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Tuesday, 14 Jul 2020

Written Answers Nos. 1097-1121

Assisted Human Reproduction

Ceisteanna (1097)

Gerald Nash

Ceist:

1097. Deputy Ged Nash asked the Minister for Health if the process for the passage of urgent legislation to provide a clear legal framework in respect of assisted human reproduction will be expedited; the timeframe for the passage of this legislation and its commencement; and if he will make a statement on the matter. [15078/20]

Amharc ar fhreagra

Freagraí scríofa

As the Deputy will be aware, the Government approved the drafting of a bill on assisted human reproduction (AHR) and associated areas of research, based on the published General Scheme of the Assisted Human Reproduction Bill. This comprehensive piece of legislation encompasses the regulation of a range of practices for the first time, including: gamete (sperm or egg) and embryo donation for AHR and research; surrogacy; pre-implantation genetic diagnosis (PGD) of embryos; posthumous assisted reproduction; and embryo and stem cell research. The General Scheme also provides for the establishment of an independent regulatory authority for AHR.

Drafting of the Bill is ongoing, in conjunction with the Office of the Attorney General. It is not possible at this time to give a definitive timeline for the publication of the Bill and its subsequent passage through the Houses of the Oireachtas. However, the recently-published Programme for Government affirms this Government’s intention to enact this legislation.

Thalidomide Victims Compensation

Ceisteanna (1098)

Kathleen Funchion

Ceist:

1098. Deputy Kathleen Funchion asked the Minister for Health if he will address a matter regarding the case of a person (details supplied). [15084/20]

Amharc ar fhreagra

Freagraí scríofa

The supports provided to the 29 Irish survivors of thalidomide include a monthly payment for life, a medical card on an administrative basis regardless of means, provision of appliances, artificial limbs, equipment, housing adaptations and access to a full range of primary care, hospital and personal social services. My Department also provides once-off ex-gratia grants to survivors towards the cost of health and personal social services. These supports are provided directly from a dedicated Department of Health subhead "Payments in respect of disablement caused by Thalidomide".

There is a designated senior manager in the Health Service Executive, to act as the National Thalidomide Liaison in respect of the ongoing health and personal social service needs of Irish survivors. I have arranged for the matter to be investigated and a separate reply will issue to the Deputy as soon as possible.

Primary Care Centres

Ceisteanna (1099)

Róisín Shortall

Ceist:

1099. Deputy Róisín Shortall asked the Minister for Health the status of the provision of a primary care centre at a location (details supplied); if the site selection process has been completed; the planned timeline for construction to begin; the facilities which will be available there; and if he will make a statement on the matter. [15088/20]

Amharc ar fhreagra

Freagraí scríofa

As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

HSE Data

Ceisteanna (1100)

Alan Dillon

Ceist:

1100. Deputy Alan Dillon asked the Minister for Health the number of persons employed by the HSE (details supplied) within the administrative and front-line sectors; and the percentage spend on salaries for both sections with the HSE annual budget. [15122/20]

Amharc ar fhreagra

Freagraí scríofa

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

Cannabis for Medicinal Use

Ceisteanna (1101)

Alan Kelly

Ceist:

1101. Deputy Alan Kelly asked the Minister for Health his plans to legalise cannabis during his term as Minister; and if he will make a statement on the matter. [15137/20]

Amharc ar fhreagra

Freagraí scríofa

The Programme for Government highlights concern about the increasing prevalence of illegal drug use over recent decades. Cannabis use by adolescents, in particular, is worrying as it poses risks of dependence and developing psychotic illness. Accordingly, the Government has no plans to legalise cannabis during its term of office.

The Programme for Government sets out a health-led approach to drug misuse. By treating the use of substances as a public health issue, rather than solely as a criminal issue, we can better help individuals, their families and the communities in which we live.

The National Drugs Strategy, Reducing Harm, Supporting Recovery, A health-led response to drug and alcohol use in Ireland 2017-2025, provides a roadmap to achieving these aims, by promoting a more compassionate and humane approach to people who use drugs, with drug use treated first and foremost as a public health issue.

The Programme for Government affirms the Government's commitment to implementing the recommendations of the Working Group on alternative approaches to the possession of drugs for personal use, as an important step in developing a public health led approach to drug use in this country. This approach will connect people who use drugs with health services and a pathway to recovery, avoiding a criminal conviction, which can have far-reaching consequences for people, particularly younger people. The Government will undertake a review of this alternative approach to ensure it is meeting all of its aims, following the first full year of implementation, and make any necessary changes.

The Department of Health, as part of the introduction of the Health Diversion Programme, is providing €100,000 in 2020 to develop a national harm reduction campaign to raise awareness of the risks associated with drug use.

I am committed to a public health approach to drug use, as it will lead to better outcomes for individuals and society. At the same time, we cannot be complacent about the risk to health posed by illegal drugs, including cannabis.

Alcohol Pricing

Ceisteanna (1102)

Alan Kelly

Ceist:

1102. Deputy Alan Kelly asked the Minister for Health when he will introduce minimum unit pricing for the purchase of alcohol; and if he will make a statement on the matter. [15139/20]

Amharc ar fhreagra

Freagraí scríofa

The Programme for Government commits to introducing the Minimum Unit Pricing of alcohol products.

The 2013 Government Decision which approved a minimum unit pricing regime envisaged its introduction in Northern Ireland and in this jurisdiction simultaneously in order to allay concerns about an impact on cross-border trade. I look forward to engagement and cooperation with the Northern Ireland administration so that we can both deliver on this important public health measure as soon as possible.

General Practitioner Services

Ceisteanna (1103)

Brendan Griffin

Ceist:

1103. Deputy Brendan Griffin asked the Minister for Health the status of the provision of a service (details supplied); and if he will make a statement on the matter. [15154/20]

Amharc ar fhreagra

Freagraí scríofa

As this question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.

Medical Aids and Appliances

Ceisteanna (1104)

Éamon Ó Cuív

Ceist:

1104. Deputy Éamon Ó Cuív asked the Minister for Health if funding can be provided to a person (details supplied) in order to purchase devices; if the exceptional medical circumstances in this case will be taken into account; and if he will make a statement on the matter. [15159/20]

Amharc ar fhreagra

Freagraí scríofa

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

Hospital Appointments Status

Ceisteanna (1105)

Brendan Griffin

Ceist:

1105. Deputy Brendan Griffin asked the Minister for Health if the case of a person (details supplied) will be prioritised; and if he will make a statement on the matter. [15174/20]

Amharc ar fhreagra

Freagraí scríofa

I am conscious that waiting times are often unacceptably long and of the burden that this places on patients and their families.

In response to the Covid-19 pandemic the HSE had to take measures to defer most elective scheduled care activity in line with the advice of the National Public Health Emergency Team (NPHET). This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work.

The decision to delay appointments and admissions is not undertaken lightly and when such a decision is made, it is based on the safe delivery of care to all patients. The trajectory of the disease means there is now an opportunity for increasing the provision of non-covid care including more routine care. In this context Children’s Health Ireland (CHI) is now re-establishing services on an incremental basis.

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 line with this policy, the clinical prioritisation of patients is the responsibility of the treating Consultant.

My Department has been made aware of the specific patient query raised. Children’s Health Ireland (CHI) have advised the Department that the hospital remains in constant contact with the patient’s family to provide updates and advice.

General Practitioner Services

Ceisteanna (1106)

Éamon Ó Cuív

Ceist:

1106. Deputy Éamon Ó Cuív asked the Minister for Health the reason the provision of a treatment (details supplied) at general practitioner clinics is not covered under the GMS scheme or the long-term illness scheme; and if he will make a statement on the matter. [15178/20]

Amharc ar fhreagra

Freagraí scríofa

In May 2019, agreement was reached with the IMO on a major package of GP contractual reforms and service developments which will benefit patients and general practitioners.

Under this agreement and since the beginning of 2020 GPs are paid by the HSE to provide venesection for GMS patients with haemochromatosis. This means that GMS patients with this condition can now be managed locally by their GP and no longer have to attend hospitals for therapeutic phlebotomy.

Question No. 1107 answered with Question No. 974.

Hospital Waiting Lists

Ceisteanna (1108)

Michael Healy-Rae

Ceist:

1108. Deputy Michael Healy-Rae asked the Minister for Health the number of persons waiting for a procedure (details supplied); and if he will make a statement on the matter. [15190/20]

Amharc ar fhreagra

Freagraí scríofa

In response to the Covid-19 pandemic the HSE had to take measures to pause all most elective scheduled care activity with effect from the end March 2020. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by National Public Health Emergency Team (NPHET) and in accordance with World Health Organisation guidelines, and the National Action Plan.

The trajectory of the disease means there is now an opportunity for increasing the provision of non-covid care including more routine care. NPHET has since revised its recommendation on the pausing of all non-essential health services, with a recommendation that the delivery of acute care be determined by appropriate clinical and operational decision making.

Application of the essential risk mitigating steps set out in the guidance developed under the auspices of the NPHET Expert Advisory group will have operational implications, which will impact on throughput.

Where possible, hospitals are working to find innovative ways to enable service provision, which include virtual clinics for some outpatient department appointments. The HSE website provides details on services currently available and operational in each hospital on its website. This information is reviewed frequently and provides up-to-date announcements on services available at each site (https://www2.hse.ie/services/hospital-service-disruptions/hospital-service-disruptions-covid19.html).

To ensure services are re-introduced in a safe, clinically-aligned and prioritised way, the HSE launched its Strategic Framework for ‘Service Continuity in a Covid Environment’ on 24 June. Its implementation will ensure service resumption is done in an integrated way. This will involve a phased approach to ensure community services are strengthened. The Framework will also consolidate new ways of working and build on international knowledge. The HSE is currently developing a Service Continuity Roadmap for the resumption of services across the health system.

As the system continues to deliver Covid-19 and non-Covid 19 care side-by-side over a more prolonged period, my Department and the HSE will continue to work closely together to protect essential non-Covid 19 acute care and progress the provision of more routine non Covid-19 care.

The data requested concerning the tonsils surgery waiting list is outlined in the attached document.

Table - tonsils surgery waiting list

HSE Correspondence

Ceisteanna (1109)

Michael Ring

Ceist:

1109. Deputy Michael Ring asked the Minister for Health if he will instruct HSE West to issue a reply in respect of a query that was raised (details supplied). [15192/20]

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

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.

HSE Data

Ceisteanna (1110)

David Cullinane

Ceist:

1110. Deputy David Cullinane asked the Minister for Health the contracts in place with taxi companies in County Waterford; the duration of the contracts; if the contracts were extended; the tendering processes involved; and if he will make a statement on the matter. [15197/20]

Amharc ar fhreagra

Freagraí scríofa

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

Covid-19 Tests

Ceisteanna (1111)

Alan Kelly

Ceist:

1111. Deputy Alan Kelly asked the Minister for Health when his attention was drawn to private hospitals charging for Covid-19 tests prior to treatment; and if he will make a statement on the matter. [15200/20]

Amharc ar fhreagra

Freagraí scríofa

As the Deputy will be aware, I do not have any responsibility for private hospitals, including in relation to charges that they apply.

An arrangement was agreed with the private hospitals earlier in the year to use their facilities as part of the public system on a temporary basis, to provide essential services in anticipation of additional demand on public hospital services. Under the arrangement, all patients in private hospitals were treated as public patients while the agreement was in place. On review, the Government decided that the existing arrangement should not be extended beyond the end of June, and on 1st July 2020 all private hospitals reverted to private activity. The Department of Health does not have a role in the operational functions of private hospitals.

More broadly in relation to testing, the HSE has developed guidance for the management of planned hospital admissions for non-COVID care which sets out advisory testing strategies for hospital patients. This guidance seeks to provide an advisory framework for mitigating risks associated with the delivery of non-COVID care while COVID-19 continues to be prevalent, and testing provides one of a number of measures that can be taken to reduce risk.

As with any procedure or test, there will be a cost. I am not in a position to comment on what the actual cost may be in private hospitals, however, I understand that the costs arising from testing for COVID-19 in public hospitals is much lower than the upper charges quoted by the Deputy.

In addition, I can confirm that the NTPF have advised my Department that no patient is liable for any charge from a private hospital for services arranged by the NTPF.

Hospital Procedures

Ceisteanna (1112)

Alan Kelly

Ceist:

1112. Deputy Alan Kelly asked the Minister for Health if he has made contact with Cork University Maternity Hospital on the lifting of visiting restrictions for designated birthing partners; and if he will make a statement on the matter. [15201/20]

Amharc ar fhreagra

Freagraí scríofa

As this is a service issue, I have asked the Health Service Executive to reply to you directly.

Disability Services Funding

Ceisteanna (1113)

Róisín Shortall

Ceist:

1113. Deputy Róisín Shortall asked the Minister for Health when a letter will be issued to disability service providers to confirm that the 1% cut earmarked in the 2020 HSE service plan no longer applies further to comments made by his predecessor in Dáil Éireann on 11 June 2020 in respect of funding for disability service providers; and if he will make a statement on the matter. [15203/20]

Amharc ar fhreagra

Freagraí scríofa

As the Deputy will be aware, the Government has agreed to allocate substantial additional funding to the Health Vote to meet the costs associated with the implementation of the measures outlined in the National Action Plan in response to COVID-19.

In this context, the HSE Executive Management Team has agreed a structured approach to addressing the financial challenges of Section 39 Agencies due to COVID-19. This includes many organisations who provide specialist disability services to both adults and children.

The objective of the programme is to provide a structured governance process and modus operandi through which Section 39 partners experiencing financial difficulties due to the COVID-19 Public Health Emergency (PHE) can engage through the HSE to ensure, where appropriate, continuity of essential services provided by these agencies. The HSE has also developed a methodology to provide a pro forma approach to support decision making in respect of Section 39 Organisations that have made submissions to the HSE for both financial & non-financial supports during the COVID-19 pandemic.

Furthermore, the HSE has advised the Department that it has given Section 38 and Section 39 providers of disability services and supports assurance that budget allocations confirmed to each provider via the relevant Community Healthcare Organisation, will remain in place to year end, subject to co-operation with the HSE and compliance with the relevant Service Arrangements.

The HSE and all of the providers it funds are expected to continually review their cost structures to ensure the best use of resources and a focus on the use of these resources for client care to the greatest extent possible. The very significant additional financial resources provided to disability services over the last year, together with the achievement of relatively modest efficiency savings, form part of the financing of the increased service levels set out in the National Service Plan 2020. It was intended that these efficiencies would be achieved in 2020 through the application of a 1% efficiency target to existing budgets across all service areas.

My Department supports the HSE in seeking efficiencies across all its spending areas. However, it is acknowledged that there will be challenges in achieving the 1% efficiency saving given the significant pressures on the disability sector in the context of COVID-19.

Covid-19 Tests

Ceisteanna (1114)

Neale Richmond

Ceist:

1114. Deputy Neale Richmond asked the Minister for Health the position regarding insurance coverage for Covid-19 tests for patients to access services in private hospitals; and if he will make a statement on the matter. [15211/20]

Amharc ar fhreagra

Freagraí scríofa

As the Deputy will be aware, I do not have responsibility for private hospitals, including in relation to charges that they apply. Neither do I have a role, as Minister for Health, in the commercial decisions taken by any health insurer regarding the treatments or services provided in their products, provided that the regulatory obligations set out in Minimum Benefit regulations and other health insurance legislation are complied with.

In relation to testing, the HSE has developed guidance for the management of planned hospital admissions for non-COVID care which sets out advisory testing strategies for hospital patients. This guidance seeks to provide an advisory framework for mitigating risks associated with the delivery of non-COVID care while COVID-19 continues to be prevalent, and testing provides one of a number of measures that can be taken to reduce risk.

As with any procedure or test, there will be a cost. I am not in a position to comment on what the actual cost may be in private hospitals, however, I understand that the costs arising from testing for COVID-19 in public hospitals is much lower than the upper charges referenced in recent media coverage. In addition, I can confirm that the NTPF have advised my Department that no patient is liable for any charge from a private hospital for services arranged by the NTPF.

Medical Cards

Ceisteanna (1115)

Michael Healy-Rae

Ceist:

1115. Deputy Michael Healy-Rae asked the Minister for Health if he will address a matter (details supplied) regarding changes to the over 70s medical card income threshold; and if he will make a statement on the matter. [15218/20]

Amharc ar fhreagra

Freagraí scríofa

The Health (General Practitioner Service and Alteration of Criteria for Eligibility) Bill 2020 was published on 1 July. This Bill provides, amongst other things, for the necessary legislative amendments to increase the weekly gross medical card income limits for those aged 70 and over to €550 per week for a single person (currently €500 per week) and to €1,050 for a couple (currently €900 per week).

The Bill is expected to proceed through the Houses of the Oireachtas in mid-July.

Health Information and Quality Authority

Ceisteanna (1116)

Fergus O'Dowd

Ceist:

1116. Deputy Fergus O'Dowd asked the Minister for Health if he will order an independent investigation into the circumstances of a death in a nursing home (details supplied); and if he will make a statement on the matter. [15224/20]

Amharc ar fhreagra

Freagraí scríofa

Since 2009 the Health Information and Quality Authority, HIQA, is the statutory independent regulator in place for the nursing home sector, whether a HSE managed or a private nursing home. The Authority, established under the Health Act 2007, has significant and wide-ranging powers up to and including withdrawing the registration of a nursing home facility, which means that it can no longer operate as a service provider.

This responsibility is underpinned by a comprehensive quality framework comprising of Registration Regulations, Care and Welfare Regulations and National Quality Standards.

HIQA in discharging its duties determines, through examination of all information available to it, including site inspections, whether a nursing homes meets the regulations in order to achieve and maintain its registration status. Should a nursing home be deemed to be non-compliant with the Regulations and the National Quality Standards, it may either fail to achieve or lose its registration status. In addition, the Chief Inspector has wide discretion in deciding whether to impose conditions of Registration on nursing homes.

During the response to COVID-19, Nursing homes continue to be regulated by HIQA, who under the Health Act 2007 have the legal authority to examine the operation of any facility under their remit.

In relation to this particular nursing home, I can confirm that my Department has received correspondence in relation to the matter raised by the Deputy and has forwarded on details to HIQA as the statutory regulator for nursing homes, and the HSE for appropriate action and follow up.

Question No. 1117 answered with Question No. 1019.

Medicinal Products

Ceisteanna (1118)

Pádraig O'Sullivan

Ceist:

1118. Deputy Pádraig O'Sullivan asked the Minister for Health when a review of hATTR amyloidosis treatment funding will commence (details supplied); and if he will make a statement on the matter. [15228/20]

Amharc ar fhreagra

Freagraí scríofa

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, 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, a company must submit an application to the HSE to have a 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).

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 whether a drug is cost-effective as a health intervention.

I am advised by the HSE that it has received an application for the reimbursement of Patisiran (Onpattro®) for the treatment of hereditary transthyretin-mediated amyloidosis (hATTR amyloidosis) in adult patients with stage 1 or stage 2 polyneuropathy.

In January 2019, a full health technology assessment was commissioned by the HSE. This assessment was completed in February 2020 with the NCPE recommending that patisiran (Onpattro®) is not considered for reimbursement unless cost-effectiveness can be improved relative to existing treatments.

The HTA report will be an important input into the decision making processes of the HSE. The HSE is currently reviewing the report received and has recently met with the applicant company to discuss this.

Once negotiations between the HSE and the applicant company are complete, this application must then be formally considered by the HSE Drugs Group. The HSE Drugs Group is the national committee which the HSE has in place to make recommendations on the pricing and reimbursement of medicines. The decision making authority in the HSE is the HSE Executive Management Team.

Disability Services Provision

Ceisteanna (1119)

Fergus O'Dowd

Ceist:

1119. Deputy Fergus O'Dowd asked the Minister for Health if assistance will be offered to persons (details supplied) regarding the urgent need for an expansion in adult disability services; and if he will make a statement on the matter. [15241/20]

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.

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.

Dental Services

Ceisteanna (1120)

Michael Healy-Rae

Ceist:

1120. Deputy Michael Healy-Rae asked the Minister for Health the status of an orthodontics appointment for a person (details supplied); and if he will make a statement on the matter. [15242/20]

Amharc ar fhreagra

Freagraí scríofa

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

Hospital Waiting Lists

Ceisteanna (1121)

Danny Healy-Rae

Ceist:

1121. Deputy Danny Healy-Rae asked the Minister for Health the status of a medical procedure for a person (details supplied); and if he will make a statement on the matter. [15251/20]

Amharc ar fhreagra

Freagraí scríofa

I am conscious that waiting times are often unacceptably long and of the burden that this places on patients and their families.

In response to the Covid-19 pandemic the HSE had to take measures to defer most elective scheduled care activity in line with the advice of the National Public Health Emergency Team (NPHET). This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work.

The decision to delay appointments and admissions is not undertaken lightly and when such a decision is made, it is based on the safe delivery of care to all patients. The trajectory of the disease means there is now an opportunity for increasing the provision of non-covid care including more routine care. In this context Children’s Health Ireland (CHI) is now re-establishing services on an incremental basis.

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.

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