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Wednesday, 20 Nov 2019

Written Answers Nos. 186-205

Ministerial Advisers Data

Ceisteanna (186)

Fiona O'Loughlin

Ceist:

186. Deputy Fiona O'Loughlin asked the Minister for Health the political advisers used by Ministers and Ministers of State in his Department since the commencement of this Government; the commencement and cessation dates in each case; and if he will make a statement on the matter. [47966/19]

Amharc ar fhreagra

Freagraí scríofa

The information requested is detailed in the following table.

Minister/Minister of State

Special Adviser

Start Date

End Date of Applicable

Simon Harris T.D.

Joanne Lonergan

25/05/2016

N/A

Sarah Bardon

20/09/2018

N/A

Majella Fitzpatrick

30/05/2016

14/06/2017

Kathyann Barrett

14/06/2017

07/09/2018

Finian McGrath T.D.

Damian O'Farrell

09/05/2016

N/A

Gerard Maguire

12/09/2016

N/A

Jim Daly T.D.

Darren Hourihane

07/09/2017

N/A

Catherine Byrne T.D.

Nicola Clavin

01/05/2018

N/A

Home Care Packages Administration

Ceisteanna (187)

Pat Deering

Ceist:

187. Deputy Pat Deering asked the Minister for Health when a person (details supplied) will be assessed by the HSE for further homecare hours. [47981/19]

Amharc ar fhreagra

Freagraí scríofa

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

Hospital Waiting Lists

Ceisteanna (188)

Michael McGrath

Ceist:

188. Deputy Michael McGrath asked the Minister for Health when a child (details supplied) in County Cork will receive an appointment to see a paediatric consultant rheumatologist at Our Lady's Children's Hospital, Crumlin; and if he will make a statement on the matter. [47982/19]

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.

Nursing Home Services

Ceisteanna (189)

Stephen Donnelly

Ceist:

189. Deputy Stephen Donnelly asked the Minister for Health the infection control measures in place in nursing and residential homes to prevent and tackle flu outbreaks; and if he will make a statement on the matter. [47985/19]

Amharc ar fhreagra

Freagraí scríofa

The Health Information and Quality Authority (HIQA) was established in 2007. HIQA is an independent authority established to drive high-quality and safe care for health and social care services in Ireland.

HIQA’s mandate extends across a range of public, private and voluntary sector services. Reporting to the Minister for Health and the Minister for Children and Youth Affairs, HIQA’s role is to develop standards, inspect and review health and social care services and support informed decisions on how services are delivered.

HIQA operates under the Health Act 2007, which sets out the functions which the Authority is to carry out. HIQA has responsibility for setting standards for healthcare services, and monitoring compliance with those standards. It also regulates facilities providing care for the elderly and those with disabilities, and has a role with regard to inspecting some of the social care services which are accessed by children to determine if they are meeting the relevant National Standards.  Section 9 of the Act sets out the grounds under which HIQA may undertake an investigation into a particular service, or may be requested to undertake such an investigation by the Minister for Health.

Following a statutory consultation process and  Ministerial approval, HIQA published specific national standards for community health and social care services in Ireland (including nursing and residential homes), which cover infection prevention and control and antimicrobial stewardship. The standards outline 20 standard statements and cover important areas such as communicating well with people who use community health or social care services, involving people in making decisions about their care, providing care in a clean and safe environment and prescribing antimicrobial medication in a safe manner.

Standard 3.4 of this document sets out measures to ensure that outbreaks of infection (including influenza infection) are identified, managed, controlled and documented in a timely and effective manner that such premises are required to implement. These measures are as follows:

- Staff report to their line manager any signs or symptoms of infection in individuals or groups of people or residents to facilitate prevention, early detection and control the spread of infection.

- Staff know who to contact for advice in the event of a suspected or confirmed outbreak and are encouraged to ask for advice from colleagues, such as a community infection prevention and control nurse, the local Department of Public Health and or a consultant microbiologist, if uncertain about the  best course of action.

- Any suspected or confirmed outbreaks of infection are promptly notified to the medical officer of health in the relevant Department of Public Health, in line with legislation. Registered providers of designated centres are also required to report outbreaks of notifiable diseases to HIQA.

- All facilities where care is delivered have a documented outbreak management plan appropriate to the services provided, detailing the action to be taken in the event of an outbreak of infection, in line with relevant national guidelines where they exist.

- Staff clearly communicate with and support people affected by an outbreak in a timely and effective manner.

-  All staff implement outbreak control measures as soon as possible to help reduce the impact of the outbreak. Consideration is given to the impact of visiting restrictions on residents and their families.

- A nominated person from the residential care service liaises with specialist staff, such as the community infection prevention and control nurse and the local Department of Public Health, and provides all information necessary to assess and control the outbreak.

Vaccination Programme

Ceisteanna (190)

Stephen Donnelly

Ceist:

190. Deputy Stephen Donnelly asked the Minister for Health if the HSE monitors the number of nursing home patients, public and private, that have been vaccinated against flu; and if he will make a statement on the matter. [47986/19]

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 the Health Service Executive collects and collates influenza statistics, it has been referred to the HSE for attention and direct reply to the Deputy.

Vaccination Programme

Ceisteanna (191)

Stephen Donnelly

Ceist:

191. Deputy Stephen Donnelly asked the Minister for Health if private hospitals have been asked to vaccinate staff against the flu; and if he will make a statement on the matter. [47987/19]

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.

Each year the HSE reviews, and updates its influenza plans, taking into account lessons learned from previous years with a view to targeting key groups in order to create the greatest impact in terms of people receiving the influenza vaccine. The seasonal influenza vaccination is recommended for persons aged 65 years of age and older, health care workers and people in at risk groups.

On 10th of October, I officially launched the HSE influenza flu vaccine campaign for 2019/2020. This year, for the first time, on foot of a recommendation from the National Immunisation Advisory Committee a quadrivalent influenza vaccine will be used instead of the standard trivalent vaccine. The provision of a quadrivalent vaccine will offer a substantially greater level of protection to the population when compared to the trivalent vaccine provided in recent years.

I am informed by the HSE that they have not written specifically to private hospitals. However, the HSE influenza campaign advises that all staff who work in any healthcare setting should be offered influenza vaccination, in order to protect themselves, their families and their patients. 

Pharmacy Services

Ceisteanna (192)

Willie Penrose

Ceist:

192. Deputy Willie Penrose asked the Minister for Health the rationale for the decision of his Department to propose significant cuts to pharmacy fees from January 2020 (details supplied); and if he will make a statement on the matter. [48001/19]

Amharc ar fhreagra

Freagraí scríofa

As the Minster for Health I recognise the significant role community pharmacists play in the delivery of patient care and the potential for this role to be developed further in the context of health service reform and modernisation.

The regulations governing the current pharmacy fee structure were made under section 9 of the FEMPI Act 2009 and are set to expire at the end of 2019. Under the Public Service Pay and Pensions Act 2017, these regulations must be replaced on 1 January 2020 to maintain a statutory basis for contractor payments and to prescribe the fees payable from that date. The fees to be set are determined by the Minister for Health, with the consent of the Minister for Public Expenditure and Reform.

In keeping with my obligations under Section 43 of the 2017 Act, Department of Health officials have begun a process of consultation with the IPU, as the representative body, prior to the introduction of new fee regulations. My officials have met with an IPU delegation on two occasions and a detailed submission was received from the IPU on 8 November.

That submission is currently being considered by my Department in the context of the statutory fee-setting process as referred to.

Medical Aids and Appliances Provision

Ceisteanna (193)

James Browne

Ceist:

193. Deputy James Browne asked the Minister for Health the number of persons in County Wexford awaiting a hearing aid for more than six, 12, 24 and 36 months, respectively; and if he will make a statement on the matter. [48007/19]

Amharc ar fhreagra

Freagraí scríofa

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

Services for People with Disabilities

Ceisteanna (194)

Mary Lou McDonald

Ceist:

194. Deputy Mary Lou McDonald asked the Minister for Health if he will provide the capital funding required to complete the upgrades needed to maintain services at a resort (details supplied). [48016/19]

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.

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 to the Deputy.

Hospital Services

Ceisteanna (195)

Michael Fitzmaurice

Ceist:

195. Deputy Michael Fitzmaurice asked the Minister for Health the reason the quality of day services offered by the Sacred Heart Hospital, County Roscommon for elderly persons has diminished recently; the reason the length of time such persons are allowed to stay has shortened; the reason the number of vehicles used to transport persons to and from the hospital has been dropped to just one; and if he will make a statement on the matter. [48017/19]

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.

Medical Conditions

Ceisteanna (196)

Thomas P. Broughan

Ceist:

196. Deputy Thomas P. Broughan asked the Minister for Health the measures he is taking to improve access to treatments for persons with multiple sclerosis here; and if he will make a statement on the matter. [48020/19]

Amharc ar fhreagra

Freagraí scríofa

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, 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.

As a country, we invest heavily in medicines, to the tune of almost €2 billion annually. As of October 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.

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 and 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.

The HSE has also received an application for reimbursement of Delta-9-tetrahydrocannabinol/Cannabidiol, THC/CBD (Sativex) which is indicated as treatment for symptom improvement in adult patients with moderate to severe spasticity due to multiple sclerosis who have not responded adequately to other anti-spasticity medication and who demonstrate clinically significant improvement in spasticity related symptoms during an initial trial of therapy.

The HSE commissioned a full HTA with respect to this indication in April 2018. On 25 September 2019, the NCPE received the applicant's submission and the HTA is currently underway.

Departmental Data

Ceisteanna (197)

Shane Cassells

Ceist:

197. Deputy Shane Cassells asked the Minister for Health the number of complaints of bullying and sexual harassment, respectively received by his Department in each of the years 2016 to 2018 and to date in 2019, in tabular form. [48039/19]

Amharc ar fhreagra

Freagraí scríofa

The Civil Service Dignity at Work Policy applies to the staff of the Department of Health.  In line with the policy, every member of staff has been made aware that all forms of bullying and sexual harassment are unacceptable and that every member of staff has a duty to behave in an acceptable and respectful manner.

There has only been one complaint in my Department in relation to bullying and sexual harassment during the years 2016 to 2018 and to date in 2019.  The finding of the subsequent external investigation was that the complaint was not upheld. 

National Dementia Strategy

Ceisteanna (198)

Michael McGrath

Ceist:

198. Deputy Michael McGrath asked the Minister for Health the position in relation to the level of community and home supports that will be available for persons with dementia nationally in 2020; the position in relation to the recruitment of dementia advisors; and if he will make a statement on the matter. [48046/19]

Amharc ar fhreagra

Freagraí scríofa

The level of community and home supports that will be available for older people, including people with dementia, will be set out in the 2020 National Service Plan (NSP). In 2020 the HSE will deliver over 19.2 million hours of home support to older people, including those with dementia. This represents a substantial increase of 1 million hours more than this year’s target.   

The Government has also decided to fund an additional ten dementia advisers as part of an expansion of health care delivery in the community in Budget 2020 to deliver on the vision of Sláintecare. As the issue of recruitment is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Paediatric Services

Ceisteanna (199)

Robert Troy

Ceist:

199. Deputy Robert Troy asked the Minister for Health if a replacement has been hired to replace a person (details supplied) when they cease employment at the end of November 2019; and if not, the procedure in place to ensure sufferers of juvenile arthritis can still avail of pain relief, such as, lidocaine infusions. [48051/19]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Children's Health Ireland to respond to you directly, as soon as possible.

Home Care Packages Provision

Ceisteanna (200)

Jackie Cahill

Ceist:

200. Deputy Jackie Cahill asked the Minister for Health if there is a 30 hour a week home care package available for a person (details supplied); and if he will make a statement on the matter. [48057/19]

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.

Departmental Staff Data

Ceisteanna (201)

Shane Cassells

Ceist:

201. Deputy Shane Cassells asked the Minister for Health the number of employees of his Department that were dismissed in each of the years 2016 to 2018 and to date 2019; the reason for the dismissal of each employee; the number of employees suspended in the same period; and the reason for the suspension of each in tabular form. [48074/19]

Amharc ar fhreagra

Freagraí scríofa

I wish to advise the Deputy that nobody in my Department has been dismissed or suspended in any of the years 2016 to 2018 and to date in 2019.

Departmental Expenditure

Ceisteanna (202)

Barry Cowen

Ceist:

202. Deputy Barry Cowen asked the Minister for Health the amount spent on public relations, promotion and advertising for the National Development Plan 2018-2027 and Project Ireland 2040 since its publication in February 2018 by category (details supplied) in tabular form; and if he will make a statement on the matter. [48126/19]

Amharc ar fhreagra

Freagraí scríofa

To date, the Department of Health has incurred no spend on public relations, promotion or advertising in relation to the National Development Plan 2018-2027 and Project Ireland 2040.  

Ambulance Service Provision

Ceisteanna (203)

Pearse Doherty

Ceist:

203. Deputy Pearse Doherty asked the Minister for Health the reason a person (details supplied) in Country Donegal was not provided with ambulance transport back to the county following an operation in Galway University Hospital; and if he will make a statement on the matter. [48155/19]

Amharc ar fhreagra

Freagraí scríofa

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

Hospital Admissions

Ceisteanna (204)

Pearse Doherty

Ceist:

204. Deputy Pearse Doherty asked the Minister for Health if a bed will be provided in the woodville ward, St Joseph’s Community Hospital, County Donegal for a person (details supplied); and if he will make a statement on the matter. [48156/19]

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.

Services for People with Disabilities

Ceisteanna (205)

Pearse Doherty

Ceist:

205. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) in County Donegal will be admitted into full-time residential care; and if he will make a statement on the matter. [48157/19]

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.

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