Written Answers Nos. 1405-1429
1406. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) in County Donegal can expect to have a medical card application processed; if consideration will be given to backdating the award date to when the applicant first applied; and if he will make a statement on the matter. [32775/19]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
1407. Deputy Pearse Doherty asked the Minister for Health the reason tenders submitted by companies which use a specific building management solutions system (details supplied) will only be considered eligible in respect to a recent competitive procurement process initiated by the HSE; if his attention has been drawn to the implications such a restrictive requirement is having on the ability of local firms which operate alternative building management systems to successfully tender for such contracts; and if he will make a statement on the matter. [32791/19]
Amharc ar fhreagraAs this is an operational matter, it has been referred to the HSE for direct reply to the Deputy.
1408. Deputy Marc MacSharry asked the Minister for Health further to Parliamentary Question No. 299 of 10 July 2019, if the HSE has considered a revised representation for the drug Tagrisso as a second line therapy for non-small cell lung cancer at recent drug group or senior leadership meetings; the dates such meetings took place or are scheduled to take place; the recommendation and decision made with regard to the reimbursement of the drug if a meeting took place; and if he will make a statement on the matter. [32804/19]
Amharc ar fhreagraThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy.
1409. Deputy Bernard J. Durkan asked the Minister for Health if an application for a primary medical certificate will be reconsidered in the case of a person (details supplied); and if he will make a statement on the matter. [32809/19]
Amharc ar fhreagraAs the Deputy's question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
1410. Deputy John Brassil asked the Minister for Health the status of discussions between the HSE and the manufacturer of the drug ocrelizumab for persons with multiple sclerosis; and if he will make a statement on the matter. [32812/19]
Amharc ar fhreagraThe 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.
The HSE has advised that it has received 2 applications for pricing and reimbursement of Ocrelizumab in Multiple Sclerosis.
Application 1 is for use of Ocrelizumab for the treatment of adult patients with relapsing forms of multiple sclerosis (RMS) with active disease defined by clinical or imaging features. Following a number of rounds of commercial negotiations, agreement has been reached in relation to the commercial terms which will apply to this indication when reimbursed. The HSE is currently working on putting in place the required administrative processes to support reimbursement of this specific indication.
Application 2 is for the use of Ocrelizumab for the treatment of adult patients with early primary progressive multiple sclerosis (PPMS) in terms of disease duration and level of disability, and with imaging features characteristic of inflammatory activity. The HSE and the manufacturer have had a number of rounds of commercial negotiations in relation to this indication (use). Commercial discussions have concluded, the medicine has been reviewed by the HSE Drugs Group and the HSE Senior Leadership Team have received the Drugs Group recommendation. The HSE's final decision on reimbursement will take into consideration the statutory criteria contained in the 2013 Health Act.
1411. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the number of personal assistant hours provided by the HSE in each of the past five years; the waiting list for persons seeking personal assistant hours by CHO area; and the estimated cost of providing an extra 500,000 personal assistant hours in tabular form. [32813/19]
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 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.
1412. Deputy Michael McGrath asked the Minister for Health his plans to create regional out-of-hours drop-in sexual health services for gay men similar to those that exist in Dublin; and if he will make a statement on the matter. [32814/19]
Amharc ar fhreagraAs this is an operational matter I have referred the Deputy's question to the Health Service Executive for direct reply to him.
1413. Deputy Michael McGrath asked the Minister for Health his plans to make funding available to LGBT+ organisations to increase the amount of awareness training and information they can provide; and if he will make a statement on the matter. [32815/19]
Amharc ar fhreagraThe Dept of Health, through the Health Services Executive (HSE), has funded a number of LGBTI+ organisations over many years. At present, the main organisations funded are;
- BelonGTo - to further develop and deliver their national network programme and mental health programme, nationwide.
- LGBT Ireland - to develop and deliver LGBT awareness training workshops nationwide and further develop their volunteer training programme for the LGBT Helpline nationwide.
- TENI - to promote and deliver transgender awareness training workshops for health professionals working in public and voluntary and community services. They also run peer support groups.
In addition, the Gay Health Network is funded via the HSE Sexual Health Programme to promote HIV prevention and sexual health awareness among men who have sex with men, with a focus on men living with HIV, and to combat the stigma associated with HIV.
Further funding for LGBT+ organisations to increase the amount of awareness training and information may be considered as part of the Estimates process for Budget 2020.
1414. Deputy Gerry Adams asked the Minister for Health the correct procedure by which a landowner may contact the HSE estates department to discuss potentially suitable lands for development for HSE projects. [32817/19]
Amharc ar fhreagraAs the Health Service Executive is responsible for the management of the healthcare property estate, I have asked the HSE to respond directly to you in relation to this matter.
1415. Deputy Denis Naughten asked the Minister for Health when a decision will be made on an application by a school (details supplied); and if he will make a statement on the matter. [32818/19]
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 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.
1416. Deputy Bernard J. Durkan asked the Minister for Health if an application for a primary medical certificate will be reconsidered in the case of a person (details supplied); and if he will make a statement on the matter. [32819/19]
Amharc ar fhreagraAs the Deputy's question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
1417. Deputy Michael Healy-Rae asked the Minister for Health the status of an operation for a person (details supplied); and if he will make a statement on the matter. [32822/19]
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.
1418. Deputy Fiona O'Loughlin asked the Minister for Health if the pension of a person (details supplied) will be investigated; and if he will make a statement on the matter. [32826/19]
Amharc ar fhreagraI have asked the HSE to respond directly to the Deputy on this matter.
1419. Deputy Fiona O'Loughlin asked the Minister for Health the reason prescriptions by hospitals are not valid on medical cards unless reissued by the green form system by the general practitioner of the person; and if he will make a statement on the matter. [32827/19]
Amharc ar fhreagraUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
1420. Deputy Fiona O'Loughlin asked the Minister for Health the procedures in place to encourage manufacturers of medicines to make their product available for sale to the health service at a manageable cost with particular reference to top of the range new products with an expensive cost; and if he will make a statement on the matter. [32828/19]
Amharc ar fhreagraThe HSE has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. As Minister I do not have any power or function in relation to the reimbursement of medicines. The Act specifies the criteria for decisions on the reimbursement of medicines.
In line with the 2013 Act and the national framework agreed with industry, if a company would like a medicine to be reimbursed by the HSE, the company must submit an application to the HSE to have the new medicine added to the reimbursement list. It is the sole responsibility of the company to make an application for reimbursement and the price sought for any product is purely at the discretion of the applicant.
However, upon receipt of an application for reimbursement, the HSE engages in a thorough assessment process to ensure that reimbursement decisions are made on objective, scientific and economic grounds, on the advice of expert bodies such as the National Centre for Pharmacoeconomics (NCPE).
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 investments on an on-going basis. This can lead to a protracted negotiation process with a view to achieving the best value for the taxpayer in terms of the final negotiated price for the product in question.
1421. Deputy Fiona O'Loughlin asked the Minister for Health the number of dieticians employed by the HSE across the service; the number employed by primary care centre in tabular form; and if he will make a statement on the matter. [32829/19]
Amharc ar fhreagraI have asked the HSE to respond directly to the Deputy on this matter.
1423. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the number of persons nationally who have been moved from a congregated setting over the past five years; the number of persons that remain in congregated settings by CHO area; and the steps he will take to endorse the recommendations contained in Time to Move On from Congregated Settings – A strategy for Community Inclusion. [32844/19]
Amharc ar fhreagraThe 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 Report identified around 4000 people (based on 2008 census) with disabilities in Ireland living in congregated settings, defined as a residential setting where people live with ten or more people.
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, we will have exceeded this target and 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.
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.
The HSE has prioritised the transition of a further 160 people from congregated settings in 2019 under its Service Plan, and I am informed that 49 people have moved into their homes in the community to the end of March this year.
As the HSE is responsible for leading out on the recommendations of "Time to Move on from Congregated Settings - A Strategy for Community Inclusion", I have asked the HSE to reply directly to the Deputy in relation to the questions posed.
1424. Deputy Danny Healy-Rae asked the Minister for Health the reason the HSE is limiting the amount of fair deal applications being approved for funding; and if he will make a statement on the matter. [32846/19]
Amharc ar fhreagraThe Nursing Homes Support Scheme, commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost.
As outlined in the HSE's National Service Plan for 2019, the NHSS is expected to support 23,042 people in 2019. The NHSS budget for 2019 is €985.8m which is an increase of €24.3m over its 2018 budget.
Over the last two years, an additional €45 million has been provided to NHSS budget for the continued provision of services in line with pricing and demand. As part of normal governance and performance management arrangements The Department and the HSE maintain regular service area engagements, which also form part of ongoing collaborative work on issues relating to older persons policy and service delivery.
The HSE have noted that the number of residents in nursing homes whom are supported by the NHSS to be ahead of forecast for the year to date. The latest available performance reports indicate that there are 23,252 people supported in the Scheme at the end of May this year. This is significantly more people than forecast and this creates a challenge. The HSE has also advised that the cost of care continues to rise and the average weekly cost per bed is higher in 2019 than anticipated.
Having regard to the available budget and the demand for support, the HSE releases funding in a managed way to ensure that the operation of the NHSS remains within the budgetary allocation. To manage the available funds throughout the year, a national placement list for the release of funding is operated by the HSE, to enable it to operate within budget. Funding issues to applicants in chronological order, to ensure equity nationally. Approved applicants are placed on the national placement list in order of their approval date and funding is released to applicants in order of their place on this list. The length of time spent on the placement list depends on the number of applicants currently receiving financial support and the number of new applications. Where demand is higher, the time spent on the waiting list may increase having regard for the prudent management of the Scheme's budget.
The HSE has put in place arrangements that a monthly analysis of performance of the Nursing Homes Support Scheme continues to ensure that the maximum number of new entrants are approved with the shortest possible waiting times while remaining on track to deliver a balanced budgetary position by year end. My Department and the HSE will continue to closely engage on this matter.
1425. Deputy Danny Healy-Rae asked the Minister for Health the reason home help hours are not being extended to weekends and bank holidays; and if he will make a statement on the matter. [32847/19]
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.
1426. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the estimated cost of reintroducing the rehabilitation training allowance for new entrants payable from Autumn 2019; and if he will make a statement on the matter. [32848/19]
Amharc ar fhreagraThe HSE’s New Directions policy seeks to reconfigure and personalise HSE funded adult day services to offer a flexible and individualised set of supports to enable each person to live a life of their choosing in accordance with their own wishes and needs.
Rehabilitative Training (RT) Programmes are designed to equip participants with basic personal, social and work-related skills. Approximately 2,300 people attend RT programmes, with 400 new attendees due to start this coming September. Payable in addition to Disability Allowance, the RT Bonus payment is currently payable at a rate of €31.80 per week to attendees of these RT Programmes, who can attend for a period of up to 4 years. The RT Bonus was introduced in 2001, aligned with a similar FÁS Training Bonus. This FÁS Training Bonus later became the Solas Vocational Training Programme payment, which was reduced in 2011 and discontinued in 2012.
Over the next four years, from September 2019, the RT Bonus will not apply to new attendees. The money that would have been spent on the bonus, estimated at approximately €3.7 million over the four years, will be redirected to address unmet need in day service provision for people with disabilities. This measure will have no impact on current participants as their payments will continue until they complete their 4 year programme. Importantly, the phasing out of the RT Bonus will mean that HSE Community Healthcare Organisations will have some funding to reallocate towards increasing the number of days per week available to those who did not receive a full service during the recession, or who are on a waiting list for a day service.
The phasing out of this Bonus payment by the HSE will ensure more people have access to a day service on an equitable basis, consistency in treatment of all day service users and maximise the use of finite resources.
1427. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the status of the running of the demonstration projects or pilot programmes for personal budgets following the €1.3 million funding provided in 2019; if a decision has been made to roll out the programme on a broader scale including children following the pilot programme; and if he will make a statement on the matter. [32856/19]
Amharc ar fhreagraI launched the report of the Task Force on Personalised Budgets in July 2018. The report sets out how personalised budgets could work as a funding mechanism for people with a disability, providing them with greater choice and control over the services and supports they receive.
The HSE is currently developing a number of pilot demonstration projects which will be rolled out shortly across each of the Community Healthcare Organisations (CHOs). The pilot demonstration projects will test models of personalised budgets and will evaluate service user experiences and costs differences. These projects will be designed to test the system of personalised budgets and how they might work.
The remit of the Task Force was to look at services for adults funded by the Health Service Executive (HSE) Disability Services. The evidence from other countries is very clear that introducing personalised budgets is a significant challenge that requires careful planning and groundwork and therefore pilot demonstration projects will test the various models and governance structures in the first instance. An evaluation will be conducted for the duration of the pilot demonstration projects and its outcome will inform Government consideration on the wider application of this funding model.
1428. Deputy Danny Healy-Rae asked the Minister for Health the reason elderly persons who wish to remain in their own homes are being limited to a few minutes of home help when they are eventually allowed home support service; and if he will make a statement on the matter. [32857/19]
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.
1429. Deputy Danny Healy-Rae asked the Minister for Health the reason for the large number of persons waiting for home help; and if he will make a statement on the matter. [32858/19]
Amharc ar fhreagraHome supports enable older people to remain in their own homes and communities, as well as facilitating timely discharge from hospital. The Government has made improved access to home support services a priority. Progress is reflected in the additional funding made available in recent years with the budget growing from €306 million in 2015 to almost €446 million in 2019.
In 2018, the total budget for the service was €416.8 million, providing 17.5 million hours. This year the HSE intends to provide over 18.2 million home support hours, including intensive home care packages, to over 53,000 people. In 2019 almost €30 million has been added to the home support budget and 800,000 more hours of support will be provided compared to the original 2018 target.
Preliminary information for end of May indicates that 52,620 people were in receipt of home support hours, including intensive packages for those with complex care needs, such as dementia. Between January and May over 7.3 million hours were delivered with 7,200 new clients granted home supports.
Despite this significant level of provision, demand for home support continues to grow and about 6,800 people have been assessed and are waiting for either new or additional services. People on the 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. The level of service provision must be in line with the HSE’s budget, delivery plan and the National Service Plan.
I acknowledge that in some cases access to the service may take longer than we would like. However, the HSE has assured the Department that people on the 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.
The Department of Health is currently developing plans for a new statutory scheme and system of regulation for home support services. The Sláintecare Implementation Strategy commits to the introduction of the new scheme in 2021.
