Vaccination Programme

Ceisteanna (1930)

Alan Kelly

Ceist:

1930. Deputy Alan Kelly asked the Minister for Health the estimated cost of providing the chickenpox varicella vaccine to all children as part of the childhood immunisation vaccination programme; if he has considered such a roll-out; the research or analysis his officials have carried out on this; if there has been research conducted on the health and productivity gains to Ireland from such a roll-out; and if he will make a statement on the matter. [34368/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The National Immunisation Advisory Committee (NIAC) is an independent committee of the Royal College of Physicians of Ireland which is comprised of experts from several specialties, including infectious diseases, paediatrics, and public health.  It makes recommendations to my Department on vaccination policy in Ireland.  Its recommendations are based on the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation.  NIAC continues to revise recommendations to allow for the introduction of new vaccines in Ireland and to keep abreast of changes in the patterns of disease.  Therefore, the immunisation schedule will continue to be amended over time.

There is no recommendation from NIAC concerning the inclusion of varicella-zoster vaccine (chicken pox) in the primary childhood immunisation schedule.  However, some parents may choose to have their children vaccinated privately if they wish.

Hospital Beds Data

Ceisteanna (1931)

Alan Kelly

Ceist:

1931. Deputy Alan Kelly asked the Minister for Health the number of additional inpatient hospital beds to be provided in 2019 across the health service; the locations the additional beds will be; the additional number provided to date since 1 January 2019; and if he will make a statement on the matter. [34369/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Health Service Capacity Review published last year was clear on the need for a major investment in additional capacity in both hospital and community – combined with a wide scale reform of the manner and the location of where health services are provided.

An additional 267 acute hospital beds opened under the Winter Initiative 2017/2018, and the National Service Plan for 2019 provides for a comprehensive capacity programme. The main elements of the 2019 capacity programme are:

- the provision of 75 acute beds and 70 community beds under the Winter Plan 2018/19 — the HSE have confirmed that 75 acute beds and 59 community beds have been opened to date:

- 47 additional beds, including a 40-bed modular build in South Tipperary General Hospital, 4 HDU beds in Cork University Hospital, and 3 HDU beds in the Mater which are due to open by Q4 2019;

- preparation of 202 beds, of which 16 are critical care, during 2019, with a view to bringing this extra capacity into operation in Q1 of 2020;

- commencement of works on a 60-bed modular ward in University Hospital Limerick.

With regard to the specific question the Deputy has asked, I have asked the HSE to respond directly with the details requested.

Hospital Beds Data

Ceisteanna (1932)

Alan Kelly

Ceist:

1932. Deputy Alan Kelly asked the Minister for Health the number of inpatient hospital beds available in each acute hospital as of 18 July 2019, in tabular form; and if he will make a statement on the matter. [34370/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As set out in the Sláintecare Action Plan 2019, the Department of Health is committed to fostering the support of citizens and stakeholders in the Sláintecare reform process, consulting them about its delivery, and informing them about progress through engagement and open reporting. In line with this commitment, my Department publishes an Open Beds Report on its website each month, which provides the latest figures received from the HSE for the numbers of inpatient beds and day case beds/places.

According to provisional data provided by the HSE Acute Business Information Unit, there were an average of 10,961 inpatient beds and 2,247 day case beds/places available nationally between January and June 2019.

In relation to the particular data requested, I have asked the HSE to respond to the Deputy directly.

Home Care Packages Data

Ceisteanna (1933, 1934)

Alan Kelly

Ceist:

1933. Deputy Alan Kelly asked the Minister for Health the additional number of home help hours and home care packages, respectively, required to meet existing demand and ensure that sufficient support is provided in circumstances in which a need has been identified; the specific cost to carry this out; the waiting list for each by CHO; and if he will make a statement on the matter. [34371/19]

Amharc ar fhreagra

Alan Kelly

Ceist:

1934. Deputy Alan Kelly asked the Minister for Health the spend to date in 2019 on home help hours and home care packages by CHO in tabular form; the projected total end of year spend for 2019; the allocation of the breakdown by region; and if he will make a statement on the matter. [34372/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 1933 and 1934 together.

As these are service matters I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Hospital Beds Data

Ceisteanna (1935)

Alan Kelly

Ceist:

1935. Deputy Alan Kelly asked the Minister for Health the all-in cost of each ten additional step-down beds; if he will provide a breakdown of the costs; and if he will make a statement on the matter. [34373/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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 Reimbursement

Ceisteanna (1936)

Alan Kelly

Ceist:

1936. Deputy Alan Kelly asked the Minister for Health the new drugs and treatments that have been approved for use but for which funding has not been provided; the cost of funding each in tabular form; and if he will make a statement on the matter. [34374/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The 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.

Medicinal Products Data

Ceisteanna (1937)

Alan Kelly

Ceist:

1937. Deputy Alan Kelly asked the Minister for Health the number of new drugs approved for use in each year since 2016, in tabular form; if in each case the treatment is now funded; and if he will make a statement on the matter. [34375/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The 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.

Medicinal Products Reimbursement

Ceisteanna (1938)

Alan Kelly

Ceist:

1938. Deputy Alan Kelly asked the Minister for Health the additional funding provided in 2019 for new drugs and treatments; the additional number of orphan drugs and immunotherapies that have been funded; and if he will make a statement on the matter. [34376/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The HSE National Service Plan 2019 includes a provision of €10m for new drugs enabled by an “invest to save” programme.  In accordance with the National Service Plan, the HSE is committed to the introduction of cost reduction measures to create the financial headroom, for new drugs in 2019.   

To assist the HSE in creating this financial headroom, the National Service Plan 2019 includes a provision of €3m for the establishment of a HSE dedicated pharmaceutical value improvement programme, to bring about greater efficiencies in medicines management and to promote changes in prescribing behaviour in favour of more clinically efficient and cost-effective products in both community and hospital settings.

These new measures are expected to complement existing cost control initiatives which are being undertaken by the HSE under the auspices of the Medicines Management Programme. Among the initiatives already being pursued are improvement in practices for the procurement of drugs in hospitals and the designation of preferred products, with a focus on high cost prescribing areas.

In 2019 to date, the HSE has approved 26 new medicines and 5 new uses of existing medicines, 17 of these medicines are for rare diseases.

In spite of significant progress on drug costs achieved from reference pricing and the price reductions under the IPHA Agreement, the Health Service is still facing significant challenges in relation to the affordability of medicines – mainly related to the emergence of increasing numbers of very expensive products, particularly in the high-tech medicines area.

Vaccination Programme

Ceisteanna (1939)

Alan Kelly

Ceist:

1939. Deputy Alan Kelly asked the Minister for Health if the HPV vaccine will be provided to boys from September 2019; the cost of the roll-out; if sufficient public health nurses are available and have been hired for same; and if he will make a statement on the matter. [34377/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The National Immunisation Advisory Committee (NIAC) made a recommendation that the HPV vaccine should be given to boys.  On foot of NIAC’s recommendation, my Department asked the Health Information and Quality Authority (HIQA) to undertake a health technology assessment (HTA) in relation to extending the national immunisation schedule to include human papillomavirus (HPV) vaccination of boys.  HIQA completed the HTA in December 2018 and recommended that the HPV immunisation programme be extended to include boys.  A policy decision was made to extend the HPV immunisation programme to include boys and introduce a 9-valent HPV vaccine starting in September 2019.

In relation to the operational matters raised I have asked the HSE to reply directly to the Deputy.

General Practitioner Services Provision

Ceisteanna (1940)

Alan Kelly

Ceist:

1940. Deputy Alan Kelly asked the Minister for Health the projected full-year cost of the provision of free general practitioner care to children under 18 years of age; and if he will make a statement on the matter. [34378/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Programme for Government commits to extend in phases, and subject to negotiation with GPs, free GP care to all children under 18 years of age.

As a first step, it is intended to extend, on a phased basis starting in 2020, GP care without fees to all children aged between 6 and 12 years. Legislative changes will be required to give effect to this extension.  As part of the recent agreement reached on GP contractual reforms and service developments, the Irish Medical Organisation has agreed that it will engage with the Department of Health and the HSE in relation to the contractual aspects of this service in advance of implementation.

It is not possible at this time to give an estimate of the cost of extending GP care without fees to a further cohort of the population. The fees payable for this service will be determined by the Minister for Health, with the consent of the Minister for Public Expenditure and Reform, in line with the provisions of the Public Service Pay and Pensions Act 2017 and following consideration of the scope and content of the general practitioner service to be provided.

General Practitioner Contracts

Ceisteanna (1941)

Alan Kelly

Ceist:

1941. Deputy Alan Kelly asked the Minister for Health the projected additional cost in 2020 for the new general practitioner contract; the provision which was made in the 2019 Estimates for a new contract; the status of progress; and if he will make a statement on the matter. [34379/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Under the General Medical Services (GMS) contract, GPs are reimbursed for a range of services they provide to medical card and GP visit card holders. Agreement was reached in April 2019 on the provision of new services and on a wide-ranging set of modernisation and reform measures.

In return for cooperation with these service developments and reforms, expenditure on general practice services will increase by approximately 40% (or €210 million) over the period 2019-2023. This will involve phased increases in capitation fees for GPs who participate in the reform programme and the introduction of new fees and subsidies for additional services - primarily the chronic disease management programme.

The estimated additional expenditure in 2019 arising from the agreement is €27 million. Further additional expenditure of approximately €53 million has been estimated for 2020, €15 million of which pertains to the implementation of the chronic disease programme.

Ambulance Service Provision

Ceisteanna (1942)

Pat the Cope Gallagher

Ceist:

1942. Deputy Pat The Cope Gallagher asked the Minister for Health if progress has been made to date on the need for a second ambulance in south-west County Donegal; if his attention has been drawn to the shortcoming in the current coverage level with just one ambulance covering this region of the county; and if he will make a statement on the matter. [34380/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this is a service issue, I have asked the HSE to reply to you directly. 

Home Help Service Provision

Ceisteanna (1943, 1944, 1945)

Donnchadh Ó Laoghaire

Ceist:

1943. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the number of new applications for home help that were approved but not allocated due to financial constraints in the south and north Lee areas in County Cork in each of the past 12 months in tabular form. [34388/19]

Amharc ar fhreagra

Donnchadh Ó Laoghaire

Ceist:

1944. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the waiting list for home help in south Lee, Cork. [34389/19]

Amharc ar fhreagra

Donnchadh Ó Laoghaire

Ceist:

1945. Deputy Donnchadh Ó Laoghaire asked the Minister for Health if all home help organiser positions in south and north Lee have been filled; and if not, when they will be filled. [34390/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 1943, 1944 and 1945 together.

As these are service matters I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Hospital Staff Recruitment

Ceisteanna (1946)

Donnchadh Ó Laoghaire

Ceist:

1946. Deputy Donnchadh Ó Laoghaire asked the Minister for Health if a locum paediatric endocrinologist at CUH is now in place; the status of the recruitment of a full-time paediatric endocrinologist for CUH; and the status of the proposal to recruit an adult endocrinologist, a business case for which has been submitted to the HSE. [34391/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Child and Adolescent Mental Health Services Data

Ceisteanna (1947)

Donnchadh Ó Laoghaire

Ceist:

1947. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the waiting list for CAMHS in south and north Lee by three, six, nine, 12, 18 and 24 months. [34392/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Medical Conditions

Ceisteanna (1948)

Donnchadh Ó Laoghaire

Ceist:

1948. Deputy Donnchadh Ó Laoghaire asked the Minister for Health if his attention has been drawn to concerns on the part of those who suffer thyroid problems including but not limited to hyperthyroidism that the condition is misdiagnosed on occasion. [34393/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Hospital Waiting Lists Data

Ceisteanna (1949, 1950, 1956)

Donnchadh Ó Laoghaire

Ceist:

1949. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the waiting list for rheumatology in CUH and the Mercy hospital by three, six, nine, 12, 18 and 24 months. [34394/19]

Amharc ar fhreagra

Donnchadh Ó Laoghaire

Ceist:

1950. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the waiting list for neurology in CUH and the Mercy hospital by three, six, nine, 12, 18 and 24 months. [34395/19]

Amharc ar fhreagra

Donnchadh Ó Laoghaire

Ceist:

1956. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the waiting list for ophthalmology in Cork University Hospital and Mercy hospital by three, six, nine, 12, 18 and 24 months, respectively. [34401/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 1949, 1950 and 1956 together.

Reducing waiting time for patients for hospital operations and procedures is a key priority for Government. In this regard, the Government is committed to improving waiting times for hospital appointments and procedures.

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 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 treatment and outpatient appointments. The plan places a strong focus on ten high-volume Inpatient/Day Case procedures. 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 high-volume procedures.

At the end of July 2017, the number of people waiting for a cataract procedure was 10,024. Under the Inpatient Day Case Access Plan 2018, cataracts were one of the specialties targeted by the NTPF and by end December 2018, the number of patients waiting had fallen to 6,440, a reduction of 36%. The number of patients waiting for a cataract procedure at the end of June 2019 had further reduced to 5,739 with 454 patients waiting over 9 months. This represents a reduction of 3,917 or 90% when compared to July 2017, when there were 4,371 patients waiting over 9 months for a cataract operation.

A key element of the Plan is the stabilisation of the Outpatient Waiting List. Under the Plan the HSE, in line with the National Service Plan, will aim to deliver 3.3 million outpatient appointments, of which approximately 1 million will be first appointments. For its part the NTPF will aim to deliver 40,000 first Outpatient appointments.

The NTPF advise that over recent months they have placed a particular focus on engaging with hospital groups and individual hospitals to identify waiting list proposals. The NTPF welcomes proposals from all acute hospitals for initiatives to improve access for patients on waiting lists.

In addition, my Department is working with the HSE and NTPF, under the Access Plan, with the objective of developing medium-long term improvement initiatives for patient access to hospital procedures. This will include moving care to more appropriate settings and providing care at the lowest level of complexity.

The data requested by the Deputy is outlined in the attached document. This data is also publically available at https://www.ntpf.ie/home/nwld.htm.

Due to the small volume of patients waiting in certain specialty timebands, to preserve patient confidentiality, when amount of patients is <5, these have been included within broader timebands.

CUH IPDC Ophthalmology, Rheumatology & Neurology Waiting List

 0-3 Mths

 3-6 Mths

6-9 Mths

15-18 Mths

Grand Total

Ophthalmology

28

7

35

Neurology

15

15

Rheumatology

0

CUH Outpatient Ophthalmology, Rheumatology & Neurology Waiting List

 0-3Months

 3-6Months

 6-9Months

 9-12Months

12-15Months

15-18Months

18-21Months

21-24Months

24-36Months

36-48Months

Grand Total

Ophthalmology

1308

823

914

701

693

600

566

524

1569

140

7838

Neurology

628

311

218

158

5

1320

Rheumatology

361

278

195

150

174

116

114

98

146

0

1632

Mercy University Hospital IPDC Ophthalmology, Rheumatology & Neurology Waiting List

 0-3 Mths

 3-6 Mths

 6-9 Mths

 9-12 Mths

12-15 Mths

15-18 Mths

18-24 Mths

Grand Total

Ophthalmology

5

6

11

Neurology

4

4

Rheumatology

0

Mercy University Hospital Outpatient Ophthalmology, Rheumatology & Neurology Waiting List

 0-3Months

 3-6Months

 6-9Months

9-12    Months

15-18 Months

Grand Total

Ophthalmology

9

9

Neurology

8

16

28

12

64

Rheumatology

0

Hospital Waiting Lists Data

Question No. 1952 answered with Question No. 1529.

Ceisteanna (1951)

Donnchadh Ó Laoghaire

Ceist:

1951. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the waiting list for pain management in CUH and the Mercy hospital by three, six, nine, 12, 18 and 24 months. [34396/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Reducing waiting time for patients for hospital operations and procedures is a key priority for Government. In this regard, the Government is committed to improving waiting times for hospital appointments and procedures.

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 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 treatment and outpatient appointments. The plan places a strong focus on ten high-volume Inpatient/Day Case procedures. 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 high-volume procedures.

 A key element of the Plan is the stabilisation of the Outpatient Waiting List. Under the Plan the HSE, in line with the National Service Plan, will aim to deliver 3.3 million outpatient appointments, of which approximately 1 million will be first appointments. For its part the NTPF will aim to deliver 40,000 first Outpatient appointments.

The NTPF advise that over recent months they have placed a particular focus on engaging with hospital groups and individual hospitals to identify waiting list proposals. The NTPF welcomes proposals from all acute hospitals for initiatives to improve access for patients on waiting lists.

In addition, my Department is working with the HSE and NTPF, under the Access Plan, with the objective of developing medium-long term improvement initiatives for patient access to hospital procedures. This will include moving care to more appropriate settings and providing care at the lowest level of complexity.

The data requested by the Deputy is outlined in the document attached.

Due to the small volume of patients waiting in certain specialties, to preserve patient confidentiality, when the amount of patients is <5, these have been included within broader timebands.

IPDC Pain Relief Waiting List Mercy University Hospital

 0-3 Mths

 3-6 Mths

 6-9 Mths

 9-12 Mths

12-15 Mths

15-18 Mths

18-24 Mths

Grand Total

Mercy University Hospital

106

71

38

21

18

8

11

273

Outpatient Pain Relief Waiting List for Mercy University Hospital

 0-3Months

 3-6Months

 6-9Months

 9-12Months

12-15Months

15-18Months

18-21Months

21-24Months

24-36Months

36-48Months

Grand Total

Mercy University Hospital

132

128

97

94

75

63

45

58

154

846

*Please note that there are no IPDC or Outpatient waiting lists for Pain Relief at Cork University Hospital

Question No. 1952 answered with Question No. 1529.

Hospitals Data

Ceisteanna (1953)

Donnchadh Ó Laoghaire

Ceist:

1953. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the number of vacancies for consultants responsible for cancer services in CUH; the number under radiation oncology; and if plans exist to replace those consultants who have stepped down in the past three years. [34398/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Disabilities Assessments

Ceisteanna (1954)

Donnchadh Ó Laoghaire

Ceist:

1954. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the number of children awaiting an assessment of need in south Lee, Cork, by three, six, nine, 12, 18 and 24 months. [34399/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.