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Tuesday, 8 Oct 2019

Written Answers Nos. 282-306

Ambulance Service Response Times

Ceisteanna (282, 283, 284)

Louise O'Reilly

Ceist:

282. Deputy Louise O'Reilly asked the Minister for Health further to Parliamentary Questions Nos. 463 to 466 of 2 July 2019, if a matter of hours would ensure that a baby would get the critical therapeutic hypothermia care the baby needs for the treatment to be effective (details supplied). [40950/19]

Amharc ar fhreagra

Louise O'Reilly

Ceist:

283. Deputy Louise O'Reilly asked the Minister for Health further to Parliamentary Questions Nos. 463 to 466 of 2 July 2019, his views on the stated response time of a matter of hours in view of the finding in a document (details supplied). [40951/19]

Amharc ar fhreagra

Louise O'Reilly

Ceist:

284. Deputy Louise O'Reilly asked the Minister for Health further to Parliamentary Questions Nos. 463 to 466 of 2 July 2019, his views on whether time is a huge factor for treatment and whether medical outcomes would improve if an ambulance from a more local depot was dispatched to carry out the transfer (details supplied). [40952/19]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 282 to 284, inclusive, together.

The National Neonatal Transport Programme operates within the Critical Care Retrieval Service which is part of the National Ambulance Service.

As the queries raised by the Deputy relate to a service matter, I have asked the HSE to reply to the Deputy directly.

Question No. 285 answered with Question No. 281.

Psychological Services

Ceisteanna (286)

Catherine Murphy

Ceist:

286. Deputy Catherine Murphy asked the Minister for Health the plans in place for psychiatry staffing services in Kilcock health centre to provide counselling services to young persons based in Kilcock, Maynooth and Leixlip who require psychological assistance (details supplied); and if he will make a statement on the matter. [40954/19]

Amharc ar fhreagra

Freagraí scríofa

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

Psychological Services

Ceisteanna (287)

Catherine Murphy

Ceist:

287. Deputy Catherine Murphy asked the Minister for Health the number of young persons and teenagers awaiting psychologist intervention services in the County Kildare area; the wait time for each district; the number of staff providing services in tabular form; and if he will make a statement on the matter. [40955/19]

Amharc ar fhreagra

Freagraí scríofa

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

Child and Adolescent Mental Health Services Provision

Ceisteanna (288)

Catherine Murphy

Ceist:

288. Deputy Catherine Murphy asked the Minister for Health if he will undertake an urgent review of the allocation of mental health services to young persons; the areas in which gaps in provision of services exist by county in tabular form; and if he will make a statement on the matter. [40956/19]

Amharc ar fhreagra

Freagraí scríofa

The allocation of mental health services, including those for young persons, is agreed in the context of the HSE annual Service Plans, following the annual Estimates process. The Department of Health, in conjunction with the HSE, regularly monitors delivery of the HSE Service Plan each year. The overall aim of developing mental health services for young people, including new e-mental health initiatives now underway, is to achieve the best possible outcomes in terms of access and treatment nationally. This matter has also been given detailed consideration in the context of the update of the policy A Vision for Change, which will be launched in the near future. In the circumstances, it is not considered that any separate review is required on the issue raised by the Deputy. I have referred this question to the HSE for direct reply to the Deputy in respect of the information sought at local level.

Question No. 289 answered with Question No. 273.

Home Help Service Data

Ceisteanna (290)

Pat Casey

Ceist:

290. Deputy Pat Casey asked the Minister for Health the number of persons in County Wicklow on waiting lists for home support hours. [40988/19]

Amharc ar fhreagra

Freagraí scríofa

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

Disability Services Provision

Ceisteanna (291)

Kevin O'Keeffe

Ceist:

291. Deputy Kevin O'Keeffe asked the Minister for Health if an appointment for a person (details supplied) in County Cork will be expedited. [40990/19]

Amharc ar fhreagra

Freagraí scríofa

As 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.

Medical Card Eligibility

Ceisteanna (292)

Brendan Griffin

Ceist:

292. Deputy Brendan Griffin asked the Minister for Health his views on a matter (details supplied) regarding medical cards for cancer patients; and if he will make a statement on the matter. [40991/19]

Amharc ar fhreagra

Freagraí scríofa

As the Deputy is aware, the HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards on the basis of illness and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. The Expert Group also concluded that a person’s means should remain the main qualifier for a medical card. This position remains unchanged.

Nevertheless, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness.

Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting documentation to fully take account of all the relevant circumstances that may benefit them in the assessment including medical evidence of cost and necessary expenses.

While it is none the less important to note that eligibility for a medical card remains primarily on the basis of financial assessment, I do recognise that patients require a responsive and efficient health system to meet their medical needs, which may often be required urgently. With regard to persons suffering from cancer and other serious medical conditions the HSE also has a system in place for the provision of medical cards in response to emergency situations i.e. in circumstances where persons are in need of urgent or on-going medical care that they cannot afford and also for persons in palliative care who are terminally ill. These medical cards are promptly issued on receipt of an application, which includes a medical report, from a health care professional involved in the person’s care.

With the exception of terminally ill patients, all medical cards, granted on an emergency basis, are valid for six months with a means test required before the end of this period for the person and their family, where applicable. Emergency medical cards granted in cases of terminal illness are not means tested or subject to review.

I would also like to note that since 1 July 2015, the HSE adopted the position that all children under 18 years of age with a diagnosis of cancer are awarded a medical card. This card is valid for a period of 5 years.

Nursing Homes Support Scheme Applications

Ceisteanna (293)

Dara Calleary

Ceist:

293. Deputy Dara Calleary asked the Minister for Health the status of the nursing homes support scheme and national placement list for a person (details supplied). [40992/19]

Amharc ar fhreagra

Freagraí scríofa

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

Hospital Waiting Lists

Ceisteanna (294)

Sean Fleming

Ceist:

294. Deputy Sean Fleming asked the Minister for Health when a person (details supplied) will be admitted to hospital; and if he will make a statement on the matter. [41001/19]

Amharc ar fhreagra

Freagraí scríofa

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

Drug Treatment Programmes

Ceisteanna (295)

Louise O'Reilly

Ceist:

295. Deputy Louise O'Reilly asked the Minister for Health if he will consider opening a drug treatment centre in north County Dublin in view of the increased population of the area and an increase in the number of persons seeking help for drug addiction. [41013/19]

Amharc ar fhreagra

Freagraí scríofa

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

Primary Care Centres Provision

Ceisteanna (296)

John Curran

Ceist:

296. Deputy John Curran asked the Minister for Health the status of the development of a primary care centre in Lucan, County Dublin; and if he will make a statement on the matter. [41014/19]

Amharc ar fhreagra

Freagraí scríofa

As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

Vaccination Programme

Ceisteanna (297)

John Curran

Ceist:

297. Deputy John Curran asked the Minister for Health his plans to review the decision not to provide a catch-up programme for the HPV free vaccine for boys; and if he will make a statement on the matter. [41015/19]

Amharc ar fhreagra

Freagraí scríofa

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) to establish the clinical and cost-effectiveness of extending the current immunisation programme, which offers HPV vaccination to all girls in their first year of second level education (generally 12 to 13 year olds), to a programme that also offers the vaccination to boys in their first year of secondary school.

HIQA completed the HTA in December 2018, recommending that the HPV immunisation programme be extended to include boys. A policy decision was made to extend the HPV immunisation programme to include boys starting in September 2019 with the introduction of a 9-valent HPV vaccine. However, the HIQA report published in December 2018 did not recommend an HPV catch-up programme for older boys for several reasons:

- Vaccinating boys in the first year of secondary school provides the best possible protection against HPV infection;

- Boys are already benefitting from the indirect herd protection provided by the girls' HPV vaccination programme which started in 2010.

The ages at which vaccines are recommended in the immunisation schedule are chosen by NIAC in order to give each child the best possible protection against vaccine preventable diseases. As the HPV vaccine is preventative it is intended to be administered, if possible, before a person becomes sexually active, that is, before a person is first exposed to HPV infection. Therefore, the gender neutral HPV vaccination programme targets all girls and boys in first year of secondary school to provide maximum coverage. All vaccines administered through the School Immunisation Programme are provided free of charge.

Extending the HPV vaccine to boys will also provide direct protection to boys against HPV-related disease. It also provides indirect herd protection to girls who have not been vaccinated. Another important factor includes the additional protection provided by a gender neutral programme to vulnerable groups (for example, men who have sex with men) and the potential to improve the resilience of the immunisation programme to fluctuations in vaccine uptake and to the movement of individuals into and out of the country.

For older children who did not receive the vaccine as part of the School Immunisation Programme the HPV vaccine can only be obtained privately from a GP. If your child is 15 years of age or older they will require three doses of the HPV vaccine in order to be fully protected. Those who have a medical card are eligible to have the vaccine administered free of charge by their GP. However, the cost of purchasing the vaccine privately is not covered by the medical card.

My Department will continue to be guided by NIAC's recommendations on any emerging evidence on this issue in the future.

Drug Treatment Programmes Data

Ceisteanna (298)

John Curran

Ceist:

298. Deputy John Curran asked the Minister for Health the number of persons by county who received drug treatment; the types of treatments received, that is, detox, residential rehabilitation, methadone, counselling and so on in each of the years 2010 to 2018 and to date in 2019, in tabular form; and if he will make a statement on the matter. [41022/19]

Amharc ar fhreagra

Freagraí scríofa

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

Disability Services Provision

Ceisteanna (299)

Stephen Donnelly

Ceist:

299. Deputy Stephen Donnelly asked the Minister for Health if funding will be allocated to carry out research involving the Central Statistics Office in order to establish the unmet need of wheelchair users for personal assistance services; and if he will make a statement on the matter. [41024/19]

Amharc ar fhreagra

Freagraí scríofa

The level of funding available for my Department is being considered as part of the national Estimates and budgetary process for 2020 which is currently underway. Pending completion of this process it is not appropriate for me to comment further at this stage.

Voluntary Sector Remuneration

Ceisteanna (300)

Stephen Donnelly

Ceist:

300. Deputy Stephen Donnelly asked the Minister for Health the estimated amount it would cost for pay restoration for workers employed by section 39 organisations; and if he will make a statement on the matter. [41027/19]

Amharc ar fhreagra

Freagraí scríofa

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

Dental Services

Ceisteanna (301)

Jack Chambers

Ceist:

301. Deputy Jack Chambers asked the Minister for Health if he is considering allowing for the establishment of dental hygiene practices; and if he will make a statement on the matter. [41028/19]

Amharc ar fhreagra

Freagraí scríofa

My Department is preparing new legislation to replace the Dentists Act 1985. The current Act provides for the establishment of the Dental Council, which is the regulatory body for the dental profession in Ireland, and which is charged with promoting high standards of professional education and professional conduct among dentists. The Act also provides for the registration of dentists and dental specialists, education and training requirements, fitness to practise procedures, and the creation of auxiliary dental health professions.

In the period since the existing dental legislation was enacted, the profession of dentistry has seen significant changes and advancements, one of which has been the growing interest and uptake in careers in allied dental health professions. Consequently, it is proposed that the regulation of these professions, which includes dental hygiene, will be addressed in the new dental legislation.

While the legislation is still at the early stages of preparation, considerable work has been undertaken in formulating the policy to underpin it. It is intended to make provision allowing for certain designated allied dental health professions, including dental hygienists, to work without being supervised by a dentist once they are working within their scope of practice.

Voluntary Sector Funding

Ceisteanna (302)

Niamh Smyth

Ceist:

302. Deputy Niamh Smyth asked the Minister for Health if further funding for staffing at a service (details supplied) under a programme will be provided; if his attention has been drawn to the fact that this rural centre is further from hospitals specialising in this treatment; if correspondence will be reviewed regarding same; and if he will make a statement on the matter. [41031/19]

Amharc ar fhreagra

Freagraí scríofa

The funding of voluntary organisations is provided through Section 39 funding and through the National Lottery scheme, both of which are administered by the HSE. As such, I have referred your question to the HSE for direct reply.

Nursing Homes Support Scheme Review

Ceisteanna (303)

Bobby Aylward

Ceist:

303. Deputy Bobby Aylward asked the Minister for Health if the review of the pricing system for long-term residential care facilities, as recommended in the review of the fair deal scheme, will be published; if an independent appeals mechanism within the fair deal scheme to provide third party recourse for nursing home providers that fail to agree a fee with the NTPF and in an effort to bring greater transparency to the fair deal pricing mechanism will be introduced; and if he will make a statement on the matter. [41037/19]

Amharc ar fhreagra

Freagraí scríofa

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 has been submitted by the NTPF to the Department. It is now being reviewed by this Department and any recommendations included in the report will be appraised before publication.

Medicinal Products Reimbursement

Ceisteanna (304)

Seán Haughey

Ceist:

304. Deputy Seán Haughey asked the Minister for Health if the age restriction will be removed in respect of the FreeStyle Libre device in order that it is available to all persons with type 1 diabetes; the weighting percentages to be used in the decision making process in the health technology assessment by the HSE that will be given to factors (details supplied); if the reimbursement dataset will specifically cover only current HSE funded users of the FreeStyle Libre device; if not, if the health technology assessment review will compare total blood glucose strip usage spend year on year; and if he will make a statement on the matter. [41045/19]

Amharc ar fhreagra

Freagraí scríofa

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.

Cancer Screening Programmes

Ceisteanna (305)

Peadar Tóibín

Ceist:

305. Deputy Peadar Tóibín asked the Minister for Health the reason his Department denies the existence of the email sent by a person (details supplied) on 27 March 2019 to the Office of the Taoiseach regarding speaking notes on the CervicalCheck delay in the results of tests crisis; and the reason his Department refused to release it to a journalist under the Freedom of Information Act 2014. [41052/19]

Amharc ar fhreagra

Freagraí scríofa

Given that there may be some misunderstanding regarding this issue, I want to clarify to the Deputy that the email in question does not concern the CervicalCheck IT issue which emerged in July this year and which related to tests undertaken at the Quest Diagnostics laboratory in Chantilly.

The email referred to by the Deputy relates to an earlier issue. In November 2018, the HSE became aware of an issue with Quest laboratories in relation to the usage, outside the manufacturers recommended timeframe, of a number of tests used for secondary HPV testing. Approximately 4,500 women required a retest.

There was an initial delay in the establishment of the required IT systems to allow for the results of these 4,500 repeat smear tests to be reported and that is the issue referred to in the email referenced by the Deputy. That issue was the subject of media coverage and was also referred to in weekly reports which are published online. The HSE advised my Department on 2 April that the issue was resolved.

I would like to clarify that the release of the email was not refused. However, it is acknowledged that this email should have been released in response to a request received by my Department under the FOI Act, which was one of over 470 FOI requests received by my Department this year, of which approximately 30 relate to CervicalCheck. Due to an administrative error, the particular email was not found in the search for documents which was undertaken in response to the FOI request in question. I can confirm my Department has now liaised with the requester, has apologised for the omission and has provided him with this additional document.

Hospital Appointments Delays

Ceisteanna (306)

Michael McGrath

Ceist:

306. Deputy Michael McGrath asked the Minister for Health when a person (details supplied) in County Cork will be seen by a consultant psychiatrist at St. Columcille’s Hospital, Loughlinstown; and if he will make a statement on the matter. [41054/19]

Amharc ar fhreagra

Freagraí scríofa

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.

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

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