, oesophago-gastro-duodenoscopy and colonoscopy; and if he will make a statement on the matter. [20831/19]
Amharc ar fhreagraFreagraí scríofa
As this is a service issue, I have asked the HSE to respond to the Deputy directly.
Health Services
Ceisteanna (47)
Thomas P. Broughan
Ceist:47. Deputy Thomas P. Broughan asked the Minister for Health his views on the place of Ireland on the European Health Consumer Index 2018; his further views on this ranking of the health system; and if he will make a statement on the matter. [20495/19]
Amharc ar fhreagraFreagraí scríofa
This index has been published since 2005 by the Sweden-based think-tank Health Consumer Powerhouse (HCP) Ltd, a private Swedish company. It is based on a combination of public statistics, patient surveys and independent research conducted by the author.
The author has ranked Ireland 22nd place out of 35 countries, with 669 points out of 1,000. Last year, Ireland ranked 24th out of 35 countries with 630 points out of 1,000.
The report has highlighted poor performance in the area of accessibility which covers, inter alia, ED waiting times and time to major elective surgery. The report does, however, highlight a reduction in resistant strains of hospital-acquired infections in Irish hospitals.
While several of the findings do match up with known national and international data, there has been international debate about how the data for this survey is collected, analysed and compared with other countries. No discussion with recognised bodies such as Eurostat, OECD or WHO seems to have taken place regarding basic definitions and choice of indicators for this report.
Other ranking systems also exist such as the Bloomberg Healthiest Country Index 2019, which ranked Ireland 20th out of 169 countries according to factors that contribute to overall health.
Mental Health Services Funding
Ceisteanna (48)
Richard Boyd Barrett
Ceist:48. Deputy Richard Boyd Barrett asked the Minister for Health his plans to ensure that funding is made available to a facility (details supplied) in order that it can continue providing care; and if he will make a statement on the matter. [20885/19]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Health Services Funding
Ceisteanna (49, 217)
Alan Kelly
Ceist:49. Deputy Alan Kelly asked the Minister for Health if additional demands have been made by his Department in respect of budget overruns to date in 2019 and the anticipated overruns up to 31 December 2019; and if he will make a statement on the matter. [18023/19]
Amharc ar fhreagra
Bernard Durkan
Ceist:217. Deputy Bernard J. Durkan asked the Minister for Health the extent to which adequate funding has been made available throughout the public health sector with a view to meeting the demand as set out throughout the sector; and if he will make a statement on the matter. [21157/19]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 49 and 217 together.
The 2019 National Service Plan set out a budget of over €16 billion for the HSE, the highest budget ever allocated. The Health budget was increased by €848 million on 2018, a substantial additional level of funding. The amount allocated follows an extensive process of engagement between my Department and the HSE, which considers both the funding requirements as submitted by the HSE and the fiscal position. These types of engagements are a normal part of the Budgetary process and happen with agencies across Government. All public bodies put forward spending proposals but all such bodies, including the HSE, are required to operate within the amounts proposed by Government and determined by the Dáil.
The issue of health funding is a major policy challenge internationally. Despite welcome increases over recent years, the need for effective financial management remains crucial as the health service deals with a larger and older population, with more acute health and social care requirements, increased demand for new and existing drugs and the rising costs of health technology. Demographic pressures, including a rise in chronic diseases and ageing populations are major challenges to health funding internationally. The additional funding secured over recent years provides a substantial basis for the Health Service to maximise the level and quality of service delivery while also implementing the Sláintecare programme.
The costs associated with these service pressures and strategic change will increasingly need to be managed not solely through annual increased Exchequer allocations but also through improved efficiencies, productivity and value from within the funding base in 2019 and beyond. The HSE has my full support in achieving these improvements as part of our shared reform agenda.
The services to be provided in 2019 are as set out in the National Service Plan, and levels are typically equal to or higher than planned or delivered in 2018. The additional funding provided in Budget 2019 for new developments will support new or expanded levels of services across priority service areas.
Home Help Service Provision
Ceisteanna (50)
Niamh Smyth
Ceist:50. Deputy Niamh Smyth asked the Minister for Health the steps he is taking to deal with the ongoing crisis in the provision of home help hours; and if he will make a statement on the matter. [20713/19]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Hospitals Capital Programme
Ceisteanna (51)
Marc MacSharry
Ceist:51. Deputy Marc MacSharry asked the Minister for Health the timeline for the proposed developments at St. Patrick's hospital, Carrick-on-Shannon, County Leitrim. [20877/19]
Amharc ar fhreagraFreagraí scríofa
As the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond directly to you in relation to this matter.
Hospitals Capital Programme
Ceisteanna (52)
Marc MacSharry
Ceist:52. Deputy Marc MacSharry asked the Minister for Health the timeline for the proposed developments at the Sheil Community Hospital, Ballyshannon, County Donegal. [20876/19]
Amharc ar fhreagraFreagraí scríofa
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 you in relation to this matter.
Disability Services Provision
Ceisteanna (53)
Martin Heydon
Ceist:53. Deputy Martin Heydon asked the Minister for Health if his attention has been drawn to the delays for children on waiting lists for assessments and services with the south Kildare network disability team; the steps being taken to reduce these waiting lists; and if he will make a statement on the matter. [20903/19]
Amharc ar fhreagraFreagraí scríofa
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.
Midwifery Services Provision
Ceisteanna (54)
Clare Daly
Ceist:54. Deputy Clare Daly asked the Minister for Health his views on the fact that the level of midwifery staffing in many maternity units remains below the Birthrate Plus recommendations and in some cases well below same; and if he will make a statement on the matter. [20840/19]
Amharc ar fhreagraFreagraí scríofa
The HSE Midwifery Workforce Planning Project Report modelled on Birthrate Plus methodologies was published in April 2016. This Report recommended a range of midwifery staffing ratios across the 19 maternity hospitals/units taking into account the variability in working arrangements and clinical practices between the different sites and services. This Report also acknowledged that the implementation of the National Maternity Strategy 2016 – 2026 would have a significant impact to the way midwifery services are delivered and will consequently have a further impact on workforce requirements. The National Women & Infants Health Programme in the HSE, is leading on the implementation of the National Maternity Strategy, which includes identifying and resolving requirements in relation to staffing.
However, as this query relates to a service matter, I have asked the HSE to reply to your query directly with additional information.
Home Care Packages Funding
Ceisteanna (55)
Louise O'Reilly
Ceist:55. Deputy Louise O'Reilly asked the Minister for Health if resources will be made available to ensure home support services can meet demand and reduce waiting lists. [20838/19]
Amharc ar fhreagraFreagraí scríofa
Improving access to home support is a priority for Government. Over the past four years we have seen a considerable increase of nearly €140 million in the budget which has grown from €306 million in 2015 to almost €446 million this year.
This year the HSE intends to provide 17.9 million home support hours to 53,000 people and intensive home care packages to 235 people.
Despite this significant level of service provision, the demand for home support continues to grow. The allocation of funding for home supports across the system, though significant, is finite and services must be delivered within the funding available. Preliminary data indicates that at the end of March there were 52,360 people in receipt of home support. During the first quarter of the year 4.2 million hours were delivered nationally, 4,411 new clients commenced the service and 6,238 people have been assessed and are waiting for either new or additional home support services.
I acknowledge that in some cases access to the service may take longer than we would like. However, the HSE has assured my Department that those people who are on a waiting list are reviewed, as funding becomes available, to ensure that individual cases continue to be dealt with on a priority basis within the available resources and as determined by the local front line staff who know and understand the clients’ needs, and who undertake regular reviews of those care needs to ensure that the services being provided remain appropriate.
While the existing home support service is delivering crucial support to many people across the country, it needs to be improved to better meet the changing needs of our citizens. We are developing plans for a new statutory scheme and system of regulation for home support services. This will improve access to the service on an affordable and sustainable basis while also introducing a system of regulation that will ensure public confidence. The Sláintecare Implementation Strategy commits to the introduction of the new scheme in 2021.
In the meantime, the Department and the HSE are continuing to improve existing services, including in 2018 the introduction of a single funding stream for home support services. This is providing significant benefits including making the services easier to understand; streamlining the application and decision-making processes; and facilitating service users to move to changed levels of service as their assessed needs change, without the need for an additional application process.
Disability Services Funding
Ceisteanna (56)
Darragh O'Brien
Ceist:56. Deputy Darragh O'Brien asked the Minister for Health his plans to ensure that the budget for disability services in CHO 9 is allocated without delay; and if he will make a statement on the matter. [20907/19]
Amharc ar fhreagraFreagraí scríofa
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.
HSE Planning
Ceisteanna (57)
Louise O'Reilly
Ceist:57. Deputy Louise O'Reilly asked the Minister for Health the projects included in the 2019 health service capital plan; and if the plan is not finalised, his views on whether it is acceptable that five months into 2019 there is still no clarity with regard to capital projects being funded in 2019. [20837/19]
Amharc ar fhreagraFreagraí scríofa
My Department is continuing to work with the Department of Public Expenditure and Reform and the Health Service Executive in a process to finalise as soon as possible a multi-annual Capital Plan for the HSE, which will include capital projects to be funded in 2019 and beyond.
Primary Care Centres Provision
Ceisteanna (58)
John Brady
Ceist:58. Deputy John Brady asked the Minister for Health the status of the development of a primary care centre in Arklow, County Wicklow; and if he will make a statement on the matter. [20905/19]
Amharc ar fhreagraFreagraí scríofa
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.
Hospital Facilities
Ceisteanna (59)
Catherine Connolly
Ceist:59. Deputy Catherine Connolly asked the Minister for Health the status of the provision of modular theatres at Merlin Park hospital, Galway; and if he will make a statement on the matter. [20829/19]
Amharc ar fhreagraFreagraí scríofa
In relation to the particular query raised, as this is a service matter, I have asked the HSE to reply to the Deputy directly.
Hospitals Capital Programme
Ceisteanna (60, 67)
Charlie McConalogue
Ceist:60. Deputy Charlie McConalogue asked the Minister for Health his long-term plans for a number of community hospitals in County Donegal, including the community hospitals in Lifford, Ramelton and St. Joseph's, Stranorlar; and if he will make a statement on the matter. [20918/19]
Amharc ar fhreagraCharlie McConalogue
Ceist:67. Deputy Charlie McConalogue asked the Minister for Health the capital investment that will be provided in order to ensure long-stay beds numbers will continue to be maintained at hospitals (details supplied) in County Donegal; and if he will make a statement on the matter. [20919/19]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 60 and 67 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 you in relation to this matter.