Climate Change Policy

Ceisteanna (182)

Robert Troy

Ceist:

182. Deputy Robert Troy asked the Minister for Business, Enterprise and Innovation the financial supports for businesses that will be introduced for actions targeted for the enterprise sector in the Climate Action Plan 2019. [28457/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Business)

My Department and its enterprise development agencies are committed to participating in emission reduction efforts and have a range of specific actions under the Climate Action Plan to support decarbonisation across a number of industry sectors. Enterprise Ireland and IDA Ireland have a range of supports available to client companies to aid enterprises in reducing CO2 emissions as set out below.

Enterprise Ireland

- The GreenStart programme is targeted towards SMEs to aid with regulatory compliance and the management of resources such as energy and water.

- The GreenPlus Assignment programme is targeted at developing high levels of environmental management capabilities within firms.

- Enterprise Ireland also has a directory of Green Service Providers which are qualified and available to undertake the assignments under the GreenStart programme.

IDA Ireland

- The Lean/Green offering encourages firms to implement the Lean business principles paired with good environmental management practices.

- The GoGreen suite is designed to achieve international environmental best practice standards. There are programmes within this suite including GreenStart, GreenPlus; and

- The Environmental Aid Programme facilitates enterprises to invest in energy efficiency schemes and capital investment, such as installing CHP (Combined Heat and Power) systems.

The Sustainable Energy Authority of Ireland (SEAI) also has a range of initiatives targeted at enterprises, including the “Lighting Support Scheme for SMEs” and the “Excellence in Energy Efficient Design”, or EXCEED programme, which incorporates energy efficiency into design projects and offers support funding for SMEs. The SEAI also offers Project Assistance Grants, which are to support the development of energy saving projects and facilitates companies to access Accelerated Capital Allowances, a tax incentive scheme aimed at promoting the investment in energy efficient products and equipment.

In order to stimulate collaboration and investment in new technologies to facilitate carbon abatement, my Department administers the Government’s Disruptive Technologies Innovation Fund, one of four funds in the National Development Plan 2018-2027. Applications to the fund align with the ‘Research Priority Areas’ which include “Energy, Climate Action and Sustainability: Decarbonising the Energy System and Sustainable Living”. The Disruptive Technologies Innovation Fund is open to decarbonisation solutions across the economy.

As per Action 36 of the Climate Action Plan 2019 my Department and its agencies will be driving the decarbonisation agenda across their client base. Our Enterprise agencies are regularly reviewing their environmental offering with a view to promoting environmental schemes to a larger cohort of client companies.

The Climate Action Plan includes a number of further proposals which will assist enterprises in decarbonising their operations, and thereby enhancing their resilience. These include a 'one-stop-shop' for the retrofitting of premises, promoting the wider use of Energy Performance Contracting and to enable the SEAI engage SMEs, expand the EXCEED program and work on a menu of actions to support decarbonisation in large industry.

I will continue to work with both the Minister for Communications, Climate Action and Environment on reaching the longer-term ambitions set out in the Plan, as well as the Enterprise Agencies to ensure that enterprises have access to supports that aid their abatement of CO2 emissions.

Pension Provisions

Ceisteanna (183)

Eugene Murphy

Ceist:

183. Deputy Eugene Murphy asked the Minister for Health the reason a person (details supplied) has not received the pension increments for 2019 as promised in line with the national wage agreement; and if he will make a statement on the matter. [40731/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

HSE Staff Remuneration

Ceisteanna (184)

Eugene Murphy

Ceist:

184. Deputy Eugene Murphy asked the Minister for Health the reason some former HSE staff have still not received their pension increments as promised in line with the national wage agreement for 2018 and 2019; and if he will make a statement on the matter. [40734/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Home Care Packages Provision

Ceisteanna (185)

Pearse Doherty

Ceist:

185. Deputy Pearse Doherty asked the Minister for Health when an approved home support package will be put in place for a person (details supplied) in County Donegal; and if he will make a statement on the matter. [40511/19]

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.

Cancer Screening Programmes

Ceisteanna (186)

Stephen Donnelly

Ceist:

186. Deputy Stephen Donnelly asked the Minister for Health if a person (details supplied) can retroactively gain access to the CervicalCheck audit by the Royal College of Obstetricians and Gynaecologists despite previously turning down the option to be part of the review; and if he will make a statement on the matter. [40512/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

An independent expert panel review of cervical screening was established with the aim of providing women who participated in the CervicalCheck national screening programme and who developed invasive cervical cancer with independent clinical assurance about the timing of their diagnosis and treatment.

The Independent Clinical Expert Review is being carried out by the Royal College of Obstetricians and Gynaecologists (RCOG) with expertise also sourced through the British Society for Colposcopy and Cervical Pathology. The review examined the screening history of women who consented to be included.

On 9 September the HSE sent a letter to all participants to provide an update on the review process and to advise when they may expect to receive their individual reports. Communication of results to participants has begun. The Royal college will produce an aggregate report which will make recommendations, where appropriate, with the aim of improving care for women. It is anticipated that this report will be received at the end of October.

As the review process is now in the final stage it will not be possible to participate at this stage.

Hospital Appointments Status

Ceisteanna (187)

Michael Healy-Rae

Ceist:

187. Deputy Michael Healy-Rae asked the Minister for Health when a person (details supplied) will be called for an appointment; and if he will make a statement on the matter. [40523/19]

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.

Medicinal Products Reimbursement

Ceisteanna (188, 189)

Michael McGrath

Ceist:

188. Deputy Michael McGrath asked the Minister for Health if the governance review of the drugs approval process as set out under Sláintecare work stream 2 has commenced; if so, the date on which it commenced; if not, the date on which it will commence; and if he will make a statement on the matter. [40528/19]

Amharc ar fhreagra

Michael McGrath

Ceist:

189. Deputy Michael McGrath asked the Minister for Health if there is a process for relevant stakeholders to feed into the drugs approval process review; if so, the nature of the process; and if he will make a statement on the matter. [40529/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 188 and 189 together.

Work on the review of the HSE reimbursement and pricing decision-making process is ongoing. The review, conducted by Mazars, is progressing and on completion my officials will consider its findings.

The agreement which was signed with Mazars, sets out the relevant stakeholders to be consulted, including patient representatives.

The review will make recommendations in respect of any required improvements to the HSE’s systems, structures, processes, governance arrangements or use of specialist resources.

Medicinal Products Availability

Ceisteanna (190)

Michael McGrath

Ceist:

190. Deputy Michael McGrath asked the Minister for Health his plans to take steps to increase the speed of access and improve the rate of availability of medicines here in view of the fact that Ireland ranks 19th out of 29 European countries for speed of access to new medicine and 16th for rate of availability of new medicines; and if he will make a statement on the matter. [40530/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

"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 a country, we invest heavily in medicines, to the tune of almost €2 billion annually. In 2019 to date, the HSE has approved 29 new medicines and 5 new indications for existing medicines for reimbursement in the public healthcare system.

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.

The legislative underpinning of the Health Act is backed up by the Framework Agreement on the Supply of Medicines 2016-2020 signed between the State and the Irish Pharmaceutical Healthcare Association (IPHA). It is expected to deliver approximately €600 million in savings from IPHA companies over the four-year lifetime of the Agreement and €150 million in savings from non-IPHA companies. This Agreement contains a number of measures intended to increase sustainable drug access and supply.

Notwithstanding the significant progress on drug costs achieved from price reductions under the IPHA Agreement and commercial negotiations conducted by the HSE, the Health Service is still facing very significant challenges in relation to the affordability of medicines. The industry continues to develop very expensive products, particularly in the high-tech medicines area and the costs involved are a challenge for health systems even in countries with much greater resources than Ireland. The Government wants new and innovative medicines to be available to our citizens as quickly as possible but this can only be achieved if medicines are priced by the pharmaceutical industry in a viable and sustainable manner.

My Department and the HSE are working on making greater efficiencies in medicines usage through a range of initiatives both domestically and internationally to ensure the greatest possible access to new treatments for patients in Ireland.

The HSE’s Medicines Management Programme (MMP), incorporating the Preferred Drugs initiative, is overseeing the implementation of a number of actions to bring about greater value for the taxpayer through cost-effective provision of medicines. Among the initiatives being pursed are improvements in practices for the procurement of drugs in hospitals and the designation of preferred products with a focus on high-cost prescribing areas, in particular optimising the use of biosimilars.

I and officials have also been engaging over the past number of years, with a number of voluntary EU forums. In June 2018, I signed the Beneluxa Initiative on Pharmaceutical Policy. This Agreement is in line with my objective to work with other European countries to identify workable solutions, in an increasingly challenging environment, to secure timely access for patients to new medicines in an affordable and sustainable way. In June 2019, Ireland became a Founding Member of the International Horizon Scanning Initiative which is being established as part of the work programme of Beneluxa.

Medicinal Products Expenditure

Ceisteanna (191)

Michael McGrath

Ceist:

191. Deputy Michael McGrath asked the Minister for Health the estimated spend on medicines in 2019, in tabular form. [40531/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The HSE National Service Plan net budget allocation for 2019 is €16,050m. The PCRS portion of the budget allocation is €2, 737.76m.

The full year budget for expenditure relating to medicines within the Primary Care Reimbursement Service in 2019 is detailed in the following table.

Primary Care Scheme

€ millions

GMS Drugs / Medicines

€836

High Tech Drugs / Medicines

€703

Long-Term Illness scheme

€241

Drug Payment Scheme

€70

Hospital/Homecare Setting arrangements

€117

Total Spend

€1,967

The above figures include the fees and charges incurred when prescribing medicines.

National Dementia Strategy

Ceisteanna (192)

John Curran

Ceist:

192. Deputy John Curran asked the Minister for Health if funding in the region of €18 million will be provided towards community supports and homecare for persons with dementia as identified by an organisation (details supplied) in its pre-budget submission; and if he will make a statement on the matter. [40533/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The implementation of the 2014 National Dementia Strategy is being led by the National Dementia Office in the HSE, which has made substantial progress in developing evidence-based care pathways for people with dementia. Actions are being implemented progressively as resources allow and Dormant Accounts funding is allowing a number of key projects to proceed. The HSE is working with key partners, including the Alzheimer Society of Ireland, to implement specific elements of the Strategy, including the Understand Together awareness campaign and the attendant community activation programme.

With regard to the specific pre-budget submission referred to by the Deputy, the level of funding available for the Department of Health in 2020 and the quantum of services to be provided by the HSE will be considered as part of the national Estimates and budgetary process and National Service Planning.

Home Care Packages Data

Ceisteanna (193)

Michael McGrath

Ceist:

193. Deputy Michael McGrath asked the Minister for Health the number of private firms providing homecare services nationwide; the position in relation to the regulation of these firms; the number that are regulated; the number of regulated and unregulated firms being paid for service provision by the HSE; and if he will make a statement on the matter. [40537/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Department of Health is currently engaged in the development of a new statutory scheme and system of regulation for home-support services. The introduction of a system of regulation will ensure that all service-users receive high-quality care and that the public have confidence in the services provided. The options for regulation are currently being explored.

I have asked the HSE to provide the operational information requested by the Deputy.

Paediatric Services

Ceisteanna (194)

Michael McGrath

Ceist:

194. Deputy Michael McGrath asked the Minister for Health the start date for the new endocrinologist for the paediatric diabetes service in Cork University Hospital; and if he will make a statement on the matter. [40538/19]

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.

Diabetes Strategy

Ceisteanna (195)

Michael McGrath

Ceist:

195. Deputy Michael McGrath asked the Minister for Health the management plans in place to help almost 100 teenagers transition into adult diabetes services at Cork University Hospital; and if he will make a statement on the matter. [40539/19]

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.

Services for People with Disabilities

Ceisteanna (196)

Michael Healy-Rae

Ceist:

196. Deputy Michael Healy-Rae asked the Minister for Health the status of full-time residential care for a person (details supplied); and if he will make a statement on the matter. [40541/19]

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 a service issue, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Medicinal Products Expenditure

Ceisteanna (197)

Mary Butler

Ceist:

197. Deputy Mary Butler asked the Minister for Health the annual cost of prescription diabetes medications as a percentage of the annual cost of prescription medications, including the blood testing strips to the HSE in each of the past three years and to date in 2019; and if he will make a statement on the matter. [40548/19]

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.

Medical Aids and Appliances Provision

Ceisteanna (198)

Michael Healy-Rae

Ceist:

198. Deputy Michael Healy-Rae asked the Minister for Health when a person (details supplied) will be fitted with a pain pump permanently; and if he will make a statement on the matter. [40557/19]

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.

Health Services Staff

Ceisteanna (199)

Niall Collins

Ceist:

199. Deputy Niall Collins asked the Minister for Health if an issue raised in correspondence by a person (details supplied) will be addressed; and if he will make a statement on the matter. [40566/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I am advised by the HSE that while there is no national recruitment embargo or moratorium, there is a priority requirement for all HSE services to maintain, or get to, an affordable staffing level that is sustainable in 2019 and 2020, while also prioritising the delivery of safe services.

In light of this, the HSE advise that they have introduced control measures relating to staffing and recruitment (including the return of employees on career breaks) to ensure that they live within the available resources provided to them. This does mean that in some Hospital Groups and Community Healthcare Organisations non-critical replacement posts will be paused. The preference is for these controls to remain in place for as short a period as necessary, with on-going review until there is satisfactory evidence of traction and delivery of balanced financial plans from Hospital Groups and CHO’s.

The HSE report that there is on-going capacity for recruitment of newly funded posts and replacement of critical clinical posts within frontline services throughout this period.

With regard to this specific employee, I have asked the HSE to respond to the Deputy directly.

Disability Support Services Provision

Ceisteanna (200)

Michael McGrath

Ceist:

200. Deputy Michael McGrath asked the Minister for Health further to Parliamentary Question No. 1262 of 6 September 2019, if the requested information will be provided to the parent who has been unable to obtain a reply from the service provider; and if he will make a statement on the matter. [40573/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As the Deputy's question relates to a service issue it has been referred to the HSE for direct reply.

Ministerial Meetings

Ceisteanna (201)

Louise O'Reilly

Ceist:

201. Deputy Louise O'Reilly asked the Minister for Health further to Parliamentary Question No. 460 of 2 July 2019, if he will meet the families that have been impacted by the misreading of scans at University Hospital Kerry in view of his commitment at the Oireachtas Joint Committee on Health on 22 May 2019; and if he will make a statement on the matter. [40584/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

My Department and I have sought to be kept regularly informed regarding the Radiology Lookback Review which took place at University Hospital Kerry in 2017/2018. The report of this review was completed and published in December 2018. It found eleven case of delayed diagnosis.

My officials last met with the South/South West Hospital Group in May 2019 to discuss the look-back review, the status of implementation of the recommendations made in the report of the review and ongoing communications with the families. I was subsequently briefed on this on 14 May.

My Department has been assured by the HSE and the South/South West Hospital Group that implementation of the report's recommendations are underway and are receiving the priority they require.

I wish to once again express heartfelt sympathies to the patients and their families. My absolute priority remains ensuring their confidentiality is respected. On an ongoing basis, my officials have been assured by the South/South West Hospital Group that all affected patients have received or are receiving the care they need. I accept that this has been distressing time for those involved.

I remain committed to meeting with any of the affected families, identified by the review, that may wish to share their experience with me.

Assisted Human Reproduction Services Provision

Ceisteanna (202, 203, 225)

Bríd Smith

Ceist:

202. Deputy Bríd Smith asked the Minister for Health if additional funding to help subsidise IVF treatment for couples will be provided in 2019; and if he will make a statement on the matter. [40585/19]

Amharc ar fhreagra

Bríd Smith

Ceist:

203. Deputy Bríd Smith asked the Minister for Health the reason promised funding to help subsidise IVF treatment has not been delivered to date in 2019; his plans to provide enhanced care and aid to persons seeking the treatment; and if he will make a statement on the matter. [40586/19]

Amharc ar fhreagra

John Brassil

Ceist:

225. Deputy John Brassil asked the Minister for Health the status of the €1 million special fund announced for in-vitro fertilisation treatment for couples unable to conceive; when the fund will be made available; and if he will make a statement on the matter. [40657/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 202, 203 and 225 together.

In parallel with the ongoing drafting of assisted human reproduction (AHR) legislation, officials in my Department, in conjunction with the HSE, have been developing a model of care for infertility, which incorporates a public funding element. This work has also included examining proposals for the allocation of the relevant €1 million.

Accordingly, options in relation to the parameters of any potential public funding model, including what access and eligibility criteria may be included, are still under consideration, and I expect to be in a position to make an announcement in the coming weeks.

It should be noted that while AHR treatment is not currently funded by the Irish Public Health Service, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Arrangements administered by the HSE. Medicines covered by the High Tech Arrangements must be prescribed by a consultant/specialist and authorised for supply to the client’s nominated community pharmacy by the High Tech Hub managed by the Primary Care Reimbursement Service. The cost of the medicines is then covered, as appropriate, under the client’s eligibility, i.e., Medical Card or Drugs Payment Scheme.

I understand that the impact on the total cost of AHR treatment for individuals who avail of these schemes is not insignificant.

In addition, there is other support available in that patients who access IVF treatment privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme.

Overall, the development of a model of care will help to ensure the provision of safe, effective and accessible infertility services at all levels of the public health system as part of the full range of services available in obstetrics and gynaecology.

Commencement of Legislation

Ceisteanna (204)

Louise O'Reilly

Ceist:

204. Deputy Louise O'Reilly asked the Minister for Health the causes of the delay in the commencement of Parts 2 and 3 of the Children and Family Relationships Act 2015 until May 2020; if he will consider an earlier commencement; and if he will make a statement on the matter. [40593/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The commencement date of the 5th of May 2020 for Parts 2&3 of the Children and Family Relationships Act 2015 allows time for individuals or couples to use donor gametes that they have already purchased and stored but are not compliant with Parts 2&3 of the Act. In addition, it was considered necessary to allow time for a sufficient pool of donors with the requisite consent detailed in the Act to accrue.

Health Strategies

Ceisteanna (205)

Louise O'Reilly

Ceist:

205. Deputy Louise O'Reilly asked the Minister for Health the status of the rollout of the PrEP programme by the HSE; and if he will make a statement on the matter. [40594/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Sexual health is a key priority, both for me and for this Government as a whole, and reducing the number of new HIV diagnoses is a priority focus under the National Sexual Health Strategy. The Health Information and Quality Authority Health Technology Assessment report on PrEP was published in June, which found that the introduction of a PrEP HIV prevention programme would be safe, effective and cost saving.

Considerable work has been done to prepare for the introduction of a PrEP programme shortly, and plans are currently being finalised. An announcement with regard to a prospective start date is imminent. It is intended to roll out an awareness campaign on PrEP, once the programme is ready to commence.

Assisted Human Reproduction Legislation

Ceisteanna (206)

Louise O'Reilly

Ceist:

206. Deputy Louise O'Reilly asked the Minister for Health the status of the assisted human reproduction Bill; his plans to bring the legislation before the Houses of the Oireachtas in 2019; and if he will make a statement on the matter. [40595/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

In October 2017, the Government approved the drafting of a bill on assisted human reproduction (AHR) and associated areas of research, based on the published General Scheme of the Assisted Human Reproduction Bill.

The Joint Oireachtas Committee on Health published the report of its review of the General Scheme on 11 July 2019, as part of the pre-legislative scrutiny process, which began in January 2018. The Committee makes 11 main recommendations, which include proposals both related to broad policy objectives and more technical amendments.

Given the comprehensive scope of the legislation and the ethical, legal and social issues which arise from AHR practices, it is anticipated that certain areas of the General Scheme will require further consideration and refinement during the ongoing process of drafting the bill in conjunction with the Office of the Attorney General. The Joint Committee’s Report and its recommendations will be considered as part of this process.

The aim of the AHR legislation is to promote and ensure the health and safety of parents, others involved in the process (such as donors and surrogate mothers) and, most importantly, the children who will be born as a result of AHR. Consideration of the welfare and best interests of children born through AHR is a key principle underpinning the legislation.