Services for People with Disabilities

Ceisteanna (392)

Brendan Howlin

Ceist:

392. Deputy Brendan Howlin asked the Minister for Health if funding to a care centre (details supplied) will be increased in order that services can be extended to support those with multiple sclerosis; and if he will make a statement on the matter. [47407/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

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

Respite Care Services Funding

Ceisteanna (393)

Jack Chambers

Ceist:

393. Deputy Jack Chambers asked the Minister for Health if he will intervene to ensure a respite centre for persons with disabilities (details supplied) will not close; and if he will make a statement on the matter. [47414/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities. The Programme for Partnership Government states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability.

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 t o the Deputy

Hospital Appointments Status

Ceisteanna (394)

Michael Healy-Rae

Ceist:

394. Deputy Michael Healy-Rae asked the Minister for Health the status of an eye scan for a person (details supplied); and if he will make a statement on the matter. [47422/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

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

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

Medicinal Products Reimbursement

Ceisteanna (395)

Michael Moynihan

Ceist:

395. Deputy Michael Moynihan asked the Minister for Health if all patients diagnosed with stage 3 melanoma cancer can have access to OPDIVO; if his attention has been drawn to the disparity between private and public patients in terms of access to the treatment; and if he will make a statement on the matter. [47423/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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 licensed indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.HSE decisions on which 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 a number of applications for the reimbursement of nivolumab (Opdivo). Some of these have already been approved for reimbursement, including applications for the following indications:

- As monotherapy for the treatment of advanced (unresectable or metastatic) melanoma in adults

- In combination with ipilimumab, indicated for the treatment of advanced (unresectable or metastatic) melanoma in adults

The HSE has received an application for the reimbursement of nivolumab as monotherapy for the adjuvant treatment of adults with melanoma with involvement of lymph nodes or metastatic disease who have undergone complete resection.In respect of this indication, a health technology assessment was completed on 13 October 2019 with the NCPE recommending that nivolumab be considered for reimbursement if cost-effectiveness can be improved relative to existing treatments. The HSE will assess this application for reimbursement in line with the 2013 Health Act.In March 2019, the VHI sent a circular to Oncologists advising them that it was extending cover to a number of new cancer medicines. The decision by the VHI applies only to private care to private VHI patients in private hospitals. It will have no impact on the availability and use of medicines in public hospitals, where there is no distinction between public and private patients.The effect of the VHI decision will be that VHI private patients in private hospitals may have access to a medicine that is not yet available in the public hospital system. However, a number of the medicines, or indications, which the VHI has now decided to cover, are at various stages of the HSE assessment and reimbursement process with a view to making them available in the public hospital system.

Services for People with Disabilities

Ceisteanna (396)

Mary Butler

Ceist:

396. Deputy Mary Butler asked the Minister for Health if consideration will be given to employing a second full-time nurse for a special school (details supplied) in County Waterford. [47426/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

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

Cross-Border Health Services Provision

Ceisteanna (397)

Louise O'Reilly

Ceist:

397. Deputy Louise O'Reilly asked the Minister for Health if correspondence from his Department issued to general practitioners in Northern Ireland on entitlements of patients following a change in interpretation of an EU directive (details supplied); the reason he decided to change its interpretation of the directive for retired cross-Border workers; and if he will make a statement on the matter. [47433/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

EU Regulation 883/2004 on the coordination of social security systems applies to insured persons working within the EU, including their entitlement to healthcare (sickness benefits). The position regarding the health entitlements of retired frontier workers under this Regulation has not changed. In this regard the Regulation states that retired frontier workers are only entitled to continue to receive healthcare in the Member State in which they were formally employed in so far as this healthcare is a continuation of treatment which began in that Member State.

Vaccination Programme

Ceisteanna (398)

Gino Kenny

Ceist:

398. Deputy Gino Kenny asked the Minister for Health if his attention has been drawn to the fact that parents who want their daughter who is 15 years of age to receive the HPV vaccine will incur charges of €900 while their 12 years of age son will receive it for free; the rationale for same; the steps he will take to provide the vaccine free of charge to those that are proactive in having their children vaccinated; and if he will make a statement on the matter. [47472/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The committee's recommendations are based on the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation. It makes recommendations on vaccination policy to my Department. NIAC continues to revise recommendations to allow for the introduction of new vaccines in Ireland and to keep abreast of changes in the patterns of disease. Therefore, the immunisation schedule will continue to be amended over time.

In 2009 the NIAC recommended HPV (human papillomavirus) vaccination for all 12-13 year old girls to reduce their risk of developing cervical cancer when they are adults. In September 2010 the HPV vaccination programme was introduced for all girls in first year of secondary school. Gardasil is the vaccine used by the HSE in the School Immunisation Programme and is provided free of charge to girls in first year of secondary school.

During the 2019/20 school year, girls attending secondary school can still join the HPV girls only programme with appointments offered in HSE mop up clinics. 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. It must be noted that vaccinated women and girls may still be at risk from other high risk types of HPV that can cause cervical cancer and will therefore need to continue to have regular cervical smear tests.

As you are aware, NIAC recommended that the HPV vaccine should also 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 to include boys in the 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.

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

Paediatric Services

Ceisteanna (399)

Thomas Byrne

Ceist:

399. Deputy Thomas Byrne asked the Minister for Health the number of children living in County Meath waiting to see a paediatrician for an outpatient appointment, a paediatric cardiologist, a paediatric ENT specialist and a paediatric surgeon. [47473/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Reducing waiting time for patients for hospital operations and procedures is a key priority for Government. In this regard, the Government is committed to improving waiting times for hospital appointments and procedures.

Budget 2020 announced that the Government has further increased investment in tackling waiting lists, with funding to the National Treatment Purchase Fund (NTPF) increasing from €75 million in 2019 to €100 million in 2020.

My Department is working with the HSE and National Treatment Purchase Fund to develop the Scheduled Care Access Plan 2020. The National Service Plan 2020 will set out HSE planned activity level for the year ahead, while the NTPF will work with the hospital system to provide additionality to improve access to inpatient/daycase treatment and with a particular focus on hospital outpatient services.

In this regard, I would encourage all hospital groups and individual hospitals to engage with the NTPF to identify waiting list proposals for the remainder of this year and for 2020.

The information requested by the deputy is outlined in the following table.

Paediatric Outpatients for Paediatric Surgery, ENT, Cardiology, with a residence in Co. Meath.

Paediatric Surgery

184

ENT

911

Cardiology

327

Hospital Services

Ceisteanna (400, 408, 422, 423)

Seán Fleming

Ceist:

400. Deputy Sean Fleming asked the Minister for Health the discussions or consideration given to remove services from a hospital (details supplied); if consideration is being given to outsourcing the service; if a role for the National Treatment Purchase Fund is being considered in the matter; and if he will make a statement on the matter. [47481/19]

Amharc ar fhreagra

Seán Fleming

Ceist:

408. Deputy Sean Fleming asked the Minister for Health the reason there has been a disregard for the employment rights of existing contract holding consultant pathologists (details supplied); and if he will make a statement on the matter. [47520/19]

Amharc ar fhreagra

Seán Fleming

Ceist:

422. Deputy Sean Fleming asked the Minister for Health if he will provide clinical evidence to support outsourcing of services from a hospital; if a risk analysis has been undertaken to evaluate the possible adverse events arising from same and the consultation involved to date (details supplied); the discussions on the issue to date; and if he will make a statement on the matter. [47588/19]

Amharc ar fhreagra

Seán Fleming

Ceist:

423. Deputy Sean Fleming asked the Minister for Health the reason there has been no regard for existing INAB accreditation service level agreements; the reason no consideration has been given to the wider implications of undermining existing services in the midlands region in particular reputational damage to his Department at the hospital (details supplied); the effect that this will have on the provision of services to patients in the future; and if he will make a statement on the matter. [47589/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 400, 408, 422 and 423 together.

As these are service matters, I have asked the Health Service Executive to respond to you directly, as soon as possible.

HSE Staff Recruitment

Ceisteanna (401)

Éamon Ó Cuív

Ceist:

401. Deputy Éamon Ó Cuív asked the Minister for Health if his attention has been drawn to the fact that the central personnel section of the HSE is not approving appointments across the health system to fill vacancies; the steps he has taken to ensure that the HSE adopts a policy to fill all vacancies in the health service in cases in which this has been recommended by the relevant section of the HSE to provide necessary services; and if he will make a statement on the matter. [47508/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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

Traveller Projects Funding

Ceisteanna (402, 403)

Éamon Ó Cuív

Ceist:

402. Deputy Éamon Ó Cuív asked the Minister for Health his plans to ensure that the HSE ring-fences funding for the full implementation of the national Traveller health action plan; if he will direct the HSE to form a structure on which Travellers will be at least half the membership to oversee the implementation of the plan; and if he will make a statement on the matter. [47511/19]

Amharc ar fhreagra

Éamon Ó Cuív

Ceist:

403. Deputy Éamon Ó Cuív asked the Minister for Health if he will have a role in the approval of the national Traveller health action plan; if so, the role; and if he will make a statement on the matter. [47512/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 402 and 403 together.

As Minister I am very aware of the health inequalities experienced by Travellers. Significant measures have been undertaken across the health service to address these inequalities, and there is ongoing and extensive engagement with Traveller organisations in this regard.

The Department of Health, via the HSE, provides in excess of €10m, to support a range of targeted initiatives, programmes and supports to improve the health status of Travellers. These include:

- primary healthcare projects, counselling services, family support programmes and men's health projects;

- Traveller Health units and related staff;

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

- Mental Health Service Coordinator for Travellers posts responsible for driving, managing and supporting the implementation of agreed improvement programmes and projects for Travellers.

Furthermore, the HSE employs a number of Public Health Nurses and related staff towards addressing priority health needs of members of the Traveller community.

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.

The HSE is developing 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. My colleague the Minister for Health and I are engaged with and supportive of the health action plan. We look forward to considering the plan and are committed to providing leadership to support the implementation of the health 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 Projects Funding

Ceisteanna (404)

Éamon Ó Cuív

Ceist:

404. Deputy Éamon Ó Cuív asked the Minister for Health his plans to reinstate the same level of funding for issues affecting Traveller health as applied in 2007 and 2008; and if he will make a statement on the matter. [47513/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Members of the Travelling community are entitled to avail of all mainstream public health services.

The Department of Health, via the HSE, provides in excess of €10m, to support a range of targeted initiatives, programmes and supports to improve the health status of Travellers. These include:

- primary healthcare projects, counselling services, family support programmes and men's health projects;

- Traveller Health units and related staff;

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

- Mental Health Service Coordinator for Travellers posts responsible for driving, managing and supporting the implementation of agreed improvement programmes and projects for Travellers.

Furthermore, the HSE employs a number of Public Health Nurses and related staff towards addressing priority health needs of members of the Traveller community.

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.

Traveller Community

Ceisteanna (405)

Éamon Ó Cuív

Ceist:

405. Deputy Éamon Ó Cuív asked the Minister for Health if the bureaucratic barriers for Travellers accessing medical cards will be reduced in view of the literacy challenges faced by some Travellers; if free general practitioner healthcare will be provided to all Travellers within five years in line with Sláintecare; if Travellers will be prioritised in the process in view of their poor health outcomes; and if he will make a statement on the matter. [47514/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Every effort is made by the HSE, within the framework of the legislation, to provide a medical card application system that is responsive and sensitive to people’s needs. If the HSE is made aware that a person has particular requirements, assistance will be afforded to help that person complete the application. This assistance can be availed of through a person's local health office or by calling LoCall 1890 252 919.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.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.

Traveller Community

Ceisteanna (406)

Éamon Ó Cuív

Ceist:

406. Deputy Éamon Ó Cuív asked the Minister for Health his plans to ensure the retention of medical cards for Traveller health workers in view of the importance of Traveller community health workers in improving traveller health; if the retention of Traveller health workers will be ensured by increasing the funding to primary health care projects and by linking their payscales to the relevant HSE payscale taking into account the experience of these workers; if progression routes for Traveller health workers into mainstream employment will be identified including full-time employment; if redundancy and pension payments will be ensured for Traveller health workers in line with the rest of the HSE; and if he will make a statement on the matter. [47515/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Traveller community health workers are employed to provide primary health care to members of the Traveller Community. The projects are supported by the HSE via Section 39 funding

The HSE grant-aids a range of service providers under section 39 of the Health Act 2004. 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.

The HSE does not 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.

In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Eligibility for health services is based primarily on residency and means. The HSE is obliged under the Act to undertake periodic reviews of eligibility in order to ensure that a person continues to meet the qualifying criteria required to continue holding eligibility. Where a medical card is due to expire, these cards are reviewed and a renewal notice is sent out to the medical card holder three months in advance of the expiry date. It is important to note that the person under review maintains eligibility for the card while the review is being conducted, including any period where additional information is requested.

Traveller Community

Question No. 408 answered with Question No. 400.

Ceisteanna (407)

Éamon Ó Cuív

Ceist:

407. Deputy Éamon Ó Cuív asked the Minister for Health the steps he will take to ensure each health policy and the implementation of same including Sláintecare are Traveller proofed to ensure that the distinct health needs of Travellers and health inequalities are addressed; and if he will make a statement on the matter. [47516/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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. The Minister for Health and I are engaged with and supportive of the health action plan. We are committed to providing leadership to support the implementation of the action plan.

Question No. 408 answered with Question No. 400.

Medicinal Products Reimbursement

Ceisteanna (409)

Willie O'Dea

Ceist:

409. Deputy Willie O'Dea asked the Minister for Health further to Parliamentary Question No. 279 of 22 October 2019, if osimertinib for adult patients with locally advanced or metastatic EGFRT790M mutation-positive non-small cell lung cancer will be made available from 1 January 2020; if the HSE senior leadership team has discussed the reimbursement of the drug for adult patients with same subsequent to its decision of 9 July 2019 that it was minded to approve the drug; and if he will make a statement on the matter. [47536/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Health Service Executive has operational responsibility for medicines expenditure, thus the matter has been referred to the HSE for their attention and direct reply to the Deputy.

HSE Reports

Ceisteanna (410)

Pat Deering

Ceist:

410. Deputy Pat Deering asked the Minister for Health the status of the sodium valproate rapid assessment report (details supplied) completed by the HSE; when it will be available; and if he will make a statement on the matter. [47545/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I am due to receive a briefing on the HSE's Valproate Response Project from officials in my Department in the coming days. I will consider the report in full at that time.

HSE National Service Plan

Ceisteanna (411)

Stephen Donnelly

Ceist:

411. Deputy Stephen Donnelly asked the Minister for Health when the HSE national service plan for 2020 will be published. [47548/19]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The HSE National Service Plan 2020 has been submitted and is under consideration in my Department. In the coming weeks it will be brought to Government, laid before the Houses of the Oireachtas and published. The National Service Plan must be laid before the Houses of the Oireachtas within 21 days of its approval. Once the service plan is laid before the Houses of the Oireachtas, the HSE will ensure it is published at the earliest possible time.