Richard Boyd Barrett
Ceist:702. Deputy Richard Boyd Barrett asked the Minister for Health the estimated cost to clear assessment of needs waiting lists for children with autism [24760/20]
Amharc ar fhreagraHSE Waiting Lists
Ceisteanna (702)
Freagraí scríofa
The Programme for Government, Our Shared Future, recognises the need to improve services for both children and adults with disabilities through better implementation and by working together across Government in a better way.
The Government commits to prioritising early diagnosis and access to services for children and ensuring that the most effective interventions are provided for each child, to guarantee the best outcomes.
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Hospital Expenditure
Ceisteanna (703)
Richard Boyd Barrett
Ceist:703. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full-year cost of adding 1,000 acute beds to the hospital network [24761/20]
Amharc ar fhreagraFreagraí scríofa
The average daily running cost of a hospital bed includes clinical staffing, theatres, laboratories, non-clinical staffing and cleaning, maintenance and other running costs. The cost includes critical care and ward beds but they are not separately identifiable. The fully absorbed cost, includes treatment and care costs (such as diagnostics and theatres) as well as the running costs such as heating, lighting and servicing equipment, but excludes capital and depreciation. In addition, this figure does not include other associated hospital costs such as day-case, outpatient and emergency department costs.
In relation to capital expenditure, several factors determine the capital cost of a hospital bed. These include the nature of the bed (day case, in-patient/overnight, intensive/critical care, etc.), and the bed’s location (within an existing hospital, within a new extension to an existing hospital or through the development of a new hospital). As such, there is no one capital cost for providing an additional hospital bed.
In relation to the Deputy's specific question on the estimated full-year cost of adding 1,000 acute beds to the hospital network, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
Medical Cards
Ceisteanna (704)
Cian O'Callaghan
Ceist:704. Deputy Cian O'Callaghan asked the Minister for Health the reason for a complete medical card renewal process for persons with conditions that cannot change; the consideration that can be given to an automatic rollover renewal process that would simplify the process for those already dealing with a lifelong condition; and if he will make a statement on the matter. [24764/20]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
Covid-19 Tests
Ceisteanna (705)
Fergus O'Dowd
Ceist:705. Deputy Fergus O'Dowd asked the Minister for Health if a Covid-19 test centre will be opened in Drogheda, County Louth in view of the ongoing pandemic; the number of persons being referred for testing; and if he will make a statement on the matter. [24782/20]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Covid-19 Pandemic
Ceisteanna (706)
Thomas Gould
Ceist:706. Deputy Thomas Gould asked the Minister for Health the steps being taken to assist recovery support groups to find alternative facilities for their meetings in cases in which usual meeting places are not suitable in view of Covid-19 restrictions [24783/20]
Amharc ar fhreagraFreagraí scríofa
The Covid-19 pandemic has created a time of uncertainty and anxiety for everyone and particularly for those who are affected by drug and alcohol addiction. The restructuring of services, social distancing measures and self-isolation can be particularly difficult for those who are trying to remain drug or alcohol free and for those who are in recovery.
The Department has set up a working group with drug and alcohol service providers to develop a 'Framework for the Restoration of Drug and Alcohol Services', in a planned and appropriate manner in line with public health advice. The working group has recently undertaken a survey of Drug and Alcohol Task Forces to identify issues on which guidance and supports are required. Recovery support groups should liaise with their drug and alcohol task forces on any issues re restoration of services, including alternative premises for their meetings.
I am very much aware of the difficulties faced by people with drug and alcohol dependency at this time. I am determined to support the restoration of drug and alcohol services in a speedy yet safe manner. To assist in this goal, I have approved additional funding to offset the costs of delivering drug and alcohol services in a Covid environment.
Medicinal Products
Ceisteanna (707)
Rose Conway-Walsh
Ceist:707. Deputy Rose Conway-Walsh asked the Minister for Health the availability of fluphenazine decanoate as a treatment for schizophrenia; and if he will make a statement on the matter. [24787/20]
Amharc ar fhreagraFreagraí scríofa
The Health Products Regulatory Authority (HPRA), the competent authority for medicines in Ireland, has advised that there are no products authorised in Ireland with the active ingredient fluphenazine decanoate. All national products previously authorised with fluphenazine decanoate have been withdrawn, and there are no centrally authorised products with this active ingredient.
The HPRA are aware, through the exempt medicines notification scheme, that fluphenazine products from other markets have been imported into Ireland for use by Irish patients. Patients who require fluphenazine should contact their doctor and local pharmacy about obtaining the medicine through this route.
If a patient has any concerns regarding their treatment with this or any other medication, they should discuss this directly with their doctor or pharmacist.
Maternity Services
Ceisteanna (708)
Carol Nolan
Ceist:708. Deputy Carol Nolan asked the Minister for Health the maternity hospitals in which values clarification workshops have taken place from 2018 to date in 2020; the number of HSE staff that have participated in the workshops; if such participation is mandatory; the organisation which delivered same; the nature of the workshops in terms of content and structure; and if he will make a statement on the matter. [24790/20]
Amharc ar fhreagraFreagraí scríofa
As this is a service issue, I have asked the Health Service Executive to reply to the Deputy directly, as soon as possible.
HSE Funding
Ceisteanna (709)
Steven Matthews
Ceist:709. Deputy Steven Matthews asked the Minister for Health if a funding review of a school (details supplied) will be carried out following a recent visit as there is a large deficit between the HSE funding and the very high level and excellence of care provided [24792/20]
Amharc ar fhreagraFreagraí scríofa
The National Treatment Purchase Fund (NTPF) has been designated by the Minister for Health pursuant to Section 40 of the Nursing Homes Support Scheme Act 2009 as a body authorised to negotiate with proprietors of non-HSE registered nursing homes to reach agreement in relation to the maximum price(s) that can be charged for the provision of long-term residential care services to NHSS residents.
As part of this function, the NTPF will enter into "Approved Nursing Home Agreements" with registered private and voluntary nursing homes to record the maximum price(s) that have been negotiated. Where, notwithstanding the best efforts of both parties, agreement is not reached through negotiation, the nursing home may elect by agreement, to enter a review process. The details of this process are set out on NTPF’s website www.ntpf.ie.
It will be appreciated that particulars of all such negotiations and reviews are a matter between the nursing home and the NTPF. Accordingly the NTPF does not discuss publicly the details of negotiations with individual nursing homes.
I understand that the St. John of God group have engaged with the NTPF in relation to both initial price negotiations and subsequent review process regarding St Joseph's. The NTPF has statutory independence and as Minister of State for Mental Health and Older People, I have no role in NHSS price negotiations. I understand however, that engagement through the established mechanisms has occurred albeit within the limits imposed by COVID-19.
I understand that the HSE is in ongoing engagement with the St. John of God group in a broader sense regarding the financial pressures being experienced.
Health Services Staff
Ceisteanna (710)
Richard Boyd Barrett
Ceist:710. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full year cost of hiring 4,000 new nurses on the pre-2011 rate of pay [24793/20]
Amharc ar fhreagraFreagraí scríofa
As this is a service related matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.
Health Services Staff
Ceisteanna (711)
Richard Boyd Barrett
Ceist:711. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full year cost of hiring 500 consultants [24794/20]
Amharc ar fhreagraFreagraí scríofa
As this is a service related matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.
Medicinal Products
Ceisteanna (712, 730, 737, 799)
Brian Leddin
Ceist:712. Deputy Brian Leddin asked the Minister for Health when the HSE executive management team will reconsider supporting the reimbursement of dupilumab dupixent for the treatment of moderate to severe atopic dermatitis in adults and adolescents of 12 years of age and older that are candidates for systemic therapy; and if he will make a statement on the matter. [24801/20]
Amharc ar fhreagra
Willie O'Dea
Ceist:730. Deputy Willie O'Dea asked the Minister for Health when dupilumab will be made available for reimbursement in for persons with eczema; and if he will make a statement on the matter. [24868/20]
Amharc ar fhreagra
Joan Collins
Ceist:737. Deputy Joan Collins asked the Minister for Health the position regarding the drug dupilumab or dupixent which treats moderate to severe atopic dermatitis in adult patients; when and the way in which this drug will become widely available; and if he will provide other relevant information on the drug. [24889/20]
Amharc ar fhreagra
Aodhán Ó Ríordáin
Ceist:799. Deputy Aodhán Ó Ríordáin asked the Minister for Health if his attention has been drawn to the drug dupilumab; if Ireland is one of only two countries in the EU in which the drug is not available as part of the health services drugs list; if his further attention has been drawn to a submission by a foundation (details supplied) regarding the efficacy of the drug and the potential impact on suitable patients; and if any progress has been made in making the drug more widely available to patients here under the community drugs schemes [25326/20]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 712, 730, 737 and 799 together.
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.
In line with the 2013 Health 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 licenced 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 HSE has advised that it has received pricing and reimbursement applications for two indications of dupilumab (Dupixent®):
- For the treatment of moderate-to-severe atopic dermatitis in adult patients who are candidates for systemic therapy.
- For the treatment of moderate-to-severe atopic dermatitis in adolescents 12 years and older who are candidates for systemic therapy.
The HSE received an application for pricing / reimbursement of dupilumab in November 2017 from the manufacturer for the treatment of moderate-to-severe atopic dermatitis in adult patients who are candidates for systemic therapy. The HSE commissioned a full HTA on 29th November 2017 as per agreed processes. This assessment was completed in December 2019 with the NCPE recommending that dupilumab be considered for reimbursement if cost-effectiveness could be improved relative to existing treatments.
Subsequently, the HSE received an application for the pricing / reimbursement of dupilumab on 13th December 2019 for the treatment of moderate-to-severe atopic dermatitis in adolescents 12 years and older who are candidates for systemic therapy.
The HSE commissioned the rapid review process on the 17th December 2019. Following receipt of a rapid review dossier, the NCPE advised the HSE 17th January 2020 that a HTA was not recommended and that dupilumab not be considered for reimbursement for this indication at the submitted price.
The HSE engaged in commercial negotiations with the company in February 2020 regarding both the adult and adolescent populations.
The final HTA report concerning dupilumab was reviewed by the HSE Drugs Group, along with the outputs of commercial negotiations, and the patient group submission received during the HTA process. The HSE Drugs Group considered all the evidence and gave a recommendation to the HSE Executive Management Team (EMT) not to support reimbursement of dupilumab for the treatment of moderate-to-severe atopic dermatitis in both adults and adolescents 12 years and older who are candidates for systemic therapy.
On 18 September 2020, the applicant company submitted representations with respect to this application. In such circumstances, under the 2013 Act, the HSE is required to consider such representations before making a final decision.
The final decision-making authority in the HSE is the HSE EMT. Dupilumab remains under consideration with the HSE EMT and a final decision will be made in line with the 2013 Act.
My Department does not collate data on the reimbursement status of specific medicines in other EU countries.
Health Services Provision
Ceisteanna (713)
Brendan Griffin
Ceist:713. Deputy Brendan Griffin asked the Minister for Health when day care services will resume in locations (details supplied) in County Kerry; and if he will make a statement on the matter. [24809/20]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible
Dental Services
Ceisteanna (714)
Kathleen Funchion
Ceist:714. Deputy Kathleen Funchion asked the Minister for Health the waiting time for orthodontic treatment in the Bagenalstown, County Carlow area (details supplied) [24817/20]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Question No. 715 answered with Question No. 682.
Medical Cards
Ceisteanna (716)
Aengus Ó Snodaigh
Ceist:716. Deputy Aengus Ó Snodaigh asked the Minister for Health the reason a pensioner with a medical card who cannot avail of the free blood test in St. James’s Hospital, Dublin due to mobility issues can be charged €20 for a routine blood test by their general practitioner [24829/20]
Amharc ar fhreagraFreagraí scríofa
Persons who are eligible for GP care without charge under the Health Act 1970 are not subject to any co-payments or other charges in respect of such services. There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for routine phlebotomy services provided by their GP which are required to either assist in the diagnosis of illness or the treatment of a condition and the HSE has advised GPs accordingly.
I am aware that, nonetheless, some GPs are charging GMS patients for phlebotomy services in some circumstances. The GP chronic disease management programme which is being phased in from this year will involve the ongoing monitoring of patients’ condition and any blood tests required in this context will be covered by the fees payable for this care.
However, it remains a matter of concern to me that a GMS and GP visit card patient might be charged for blood tests which are clinically necessary and I have asked my officials to discuss with the HSE what further solutions to this issue may be possible. If a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient should report the matter to their HSE Local Health Office.
Hospital Appointments Status
Ceisteanna (717)
Seán Sherlock
Ceist:717. Deputy Sean Sherlock asked the Minister for Health when a person (details supplied) in County Cork will be allocated a date for advanced cataract surgery [24831/20]
Amharc ar fhreagraFreagraí scríofa
It is recognised that waiting times for scheduled appointments and procedures have been impacted as a direct result of the COVID-19 pandemic.
In response to the Covid-19 pandemic the HSE had to take measures to defer most scheduled care activity in March, April, and May of this year. 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 the National Public Health Emergency Team (NPHET) in accordance with the advice of the World Health Organisation.
The resumption of services from June onwards has allowed for increased activity, with the HSE utilising innovative methods including telemedicine to facilitate patient appointments. Patient safety remains at the forefront of service resumption. To ensure services are re-introduced in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols which has resulted in reduced capacity and activity
The HSE continues to optimise productivity through alternative work practices such the use of alternative settings including private hospitals, community facilities and alternative outpatient settings.
The National Treatment Purchase Fund has also recommenced arranging treatment in both private and public hospitals for clinically suitable patients who have been waiting for long periods on public hospital waiting lists.
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 is a standardised approach used by the HSE to manage scheduled care treatment for in-patient, day case and planned procedures. It sets out the processes that hospitals are to implement to manage waiting lists and was developed in 2014 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.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Disability Support Services
Ceisteanna (718)
Seán Crowe
Ceist:718. Deputy Seán Crowe asked the Minister for Health if his attention has been drawn to the difficulties and cuts in supports for the disability care sector due to Covid-19 and the resulting social distance guidelines, particularly but not exclusively, in the south-west Dublin area; his plans to support these vulnerable citizens; the contact his Department has had with various support organisations; if plans are being rolled out to move from part-time to full-time supports; if respite supports are being discussed or planned; and if he will make a statement on the matter. [24832/20]
Amharc ar fhreagraFreagraí scríofa
As part of the overall effort to contain the spread of COVID-19 and in line with public health advice, day service locations closed in March.
Since then, HSE Disability Services have been working to develop national guidance on the part of the disability sector to direct how all day services can be delivered. The Guidance to support the Framework for the Resumption of Adult Disability Day Services was published by the HSE on 8th July 2020.
In developing the guidance document to guide providers, the HSE worked closely with service providers through representative organisations such as the National Federation of Voluntary Service Providers, Disability Federation of Ireland and the Not for Profit Association, in addition to Inclusion Ireland, who represent people with intellectual disabilities and their families.
The guidance document seeks to support the safe return of services in the context of ongoing public health guidance. It also recognises that the impact of public health guidance will result in services being provided at a reduced level and will require changes in how people are supported, increased use of technology where appropriate and more use of outreach supports.
Day services gradually resumed during August and early September. Service providers are working reopen day services safely, and in line with public health guidance. Service providers have been in touch with all families and service users to discuss when they may expect the resumption of their service and what that service will consist of.
As services resume, capacity in day service locations will be reduced. However, the HSE and service providers will keep this measure under review and as public health guidance evolves, capacity to provide supports will adapt accordingly. Both the HSE and service providers are committed to maximising the support that can be provided within these restrictions.
The Guidance to support the Framework for Resumption of Adult Disability Day Services is available on the New Directions website: www.hse.ie/newdirections. The HSE have also issued monthly communications updates for service users and their families, and the latest update, a video message from the Head of Strategy and Planning HSE Disability Services, is available at the above link.
An information portal that contains the dates on which the 966 disability day service locations will reopen around the country is now available. Service users and families can access this information on www.hse.ie/newdirections
With regard to respite services, the HSE’s A Safe Return to Health Services outlines a three phased approach to the return of health and social care services. This plan states that short-stay residential and emergency/residential respite will begin to re-open from July to August with activity increasing in the next two phases September – November and December 2020 to February 2021. The main assumption underpinning this schedule is the level of illness and health service pressure caused by COVID-19. If this increases in later surges, the timelines in this document will change.
I want to acknowledge the many challenges experienced by individuals and their families over this difficult time. Families across the country have had their routines upended due to the impact of COVID-19 and I hope that these will be the first steps towards returning to some sense of normalcy.
As the Deputy's question also pertains to a service matter, I have asked the Health Service Executive to reply to the Deputy directly, as soon as possible.
Health Services Expenditure
Ceisteanna (719)
Martin Browne
Ceist:719. Deputy Martin Browne asked the Minister for Health the cost of transporting patients requiring psychiatric services at St. Luke’s, Kilkenny and accompanying staff from South Tipperary General Hospital to St. Luke’s since the closure of St. Michael’s unit by year [24833/20]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Health Services Expenditure
Ceisteanna (720)
Martin Browne
Ceist:720. Deputy Martin Browne asked the Minister for Health the estimated cost that will be incurred over the next five years, by year, of transporting patients requiring psychiatric services and accompanying staff to St. Luke’s, Kilkenny from South Tipperary General Hospital [24834/20]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Drug Treatment Programmes
Ceisteanna (721)
Christopher O'Sullivan
Ceist:721. Deputy Christopher O'Sullivan asked the Minister for Health the reason for the closure of the Cara Lodge drug rehabilitation centre in west County Cork; and if he will put in place a strategy for the reopening of same [24844/20]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.