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Tuesday, 15 Oct 2019

Written Answers Nos. 428-451

Hospital Staff Data

Ceisteanna (428)

Alan Kelly

Ceist:

428. Deputy Alan Kelly asked the Minister for Health the breakdown of staff at Beaumont Hospital. [42045/19]

Amharc ar fhreagra

Freagraí scríofa

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

Hospital Staff Data

Ceisteanna (429)

Alan Kelly

Ceist:

429. Deputy Alan Kelly asked the Minister for Health the breakdown of staff at University Hospital Limerick. [42046/19]

Amharc ar fhreagra

Freagraí scríofa

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

Medicinal Products Reimbursement

Ceisteanna (430)

Tom Neville

Ceist:

430. Deputy Tom Neville asked the Minister for Health if he will address a matter (details supplied) regarding FreeStyle Libre. [42049/19]

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.

Home Care Packages Administration

Ceisteanna (431)

Fiona O'Loughlin

Ceist:

431. Deputy Fiona O'Loughlin asked the Minister for Health if the delays being experienced in the delivery of home care packages in the CHO 7 areas in counties Kildare and Wicklow will be addressed; and if he will make a statement on the matter. [42081/19]

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.

Pension Provisions

Ceisteanna (432)

Eugene Murphy

Ceist:

432. 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. [42083/19]

Amharc ar fhreagra

Freagraí scríofa

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

Home Help Service

Ceisteanna (433)

John Curran

Ceist:

433. Deputy John Curran asked the Minister for Health the provision that will be made for home support services for the elderly in 2020 recognising the significant difficulty many persons experienced in securing home support services in 2019 arising from a very significant increase in health funding as announced in budget 2020; and if he will make a statement on the matter. [42102/19]

Amharc ar fhreagra

Freagraí scríofa

The Government has made improved access to home support services a priority. We have committed to an additional investment of €52 million in Budget 2020 to bring the total funding for home supports to €487 million in 2020.

 In 2020 the HSE will deliver over 19.2 million hours of home support, representing a substantial increase of 1 million hours more than this year’s target.   

 This investment is focused on enabling older people to remain at home and, as appropriate, provision of hours will also be targeted at times of peak demand in Winter 2020, at the beginning and end of the year, to ensure more timely egress from hospital for our older citizens.

 While the existing home support service is delivering crucial support to many people across the country, it needs to be improved to better meet the changing needs of our citizens. Dedicated funding has been included within the €52m for the testing of the new statutory home-support scheme in 2020.

Drug and Alcohol Task Forces

Ceisteanna (434)

John Curran

Ceist:

434. Deputy John Curran asked the Minister for Health the amount of funding from the health budget announced in budget 2020 that will go towards local and regional drug task forces in 2020; the increases in funding planned for the task forces; and if he will make a statement on the matter. [42109/19]

Amharc ar fhreagra

Freagraí scríofa

I am pleased that the additional funding of €1m announced by me in March 2019 to support the implementation of the National Drugs Strategy will be continued in 2020.

€240,000 of this funding will allow for the continuation of €10,000 in additional funding to each of the 24 Drug and Alcohol Task Forces in 2020.

€720,000 of this funding will be used to support the 12 strategic health initiatives approved last month. These initiatives reflect priorities agreed between the Community Health Organisations and Drug and Alcohol Task Forces to target resources at groups most in need. Each initiative will receive €60,000 in 2020.

I am confident that these initiatives will improve access to addiction services for people with complex needs and assist them in their journey to recovery.

Vaccination Programme

Ceisteanna (435)

John Curran

Ceist:

435. Deputy John Curran asked the Minister for Health his plans to increase the uptake of the influenza vaccine for the winter 2019 season; and if he will make a statement on the matter. [42112/19]

Amharc ar fhreagra

Freagraí scríofa

Vaccination remains the most effective means of preventing infection by seasonal influenza viruses and can reduce severe disease that can lead to hospitalisation and death.

As this question relates to a service matter, it has been referred to the HSE for attention and direct reply to the Deputy.

Medicinal Products Reimbursement

Ceisteanna (436)

John Curran

Ceist:

436. Deputy John Curran asked the Minister for Health the steps he has taken to ensure that patients here have the same access to new medicines as patients throughout Europe; and if he will make a statement on the matter. [42113/19]

Amharc ar fhreagra

Freagraí scríofa

Attempts at comparing the 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 licenced 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.  It is a strategic long term project which allows the Beneluxa members to work closely together to identify pragmatic solutions to the challenges which we all now face with regards to medicine pricing, sustainability and supply.

Medicinal Products Reimbursement

Ceisteanna (437)

Tom Neville

Ceist:

437. Deputy Tom Neville asked the Minister for Health his views that there is a need to have the FreeStyle Libre device to assist persons with diabetes available on the long-term illness card (details supplied); when this will be available on the long-term illness card; and if he will make a statement on the matter. [42114/19]

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.

Disability Services Provision

Ceisteanna (438)

Niamh Smyth

Ceist:

438. Deputy Niamh Smyth asked the Minister for Health further to Parliamentary Question No. 438 of 8 October 2019 (details supplied) to the Department of Children and Youth Affairs, if same will be reviewed; and if he will make a statement on the matter. [42115/19]

Amharc ar fhreagra

Freagraí scríofa

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.

Disability Services Provision

Ceisteanna (439)

Robert Troy

Ceist:

439. Deputy Robert Troy asked the Minister for Health if a suitable residential care unit place is put in place for a person (details supplied). [42119/19]

Amharc ar fhreagra

Freagraí scríofa

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

Maternity Services

Ceisteanna (440)

Seán Sherlock

Ceist:

440. Deputy Sean Sherlock asked the Minister for Health his plans to improve support for and promote birthing centres and home births, particularly as an option for mothers in rural Ireland; if he has reviewed evidence on the benefits of birthing centres in terms of safety, less infection and so on; the outcome of this review; and the funding currently set aside to promote and cater for birthing centres and home births. [42121/19]

Amharc ar fhreagra

Freagraí scríofa

The National Maternity Strategy - Creating A Better Future Together 2016 - 2026 - aims to ensure that appropriate care pathways are in place in order that mothers, babies and families get the right care, at the right time, by the right team and in the right place.  The Strategy recognises that, while all pregnant women need a certain level of support, some will require more specialised care.  Accordingly, it proposes an integrated model that delivers care at the lowest level of complexity and encompasses all the necessary safety nets in line with patient safety principles.  The model consists of three care pathways - Supported, Assisted and Specialised.  

The Supported Care Pathway is intended for normal-risk mothers and babies, with midwives leading and delivering care within a multidisciplinary framework.  Through the implementation of the Strategy, care will be delivered by a community midwifery team, with most antenatal and postnatal care being provided in the community and home settings.  The Strategy makes it clear that women should be offered choice regarding their preferred pathway of care, in line with their clinical needs and best practice.  The woman should be able to exercise a choice with her healthcare professional with regard to the birth setting, which may be in an Alongside Birth Centre in the hospital, or at home.  Home birth services will over time be integrated with the community midwifery and the wider maternity service as part of the maternity network.

I should perhaps explain that the Strategy recommends that Alongside Birth Centres should be located in a maternity hospital and ideally situated immediately alongside a Specialised Birth Centre so that any necessary critical care services will be immediately available to a woman in need.  The Steering Group, which developed the Strategy, noted that freestanding birth centres i.e. birth centres not co-located with an obstetric unit, were provided in some jurisdictions.  However, they did not recommend the provision of freestanding birth centres in Ireland at this stage in the development the new model of care and pointed to the need, in the first instance, to monitor and evaluate the implementation of Alongside Birth Units in an Irish context.

Health Services Provision

Ceisteanna (441)

Mary Butler

Ceist:

441. Deputy Mary Butler asked the Minister for Health the position regarding podiatry services provided by the HSE in County Carlow; the status of the service going forward; the number of persons on the waiting list for the service; and if he will make a statement on the matter. [42134/19]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter it has been referred to the HSE for reply to the Deputy.

Hospital Appointments Delays

Ceisteanna (442)

Maurice Quinlivan

Ceist:

442. Deputy Maurice Quinlivan asked the Minister for Health the length of time a person (details supplied) must wait for an appointment with a person in the regional hospital, Limerick; and if he will make a statement on the matter. [42140/19]

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.

General Medical Services Scheme

Ceisteanna (443)

Peter Burke

Ceist:

443. Deputy Peter Burke asked the Minister for Health if he will advise on a payment to a person (details supplied). [42142/19]

Amharc ar fhreagra

Freagraí scríofa

Under the Health Act 1970 (as amended) all persons ordinarily resident in the State are eligible for public health services provided by or on behalf of the HSE on a full or limited eligibility basis. 

When a patient opts to avail of private treatment from a private provider, the relationship between the patient and the provider is a private contractual matter. The current public health eligibility framework provide no basis for reimbursing any private patient charges incurred by a patient in these circumstances.

Home Help Service Provision

Ceisteanna (444)

Mary Butler

Ceist:

444. Deputy Mary Butler asked the Minister for Health when the 1 million extra home care hours announced in budget 2020 will commence; his views on the fact that the waiting list is causing undue hardship for the elderly and frail; and if he will make a statement on the matter. [42145/19]

Amharc ar fhreagra

Freagraí scríofa

The Government has made improved access to home support services a priority. We have committed to an additional investment of €52 million in Budget 2020 to bring the total funding for home supports to €487 million in 2020.

 In 2020 the HSE will deliver over 19.2 million hours of home support, representing a substantial increase of 1 million hours more than this year’s target. This investment is focused on enabling older people to remain at home and, as appropriate, provision of hours will also be targeted at times of peak demand in Winter 2020, at the beginning and end of the year, to ensure more timely egress from hospital for our older citizens.

 The Department of Health is engaging extensively with the HSE in the context of planning for winter, including consideration of the response to dealing with current challenges, including delayed transfers of care. Funding is being made available to assist with managing those challenges including by providing further egress options in the form of transitional care, Nursing Homes Support Scheme funding and home support. Engagement will continue over the coming weeks having regard to the HSE’s National Service Planning 2020 process.

Health Services Provision

Ceisteanna (445)

Eamon Scanlon

Ceist:

445. Deputy Eamon Scanlon asked the Minister for Health the plans and measures in place for increases in podiatry services in County Sligo; if the lack of services and facilities in Sligo town will be addressed; and if he will make a statement on the matter. [42152/19]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter it has been referred to the HSE for reply to the Deputy.

Health Services Provision

Ceisteanna (446)

Eamon Scanlon

Ceist:

446. Deputy Eamon Scanlon asked the Minister for Health the waiting time for a podiatry appointment in County Sligo; and if he will make a statement on the matter. [42155/19]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter it has been referred to the HSE for reply to the Deputy.

Health Services Provision

Ceisteanna (447)

Mary Butler

Ceist:

447. Deputy Mary Butler asked the Minister for Health the status of the provision of podiatry services in County Carlow; and if he will make a statement on the matter. [42165/19]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter it has been referred to the HSE for reply to the Deputy.

Electronic Cigarettes

Ceisteanna (448)

Brendan Griffin

Ceist:

448. Deputy Brendan Griffin asked the Minister for Health his views on a matter (details supplied) relating to vaping; and if he will make a statement on the matter. [42168/19]

Amharc ar fhreagra

Freagraí scríofa

I very much welcome the engagement of the students from Mercy Secondary School in Tralee on this important issue. I share their goal of discouraging young people and non-smokers from using electronic cigarettes. In relation to young people in particular, it is my intention, in the coming weeks, to seek Government approval for the drafting of a Public Health (Tobacco Products and Nicotine Inhaling Products) Bill that will include provisions to prohibit the sale of nicotine-inhaling products such as electronic cigarettes by and to persons under the age of 18.

In addition, in March of this year I asked the Health Research Board to undertake a review of the evidence in relation to the health harms of electronic cigarettes. The Health Research Board will report back in the spring of 2020 and its findings will go towards informing decisions on any future regulation of nicotine-inhaling products.

Orthodontic Services

Ceisteanna (449)

Catherine Murphy

Ceist:

449. Deputy Catherine Murphy asked the Minister for Health if his attention has been drawn to a report (details supplied) concerning children who were harmed by HSE orthodontic services in the Dublin mid-Leinster region over a period of time; if he will request the HSE to immediately publish the report; and if he will make a statement on the matter. [42173/19]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.

Medicinal Products

Ceisteanna (450)

Michael McGrath

Ceist:

450. Deputy Michael McGrath asked the Minister for Health his plans to provide for incremental increases in the drugs budget for new drugs in 2020; and if he will make a statement on the matter. [42174/19]

Amharc ar fhreagra

Freagraí scríofa

I wish to advise the Deputy that funding is provided to the HSE for Health services in accordance with the letter of determination which sets out the approved level of overall HSE expenditure for the year in question. I expect to issue the letter of determination for 2020 shortly.

It is the responsibility of the HSE to manage the entire budget and prepare and implement the National Service Plan which must, under legislation, set out the type and volume of health and personal social services, to be provided during the year in question within the funding allocated.

Medicinal Products Prices

Ceisteanna (451)

Michael McGrath

Ceist:

451. Deputy Michael McGrath asked the Minister for Health the amount of savings delivered over the entire course of the framework agreement with industry; the projected savings for 2020; if these projected savings will be reinvested into the drugs budget for 2020; and if he will make a statement on the matter. [42175/19]

Amharc ar fhreagra

Freagraí scríofa

The 2016 Framework Agreement on the Supply and Pricing of Medicines between the State and the Irish Pharmaceutical Healthcare Association (IPHA), 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.

Between 2016 and 2018 the agreement created €354 million in savings. The 2019 forecast savings from the Agreement are €252m with the 2020 forecast savings being €262m. Where the agreement remains in place for the entirety of 2020, the forecasted savings next year is estimated to be in the region of €262 million. 

It is the responsibility of the HSE to manage the entire budget and prepare and implement the National Service Plan which must, under legislation, set out the type and volume of health and personal social services, to be provided during the year in question within the funding allocated. The objective of the HSE is to determine what healthcare services, products, and interventions would best maximise health gain for patients and the public within the resources available to them.

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