Written Answers Nos. 381-391
381. Deputy Mary Lou McDonald asked the Minister for Health the status of each recommendation made by the National Transgender Healthcare Steering Committee in 2020; the progress on the implementation of each recommendation; and if he will make a statement on the matter. [13641/22]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
382. Deputy Brendan Griffin asked the Minister for Health if the CBD oil licensed for the treatment of epilepsy will be covered under the medical card and long-term illness schemes; and if he will make a statement on the matter. [13644/22]
Amharc ar fhreagraThe Health Service Executive (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. Reimbursement for medicines under the community drugs schemes is for licensed 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. The Minister for Health has no role in these decisions.
The Medical Cannabis Access Programme (MCAP) is a 5-year pilot programme that allows medical consultants to prescribe specified cannabis-based products for patients with certain medical conditions who have exhausted all other available medical treatment options. Those conditions are:
- Spasticity associated with multiple sclerosis
- Intractable nausea and vomiting associated with chemotherapy
- Severe, refractory (treatment-resistant) epilepsy
The MCAP is now open for medical consultants to make an application for themselves and their patients to be registered on the Cannabis for Medical Use Register, operated by the HSE.
Prospective suppliers of products to the MCAP can apply to the Health Products Regulatory Authority (HPRA), acting on behalf of the Minister for Health, to have a cannabis product considered for inclusion in the schedule to the Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019. The onus is on prospective suppliers to submit applications to the HPRA.
For medical indications not included in the MCAP, doctors may continue to utilise the Ministerial licensing route to prescribe medical cannabis for their patients. In line with the Chief Medical Officer's advice, the granting of a licence for cannabis for medical purposes must be premised on an appropriate application being submitted to the Department of Health, which is endorsed by a consultant who is responsible for the management of the patient and who is prepared to monitor the effects of the treatment over time.
From 1st December 2021, the HSE approved reimbursement of Cannabidiol (Epidyolex®)100 mg/ml oral solution via the High Tech Drug Arrangements for the following indications:
- use as adjunctive therapy of seizures associated with Lennox-Gastaut Syndrome (LGS) in conjunction with Clobazam, for patients 2 years of age and older,
- use as adjunctive therapy of seizures associated with Dravet Syndrome (DS) in conjunction with Clobazam, for patients 2 years of age and older, and
- use as adjunctive therapy of seizures associated with tuberous sclerosis complex (TSC) for patients 2 years of age and older.
Approved prescribers will be required to provide confirmation that Cannabidiol (Epidyolex®) 100 mg/ml oral solution is being prescribed in accordance with the licensed indications and in line with the terms of reimbursement approval given by the HSE.
Finally, it is important to note that the medical decision to prescribe or not prescribe any treatment, including cannabis treatment, for an individual patient is strictly a decision for the treating clinician, in consultation with their patient. The Minister for Health has no role in this clinical decision-making process.
383. Deputy Róisín Shortall asked the Minister for Health the work that has been carried out by his Department and the HSE with regard to the specific physical and mental health needs and clinical pathways for intersex persons in Ireland as distinct from transgender persons; if he will develop a strategy in this regard through engagement with intersex persons and representative organisations; and if he will make a statement on the matter. [13645/22]
Amharc ar fhreagraThe National Lesbian Gay Bisexual Transgender and Intersex+ Inclusion Strategy 2019-2021 commits to ensuring LGBTI+ people, including intersex people, can fully and equally avail of mainstream health services. It seeks to eliminate barriers that may prevent LGBTI+ people, including intersex people, from accessing health and social services due to a lack of understanding of their specific needs and a lack of targeted service promotion.
The actions in the strategy aim to reduce barriers to access to health services and to improve health outcomes for the LGBTI+ community, including intersex people. A specific objective is that better data are available on the prevalence of intersex conditions and that consideration is given to appropriate clinical governance in the context of international evidence and guidelines.
The development of the strategy was underpinned by a robust consultation process, with a series of regional and thematically focused workshops facilitated by leading LGBTI+ experts and researchers. . In addition, specific workshop sessions were organised for intersex people and other groups to ensure that the voices of the more marginalised members of the LGBTI+ community were adequately heard.
As the specific physical and mental health needs and clinical pathways for intersex persons are a service matter, the question has been referred to the HSE for direct reply to the Deputy.
384. Deputy Colm Burke asked the Minister for Health the proposals he is bringing forward to the European Commission to take action in the forthcoming review of the EU Tobacco Excise Directive in view of the worrying trend of increased consumption of e-cigarettes by young people in Ireland; and if he will make a statement on the matter. [13660/22]
Amharc ar fhreagraThe Department of Finance is the lead department in relation to the review of the EU Tobacco Tax Directive. However, both my Department and the Department of Finance are of the view that tax policy regarding novel products such as e-cigarettes may be best addressed at EU level in the context of the revision of that Directive. I understand that a proposal resulting from the review is expected from the European Commission this year.
385. Deputy John McGuinness asked the Minister for Health if an appropriate place will be provided in full-time residential care for a person (details supplied); if the necessary assessments will be expedited; and if he will make a statement on the matter. [13674/22]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
386. Deputy Éamon Ó Cuív asked the Minister for Health the services that were provided at any time at two health centres (details supplied) in County Galway between 2010 to 2019; the services that are available at present there; if full services are due to re-commence; if so when; if he will provide details of the other services proposed for these centres; and if he will make a statement on the matter. [13677/22]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
387. Deputy Éamon Ó Cuív asked the Minister for Health when a permanent doctor will be appointed to a general practice (details supplied); if a new competition will be advertised for same; if so, when; if the entire practice area will be offered in one lot; if not, if the contract for two islands which were included in this practice area will be offered separately; and if he will make a statement on the matter. [13682/22]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
388. Deputy Louise O'Reilly asked the Minister for Health the financial supports that are available for a family that is in inappropriate accommodation which it owns and which is no longer suitable for their child who is a wheelchair user in cases in which the financial circumstances do not allow for the family to purchase a new house; and if he will make a statement on the matter. [13699/22]
Amharc ar fhreagraThe Deputy's office have clarified with my officials that this question relates to a case whereby adaptations of this accommodation would not be suitable as the accommodation is up a flight of stairs and the child is a wheelchair user. There are no health related supports which would be of assistance in such a case, however there may be supports within the remit of other Departments which could assist the family. On accommodation issues, my colleague the Minister for Housing, Planning and Local Government would be better placed to indicate what supports may be of assistance, however as the question relates to potential financial supports for the family, my colleague the Minister for Social Protection is best placed to provide information in response to this question.
389. Deputy David Cullinane asked the Minister for Health the amount of funding that was provided to tackle smoking in 2021; and the estimated amount that will be provided in 2022; and if he will make a statement on the matter. [13706/22]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
In addition to the HSE service provision, the Healthy Ireland fund provides monies for a number of initiatives such as Healthy Campuses and Clubs and Healthy Communities which include tobacco control measures. As these initiatives also include the promotion of physical activity, healthy eating and positive aging it is not possible to give a specific figure for the tobacco control element.
390. Deputy Pádraig O'Sullivan asked the Minister for Health if the case of a person (details supplied) will be examined; and if he will make a statement on the matter. [13708/22]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
391. Deputy Michael Healy-Rae asked the Minister for Health if he will support the nursing home sector; and if he will make a statement on the matter. [13709/22]
Amharc ar fhreagraThe Nursing Home Support Scheme (NHSS), commonly referred to as 'Fair Deal', is a system of financial support for people who require long-term residential care. The primary legislation underpinning the NHSS is the Nursing Home Support Scheme Act 2009. Participants in the NHSS contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.
Funding to support people to access services in the sector continues to be provided in line with the long-established statutory mechanisms under the Nursing Homes Support Scheme Act 2009. This is the mechanism established by the Oireachtas to provide for the processes relating to funding under the NHSS and the negotiation of prices for services for private and voluntary providers with the designated State agency, the National Treatment Purchase Fund (NTPF). Accordingly, the NTPF does not discuss publicly the details of negotiations with individual nursing homes. Neither Ministers nor the Department have a role in individual price negotiations.
The Department of Health has also provided significant specific supports to the private and voluntary nursing home sector over the course of the pandemic. As you are aware, the COVID-19 Temporary Assistance Payment Scheme, also known as TAPS, was established as part of a package of support measures for nursing homes at the start of the pandemic. €134.5 million was made available under the scheme from March 2020 to June 2021. The outbreak assistance element of the scheme is still in payment. In addition to TAPS, direct support has been provided by the HSE to private nursing homes in many areas, including the provision of PPE, serial testing and support with staffing.
The Department published a review of the NTPF pricing system in June 2021. This review was conducted by the NTPF with input from stakeholders and external experts. It recommended several actions to improve the pricing system. These are now being taken forward by the Department and NTPF. Given the size and scope of the NHSS, which is expected to cost the State more than €1.04 billion this year, any changes must be delivered carefully and with due consideration to their impact and any unexpected consequences.
The department is also taking forward the 9 recommendations of the Value for Money Review on Nursing Home Costs, which was published in December 2021. The purpose of the VFM Review was to identify, quantify and analyse the reasons for any cost differential between private/voluntary and public nursing homes and, following analysis, to make recommendations for improving the value for money obtained by the Health sector.
To continue the substantial progress being made on implementing the recommendations of the COVID-19 Nursing Homes Expert Panel report, nearly €18 million euro was allocated in Budget 2022 including investment in Community Support Teams and Safeguarding supports.
Finally, in response to the strategic workforce challenges in the nursing home and home care sector, a Cross-Departmental Strategic Workforce Advisory Group has been established. The Group is working to a tight timeline and is committed to providing a set of recommendations to me by September 2022.
