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Wednesday, 2 Mar 2022

Written Answers Nos. 190-209

Disability Services

Ceisteanna (190)

Jim O'Callaghan

Ceist:

190. Deputy Jim O'Callaghan asked the Minister for Health when the shortage of dedicated residential places in the catchment area in County Kerry will be resolved; and if he will make a statement on the matter. [11888/22]

Amharc ar fhreagra

Freagraí scríofa

As the Deputy's question relates to a service matter, I am referring the question for response to the HSE for direct reply to the Deputy as soon as possible.

Covid-19 Pandemic

Ceisteanna (191)

Mattie McGrath

Ceist:

191. Deputy Mattie McGrath asked the Minister for Health when the Covid bonus will be paid to frontline workers; and if he will make a statement on the matter. [11889/22]

Amharc ar fhreagra

Freagraí scríofa

Firstly I would like to extend my sincere gratitude to all healthcare workers for their efforts during this most challenging period.

In recognition of the efforts of the general public, volunteers and all workers during the COVID-19 pandemic and in remembrance of people who lost their lives due to the COVID-19 pandemic, on Wednesday 19 January, the Government announced a once-off public holiday will take place this month on Friday 18 March 2022.

The Government also announced COVID-19 recognition payment for frontline public sector healthcare workers, to recognise their unique role during the pandemic. The payment of €1,000 will not be subject to income tax, USC, or PRSI. The measure will be ring fenced to staff ordinarily onsite in COVID-19 exposed healthcare environments within the period between 1 March 2020 and 30 June 2021.

Those public sector frontline healthcare workers eligible for the payment will be directly employed public health sector staff working in clinical settings. A pro-rata arrangement will apply for eligible part time staff / equivalents and supernumerary students who were required to perform training in clinical sites. The Department of Health will also introduce a measure for making a similar payment to staff in private sector nursing homes and hospices (eg: nursing homes and hospices that are private, public, section 39, voluntary etc.) that were affected by Covid-19.

The Department of Health appreciates the levels of interest this announcement has generated. We are working together with the HSE to provide additional details on this measure including full eligibility criteria, particulars (including payment dates), terms and conditions that apply. It is important that this measure is applied fairly as intended and I welcome the work that is ongoing to ensure this is so.

Though noting the above work is still ongoing, it is envisaged that the process for paying eligible public sector healthcare workers will commence this month. For eligible healthcare workers in private sector nursing homes and hospices, noting the additional complexities involved, it is envisaged the process will commence in the second quarter of this year.

Healthcare Infrastructure Provision

Ceisteanna (192)

Seán Canney

Ceist:

192. Deputy Seán Canney asked the Minister for Health the progress that has been made with the tender for an audiology testing facility for Tuam primary care centre; when the testing facility will be operational; and if he will make a statement on the matter. [11895/22]

Amharc ar fhreagra

Freagraí scríofa

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

Legislative Reviews

Ceisteanna (193)

Seán Canney

Ceist:

193. Deputy Seán Canney asked the Minister for Health if he will provide a full breakdown of the areas being covered in the research being carried out by a person (details supplied) as part of the three year review of the Health (Regulation of Termination of Pregnancy) Act 2018; and if he will make a statement on the matter. [11896/22]

Amharc ar fhreagra

Freagraí scríofa

The Health (Regulation of Termination of Pregnancy) Act 2018 was signed into law on 20 December 2018 and commenced on 1 January 2019. Under section 7 of the Act, a review of the operation of the Act must be initiated within three years of the commencement of the Act.

As I stated previously, the review comprises a three-part approach to appraise the operation of the Act, with strands focusing on service users, service providers and a public consultation. Independent research commissioned to inform the service user and service provider strands will form key elements of the review.

Research to inform the service user strand is being carried out by Dr Catherine Conlon, Associate Professor, Trinity College, who is progressing a large qualitive study to analyse unplanned pregnancy and abortion care. The study, which was commissioned by the HSE’s Sexual Health and Crisis Pregnancy Programme in September 2019, will generate an in-depth understanding of the experiences of women who have accessed abortion care services since the commencement of the Act.

Independent research is also being commissioned on service providers’ views on the operation of the legislation. The tender application process for this research closed in January 2022 and the applications are currently being evaluated.

As the Deputy may be aware, I have appointed Ms. Marie O’Shea B.L. as the independent Chair to lead the second phase of the review of the operation of the Health (Regulation of Termination of Pregnancy) Act 2018. The independent Chair will assess the extent to which the objectives of the Act have been achieved, analysing in that regard the findings of the three strands of research to consider the effectiveness and operation of the Act. The Chair may also consult with stakeholders to gather additional information on the operation of the legislation and draw on the findings of other relevant peer-reviewed research to inform her report.

Medical Aids and Appliances

Ceisteanna (194)

Seán Canney

Ceist:

194. Deputy Seán Canney asked the Minister for Health if he will include supplementary allowance payments to persons who are amputees who work and have medical cards granted on a discretionary basis to assist in the purchase of prosthetic limbs; and if he will make a statement on the matter. [11897/22]

Amharc ar fhreagra

Freagraí scríofa

The HSE provides a wide range of medical and surgical aids and appliances, including prosthetics, free of charge to eligible persons following assessment by a relevant health professional. These are provided through community services known as Community Funded Schemes and play a key role in assisting and supporting people to maintain everyday functioning, and to remain living in their homes and local community.

Applications within Community Health Organisations (CHOs) are assessed by the local Resource Allocation Group and a determination is made regarding approval based on clinical priority and the funding available. At times, due to the demand for resources exceeding the available capacity, waiting lists may apply for some categories of items but CHOs undertake a range of initiatives to ensure optimum use of resources.

Amputees, whose amputation arose from either a traumatic or elective event, usually have their primary prosthesis fitted at the hospital where the surgery was undertaken. Subsequent prostheses are provided to eligible clients through the Community Funded Schemes. Rehabilitation services are provided by the National Rehabilitation Hospital (NRH) primarily at their site in Dun Laoghaire and augmented by a number of satellite clinics that they operate throughout the country. There are also a number of smaller services operated at regional level that provide assessment and fitting clinics along with prostheses at a local level. Counselling services for amputees are available through the POLAR service provided by the NRH and through the Irish Association for Counselling and Psychotherapy.

A HSE Primary Care led National Service Improvement Programme has the aim of improving the equity of access, value for money, and functional processes of the Community Funded Schemes through the establishment of national guidelines for the provision of medical and surgical aids and appliances. While this work was delayed due to the Covid-19 pandemic, as the situation involving the pandemic improves, this Programme will gather pace.

Health Services

Ceisteanna (195)

Brendan Smith

Ceist:

195. Deputy Brendan Smith asked the Minister for Health if he will consider the issues raised in correspondence (details supplied) in relation to the need to improve services; and if he will make a statement on the matter. [11899/22]

Amharc ar fhreagra

Freagraí 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

Ceisteanna (196)

Barry Cowen

Ceist:

196. Deputy Barry Cowen asked the Minister for Health the status of the case of a person (details supplied); and when the person concerned can expect an appointment with the National Rehabilitation Hospital, Dún Laoghaire, County Dublin. [11906/22]

Amharc ar fhreagra

Freagraí 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 Tests

Ceisteanna (197)

Patricia Ryan

Ceist:

197. Deputy Patricia Ryan asked the Minister for Health if he will make low-cost PCR tests widely available in view of the decision to wind down testing centres; and if he will make a statement on the matter. [11911/22]

Amharc ar fhreagra

Freagraí scríofa

From 28 February 2022, testing for SARS-Cov-2 will progressively move from extensive case finding and tracing of infection to reduce transmission, towards a focus on mitigation of the severe impacts of COVID-19 for those most vulnerable to the severe effects of the disease and those with risk factors for severe disease who may benefit from specific interventions. This decision is facilitated by the high level of vaccine-induced and naturally acquired population immunity in Ireland which is mitigating against the worst impacts of infection.

It is important to point out that anyone who has symptoms of COVID-19 or other viral respiratory tract infection should immediately self-isolate and continue to do so until 48 hours after symptoms have substantially or fully resolved.

Testing for public health purposes is now advised for those most vulnerable to the effects of the disease. This includes those aged 55 years and older who have not received a booster vaccination, those with a high-risk medical condition, who are immunocompromised, who live in the same household as a person who is immunocompromised, who provide care or support for a person they know to be immunocompromised and those who are pregnant. Antigen testing will be recommended for use by asymptomatic healthcare workers identified as close contacts, and to facilitate social welfare claims related to a person’s absence from work. The HSE will continue to maintain access to swabbing for PCR tests at test centres around the country during this transition phase. There continues to be no cost for access to tests provided for public health purposes by the HSE.

Individuals who are concerned about an underlying condition and/or their level of risk in relation to COVID-19 should continue to seek advice from their GP or treating clinician.

The approach to public health management of the pandemic, including changes to testing, tracing and surveillance management will remain under continuing review under the guidance of the Office of the Chief Medical Officer and will be subject to the evolving epidemiological situation, the impact of the disease on healthcare utilisation and outcomes, the vaccination status of the population, European Centre for Disease Prevention and Control (ECDC) guidance and other international evidence and guidance.

Health Services

Ceisteanna (198)

Patricia Ryan

Ceist:

198. Deputy Patricia Ryan asked the Minister for Health if there has been any progress on the refurbishment of Monasterevin daycare centre; and if he will make a statement on the matter. [11924/22]

Amharc ar fhreagra

Freagraí scríofa

As the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.

Dental Services

Ceisteanna (199)

Ruairí Ó Murchú

Ceist:

199. Deputy Ruairí Ó Murchú asked the Minister for Health the number of dentists participating in the dental treatment services scheme per CHO region per year from inception; the number of dentists that have withdrawn from the scheme since 2017; the number of new dental treatment services applications currently being processed to date; and if he will make a statement on the matter. [11933/22]

Amharc ar fhreagra

Freagraí scríofa

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

Departmental Correspondence

Ceisteanna (200)

Niall Collins

Ceist:

200. Deputy Niall Collins asked the Minister for Health if he will advise on matters raised in correspondence (details supplied); and if he will make a statement on the matter. [11977/22]

Amharc ar fhreagra

Freagraí scríofa

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

Disease Management

Ceisteanna (201)

Róisín Shortall

Ceist:

201. Deputy Róisín Shortall asked the Minister for Health if he will respond to issues raised in correspondence by an organisation (details supplied); and if he will make a statement on the matter. [11994/22]

Amharc ar fhreagra

Freagraí scríofa

I understand that my colleague Mary Butler, Minister of State for Mental Health and Older People, recently met with officials in the Department of Health and the Huntington’s Disease Association of Ireland to discuss matters concerning people with Huntington's Disease. Officials in my department have made enquiries with the HSE on foot of correspondence from Huntington's Disease Association Ireland and a response will issue in due course.

Medicinal Products

Ceisteanna (202, 203, 204, 205)

Colm Burke

Ceist:

202. Deputy Colm Burke asked the Minister for Health if consideration will be given to the reimbursement of the gene therapy treatment luxturna for persons suffering with inherited retinal diseases (details supplied); and if he will make a statement on the matter. [11996/22]

Amharc ar fhreagra

Colm Burke

Ceist:

203. Deputy Colm Burke asked the Minister for Health if he will correspond with the HSE Executive Management Team to request it to reconsider the decision regarding the reimbursement of the gene therapy treatment luxturna (details supplied); and if he will make a statement on the matter. [11997/22]

Amharc ar fhreagra

Colm Burke

Ceist:

204. Deputy Colm Burke asked the Minister for Health if consultations have taken place in order to improve the cost effectiveness of the gene therapy treatment luxturna (details supplied); and if he will make a statement on the matter. [11998/22]

Amharc ar fhreagra

Colm Burke

Ceist:

205. Deputy Colm Burke asked the Minister for Health if consideration will be given to the reimbursement of the gene therapy treatment luxturna which complements national policy objectives as set out in the Programme for Government to update the Rare Diseases Plan and the promotion of research particularly clinical trials which are key to improving the prevention, diagnosis and treatment of rare diseases; and if he will make a statement on the matter. [12000/22]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 202 to 205, inclusive, 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.

In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost-effectiveness and potential or actual budget impact.

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 HSE has advised that on 23 September 2019 an application was received for the reimbursement of Voretigene neparvovec (Luxturna) for the treatment of adult and paediatric patients with vision loss due to inherited retinal dystrophy caused by confirmed biallelic RPE65 mutations and who have sufficient viable retinal cells.

On 29 October 2019, following the completion by the NCPE of a rapid review, the HSE commissioned a full pharmacoeconomic assessment with respect to this indication.

On 3 April 2020, the NCPE received the applicant’s submission for this assessment. On 18 September 2020, the NCPE completed its assessment and recommended that Voretigene neparvovec not be considered for reimbursement unless cost-effectiveness could be improved relative to existing treatments.

The HSE engaged in commercial negotiations with the applicant company in November 2020.

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 membership of the HSE Drugs Group includes public interest members and clinicians.

The HSE Drugs Group considered Voretigene neparvovec at its February 2021 meeting, and requested Patient and Clinician Engagement input via the Rare Diseases Technology Review Committee (RDTRC) to assist the group in making its recommendation to the HSE Executive Management Team (EMT) regarding reimbursement of Voretigene neparvovec.

The HSE has advised that, on 23 March 2021, the RDTRC held a meeting at which Voretigene neparvovec was the main agenda point.

The Committee met on 26 August and concluded its patient and clinician engagement with respect to Voretigene neparvovec. The Committee submitted a statement in December regarding this review for the Drugs Group’s consideration.

The Drugs Group had specifically requested a Prescribing Guideline to inform their deliberations. This guideline is currently under development. The Drugs Group will review the output of the RDTRC and the Prescribing Guideline with a view to making a recommendation at the earliest opportunity to the HSE EMT.

The HSE EMT is the decision-making body for the reimbursement of medicines under the Health Act 2013 and it will, following receipt of the outcome of the HSE Drugs Group's deliberations, make the decision on whether Voretigene neparvovec will be reimbursed.

Question No. 203 answered with Question No. 202.
Question No. 204 answered with Question No. 202.
Question No. 205 answered with Question No. 202.

General Practitioner Services

Ceisteanna (206)

Róisín Shortall

Ceist:

206. Deputy Róisín Shortall asked the Minister for Health if he will address the inability of persons to access antenatal and postnatal general practitioner care if they opt for a home birth despite their entitlement under the maternity and infant care scheme; the steps he is taking to address this issue; and if he will make a statement on the matter. [12001/22]

Amharc ar fhreagra

Freagraí scríofa

The Maternity and Infant Care Scheme provides an agreed programme of care to expectant mothers ordinarily resident in Ireland. This combined medical service is provided by the family GP and a hospital obstetrician and includes a schedule of alternating examinations at the GP’s practice and a maternity unit/hospital, as well as two post-natal visits to the GP. Private medical indemnity providers currently do not provide indemnity cover to GPs for services under the Maternity and Infant Care Scheme if a patient is opting for a home birth.

The State indemnifies enterprises on behalf of the Minister for Health under the Clinical Indemnity Scheme (CIS) when national policy confirms that this should be provided. This includes Community Midwives who have an SLA with the HSE for the provision of home births. In the case of GPs, they are private practitioners and to date services provided by them and by GP practice nurses are not covered by the CIS. Instead, as private practitioners, GPs receive professional indemnity from private medical indemnity providers. As this is an arrangement between two private parties, the medical indemnity cover provided is a matter for GPs and their private insurers.

The National Maternity Strategy aims to ensure that appropriate care pathways are in place in order that mothers, babies and families get the right care, at the right time, by the right team and in the right place. The Strategy makes it clear that women should be offered a choice regarding their preferred pathway of care, in line with their clinical needs and best practice, including in regard to the birth setting. Further discussions need to take place with relevant parties to agree national policy on the role of GPs in relation to home births, in the context of the National Maternity Strategy.

Dental Services

Ceisteanna (207)

Ruairí Ó Murchú

Ceist:

207. Deputy Ruairí Ó Murchú asked the Minister for Health the status of the dental treatment services scheme; and if he will make a statement on the matter. [12005/22]

Amharc ar fhreagra

Freagraí scríofa

The Dental Treatment Services Scheme (DTTS), which dates from the 1990s is available to medical card holders aged 16 and over. The dental care is provided by independent dental practitioners who have a contract with the HSE. Patients may choose to have their treatment undertaken by any dentist who participates in the scheme. The Scheme covers a dental examination, two fillings in each calendar year, prescriptions, denture repairs and extractions as necessary. Other more complex treatments such as the provision of dentures require the approval of the HSE before the dentist can proceed and in this case the dentist applies directly to the HSE.

There is a need to align the DTSS with best international evidence and practice, and legislation, as outlined in Smile agus Sláinte, the National Oral Health Policy. Regretfully, the COVID-19 pandemic caused the roll-out of the Policy to be delayed and the proposed review of the DTSS contract to be deferred.

It is regrettable that a significant number of dentists chose to leave the DTSS that provides care for medical card patients during the pandemic, which has led to difficulties for medical card patients in accessing dental care in some parts of the country. In such circumstances, I have been assured that the HSE Public Dental Service is seeking to provide emergency cover for any medical card patients who are experiencing such problems.

I have given a commitment to a substantive review of the DTSS, which will include fees paid to dentists. I have also acknowledged the immediate issues of concern with current arrangements under the Scheme.

My officials met with the Irish Dental Association in December to address both of these issues. A further round of discussions with the IDA is to take place on 2 March.

I would also wish to point out that I secured additional funding of €10 million in Budget 2022 to address immediate issues with the DTSS, which is on top of the annual allocation of €56 million for 2022.

Mental Health Services

Ceisteanna (208)

Ruairí Ó Murchú

Ceist:

208. Deputy Ruairí Ó Murchú asked the Minister for Health the number of vacant positions to be filled in the mental health services in CHO8; and if he will make a statement on the matter. [12006/22]

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.

Health Services

Ceisteanna (209)

Aengus Ó Snodaigh

Ceist:

209. Deputy Aengus Ó Snodaigh asked the Minister for Health the length of time a patient who has been diagnosed must wait on the waiting list before they can apply for the treatment abroad scheme when a patient has been diagnosed with a condition and requires an operation; and if can they avail of the scheme if they are on a medical card. [12008/22]

Amharc ar fhreagra

Freagraí scríofa

The EU Cross Border Directive (CBD) provides rules for the reimbursement to patients of the cost of receiving treatment abroad, where the patient would be entitled to such treatment in their home Member State, and supplements the rights that patients already have at EU level. The CBD enables persons resident in the State to access and be reimbursed for healthcare in another Member State by the HSE, provided such healthcare is publicly available within Ireland. The patient is responsible for paying the provider of the treatment and claiming a reimbursement. The CBD scheme is not part of the Medical Card scheme.

There is no minimum period of time required on a waiting list to avail of the CBD.

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