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Thursday, 14 Nov 2019

Written Answers Nos. 139-158

Prescriptions Data

Ceisteanna (139)

Jack Chambers

Ceist:

139. Deputy Jack Chambers asked the Minister for Health if changes have been made to the way in which prescription medication is dispensed in pharmacies (details supplied); and if he will make a statement on the matter. [47038/19]

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.

Community Intervention Teams

Ceisteanna (140)

James Browne

Ceist:

140. Deputy James Browne asked the Minister for Health the status of the community intervention team based in County Wexford; and if he will make a statement on the matter. [47040/19]

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.

Traveller Community

Ceisteanna (141, 142)

Louise O'Reilly

Ceist:

141. Deputy Louise O'Reilly asked the Minister for Health his plans to resource and implement the national Traveller health action plan including a commitment to ring-fence funding; and his plans for the establishment of an institutional mechanism with the HSE and his Department to drive the delivery and implementation of same. [47041/19]

Amharc ar fhreagra

Louise O'Reilly

Ceist:

142. Deputy Louise O'Reilly asked the Minister for Health the role of his Department in the development, approval and implementation of the forthcoming national Traveller health action plan [47042/19]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 141 and 142 together.

Health and wellbeing are not evenly distributed across society. There are socially excluded groups who experience extreme health inequalities. Such groups include Travellers homeless people, refugees and asylum seekers and people with addiction issues. Inequalities in health are reflected in the mortality and morbidity rates of the population.  Rates of chronic diseases are another indicator of health inequalities.

The National Traveller and Roma Inclusion Strategy (NTRIS) has over 30 actions to address the health needs of Travellers and Roma. It includes an action for the HSE to develop and implement a detailed action plan, based on the findings of the All Ireland Traveller Health Study, 2010, to continue to address the specific health needs of Travellers, using a social determinants approach.    

I understand the health action plan will be finalised by the HSE by the end of the year.  I and the Minister for Health are engaged with and supportive of the health action plan. We are committed to providing leadership to support the implementation of the action plan. The Department will review the arrangements for engagement with Traveller organisations to support the action plan and is willing to participate in any new HSE structure to oversee the implementation of the plan.

Traveller Community

Ceisteanna (143, 145)

Louise O'Reilly

Ceist:

143. Deputy Louise O'Reilly asked the Minister for Health the steps he will take to reinstate the €1.8 million that was used to balance HSE accounts (details supplied) in view of the disproportionate disinvestment in Traveller health as highlighted by Traveller organisations in 2009 to the Joint Oireachtas Committee on Health and Children and recently in the Joint Oireachtas Committee on Key Issues affecting the Traveller Community. [47043/19]

Amharc ar fhreagra

Louise O'Reilly

Ceist:

145. Deputy Louise O'Reilly asked the Minister for Health his plans to increase resources to address Traveller health inequalities from the additional funding allocated in budget 2020. [47045/19]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 143 and 145 together.

The Department provides funding in the region of €10m per annum to the HSE for targeted measures to improve the health status of the Travelling community. These include:

- primary healthcare projects, counselling services, family support programmes and men's health projects; dedicated public health nurses and related staff;

- mental health promotion and suicide prevention services in a culturally sensitive manner, to reduce the stigma associated with mental health.

The Department will allocate €17 billion to the HSE for the delivery of health services in 2020. The details of these services will be set out in the HSE National Service Plan for 2020. The plan will include specific measures to improve Traveller health, including a Traveller health action plan.

Both I and the Minister for Health are engaged and supportive of the Traveller health action plan and we are committed to providing the leadership to support the implementation of the plan.

Traveller Community

Ceisteanna (144)

Louise O'Reilly

Ceist:

144. Deputy Louise O'Reilly asked the Minister for Health his plans to prioritise and fast-track Travellers in access to universal free general practitioner healthcare within the next five years in view of Sláintecare recommendations and health inequalities (details supplied); and if he will make a statement on the matter. [47044/19]

Amharc ar fhreagra

Freagraí scríofa

My Department provides funding in the region of €10m per annum, through the HSE, for targeted measures to improve the health status of the Travelling community.  These include:

- primary healthcare projects, counselling services, family support programmes and men's health projects; dedicated public health nurses and related staff; and

- mental health promotion and suicide prevention services in a culturally sensitive manner, to reduce the stigma associated with mental health. 

In addition, the Department of Justice and Equality's National Traveller and Roma Inclusion Strategy also details HSE-specific actions. Of particular note is the commitment by the HSE to develop a National Traveller Health Action Plan to continue to address the specific health needs of Travellers. The Plan is expected to be finalised by the end of this year.

Regarding eligibility for health services in Ireland, this is based primarily on residency and means, in accordance with the provisions of the Health Act 1970 (as amended). The Act provides that persons who are unable, without undue hardship, to arrange GP services for themselves and family can qualify for full eligibility (a medical card). The HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards and concluded that a person’s means should remain the main qualifier for a medical card. This position remains unchanged.

However, the HSE may exercise discretion and grant a medical card or general practitioner card, even though an applicant exceeds his or her income threshold, where he or she faces difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.

Sláintecare provides the framework within which a system-wide health reform programme will be advanced, including a phased expansion of eligibility to move towards universal healthcare. To that end, it will be necessary to review the current eligibility framework for all services and consider different options that will enable a phased expansion of universal access to a prescribed range of services. These options will take account of the ability of the health system to meet the increase in demand that would be expected, including the resource requirements needed from a workforce and service delivery perspective, as well as the impact on the effective management of the financial resources of the total health service.

Question No. 145 answered with Question No. 143.

Traveller Community

Ceisteanna (146)

Louise O'Reilly

Ceist:

146. Deputy Louise O'Reilly asked the Minister for Health his plans to provide better terms and conditions for Traveller community health workers (details supplied). [47046/19]

Amharc ar fhreagra

Freagraí scríofa

The HSE grant-aids a range of service providers under section 39 of the Health Act 2004.   The employees of agencies that receive grant-aid from the HSE under Section 39 are not public servants and are not specifically subject to the pay-scales approved for public servants. These employees have a private sector employment relationship with their employer.  

Primary Health Care for Travellers Projects are supported by HSE Social Inclusion in each Community Health Organisation area via Section 39 funding.  Each project employs Travellers as Community Health Workers to provide primary health care to the Traveller Community.  

Any individuals employed by section 39 organisations are not HSE employees, therefore neither the HSE nor I have a role in determining the salaries or other terms and conditions applying to these staff.  It is a matter for Section 39 organisations to negotiate salaries with their staff as part of their employment relationship and within the overall funding available for the delivery of agreed services.

Traveller Community

Ceisteanna (147)

Louise O'Reilly

Ceist:

147. Deputy Louise O'Reilly asked the Minister for Health his plans to ensure that existing health policy such as Sláintecare and new and existing strategies or policies are Traveller proofed to ensure that distinct health needs and significant health inequalities in relation to Travellers are addressed. [47047/19]

Amharc ar fhreagra

Freagraí scríofa

Sláintecare is a high-level delivery programme, tasked with delivering a health and social care service that meets the needs of all our population.

As part of Sláintecare, a resource allocation model is to be implemented on a regional basis. The model will be based on the population profile of the regions, which, it is intended, will capture the differing health needs of the region. As committed to in the Sláintecare Action Plan 2019, work is ongoing under the Population-Based Planning Programme to establish population quantum and profile by region, which includes factors such as age, deprivation and ability.

The Department of Health is developing an inclusion health framework to enhance the delivery of health and social care services to meet the complex health needs of socially excluded groups.

The HSE Intercultural Health Strategy provides an integrated approach to addressing the many unique health and support needs experienced by service users of diverse ethnic, cultural and religious backgrounds who live in Ireland.

The HSE is developing a Traveller health action plan, based on the findings of the All Ireland Traveller Health Study, to address the specific health needs of Travellers, using a social determinants approach.    

I understand the health action plan will be finalised by the HSE by the end of the year.  I and the Minister for Health are engaged with and supportive of the health action plan. We are committed to providing leadership to support the implementation of the action plan.

Medicinal Products Reimbursement

Ceisteanna (148)

Peter Burke

Ceist:

148. Deputy Peter Burke asked the Minister for Health when osimertinib will be approved for reimbursement to replace tarceva for the treatment of patients with a specific type of lung cancer; if the HPRA has commissioned a review of the effectiveness of the new drug; if it will consider granting it to patients here in view of the relatively modest cost due to the small number of patients suffering with this specific form of lung cancer; if the Health Products Regulatory Authority, HPRA, and his Department have spoken to consultants here that are recommending their patients be treated with this drug; and if he will make a statement on the matter. [47050/19]

Amharc ar fhreagra

Freagraí scríofa

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

In line with the 2013 Act and the national framework agreed with industry, if a company would like a medicine to be reimbursed by the HSE, the company must submit an application to the HSE to have the new medicine added to the reimbursement list.

Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority. Osimertinib (Tagrisso) was granted market authorisation by the EMA in April 2017.

HSE decisions on which licensed medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).

I am advised by the HSE that it has received two applications for the reimbursement of osimertinib (Tagrisso):

1) The treatment of adult patients with locally advanced or metastatic EGFR T790M mutation-positive non-small cell lung cancer (NSCLC).

In May 2018, the NCPE recommended that osimertinib not be considered for reimbursement for this indication unless cost-effectiveness can be improved relative to existing treatments. Following the assessment and after a number of rounds of commercial negotiations, the HSE notified the applicant in February 2019 that it was minded to not approve reimbursement for this indication.

The 2013 Act provides for a period of representations after such notifications, before the HSE can make its final decision. The HSE have received representations from the manufacturer and these are under consideration by the HSE leadership team in advance of a final reimbursement decision.

2) The first-line treatment of adult patients with locally advanced or metastatic NSCLC with activating epidermal growth factor receptor (EGFR) mutations.

In respect of the second indication, a health technology assessment was completed on 6 August 2019 with the NCPE recommending that osimertinib not be considered for reimbursement unless cost effectiveness can be improved relative to existing treatments. The HSE will assess this application for reimbursement in line with the 2013 Health Act.

The Department of Health has received correspondence concerning osimertinib from a number of consultants. Responses clarifying the reimbursement process in respect of the above indications have been issued.

Services for People with Disabilities

Ceisteanna (149)

Tony McLoughlin

Ceist:

149. Deputy Tony McLoughlin asked the Minister for Health the reason a new transport charge of €4 for persons with disabilities who are travelling to HSE day services has been introduced in County Sligo; and if he will make a statement on the matter. [47058/19]

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.

Hospitals Data

Ceisteanna (150)

Bernard Durkan

Ceist:

150. Deputy Bernard J. Durkan asked the Minister for Health the number of scoliosis procedures undertaken in each of the past five year to date; the number availing of such treatments on a daily and weekly basis in each of the past two years; and if he will make a statement on the matter. [47070/19]

Amharc ar fhreagra

Freagraí scríofa

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

EU Funding

Ceisteanna (151)

Robert Troy

Ceist:

151. Deputy Robert Troy asked the Minister for Agriculture, Food and the Marine the funds allocated to Ireland over the 2014 to 2020 period and expended in each year to date; the breakdown between Exchequer funding and EU funding (details supplied), in tabular form. [47067/19]

Amharc ar fhreagra

Freagraí scríofa

The information requested by the Deputy is being compiled and will be forwarded to him as soon as possible.

Beef Environmental Efficiency Scheme Applications

Ceisteanna (152)

Michael Healy-Rae

Ceist:

152. Deputy Michael Healy-Rae asked the Minister for Agriculture, Food and the Marine the status of a beef environmental efficiency pilot, BEEP, scheme application by a person (details supplied); and if he will make a statement on the matter. [46911/19]

Amharc ar fhreagra

Freagraí scríofa

The Beef Environmental Efficiency Pilot scheme (BEEP) aims to further increase economic and environmental efficiency in the suckler herd through collation of better quality data on herd performance which helps to support decision making on the farm. BEEP targets the weaning efficiency of suckler cows and calves through the collection of live weights of cows and progeny in the herd of each participant. 

An application under BEEP was received from the person named on 7th February 2019. 

Payments have recently commenced to BEEP participants who have completed the weighing and submission of data in respect of all of their eligible animals. As the person named had not fully weighed all their eligible animals, their payment has not yet issued.

Final payments, including to the person named, are scheduled for December 2019.

Control of Horses

Ceisteanna (153)

Jackie Cahill

Ceist:

153. Deputy Jackie Cahill asked the Minister for Agriculture, Food and the Marine the number of horses seized and or impounded for trespass and for non-compliance with chipping law and regulation by county in each of the years 2015 to 2018 and to date in 2019, in tabular form; and if he will make a statement on the matter. [46932/19]

Amharc ar fhreagra

Freagraí scríofa

The Control of Horses Act 1996, provides the necessary powers to Local Authorities to deal with stray and abandoned horses.

The Act contains provisions for the licencing and identification of horses and was introduced to address the issues caused by stray and wandering horses due to public safety concerns.  The primary purpose of the Act was to address the dangerous and unacceptable situation of horses being kept in unsuitable conditions which in many cases resulted in horses wandering onto public roads and public lands posing very serious risks to the public especially motorists and young children. The Act provides for the designation, by local authority byelaws, of control areas in which horses cannot be kept without a licence.  Enforcement the Act is a matter for each Local Authority.

The number of horses being seized nationally continues to decline. This reduction is reflective of a number of factors including initiatives being progressed by my Department in the animal welfare area as well as active enforcement of the Animal Health and Welfare Act 2013 and the EU Equine Identification Regulations. In tandem with the work of the Local Authorities under the Control of Horses Act, officials of my Department have been directly involved in a number of horse seizures and have initiated prosecutions under the Animal Health and Welfare Act.

Horses Seized 2015-2019

City/County Co's

2015

2016

2017

2018

to Q3 2019

Carlow Co. Council

69

76

24

13

20

Cavan Co. Council

21

4

1

5

2

Clare Co. Council

47

11

18

14

22

Cork Co. Council

155

91

87

63

65

Cork City Council

54

47

39

33

13

Donegal Co. Council

10

19

13

7

4

Dublin City Council

145

193

120

183

74

Sth Dublin Co. Council

231

266

227

147

76

Dunlaoghaire/Rathdown Co Council

25

29

7

13

15

Fingal Co. Council

145

161

155

86

22

Galway City Council

81

64

34

35

9

Galway Co. Council

94

40

40

66

67

Kerry Co. Council

24

28

12

22

15

Kildare Co. Council

273

155

145

91

64

Kilkenny Co. Council

75

52

21

21

13

Laois Co. Council

111

66

49

64

15

Leitrim Co. Council

26

16

10

8

8

Limerick City & County

343

206

166

206

81

Longford Co. Council

41

19

21

13

9

Louth Co. Council

43

23

38

37

6

Mayo Co. Council

0

0

7

1

0

Meath Co. Council

40

80

57

25

17

Monaghan Co. Council

35

29

11

5

0

Offaly Co. Council

101

66

60

16

6

Roscommon Co. Council

0

0

0

0

0

Sligo Co. Council

14

19

6

9

4

Tipperary County Council

152

129

97

105

56

Waterford City & County Council

39

32

18

28

31

Westmeath Co. Council

61

50

36

37

18

Wexford Co. Council

86

89

39

50

20

Wicklow Co. Council

138

65

45

57

17

Totals

2,679

2,125

1,603

1,460

769

Teagasc Activities

Ceisteanna (154)

Thomas Pringle

Ceist:

154. Deputy Thomas Pringle asked the Minister for Agriculture, Food and the Marine the policy of Teagasc towards stakeholder engagement; the bodies that are designated stakeholders; the way in which they are routinely consulted; his views on whether environmental organisations are stakeholders; and the approach of his Department to stakeholder engagement with environmental organisations. [46938/19]

Amharc ar fhreagra

Freagraí scríofa

Teagasc operates as a non-commercial state agency under the aegis of my Department.  I understand that Teagasc engages in on-going consultation with stakeholders through a network of consultative committees and through input from stakeholder representatives on the Teagasc Authority. I have asked Teagasc to provide further information directly to the Deputy on the level of engagement as this is an operational matter for Teagasc in the first instance.

My Department is committed to working collaboratively with stakeholders to achieve optimal outcomes for the agri food sector including protection of the environment. We engage with environmental stakeholders through the Environmental Pillar which is made up of national environmental non-governmental organisations who work together to represent the views of the Irish environmental sector. Engagement takes place across a wide range of issues including major policies such as the CAP where they are represented on the CAP Consultative Committee. My officials also have ongoing engagement on a formal and informal basis with the Environmental Pillar and/or its organisations.  I also met with the Environmental Pillar earlier this year. My Department is committed to ongoing consultation to improve the environmental sustainability of agriculture and land use.

Waste Management

Ceisteanna (155)

Darragh O'Brien

Ceist:

155. Deputy Darragh O'Brien asked the Minister for Communications, Climate Action and Environment if construction and demolition waste landfill availability and recycling facilities capacity has been reviewed; if his Department has contacted the Environmental Protection Agency on the issue; and if he will make a statement on the matter. [47028/19]

Amharc ar fhreagra

Freagraí scríofa

Waste management planning, including with regard to infrastructure provision, is the responsibility of local authorities under Part II of the Waste Management Act, 1996 (as amended). Under section 60(3) of the Act I am precluded from exercising any power or control in relation to the performance, in specific cases, by a Local Authority of their statutory functions under the Act. However, my officials engage on an ongoing basis with the three Regional Waste Management Planning Lead Authorities, the Environmental Protection Agency and the waste industry on the issue of managing construction and demolition (C&D) and residual municipal solid waste (rMSW).

In addition, in June 2018, my Department established a Construction Waste Resource Group comprising key Construction and Demolition sector and Waste sector stakeholders, including policy, regulatory and industry to provide a valuable platform to discuss and monitor C&D waste issues arising, including the capacity of the sector to manage C&D waste.

Renewable Energy Generation

Ceisteanna (156)

Denis Naughten

Ceist:

156. Deputy Denis Naughten asked the Minister for Communications, Climate Action and Environment the steps he has taken with the Minister for Agriculture, Food and the Marine to support the production of domestic biomass to supply Lanesboro and Shannonbridge power stations in advance of the decision by the ESB not to proceed with planning for both plants; and if he will make a statement on the matter. [46928/19]

Amharc ar fhreagra

Freagraí scríofa

The Department of Agriculture, Food and the Marine has a number of support measures in place to increase and mobilise biomass with an increasing biomass harvest of over 1 million cubic metres harvested from private forest estate last year.

In the event that all three of the electricity generating plants in the Midlands co-fired peat with biomass, there would not be sufficient amounts of indigenous biomass to meet the demand. Decisions regarding the sourcing of biomass are operational matters for the power plant operator, ESB.

In addition to the three Midlands power stations, there is demand for biomass for use in industry and in residential heating, and the Government’s Support Scheme for Renewable Heat will also create a demand for biomass supplies in the coming years.

Renewable Energy Projects

Ceisteanna (157)

Darragh O'Brien

Ceist:

157. Deputy Darragh O'Brien asked the Minister for Communications, Climate Action and Environment the transition protocol needed to facilitate the development of legacy offshore renewable energy projects which is required under action 25 of the Climate Action Plan 2019; the work carried out to date to develop the protocol; and if he will make a statement on the matter. [46937/19]

Amharc ar fhreagra

Freagraí scríofa

The Climate Action Plan includes, inter alia, a suite of actions to decarbonise the electricity sector and boost the quantity of renewable generation in order to meet our target of 70% of demand from renewable sources by 2030; the Plan commits to connecting at least 3.5GW of Offshore Wind by 2030.

Currently, only offshore renewable energy projects within the limits of the foreshore (12 nautical miles) may be licensed under the Foreshore Act 1933, as amended. The relevant provisions of the Foreshore Act are administered by the Department of Housing, Planning and Local Government.The Marine Planning and Development Management Bill aims to address both current deficiencies in the foreshore regime and the legal lacunae in regard to the State’s inability to regulate certain activities such as offshore renewable energy in areas beyond the foreshore. The Bill, which is one element of an overall reform of marine planning policy, is being developed by the Department of Housing, Planning and Local Government, working closely with my Department insofar as offshore renewable energy is concerned. The transition protocol to facilitate the development of legacy offshore renewable energy projects has been included as part of the overall Marine Planning and Development Management Bill drafting process. The Climate Action Plan commits to publishing this Bill by the end of this year and my department is working closely with Department of Housing and Planning to deliver on this.

Harbours and Piers Development

Ceisteanna (158)

Seán Sherlock

Ceist:

158. Deputy Sean Sherlock asked the Minister for Communications, Climate Action and Environment if his attention has been drawn to a liquid natural gas, LNG, terminal for Cork Harbour; and his views on same. [46962/19]

Amharc ar fhreagra

Freagraí scríofa

I understand that in July 2017 US company NextDecade announced it had signed a Memorandum of Understanding with the Port of Cork to develop a Liquid Natural Gas import terminal in Cork harbour, using a floating storage and regasification unit. NextDecade’s “Inisfree” project is a private sector project . Final investment decisions for this project and compliance with all legal and regulatory requirements in relation to consents or permits will be the responsibility of the project promoter.

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