Léim ar aghaidh chuig an bpríomhábhar
Gnáthamharc

Medical Cards

Dáil Éireann Debate, Tuesday - 6 October 2020

Tuesday, 6 October 2020

Ceisteanna (667)

Marian Harkin

Ceist:

667. Deputy Marian Harkin asked the Minister for Health if medical cards will be provided for those women that have had severe life altering and ongoing complications from transvaginal mesh implants (details supplied); and if he will make a statement on the matter. [28340/20]

Amharc ar fhreagra

Freagraí scríofa

I understand that complications from a mesh implant are very distressing and painful for those involved. Ensuring that all women who develop mesh-related complications receive high quality, multi-disciplinary and patient-centred care is a priority for me and my Department. I would assure the Deputy that considerable work has been done to date in this country and continues to progress on patient safety in relation to mesh implants as set out below.

I am aware that in response to concerns raised in Ireland regarding complications associated with the use of mesh devices in late 2017, the then Minister for Health requested the Chief Medical Officer (CMO) to prepare a report on the clinical and technical issues involved in ensuring both the safe and effective provision of mesh procedures in urogynaecology and an appropriate response to women who suffer complications as a result of undergoing such procedures. The report was informed by the available national and international evidence and the personal experiences of women who have suffered complications following mesh surgery.

In July 2018, in advance of publication of the full report, the CMO requested the HSE to pause all mesh procedures where clinically safe to do so. This pause was instigated pending implementation of initial recommendations regarding (i) professional training requirements, (ii) patient information and consent and (iii) the development and maintenance of a national data set for all mesh procedures carried out in HSE funded hospitals.

The CMO report, published in November 2018, made a number of recommendations, the implementation of which will provide significant assurance that both women presenting for treatment and who develop mesh-related complications, receive high quality, multi-disciplinary patient centred care in accordance with the evidence and supported by robust clinical governance mechanisms.The HSE published a detailed Implementation Plan for the recommendations in the report in April 2019. The HSE’s National Women & Infants Health Programme (NWIHP) is progressing treatment pathways and referral services for women suffering from mesh-related complications. The HSE has published a dedicated webpage about vaginal mesh implants, including contact information regarding the pathways for women suffering complications. This can be found on the HSE website.

A multidisciplinary National Specialist Centre is being developed over 2 sites at Cork University Maternity Hospital (CUMH) and the National Maternity Hospital (NMH) Dublin. In addition, two translabial scanners, were procured by the HSE in late 2019, and are now onsite in both hospitals. However, the first scanning clinic, which was due to take place last March had to be postponed, due to the pandemic.

The pathways for women experiencing mesh complications, established by the HSE, have been in place for over a year. All appointments offered to women through these pathways have been to the public system. I would strongly encourage all women affected by mesh to engage with the relevant HSE contact points provided, to ensure that their service needs can be identified and provided for.

To address the question of medical cards, under the Health Act 1970 (as amended), eligibility for a medical card is primarily based on residence and means. The Act does not provide for an automatic entitlement to a medical card based on having a particular disease or illness. The HSE's Expert Group on Medical Need and Medical Card Eligibility previously examined the issue of awarding medical cards and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card. However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds his or her income threshold, where he or she faces difficult financial circumstances, such as extra costs arising from an illness. Furthermore, if the HSE is made aware that persons have particular requirements, assistance will be afforded to help that person to complete their application. This assistance can be availed of through a person's local health office.

Barr
Roinn