Capital Expenditure Programme

Ceisteanna (305)

Michael McGrath

Ceist:

305. Deputy Michael McGrath asked the Minister for Business, Enterprise and Innovation the final agreed tender price, the date of the tender for the contract and the final overall amount paid and the date of the final payment in respect of each capital expenditure project completed since 1 January 2014 by her Department or an agency under the remit of her Department and which ended up costing €10 million or more in tabular form; the reason the final amount paid exceeded the final tender price; the details available in respect of projects in which construction is not complete to date or in which the final settlement account has not been agreed to date; and if she will make a statement on the matter. [39917/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Business)

I would advise the Deputy that capital expenditure by my Department is mainly by way of grants to support the multi-annual capital investment programmes of our Enterprise Development and Innovation Agencies and as such does not involve capital projects requiring tendering etc. In terms of my Department’s Agencies, I have asked my officials to contact the relevant Agencies concerned in relation to the information sought by the Deputy and I will contact the Deputy in relation to the information received in due course.

HSE Staff Remuneration

Ceisteanna (306)

Jack Chambers

Ceist:

306. Deputy Jack Chambers asked the Minister for Health the status of pay restoration for grade 3 and clerical officer that was agreed in March of this year (details supplied) but has not been implemented to date in the HSE; and if he will make a statement on the matter. [39742/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I have asked the HSE to respond directly to the Deputy on this matter.

Nursing Homes Support Scheme Administration

Ceisteanna (307)

Michael Healy-Rae

Ceist:

307. Deputy Michael Healy-Rae asked the Minister for Health if he will address a matter (details supplied) regarding the fair deal scheme; and if he will make a statement on the matter. [39803/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The proposed policy change to the Nursing Homes Support Scheme (NHSS), to cap contributions based on farm and business assets at 3 years where a family successor commits to working the productive asset, has been approved by Government. My Department developed draft Heads of Bill while considering a number of complex ancillary policy and operational matters which may need to be addressed in the proposed legislation. 

It is intended that this proposed policy change, the 3 year cap, will be extended to eligible existing participants in long term residential care so that they are not disadvantaged, but that there would be no retrospective recoupment of contributions for those who have paid contributions over and above the 3 year period. 

The General Scheme of Bill for the NHSS was approved by Government on the 11 June 2019 and subsequently published. The changes to the Scheme will come into effect as soon as the legislative process is successfully complete. I intend to progress this as quickly as possible, however, the timeline for completion of the legislation will also depend on how it passes through the Houses. The General Scheme has been sent to the relevant Joint Committee and I look forward to participating in pre-legislative scrutiny when a date is agreed with the Committee.

General Practitioner Services

Ceisteanna (308)

Martin Heydon

Ceist:

308. Deputy Martin Heydon asked the Minister for Health if consideration will be given to extending the general practitioner visit card to include carers that are in receipt of the carer's support grant; and if he will make a statement on the matter. [39972/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Since 1 September 2018 all those in receipt of either a full or half-rate Carer's Allowance or Carer's Benefit are automatically eligible for a GP service free of charge.

There are currently no plans to extend GP Visit Cards to persons specifically in receipt of a Carer's Support Grant (formerly known as the Respite Care Grant). However it is noted that many persons in receipt of this Grant will qualify for a GP visit card as the Carer's Support Grant is paid automatically to persons in receipt of Carer's Allowance or Carer's Benefit.

Medicinal Products Reimbursement

Ceisteanna (309)

Micheál Martin

Ceist:

309. Deputy Micheál Martin asked the Minister for Health the average waiting times for approval for new drugs; the way in which this compares to other OECD or EU countries; and if he will make a statement on the matter. [39267/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

My Department does not collate data on the average time taken for new medicines to become available in Ireland compared to other EU or OECD countries.

"League tables" comparing speed of reimbursement in Ireland with other countries are often misleading since several countries have quite different and often less rigorous statutory assessment arrangements than Ireland. Furthermore, many of the newer products being licensed are falling well short of cost-effectiveness thresholds, with limited clinical benefits.

As the Deputy is aware, the Oireachtas put in place a robust legal framework, in the Health (Pricing and Supply of Medical Goods) Act 2013, to give full statutory powers to the HSE to assess and make decisions on reimbursement of medicines, taking account of a range of objective factors and expert opinion as appropriate. These include the clinical and cost effectiveness of the product, the opportunity cost, the potential or actual budget impact, and the impact on resources that are available to the HSE.

In line with the 2013 Act, if a company would like a medicine to be reimbursed by the HSE pursuant to the Community Drugs scheme, the company must first submit an application to the HSE to have the new medicine added to the Reimbursement List.

As outlined in the IPHA agreement, and in line with the 2013 Act, the HSE will decide, within 180 days of receiving the application (or a longer period if further information is sought from the company), to either add the medicine to the reimbursement list or agree to reimburse it as a hospital medicine, or refuse to reimburse the medicine.

HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, 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 is cost-effective as a health intervention.

The process for assessing applications works very well where the new medicines have strong evidence of clinical effectiveness and are priced in a cost-effective manner.  Delays in reimbursement decisions for new products do occur in cases where the evidence of clinical effectiveness is weak, and where prices are set well outside of cost effectiveness parameters.

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

In 2019 to date, the HSE has approved 29 new medicines and 5 new uses of existing medicines representing a significant investment by the HSE to provide access to new and innovative treatment for Irish patients.  It is expected that over 3,000 patients will benefit from access to these new medicines over the next five years. 

Hospital Waiting Lists

Ceisteanna (310)

Richard Boyd Barrett

Ceist:

310. Deputy Richard Boyd Barrett asked the Minister for Health when a person (details supplied) will be called for a hospital appointment; the number of persons ahead of them on the list; his plans to invest in the service to improve the waiting times; and if he will make a statement on the matter. [39286/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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. 

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 access for patients waiting for scheduled care this year.  

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

HSE Reviews

Ceisteanna (311)

Brendan Howlin

Ceist:

311. Deputy Brendan Howlin asked the Minister for Health the weighting percentages to be used as part of the upcoming HSE FreeStyle Libre review decision making process that will be given to criteria (details supplied); and if he will make a statement on the matter. [39291/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Under 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.

Medicinal Products Reimbursement

Ceisteanna (312)

Brendan Howlin

Ceist:

312. Deputy Brendan Howlin asked the Minister for Health if the reimbursement dataset will cover only current HSE funded users of FreeStyle Libre or if the health technology assessment review will simply compare total blood glucose strip usage spend year on year; and if he will make a statement on the matter. [39292/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Under 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.

Treatment Benefit Scheme Applications

Ceisteanna (313)

Kathleen Funchion

Ceist:

313. Deputy Kathleen Funchion asked the Minister for Health the reason for the delay in authorising the treatment abroad scheme for a person (details supplied); and if he will make a statement on the matter. [39294/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Cancer Screening Programmes

Ceisteanna (314)

Mary Butler

Ceist:

314. Deputy Mary Butler asked the Minister for Health his plans to incrementally reduce the age limit for a cervical screening test which is currently available to women aged 25 years and over; and if he will make a statement on the matter. [39295/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As the Deputy will be aware, CervicalCheck, the National Cervical Screening Programme, was introduced in 2008 and offers free smear tests to women aged 25-60.

Women under the age of 25 are not invited for screening. The HSE advises that this is because there is no evidence that screening would be of any benefit to them. At this stage in life, normal cell changes in the cervix can look very like abnormal cells. If CervicalCheck tested women under 25, changes that are normal might be treated as abnormal and a woman could be sent for treatment when they don't need it. Invasive cervical cancer is also very rare at this age. The HSE advises any woman under 25 who is worried about their risk of developing cervical cancer to speak to their GP. 

This approach is in line with screening programmes in other countries. The UK National Screening Committee recommended in November 2012 that the age of first invitation for cervical screening should be raised to 25 in Wales and Scotland on the basis that there is evidence of a large number of women screened and treated with relatively little benefit below this age.

Cancer screening is one important aspect of cancer prevention, and another is vaccination. The HPV vaccine protects against the HPV virus which can cause cancer and genital warts in both women and men, and has been offered to girls in their first year of secondary school since 2010. The Deputy may wish to know that, following a positive recommendation from HIQA, that an extension of the HPV vaccination programme to boys would be both clinically and cost effective, as of September this year HPV vaccination is now available to boys in first year of secondary school also.

Services for People with Disabilities

Ceisteanna (315)

Michael McGrath

Ceist:

315. Deputy Michael McGrath asked the Minister for Health the number of children awaiting an assessment of needs in the CH0 4 area; the length of time they are waiting; the details of the assessment of needs process; if it is desktop based; if not, if the child is actually seen; and if he will make a statement on the matter. [39298/19]

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.

Autism Support Services

Ceisteanna (316)

Michael McGrath

Ceist:

316. Deputy Michael McGrath asked the Minister for Health the number of children awaiting an ASD assessment as opposed to an assessment of needs in the CH0 4 area; the length of time they are waiting; and if he will make a statement on the matter. [39299/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Home Care Packages Provision

Ceisteanna (317)

Pearse Doherty

Ceist:

317. Deputy Pearse Doherty asked the Minister for Health the reason for the delays in securing approved homecare services for a person (details supplied) in County Donegal; if supports will commence and be made available to the person; and if he will make a statement on the matter. [39301/19]

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.

Rehabilitative Training Allowance Payments

Ceisteanna (318)

James Browne

Ceist:

318. Deputy James Browne asked the Minister for Health if the training allowance payment to disability allowance recipients will be reinstated; and if he will make a statement on the matter. [38313/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

This 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.  The 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. 

The payment of the Rehabilitative Training (RT) Bonus came into place on the transition of Rehabilitative / Training Programmes to the HSE following the dissolution of the National Rehabilitation Board in June 2000.

The decision to phase out the Rehabilitative Training (RT) Bonus payment is designed to bring equity and consistency between people with a disability attending HSE funded rehabilitative training programmes who receive the payment, and those attending similar HSE funded Day Services or in other State schemes such as further education and training, who do not.  

This action will ensure all HSE funded Day Services are provided on an equitable basis and will also ensure that the use of finite resources is maximised. 

The Rehabilitative Training (RT) Bonus Payment is a historical payment, introduced in July 2001, aligned with a similar FÁS Training Bonus. However, during 2011 the FÁS Training Bonus was reduced to €20.00 and then eliminated the following year while to date the RT Bonus Payment has continued to be paid in the Health Sector  

It is worth remembering that:

There is no cut in the number of RT places available

There is no cut in payment of the bonus - those who have it will continue to receive it for the remainder of their RT Placement

All participants continue to be eligible for Disability Allowance of €203 per week

All participants continue to be eligible for a free travel pass

No expectation of an additional RT bonus payment has been created by HSE for 2019 participants

The redirected funding (€3.7 m over 4 years), which will be ring-fenced, will facilitate 148 full day placements or 370 enhanced day places nationally based on priority need.

Each CHO will have the flexibility to redirect its own savings to address local service requirements. The HSE will put in place a monitoring system and regularly report the additional placements realised to the Department of Health.

Health and Social Care Professionals Regulation

Ceisteanna (319)

John Brassil

Ceist:

319. Deputy John Brassil asked the Minister for Health the provisions made to streamline the registration of doctors from the UK, the Netherlands, South Africa, Australia and New Zealand with the national doctors training programme and the Irish Naturalisation and Immigration Service; and if he will make a statement on the matter. [39311/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Medical Council is the body responsible for the regulation of registered medical practitioners in Ireland under the Medical Practitioners Act 2007 (the Act).   It has a statutory role in protecting the public by promoting the highest professional standards among medical practitioners practising in the State, and is responsible for setting the standards of medical education and training in Ireland. 

Section 7 of the Act sets out the functions of the Medical Council, one of which is to establish procedures and criteria for registration including the issue of certificates of registration and renewal of registration. The Council considers applications for registration in accordance with the provisions of the MPA and EU Directive 2005/36/EC (as amended). Under the provisions of the Act, eligibility for registration is based on the applicant's medical credentials rather than their citizenship.  As the Council is the body responsible for determining registration, I have forwarded the Deputy's question to the Council for consideration and direct reply.

Requirements regarding residency are primarily a matter for the Irish Naturalisation and Immigration Service.

Hospital Waiting Lists

Ceisteanna (320)

Mary Butler

Ceist:

320. Deputy Mary Butler asked the Minister for Health when a person (details supplied) will be called for a CT scan at University Hospital Waterford; and if he will make a statement on the matter. [39314/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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.

Cross-Border Health Initiatives

Ceisteanna (321)

Stephen Donnelly

Ceist:

321. Deputy Stephen Donnelly asked the Minister for Health the number of persons availing of the cross-Border directive in each year since its inception; the cost of reimbursements for same in each year since its inception; the number of claims awaiting reimbursement as of 1 September 2019; the estimated cost in 2019; and if he will make a statement on the matter. [39320/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Hospital Appointments Status

Ceisteanna (322)

Peter Burke

Ceist:

322. Deputy Peter Burke asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [39322/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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 (323)

Charlie McConalogue

Ceist:

323. Deputy Charlie McConalogue asked the Minister for Health the status of works at a community hospital (details supplied); and if he will make a statement on the matter. [39323/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As the Health Service Executive is responsible for the delivery of healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.

Nursing Homes Support Scheme Administration

Ceisteanna (324)

Peter Burke

Ceist:

324. Deputy Peter Burke asked the Minister for Health the status of the publication of the review of pricing system for long-term residential care facilities; and if he will make a statement on the matter. [39325/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Nursing Homes Support Scheme (NHSS), 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. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.

The Report of the NHSS Review published in 2015 identified a number of issues for more detailed consideration, including a review of the pricing mechanism used by the NTPF, with a view to:

- Ensuring value for money and economy,  with the lowest possible administrative costs for clients and  the State and administrative burden for providers;

- Increasing the transparency of the pricing mechanism  so that existing and potential investors can  make as informed decisions as possible; and

- Ensuring that  there is adequate residential capacity for those residents with more complex needs.

A Steering Group was established to oversee and manage the pricing review. The Steering Group is chaired by the NTPF and includes representatives from the Department of Health and the Department of Public Expenditure and Reform. As part of its work on the review the NTPF sought various inputs including external expertise and stakeholder engagement to inform the review. These inputs were considered in detail. It is recognised that any change to any part of the Scheme must be considered in terms of the short- and long-term impact on the viability of the Scheme and accessibility of long-term residential care in general. It is therefore important that the relevant issues are considered thoroughly. 

The NTPF has now completed its report and the Steering Group has completed its consideration of it, the report was recently submitted by the NTPF to the Department. It is now being reviewed by Department officials and any recommendations included in the report will be appraised before publication.