HSE Correspondence

Question No. 223 answered with Question No. 214.

Ceisteanna (222)

Alan Kelly

Ceist:

222. Deputy Alan Kelly asked the Minister for Health if he will provide a copy of letters and-or emails from a person (details supplied) to the HSE on 1 April 2019. [42776/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The following is the information that relates to the matters referred to by the Deputy.

The officer in question works in my Department's Acute Hospital Division, the division with responsibility for maternity services. In that context, two electronic correspondences were issued by the officer to the HSE on April 1st, 2019 as follows;

- An email was issued, replying to the HSE’s National Women & Infants Health Programme, requesting further information on the implementation of termination of pregnancy services in a number of acute hospitals. Clarification was sought in relation to the timelines for the roll out of termination services and more detail was requested in relation to the potential challenges arising. Advice was also provided in relation to a funding requirement identified for supports from the Institue of Obstetricians and Gynaecologists.

- A second email was issued to HSE Estates acknowledging a request for a meeting and questioning whether further legal advice had been received from the HSE legal advisers in the context of the National Maternity Hospital relocation project. The correspondence is part of the ongoing engagement between my Department and the HSE in relation to the development of the legal framework to protect the State’s investment in the new hospital.

Question No. 223 answered with Question No. 214.

Departmental Correspondence

Ceisteanna (224)

Alan Kelly

Ceist:

224. Deputy Alan Kelly asked the Minister for Health if he will provide all correspondence between him and-or his office and-or his advisers and-or the Secretary General and-or the office of the Secretary General and the Departments of Finance and Public Expenditure and Reform in September and to 10 October 2019. [42784/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Correspondence between my office and/or the office of the Secretary General of my Department and the Department of Finance and the Department of Public Expenditure and Reform is currently being identified, collated and examined. It is expected to cover a wide range of issues including scheduling of meetings and associated information, circulars, HR related matters for the civil service and financial matters. The details are currently being compiled and, in accordance with Standing Order 42A, I will provide a further response to the Deputy in the coming days.

Medical Aids and Appliances Provision

Ceisteanna (225)

Brendan Griffin

Ceist:

225. Deputy Brendan Griffin asked the Minister for Health if a hospital bed will be provided to a person (details supplied) in County Kerry; and if he will make a statement on the matter. [42791/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Medicinal Products Reimbursement

Ceisteanna (226)

Willie O'Dea

Ceist:

226. Deputy Willie O'Dea asked the Minister for Health the steps he is taking to ensure that persons here suffering with MS will have the same access to medication as persons in Europe; and if he will make a statement on the matter. [42814/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The HSE has statutory responsibility for medicine pricing and reimbursement decisions, under the Health (Pricing and Supply of Medical Goods) Act 2013. The Act specifies criteria for decisions on the reimbursement of medicines.

HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, including 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 a drug's clinical and cost effectiveness as a health intervention.

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

The HSE received 2 applications for pricing and reimbursement of Ocrelizumab (Ocrevus) in Multiple Sclerosis.

Application 1 is for use of Ocrelizumab for the treatment of adult patients with relapsing forms of Multiple Sclerosis (RMS) with active disease defined by clinical or imaging features. Following a number of rounds of commercial negotiations, an agreement was reached in relation to the commercial terms which will apply to this indication. The HSE intends to progress Ocrelizumab for the RMS indication, which has been approved for funding from October 2019, on a patient-specific basis for this indication.

Application 2 is for the use of Ocrelizumab for the treatment of adult patients with early primary progressive multiple sclerosis (PPMS) in terms of disease duration and level of disability, and with imaging features characteristic of inflammatory activity. On 4 October 2018 the NCPE completed its assessment for this indication. They did not recommend that Ocrelizumab be reimbursed for this indication.

The HSE and the manufacturer have had a number of rounds of commercial negotiations in relation to this indication. Commercial discussions have concluded, the medicine has been reviewed by the HSE Drugs Group.  The HSE Senior Leadership Team have received the Drugs Group recommendation. The HSE's final decision on reimbursement will take into consideration the criteria contained in the 2013 Health Act.

As a country, we invest heavily in medicines, to the tune of almost €2 billion annually. As of September 2019, there have been 29 new medicines and 5 new indications for existing medicines approved for reimbursement in the public healthcare system. The approvals to date represent an additional investment by the HSE over five years of approximately €220m in providing 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 5 years.

Notwithstanding the significant progress on drug costs achieved from price reductions under the pricing framework agreed with industry 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. These measures include 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. 

National Treatment Purchase Fund Data

Ceisteanna (227)

Stephen Donnelly

Ceist:

227. Deputy Stephen Donnelly asked the Minister for Health the funding drawn down by the National Treatment Purchase Fund in 2017, 2018 and to date in 2019; the amount of funding in each year spent in procuring services from private healthcare providers; and the amount spent in the public system in tabular form. [42819/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Programme for Government includes a commitment to improving waiting times for hospital procedures.

In 2017, National Treatment Purchase Fund (NTPF) was initially allocated funding of €15m to address waiting lists.  A further €2.5m was allocated in late 2017 in order to further reduce the number of long-waiting patients and also address those patients waiting for complex treatments such as complex spinal and cardiothoracic surgery. Budget 2018 announced a total allocation of €55 million for the NTPF, and Budget 2019 announced that the Government had further increased investment in tackling waiting lists, with funding to the NTPF increasing to €75 million in 2019.

The NTPF has advised that the funds drawn down in relation to 2017 and 2018 were €17.5m and €55m respectively and estimates that €75m will be drawn down by the end of 2019.

The NTPF further advises that in 2017, patient care expenditure amounted to €13,050,001. Of this amount, €9,948,651 was spent in Private Hospitals and €3,101,350 spent in Public Hospitals.

In relation to expenditure in 2018 and 2019, the NTPF advise that the 2018 and 2019 Annual Financial Statements have not been completed and therefore are not available at this time.

2017 Patient Care Expenditure by payee

Private Hospitals

9,948,651

Public Hospitals

3,101,350

Medical Aids and Appliances Provision

Ceisteanna (228)

Michael Healy-Rae

Ceist:

228. Deputy Michael Healy-Rae asked the Minister for Health if a new hospital bed will be provided for a person (details supplied); and if he will make a statement on the matter. [42820/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

HSE Staff Data

Ceisteanna (229)

Joan Burton

Ceist:

229. Deputy Joan Burton asked the Minister for Health the average time for the commencement of the payment of pension following retirement of staff in the HSE; the number of applicants who have to wait three months or longer for payment of their pension; the number of pension applications currently in arrears; and if he will make a statement on the matter. [42829/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Long-Term Illness Scheme

Ceisteanna (230)

Joan Burton

Ceist:

230. Deputy Joan Burton asked the Minister for Health if persons qualifying under the long-term illness scheme are eligible for workplace programmes and training courses even if they are drawing credits rather than receiving a social welfare payment; the supports available for persons in this category to assist them in returning to the labour market in circumstances in which this is possible; and if he will make a statement on the matter. [42830/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Long Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). The conditions covered by the LTI are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of thalidomide.

Under this scheme, patients receive medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.

Issues in relation to eligibility for workplace programmes and training courses are a matter for my colleagues, the Minister for Education and Skills and the Minister for Employment Affairs and Social Protection.

Long-Term Illness Scheme

Ceisteanna (231)

Dara Calleary

Ceist:

231. Deputy Dara Calleary asked the Minister for Health if the FreeStyle Libre device for diabetes will be added to the long-term illness scheme. [42832/19]

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.

Home Care Packages Provision

Ceisteanna (232)

Pearse Doherty

Ceist:

232. 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. [42838/19]

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.

National Children's Hospital

Ceisteanna (233)

Barry Cowen

Ceist:

233. Deputy Barry Cowen asked the Minister for Health the number of outside consultant contracts awarded under the national children’s hospital in each year since commencement; the consultant that was ultimately awarded the contract; the final cost of the contract; and if he will make a statement on the matter. [42857/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The National Paediatric Hospital Development Board (NPHDB) has statutory responsibility for planning, designing, building and equipping the new children's hospital.  I have referred your question to the NPHDB for direct reply.

Capital Expenditure Programme

Ceisteanna (234, 235)

Barry Cowen

Ceist:

234. Deputy Barry Cowen asked the Minister for Health the number of capital projects that cost €100 million or more in the past five years; the cost of outside consultants for each of the projects costing €100 million or more; and if he will make a statement on the matter. [42870/19]

Amharc ar fhreagra

Barry Cowen

Ceist:

235. Deputy Barry Cowen asked the Minister for Health the number of capital projects anticipated to commence in the next five years that cost €100 million or more; the expected cost of external consultants for each project; and if he will make a statement on the matter. [42886/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 234 and 235 together.

The development of modern healthcare infrastructure is a complex process. As the Deputy knows, technical and specialist knowledge and expertise and capacity is required at all stages of capital projects such as appraisal, planning, design, procurement, construction, equipping and commissioning, and is typically procured from outside specialist consultancy firms and contractors. 

The expenditure to date (September 2019) on projects costing more than €100 million is as follows and includes costs relating to outside contractors and consultancy firms:

- New Children's Hospital: €385 million

- National Forensic Mental Health Service Hospital: €160 million

It is important to recognise that all capital development proposals must progress through a number of approval stages, in line with the Public Spending Code, including detailed appraisal, planning, design and procurement, before a firm timeline or funding requirement can be established.

The HSE procures construction works using the Department of Public Expenditure and Reform's Capital Works Management Framework.

Medicinal Products Reimbursement

Ceisteanna (236)

Bernard Durkan

Ceist:

236. Deputy Bernard J. Durkan asked the Minister for Health when a person (details supplied) will have access to the drug Repatha restored to reimbursement in view of the person's dependency on the drug for the past number of years and whose loss of access to the drug will cause extreme pain, discomfort and anxiety; and if he will make a statement on the matter. [42899/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this refers to an individual case, I have referred this matter to the HSE for their attention and direct reply to the Deputy.

Agriculture Scheme Data

Ceisteanna (237)

Niamh Smyth

Ceist:

237. Deputy Niamh Smyth asked the Minister for Agriculture, Food and the Marine the number of persons in counties Cavan, Monaghan and nationwide waiting on farm payments; the type of payment they are waiting for; and if he will make a statement on the matter. [42631/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Agriculture)

The detailed information requested by the Deputy is not readily available.

It is currently being compiled and I will be in contact with the Deputy as soon as it is available.

Greyhound Industry

Ceisteanna (238)

Thomas P. Broughan

Ceist:

238. Deputy Thomas P. Broughan asked the Minister for Agriculture, Food and the Marine if his attention has been drawn to a report (details supplied) detailing the sale of an Irish greyhound to China; the action he and the Irish Greyhound Board will take; the route of export of the dog from Ireland to China; and if efforts will be made to repatriate the animal and the 50 other Irish greyhounds now in China in view of the deplorable animal welfare record of China. [42691/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Agriculture)

Bord na gCon is a commercial state body, established under the Greyhound Industry Act, 1958 chiefly to control greyhound racing and to improve and develop the greyhound industry.  Bord na gCon is a body corporate and a separate legal entity to the Department of Agriculture, Food and the Marine.  

My Department is not in a position to know whether dogs, including greyhounds, that are moved from Ireland to another EU Member State are subsequently exported to a further destination. However, I can confirm that no dog has been certified to travel from Ireland directly to the country in question since 2016. 

The rules covering the movement of all breeds of dogs, including greyhounds, between EU Member States is currently set at a European level rather than as a national measure in isolation.  Bord na gCon have informed me that they are opposed to exports to countries that do not meet Ireland’s welfare standards.  They have also informed me that the greyhound in question was not exported directly to its final destination from Ireland and its journey would have been either via other EU jurisdictions or via the USA.

Bord na gCon has emphasised to the individual in question their responsibilities in exporting to destinations that do not provide the expected levels of greyhound welfare set out in its Code of Practice on the Care and Welfare of the Greyhound and will continue to do so to all other greyhound owners.

Animal Carcase Disposal

Ceisteanna (239)

Peter Burke

Ceist:

239. Deputy Peter Burke asked the Minister for Agriculture, Food and the Marine the restrictions in place for the movement of offal from meat processing plants for cattle over 30 months of age; and if he will make a statement on the matter. [42765/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Agriculture)

There are no restrictions in place for the movement of offal from meat processing plants other than the animal by-products must be transported by a registered haulier and the material must be transported to an EU-approved plant.

Animal Identification Schemes

Ceisteanna (240)

Peter Burke

Ceist:

240. Deputy Peter Burke asked the Minister for Agriculture, Food and the Marine if third parties including meat processors have access to the CMMS system; and if he will make a statement on the matter. [42766/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Agriculture)

No third parties are provided with access to the Department’s Animal Identification and Movement (AIM) system without the requisite consent of the herd keeper or where there is a legal basis to provide pertinent information.  The provision of access on AIM to meat processors is restricted to information on the specific bovine animals presented for slaughter as required by the Food Business Operator (FBO).   

I can confirm that FBOs do not have access to AIM data in relation to the other animals on the holding of a keeper presenting animals to that slaughter plant. 

Departmental Correspondence

Ceisteanna (241)

Alan Kelly

Ceist:

241. Deputy Alan Kelly asked the Minister for Agriculture, Food and the Marine if he will provide a copy of all correspondence his Department had with the European Commission in July 2019. [42787/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Agriculture)

It is not possible to provide the information requested by the Deputy in the required time. 

The information is being compiled and will be forwarded to the Deputy as soon as it is available.

Farm Inspections

Ceisteanna (242)

Pearse Doherty

Ceist:

242. Deputy Pearse Doherty asked the Minister for Agriculture, Food and the Marine further to Parliamentary Question No. 211 of 10 October 2019, the outcome of the investigation carried out by his Department at the farm as reported (details supplied). [42807/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Agriculture)

As indicated to the Deputy previously, the position is that my Department did not carry out an investigation into environmental concerns at the farm detailed.

Checks were carried out in relation to digestate under Regulation 1069/2009 which includes legislation to protect ‘public and animal health’ rather than ‘environment’.

The outcome of animal health investigations on the farm were satisfactory and are concluded.

Aquaculture Licence Administration

Ceisteanna (243)

Michael Collins

Ceist:

243. Deputy Michael Collins asked the Minister for Agriculture, Food and the Marine the reason a decision was never made on licences (details supplied) in over 20 years; and if he will make a statement on the matter. [42810/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Agriculture)

The applications referred to by the Deputy are currently under consideration by my Department in accordance with the applicable legislation.

As the applications are under consideration as part of a statutory process, it would not be appropriate for me to comment further at this time.

Aquaculture Licence Administration

Ceisteanna (244)

Michael Collins

Ceist:

244. Deputy Michael Collins asked the Minister for Agriculture, Food and the Marine the reason there are so many licenced shellfish areas which are unused (details supplied). [42811/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Agriculture)

The application referred to by the Deputy is currently under consideration by my Department in accordance with the applicable legislation.

As the application is under consideration as part of a statutory process, it would not be appropriate for me to comment further at this time.

Aquaculture Licence Administration

Ceisteanna (245)

Michael Collins

Ceist:

245. Deputy Michael Collins asked the Minister for Agriculture, Food and the Marine the reason licences (details supplied) have active mussel licences despite being unused for years. [42812/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Agriculture)

With one exception, the applications referred to by the Deputy are currently under consideration by my Department in accordance with the applicable legislation.

As these applications are under consideration as part of a statutory process it would not be appropriate for me to comment further at this time.

In the case of T05/306A, my Department’s records indicate that this application was withdrawn in 2005.

Aquaculture Licence Administration

Ceisteanna (246)

Michael Collins

Ceist:

246. Deputy Michael Collins asked the Minister for Agriculture, Food and the Marine the policy with regard to unused aquaculture licences; and if he will make a statement on the matter. [42813/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Agriculture)

Section 69 of the Fisheries (Amendment) Act 1997 sets out the legislative position in regard to unused aquaculture sites.

Section 69 of the Act states:

"(1) (a) Subject to paragraph (b), where aquaculture in respect of which a licence has been granted has not commenced within 2 years after the date on which the licence was granted, the licence ceases to have effect.

(b) A licensee, who considers that there are exceptional reasons why aquaculture, in respect of which a licence has been granted to the licensee, has not been commenced or cannot commence within the period specified in paragraph (a), may apply to the Minister, giving those reasons, for a determination that the licence concerned shall not cease to have effect.

(c) The Minister may, at his or her discretion, having considered the reasons given by the licensee under paragraph (b), determine whether or not the licence shall cease to have effect. The determination of the Minister is final.

(2) (a) Subject to paragraph (b), where aquaculture in respect of which a licence has been granted has ceased for a continuous period of 2 years, the Minister shall, without compensation to the licensee, revoke the licence.

(b) A licensee, who considers that there are exceptional reasons why aquaculture, in respect of which a licence has been granted to the licensee, has ceased or is likely to cease for the period referred to in paragraph (a), may apply to the Minister, giving those reasons, for a determination not to revoke the licence.

(c) The Minister may, in his or her discretion, having considered the reasons given by the licensee under paragraph (b), determine whether or not to revoke the licence. The determination of the Minister is final.

(d) This subsection is deemed to have come into operation on 30 June 1998.”