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Wednesday, 3 Jul 2019

Written Answers Nos. 220-239

IDA Ireland Site Visits

Ceisteanna (220)

Fiona O'Loughlin

Ceist:

220. Deputy Fiona O'Loughlin asked the Minister for Business, Enterprise and Innovation the number of visits the IDA has made to Portarlington, County Laois over the past five years; and if she will make a statement on the matter. [28421/19]

Amharc ar fhreagra

Freagraí scríofa

The IDA's performance in 2018 reflects the emphasis the Agency and the Government have placed on increasing foreign direct investment (FDI) into regional locations. Last year, for example, 56% of all net new jobs created by IDA client firms were in locations outside Dublin. There are now over 132,000 people employed across 681 firms in IDA client companies outside the capital. 

County Laois is marketed as part of the IDA’s Midlands Region. There are currently four IDA client companies operating in Co. Laois employing a total of 122 people. Last April the Canadian company Greenfield Global announced plans to establish a new manufacturing facility in Portlaoise which will create 75 new jobs.  The Agency is working hard to attract further such investment to the County.

Data on IDA Ireland site visits is collated on a county by county basis. Information on site visits to specific locations - including individual towns - is therefore unavailable. Whilst site visits do remain an important tool in helping showcase regional locations to investors, it is important to remember that the final decision as to where to invest rests solely with the company concerned. It is also the case that site visit activity does not necessarily reflect investment potential, as a significant proportion of all new FDI comes from existing IDA clients already present in the country. 

The following table provides details on the number of site visits to Laois from 2015 to Q1 2019:

County

2015

2016

2017

2018

Q1 2019

Laois

4

6

4

10

2

Trade Agreements

Ceisteanna (221)

Micheál Martin

Ceist:

221. Deputy Micheál Martin asked the Minister for Business, Enterprise and Innovation if she has discussed the potential Mercosur agreement with her other EU counterparts recently. [28209/19]

Amharc ar fhreagra

Freagraí scríofa

On Friday 28th June last, the EU concluded negotiations for an Association Agreement with Mercosur – after nearly 20 years and 40 rounds of talks. This marks the EU’s largest trade deal to date and is four times the size of the trade agreement with Japan.

Irish exporters have been subject to trade tariffs, barriers and restrictions when exporting to Mercosur. This Agreement will see a significant reduction, or elimination, of tariffs and barriers to trade which will allow a cross flow of trading and investment between Ireland, the EU and the Mercosur region. The EU-Mercosur Agreement should make exports from Ireland more attractive, and potentially increase the demand for Irish products.

As with every Free Trade Agreement, Ireland – like all Member States – has defensive as well as offensive interests. The Agreement with Mercosur presents sectoral opportunities for Ireland in areas such as software and services in telecoms, financial services, digital content and travel, engineering products and services, life sciences, food and beverages, and education services.

On the other hand, I was always keenly aware of the potential impact that this Agreement presents to the EU’s and Ireland’s beef sector. Ireland, along with a number of other Member States, asserted early on in the negotiations that these agricultural sensitivities (and beef in particular) must be fully considered in the negotiations.

In this regard, Ireland has continually highlighted the cumulative impact of agricultural market access in relation to all EU trade agreements. My Department has done this through engagement with the Trade Policy Committee in Brussels, as well as joining with other Member States in formally writing to the Commission outlining our concerns. In addition, our concerns have been raised at political level – including myself and my officials raising the issues with counterparts, both at Trade Council deliberations and bilaterally with the EU Commission.

To that end, I wrote to the EU Trade Commissioner, Cecilia Malmström as recently as 31st May this year to restate my views, which I had previously articulated at European Trade Council meetings, as well as directly with the Trade Commissioner, regarding the current challenges facing the beef sector.

I had sought assurances from the Commission that the final offer on beef – an offensive demand from the Mercosur side – would ensure that:

- the tariff rate quota for beef was low.

- that phasing-in periods were designed to allow sufficient time for Irish and EU industry to adjust,

- the Commission continually monitor quota levels taking into account domestic market conditions,

- the composition of beef imports from the region would be limited in relation to fresh chilled beef, and

- robust checks would be established and monitored at points of import to the EU to ensure animal health and welfare standards have been maintained.

As I am sure you are aware, An Taoiseach also recently wrote to the Commission to highlight our particular sensitivities in these negotiations. An Taoiseach joined the leaders of France, Poland and Belgium on 17th June, in writing to Commission President Juncker expressing our concerns on the inclusion of sensitive agricultural products in the negotiations, and stating that the current quotas for such products must not be increased.

It is disappointing that the agreement reached on beef access is more than we would have wished.  Although the quota of 99,000 tonnes is far less than the Mercosur countries were looking for. Also, the Agreement ensures an extended lead-in period before the full “TRQ” takes effect and that five-year period will only commence after the legal text of the Agreement is finalised and “legally scrubbed”, such that the full TRQ for beef will not take effect for some 7/8 years from now. The Government’s active campaign, together with some other Member States, to secure the viability of the Irish and EU beef sector, has been a key component in achieving these ameliorating elements to this particular TRQ for beef.

Despite our strenuous efforts, we obviously are disappointed in relation to beef. However, it’s important also to recognise the positive aspects to the deal as I’ve outlined earlier. In terms of Agriculture, it is important to note that the dairy sector will benefit from the removal of tariffs on cheese, milk powder and infant formula. There are also benefits for the drinks industry.

We now intend to carry out a comprehensive economic assessment of the deal to see what impact it’ll have on the Irish economy and on jobs and that will inform future actions.

Departmental Funding

Ceisteanna (222)

Willie Penrose

Ceist:

222. Deputy Willie Penrose asked the Minister for Business, Enterprise and Innovation the budget allocation for the Labour Court and Workplace Relations Commission in 2018 and 2019, in tabular form; and if she will make a statement on the matter. [28604/19]

Amharc ar fhreagra

Freagraí scríofa

The Deputy should note that the Labour Court and Workplace Relations Commission form part of the overall Workplace Relations Programme area of my Department. The overall funding allocation for this area increased by €1,106m in 2019.

The distribution of Exchequer funding allocations for the Labour Court and the Workplace Relations Commission as per the 2018 and 2019 Revised Estimates Volumes provided through my Department’s Vote is set out in the following table.

 

2018 REV Allocation Current

(€,000)

2019 REV Allocation Current

(€,000)

Labour   Court 

3,800

3,876

Workplace   Relations Commission 

14,014

15,014

Workplace   Relations Programme

18,104

19,120

It will be seen that the allocation to the Workplace Relations Programme, including the specific allocations to the Labour Court and the Workplace Relations Commission, increased in 2019.

This increase demonstrates the Government’s commitment to ensuring that the Department’s Offices in the Workplace Relations Programme area are sufficiently funded and resourced to enable them to carry out their regulatory functions.

Cancer Screening Programmes

Ceisteanna (223)

Alan Kelly

Ceist:

223. Deputy Alan Kelly asked the Minister for Health his plans to apologise to the women and their families who have been affected by the cervical cancer scandal; the way in which he will do same; and if he will make a statement on the matter. [28426/19]

Amharc ar fhreagra

Freagraí scríofa

Consideration is being given to an appropriate form of apology, and this will be discussed with the 221+ before any final decision is made. I have met and spoken with many of the women involved, including at a meeting in January 2019, at which I apologised for how women and families were treated, as well as thanking them for sharing their views and experiences. The National Cancer Screening Service wrote last year to each woman affected, or their next of kin, apologising for the failures in relation to disclosure and setting out the actions being taken by the HSE to address the issues identified. The former Director General of the HSE, and the former head of Cervical Check have also apologised personally to individual women when the opportunity has arisen. Last year, Cervical Check placed advertisements with national media outlets apologising for how standards fell short in relation to this issue. It is also very important to note the actions taken by the State to address the issues identified in the Scoping Inquiry led by Dr Scally. Government has accepted in full the recommendations of the Scoping Inquiry and work is ongoing to implement these in full. In relation to the women concerned I am pleased that the Ex-Gratia Scheme has made its first payments in relation to the non-disclosure of audit results, and I understand that the panel will meet again shortly to consider further payments

General Practitioner Services

Ceisteanna (224)

Seán Haughey

Ceist:

224. Deputy Seán Haughey asked the Minister for Health if non-EU general practitioners will be encouraged to live and work here in view of the shortage of general practitioners including locum doctors; the measures he is taking to deal with the situation; and if he will make a statement on the matter. [28314/19]

Amharc ar fhreagra

Freagraí scríofa

The Government is committed to increasing GP capacity to ensure that patients across the country continue to have access to GP services and that general practice is sustainable in all areas into the future.

General Practitioners are self-employed private practitioners, most of whom have contracts with the HSE to provide services under various public health schemes.

A range of measures have been introduced in recent years that will benefit patients and help make general practice more sustainable and a more attractive career option for all GPs, including non-EU general practitioners eligible to practise in Ireland.

These include changes to the entry provisions to the GMS scheme to accommodate more flexible/shared GMS GP contracts, and to the retirement provisions for GPs under the GMS scheme, allowing GPs to hold GMS contracts until their 72nd birthday. Enhanced supports for rural GP practices have also been introduced. There has also been a significant expansion in the number of places on GP training programmes in recent years; up from 120 places in 2009 to 183 filled in 2019.

An agreement with the Irish Medical Organisation on contractual reform has been recently concluded. In return for cooperation with a wide range of service developments and reforms, the Government will increase investment in general practice by approximately 40% (or €210 million) over the 2019-2023 period.

This will see significant increases in capitation fees for GPs who participate in the reform programme and the introduction of new fees and subsidies for additional services such as the chronic disease management programme. There will also be increased support for GPs working in rural practices and for those in disadvantaged urban areas. Improvements in the maternity and paternity leave arrangements have also been agreed, in recognition of the need to ensure that general practice is compatible with doctors’ family commitments.

Hospital Appointments Status

Ceisteanna (225)

Barry Cowen

Ceist:

225. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) can expect an appointment for cataract treatment. [28322/19]

Amharc ar fhreagra

Freagraí scríofa

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.

Care of the Elderly Provision

Ceisteanna (226)

Imelda Munster

Ceist:

226. Deputy Imelda Munster asked the Minister for Health further to Parliamentary Question No. 458 of 11 June 2019, when a reply will issue from the HSE. [28326/19]

Amharc ar fhreagra

Freagraí scríofa

I understand that the Health Services Executive responded to the Deputy on the 28/06/2019.

Medicinal Products Reimbursement

Ceisteanna (227)

Kevin O'Keeffe

Ceist:

227. Deputy Kevin O'Keeffe asked the Minister for Health if the reimbursement of the cost of Respreeza to patients will be reconsidered. [28329/19]

Amharc ar fhreagra

Freagraí scríofa

The HSE has statutory responsibility for decisions on the pricing and reimbursement of medicines under the Health (Pricing and Supply of Medical Goods) Act 2013. The HSE carefully considered the pricing and reimbursement of human alpha1-proteinase inhibitor (Respreeza). The applicant was notified in August 2017 that the HSE was unable to recommend reimbursement. The HSE concluded that there was not enough evidence to suggest that patients would derive a clinically meaningful benefit from this treatment and that the current price was not a cost effective use of resources. I understand that the HSE and the applicant have since signed a ring-fenced agreement for the continued supply of this medicine to the patients involved in the original patient access programme, which starts from the commencement of the next clinical trial. This is expected to commence this year.

Cross-Border Health Services Provision

Ceisteanna (228)

Niamh Smyth

Ceist:

228. Deputy Niamh Smyth asked the Minister for Health the length of time it is taking for patients to receive back payment after using the cross-border directive scheme for surgery; and if he will make a statement on the matter. [28337/19]

Amharc ar fhreagra

Freagraí scríofa

The HSE is responsible for the operation of the Cross Border Directive and the management of the HSE Cross Border Directive (CBD) office is an operational matter for the HSE. I have, therefore, asked the HSE to respond directly to the Deputy.

It should be noted that the numbers of persons availing of the Directive has been increasing steadily for a number of years with a corresponding increase in the workload for the CBD office. I am aware that the HSE is currently considering a business case, and other interim steps, to address issues which have arisen with regard to the processing of reimbursements.

Cross-Border Health Services Provision

Ceisteanna (229)

Niamh Smyth

Ceist:

229. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) is waiting since April 2019 for arrears from the cross-border directive payment; and if he will make a statement on the matter. [28346/19]

Amharc ar fhreagra

Freagraí scríofa

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

Departmental Communications

Ceisteanna (230)

Alan Kelly

Ceist:

230. Deputy Alan Kelly asked the Minister for Health the details of all travel, meetings and attendance of all meetings a person (details supplied) and their team or their associates and his Department or related parties had as part of the review by them of the cervical cancer scandal by date, in tabular form. [28348/19]

Amharc ar fhreagra

Freagraí scríofa

As outlined in my response to the Deputy's previous questions on 21 and 28 May, I and/or officials from my Department have met with the Scoping Inquiry on a number of occasions since the Scoping Inquiry was established. These meetings were led by Dr Scally and in some instances he was accompanied by other members of his team. In keeping with the independence of the Scoping Inquiry in conducting this work my Department does not hold records of the travel arrangements of Dr Scally or other members of the Scoping Inquiry team. 

The dates of all meetings involving the Department, insofar as they have been ascertained following a comprehensive search of records, are outlined in the following table:

Date

Details

7 May

Preliminary meeting with Department officials on work of the Inquiry

24 May

Dr Scally met with Department officials to facilitate the work of the Inquiry

11 June

Dr Scally met with Minister and Department officials to submit his First and Progress Reports

12 July

Dr Scally participated in a teleconference with Department officials and RCOG representatives

8 August

Dr Scally met with Department official to facilitate the work of the inquiry

28 August

Dr Scally met with Department official to facilitate the work of the inquiry

 28 August

 Dr Scally met with Department official to facilitate the work of the inquiry

10 September

Dr Scally met with Minister and Department officials to discuss his Final Report

10 October

Dr Scally met with Minister and Department officials to discuss the implementation of his recommendations and the progress of his supplementary report

20 November

Dr Scally met with Department officials to discuss implementation of his recommendations

17 December

Dr Scally met with Department officials to discuss implementation of his recommendations

31 January

Dr Scally attended Minister’s meeting with 221+ Patient Support Group, following which he met with Minister and Department officials to discuss progress of supplementary report

14 February

Dr Scally met with Department officials to discuss progress of Supplementary Report

7 June

Dr Scally met with Minister and Department officials to discuss his Supplementary Report following submission

Medicinal Products Availability

Ceisteanna (231)

John Curran

Ceist:

231. Deputy John Curran asked the Minister for Health when in 2019 he expects to bring forward a policy statement in order to increase the use of biosimilar drugs in order that better value for money is achieved in the purchase of medicines; and if he will make a statement on the matter. [28360/19]

Amharc ar fhreagra

Freagraí scríofa

My Department and the HSE are engaging in a number of initiatives which will lead to better access to medicines for patients, value for the taxpayer and the cost- effective provision of medicines in Ireland.

A public consultation on a National Biosimilar Medicines Policy was undertaken by my Department in 2017. The responses to that consultation and other possible policy levers are being considered by my Department, with a view to developing a National Biosimilar Medicines Policy statement.. At an operational level, the HSE's Acute Hospitals Drugs Management Programme has a biosimilar strategy in place since 2017, which is making considerable progress using a collaborative approach with hospital pharmacists and clinical teams to bring about changes in prescribing practice. In that respect, hospitals are working towards a targeted minimum prescribing rate for biosimilars of 50%.

The HSE is also working on identifying barriers to the prescribing of biosimilars, with a specific focus on education and support. It is seeking to increase understanding of biosimilars through targeted presentations to clinicians and hospitals.

The objective of these initiatives is a greater uptake in the use of biosimilars and this is evident by hospital dispensing data. For example, the prescribing rate for the biosimilar drug Infliximab has increased from 5% in 2017 to 40% in 2018. I am informed that, since the introduction of the Medicines Management Programme's biosimilar guidelines on 1 June 2019, more than 100 patients have already moved to biosimilar medicines.

My Department proposes to build on these positive developments and to bring forward a policy statement that would support and complement the many initiatives which are already underway.

Primary Care Centres Data

Ceisteanna (232)

John Curran

Ceist:

232. Deputy John Curran asked the Minister for Health the number of primary healthcare centres delivered and that are fully operational to date in 2019, in each CHO area; the number of primary healthcare centres under construction and due to open in 2019 in each CHO area; and if he will make a statement on the matter. [28361/19]

Amharc ar fhreagra

Freagraí 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.

Cancer Services Provision

Ceisteanna (233, 234)

Carol Nolan

Ceist:

233. Deputy Carol Nolan asked the Minister for Health when two new treatments for colon cancer (details supplied) will be made available in hospitals here; and if he will make a statement on the matter. [28364/19]

Amharc ar fhreagra

Carol Nolan

Ceist:

234. Deputy Carol Nolan asked the Minister for Health the reason new treatments for colon cancer have not been made available to patients in view of the fact that some oncologists working in hospitals here have been trained to deliver the new treatments; and if he will make a statement on the matter. [28367/19]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 233 and 234 together.

Hepatic Arterial Infusion (HAI) is a medical procedure that delivers chemotherapy directly to the liver. A number of innovative liver-directed treatments are utilised in Irish hospitals including Radio-Frequency Ablation which uses heat to kill cancer cells and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) which delivers chemotherapy directly to the peritoneal (abdominal) cavity.

The HSE’s National Cancer Control Programme (NCCP) provides some funding for a variety of chemotherapy programmes including HIPEC, as agreed during the HSE service planning process. The funding of any new services requiring additional resources takes place via the HSE service planning process.

Home Help Service Data

Ceisteanna (235)

Carol Nolan

Ceist:

235. Deputy Carol Nolan asked the Minister for Health the number of persons in counties Laois and Offaly on waiting lists for home help hours, homecare packages and respite care by category; and if he will make a statement on the matter. [28366/19]

Amharc ar fhreagra

Freagraí scríofa

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

Medicinal Products Availability

Ceisteanna (236)

Bobby Aylward

Ceist:

236. Deputy Bobby Aylward asked the Minister for Health the steps he will take to ensure fast, efficient and equal access to new medicines for persons with MS here is in line with other countries in Europe; and if he will make a statement on the matter. [28371/19]

Amharc ar fhreagra

Freagraí scríofa

The HSE has statutory responsibility for medicine pricing and reimbursement decisions, under the Health (Pricing and Supply of Medical Goods) Act 2013. The Act specifies criteria for decisions on the reimbursement of medicines. As Minister, I have no role in this statutory process.

HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, including on the advice of the National Centre for Pharmacoeconomics (NCPE). The NCPE conducts health technology assessments (HTAs) for the HSE and makes recommendations on reimbursement to assist HSE decisions. The NCPE uses a decision framework to systematically assess whether a drug's clinical and cost effectiveness as a health intervention.

The HSE strives to reach a decision in as timely a manner as possible. However, because of the significant monies involved, it must ensure that the best price is achieved, as these commitments are often multi-million euro, ongoing investments. This can lead to a protracted deliberation process.

In regard to new treatments for multiple sclerosis, I wish to advise you that the NCPE completed a health technology assessment in August 2018 on ocrelizumab for adult patients with relapsing forms of multiple sclerosis. The NCPE recommended that ocrelizumab not be considered for reimbursement unless cost-effectiveness can be improved relative to existing treatments.

In addition, in October 2018 the NCPE completed its assessment of ocrelizumab for adult patients with early primary progressive multiple sclerosis and did not recommend that it be reimbursed for this indication.

The HSE has advised that there has been considerable engagement with the applicant and commercial discussions are ongoing. The HSE's final decision on reimbursement will take into consideration the statutory criteria contained in the 2013 Health Act.

The HSE has also commissioned an HTA for Delta-9-tetrahydrocannabinol/cannabidiol (THC/CBD). This is indicated for symptom improvement in adult patients with moderate to severe spasticity due to multiple sclerosis, who have not responded adequately to other anti-spasticity medication and who demonstrate clinically significant improvement in spasticity-related symptoms during an initial trial. The NCPE is currently awaiting information from the applicant for the HTA.

Hospital Appointments Status

Ceisteanna (237)

Barry Cowen

Ceist:

237. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) can expect an appointment. [28381/19]

Amharc ar fhreagra

Freagraí scríofa

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.

Healthcare Infrastructure Provision

Ceisteanna (238)

Alan Kelly

Ceist:

238. Deputy Alan Kelly asked the Minister for Health when funding will be provided for the design of the new maternity hospital in Limerick; and if he will make a statement on the matter. [28382/19]

Amharc ar fhreagra

Freagraí 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.

Mental Health Services Provision

Ceisteanna (239)

Pearse Doherty

Ceist:

239. Deputy Pearse Doherty asked the Minister for Health if his attention has been drawn to the concerns raised that persons are being admitted through the emergency department of Letterkenny University Hospital for psychiatric care; if consideration will be given to change the practice; and if he will make a statement on the matter. [28397/19]

Amharc ar fhreagra

Freagraí scríofa

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

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