Written Answers Nos. 889-911
889. Deputy Pearse Doherty asked the Minister for Health the status of the inquiry and terms of reference for the drug sodium valproate, the disability package for those affected by sodium valproate; and if he will make a statement on the matter. [14237/22]
Amharc ar fhreagraValproate-containing medicines (also known as sodium valproate or valproic acid) are approved in Ireland under the brand name Epilim, for the treatment of epilepsy and bipolar disorder. Based on the totality of available scientific data on this drug, it is known that children exposed in utero are at a high risk of serious developmental disorders (in up to 30-40% of cases) and congenital malformations (in approximately 10% of cases).
To prevent exposure during pregnancy, there is a robust regulatory framework for the licensed use of Epilim in women of childbearing potential. This regulatory framework was strengthened following participation by the Health Products Regulatory Authority (HPRA) in two EU-wide reviews in 2014 and 2017.
After the European Medicines Agency (EMA) issued new recommendations on the use of sodium valproate in early 2018, the HPRA collaborated with national stakeholders, including patient representatives and healthcare professionals, to implement the new valproate risk-minimisation measures in Ireland. These measures included changes to the product information for patients and healthcare professionals; a visual warning on the packaging of valproate medicines; updated educational materials to reflect the new measures and provide age-appropriate advice; and a patient alert card to be attached to the packaging so that pharmacists can go through it with the patient when valproate is dispensed.
To support the actions taken by the HPRA, the Pharmaceutical Society of Ireland directed pharmacists that they must inform women of child-bearing age of the potential risk of abnormal pregnancy outcomes when supplying any medicine containing valproate. This includes providing counselling and including a Package Leaflet and Alert Card with each supply of these medicines.
To address the more operational aspects of this issue, a HSE Valproate Response Project was established in May 2018 under the remit of the HSE Office of the Chief Clinical Officer. The Project Team was able to provide expert support to individuals and families with concerns about previous exposure to valproate and the possible impact on their children. The HSE team has also worked to improve the structures in place to support families affected by foetal valproate syndrome. A specialist dedicated genetics clinic has been established in Our Lady’s Hospital, Crumlin, to support diagnosis, and the HSE is working to improve access to genetic testing.
The HSE’s medium- to long-term response to the valproate issue is focused on the establishment of a Programme for Women’s Health in Epilepsy within one of the Regional Epilepsy Centres, which will coordinate this national response. This means that all women taking valproate will have yearly follow-up, sign a valproate agreement form, be kept up-to-date with developments and signposted to other services, including the diagnostic service for those potentially exposed during pregnancy.
Details of the proposed inquiry into the historical licensing and use of sodium valproate in Ireland, and the establishment of a related stakeholder group, are currently being considered by officials within the Department of Health.
890. Deputy Michael Creed asked the Minister for Health if public respite beds are available at private nursing homes (details supplied). [14239/22]
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.
891. Deputy Jennifer Murnane O'Connor asked the Minister for Health the updated timeline regarding the HIQA health technology assessment on a varicella vaccine; the frequency with which he is updated on the assessment process; if the assessment will be completed in 2022; if his Department is planning and budgeting for the addition of the varicella vaccine to the national immunisation programme in 2023, subject to a favourable health technology assessment outcome; and if he will make a statement on the matter. [14243/22]
Amharc ar fhreagraThe immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The committee's recommendations are based on the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation. It makes recommendations on vaccination policy to my Department.
NIAC continues to revise recommendations to allow for the introduction of new vaccines in Ireland and to keep abreast of changes in the patterns of disease. Therefore, the immunisation schedule will continue to be amended over time. All vaccines administered through the Primary Childhood Immunisation Schedule are provided free of charge.
Varicella (chickenpox) is an acute infectious disease caused by varicella-zoster virus (VZV). Primary infection with varicella results in varicella (chickenpox). Recurrent infection results in herpes zoster (shingles).
Varicella vaccination is not currently included as part of the routine childhood immunisation schedule.
The Varicella Zoster Vaccine was proposed for a Health Technology Assessment (HTA) by my Department in December 2019. Unfortunately, HIQA's HTA prioritisation process due to complete in Q1 2020 was paused as the HTA team was diverted to provide evidence synthesis to support the work of the NPHET and associated groups
This topic was subsequently considered by HIQA during the 2021 prioritisation process and was prioritised for inclusion in the HIQA HTA work programme for 2021/2022. I can confirm that this HTA is currently underway and is expected to be completed in 2022. On completion, the HTA will inform the next steps to be taken.
892. Deputy Jennifer Murnane O'Connor asked the Minister for Health the number of doses of the pneumococcal vaccine PPV23 that have been administered for free to persons over 65 years of age and at-risk groups in each of the years 2018 to 2021 and to date in 2022, in tabular form; and if he will make a statement on the matter. [14244/22]
Amharc ar fhreagraAs this is an operational matter for the HSE, I have referred the question to the HSE for a direct reply.
893. Deputy Jennifer Murnane O'Connor asked the Minister for Health his plans to revisit SI No. 449/2015 relating to the administration of vaccines by pharmacists; if he will increase the number of vaccines permitted to be used by qualified pharmacists; if he has undertaken a review to assess the other vaccines that could be permitted to be used by qualified pharmacists; if he has reviewed the number and types of vaccines permitted to be administered by qualified pharmacists in other European Union states; and if he will make a statement on the matter. [14245/22]
Amharc ar fhreagra894. Deputy Jennifer Murnane O'Connor asked the Minister for Health if he will consider extending the free pneumococcal vaccine programme for persons over 65 years of age and at-risk groups to community pharmacies; if he has undertaken a cost benefit analysis of the extension of the programme; and if he will make a statement on the matter. [14246/22]
Amharc ar fhreagraI propose to take Questions Nos. 893 and 894 together.
Immunisation is a simple, safe and effective way of protecting people against harmful diseases before they come into contact with them in the community. Immunisation not only protects individuals, but also others in the community, by reducing the spread of disease. I am fully committed to improving the immunisation uptake rates in the general population and am keen to ensure that vaccines are as accessible as possible, where appropriate.
I very much appreciate the fundamental role community pharmacists play in the wider Irish Health Service in the delivery of holistic patient care and in supporting the direction of travel envisaged in Sláintecare. Currently, adult vaccinations are available either from a patient’s General Practitioner (GP), a pharmacist or in the case of Covid19, at a Covid19 vaccination centre.
Since 2011, pharmacists under the provisions of the Medicinal Products (Prescription and Control of Supply) (Amendment) Regulations 2011 S.I. No. 525 of 2011, have been authorised to provide a seasonal influenza vaccination service in pharmacies, and to supply and administer adrenaline injections for the emergency treatment of anaphylactic shock that may arise from the administration of such vaccines. This legislation provides a framework whereby the authority to autonomously “supply and administer” specified prescription controlled medicinal products is given to pharmacists, in addition to the authority conferred in the Medicinal Products (Prescription and Control of Supply) Regulations 2003 to supply prescription controlled medicinal products of receipt of a prescription issued by a practitioner authorised to do so.
In 2015 the legislation was amended to permit pharmacists to “supply and administer” two additional vaccines, the pneumococcal polysaccharide and herpes zoster (shingles) vaccines. In 2020, in response to the Covid-19 Pandemic this authority was extended to allow pharmacists fully participate in the provision of vaccination services in the context of the Covid-19 pandemic. Thereafter the Medicinal Products (Prescription and Control of Supply) (Amendment) Regulations 2022 (S.I. No.32/2022) added an additional herpes zoster vaccine to those which pharmacists were authorised to supply and administer.
The autonomous “supply and administration” of any vaccine by a pharmacist is subject to the completion of approved training by the pharmacist, and the Immunisation Guidelines for Ireland as published and updated by the National Immunisation Advisory Committee. The Pharmaceutical Society of Ireland, which is the entity responsible for the regulation of pharmacists and pharmacies in Ireland has produced guidance to support pharmacists in providing vaccination services in line with the legislation. It details the general requirements for providing vaccination services and additional considerations specific to the provision of each particular vaccination service. This governance framework is in place to assure trust and safety for all patients and the public on receipt of such services, and the consideration of any expansion of service will be subject to these criteria.
In relation to the Pneumococcal vaccine, NIAC have recommended the Pneumococcal polysaccharide vaccine (PPV23) for those aged over 65 years and individuals in certain at-risk groups. The Pneumococcal conjugate vaccines (PCV) may also be prescribed for those in at risk groups. These vaccines are available from an individual’s GP.
I can confirm that there are no plans in place at present to review or revise the current vaccine provision arrangements.
895. Deputy Róisín Shortall asked the Minister for Health his position regarding funding for a training post (details supplied); the reason that the funding was refused; and if he will make a statement on the matter. [14247/22]
Amharc ar fhreagraIn 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.
896. Deputy Joe Flaherty asked the Minister for Health when the full-time ophthalmologist service for children at St. Joseph’s care centre campus, Longford ceased. [14249/22]
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.
897. Deputy Joe Flaherty asked the Minister for Health if he will provide an update on a replacement for a vacant ophthalmologist post at St. Joseph’s care centre campus, Longford. [14250/22]
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.
898. Deputy Joe Flaherty asked the Minister for Health the reason that all children have not been transferred to Athlone in the absence of an ophthalmologist post as was done on previous occasions at St. Joseph’s care centre campus, Longford. [14251/22]
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.
899. Deputy Denis Naughten asked the Minister for Health when a person (details supplied) will receive an appointment; the reason for the delay in same; and if he will make a statement on the matter. [14253/22]
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.
900. Deputy Pearse Doherty asked the Minister for Health when a provisional date for a procedure in Letterkenny University Hospital will be confirmed for a person (details supplied) in County Donegal; and if he will make a statement on the matter. [14267/22]
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.
901. Deputy Jennifer Whitmore asked the Minister for Health the status of the implementation of plans to increase breastfeeding supports including the recruitment of lactation consultations across all hospitals; and if he will make a statement on the matter. [14287/22]
Amharc ar fhreagraAs this refers to an operational matter, it has been referred to the HSE for direct reply to the Deputy.
902. Deputy Jennifer Whitmore asked the Minister for Health if his Department will work with its Northern Ireland counterparts to develop an infant and young child feeding in emergencies preparedness plan for the island of Ireland; the timeline for the project; and if he will make a statement on the matter. [14291/22]
Amharc ar fhreagraI am aware that under the “Shared Island North South research programme” work is being carried out on developing an infant and young child feeding in emergencies preparedness plan for the island of Ireland. This research is being led out by staff at Queen’s University Belfast and Technological University Dublin) and comes under the remit of the Department of Further and Higher Education, Research, Innovation and Science.
903. Deputy Jennifer Whitmore asked the Minister for Health the efforts that are being taken by his Department to support brain health and dementia supports in communities as part of Budget 2022; and if he will make a statement on the matter. [14292/22]
Amharc ar fhreagraThis Government is committed to ensuring that those living with dementia have access to the right services and supports to help them to live well in their communities.
As Minister of State with Responsibility for Mental Health and Older People, I was delighted to secure an additional allocation of €7.3 million in Budget 2022 for dementia services and supports. I am confident that this investment will continue to improve diagnosis and access to services for people with dementia across the country, enabling people with dementia to live well for as long as possible.
The additional funding will allow for a range of measures to enhance services and supports for people with dementia. These services include:
- 5 new memory assessment and support services and one new regional specialist memory clinic in Galway
- Specialist diagnostic services for people with an intellectual disability through the National Intellectual Disability Memory Service in Tallaght University Hospital
- Enhancement of memory technology resource rooms to demonstrate assistive technology options for people living with dementia
- Implementation of a dementia minimum dataset across all care settings to standardise data collection and reporting
- 6 dementia assistant director of nursing posts (one in each hospital group) to improve quality and safety of care for people with dementia
- 4 additional dementia clinical nurse specialists to improve care pathways in acute care settings
- Undertake the third wave of the Irish National Audit of Dementia in acute hospitals
- Promote brain health and reduce the prevalence and delay the onset of dementia through collaboration with clinical programmes, the understand together campaign and dementia risk reduction group through the provision of a brain health project manager
In addition, the Government is committed to the development of improved community-based services, shifting care to the home, and offering greater choice for older people including people living with dementia. As Minister with responsibility for this area I have prioritised home support services so that additional funding secured in Budget 2021 to provide an extra 5 million hours has been maintained under Budget 2022. It is estimated that in 2021 some 20.4 million hours had been provided to over 55,000 people. This is about 2.9 million more hours compared to 2020, an increase of 17%.
In addition to the €7.3m for dementia services outlined above, the proportion of new home support hours ringfenced for people with dementia will more than double from 5% in 2021 to 11% in 2022.
Taken together, this will represent 15 million euro of investment dedicated to dementia specific supports and services in 2022, on top of the €12.9m of additional funding in 2021.
As the Deputy is aware I have long been an advocate for the development of services for people with dementia and their families and I am pleased to be able to continue the focused investment in these services and supports in 2022.
904. Deputy Mark Ward asked the Minister for Health if he will provide an update on the €200 million provided to the HSE to address waiting lists and waiting times for acute and community services that was due to be finalised by year end 2021; if it has been finalised; the breakdown of allocation by service; and if he will make a statement on the matter. [14302/22]
Amharc ar fhreagraThe 2022 Waiting List Action Plan was launched on 25 February this year following extensive consultation between the Department of Health, the HSE and the NTPF (National Treatment Purchase Fund). The Plan allocates €350 million to the HSE and NTPF to reduce active waiting lists for acute scheduled care by 18% this year, which will bring the number of people waiting to their lowest point in five years.
The Plan has a dual focus of delivering immediate activity to reduce waiting lists and progress towards achieving maximum waiting time targets, and laying the foundations for longer-term reforms.
The €350 million includes:
- Existing funding of €100 million allocated to the NTPF for 2022 plus an additional funding of €50 million, providing it with a total budget of €150 million for the year. With this funding, NTPF activity is projected to remove 273,000 patients from waiting lists.
- €152 million has been allocated to fund additional activity in 2022 within the private and public system, including €15 million to the priority areas of gynaecology, paediatric orthopaedics (with a specific focus on spinal surgery) and bariatric/obesity treatments, and €20 million for initiatives that will reduce specific community care waiting lists (including orthodontics, primary care child psychology/counselling, CAMHS and autism).
- The remaining €48 million will be allocated to specific acute scheduled care reform initiatives, such as modernising care pathways, and enhancing and improving data and information.
Further details are contained within the published Plan: www.gov.ie/en/publication/323b5-the-2022-waiting-list-action-plan/.
905. Deputy Mark Ward asked the Minister for Health in relation to the €200 million provided to the HSE to address waiting lists and waiting times for acute and community services if progress has been made for persons accessing mental health services; and if he will make a statement on the matter. [14303/22]
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.
906. Deputy Colm Burke asked the Minister for Health the estimated cost of introducing free contraception for women aged 26 to 28 years of age; and if he will make a statement on the matter. [14304/22]
Amharc ar fhreagra907. Deputy Colm Burke asked the Minister for Health the estimated cost of introducing free contraception for women aged 26 to 30 years of age; and if he will make a statement on the matter. [14305/22]
Amharc ar fhreagraI propose to take Questions Nos. 906 and 907 together.
The Programme for Government commits to providing free contraception for women, starting with the 17-25 age cohort; roll-out is scheduled to commence in August 2022.
The scheme will provide for:
1. The cost of prescription contraception;
2. The cost of a minimum of two consultations per annum with GPs and other doctors to discuss suitable contraception for individual patients and to enable prescription of same;
3. The cost of fitting and/or removal of various types of long-acting reversible contraception (LARCs) plus any necessary checks, by medical professionals certified to fit/remove same;
4. The cost of training and certifying additional medical professionals to fit and remove LARCs;
5. Provision of contraceptive options currently available to GMS (medical) card holders through this scheme, to include contraceptive injections, implants, IUS and IUDs (coils), the contraceptive patch and ring, and various forms of oral contraceptive pill, including emergency contraception.
Full year costs for the 17-25 age cohort are currently estimated at €26 million. This figure is based on using methods analogous to those published in the Report of the Working Group on Contraception. The estimated cost of rolling out the scheme to women aged 17-55 is approximately €110 million. Formal costings for specific age ranges outside the 17-25 year cohort have not been completed, as the scheme is being rolled out in line with the Programme for Government, starting with 17-25 year olds.
Expanding the scheme to further age cohorts will be considered following the monitoring and evaluation the scheme for 17–25-year-olds, once operational. Costings for additional age cohorts will be refined once real world data from the operational 17-25 year old scheme is available. This will ensure that the scheme is working smoothly in terms of gauging demand levels and ensuring sufficient numbers of medical practitioners are certified to fit and remove LARCs.
As part of the Budget 2022 allocation, funds are being made available for additional training capacity with respect to certification of medical professionals to fit and remove LARCs. The HSE is currently working on preparing to roll out these additional training supports.
908. Deputy Colm Burke asked the Minister for Health the estimated cost of reducing the monthly drug payment scheme threshold by €2, €5, €10 and €15; and if he will make a statement on the matter. [14307/22]
Amharc ar fhreagra926. Deputy Colm Burke asked the Minister for Health the estimated cost of reducing the monthly drug payment scheme threshold by €2, €5, €10 and €20, respectively; and if he will make a statement on the matter. [14332/22]
Amharc ar fhreagraI propose to take Questions Nos. 908 and 926 together.
The estimated annual cost of reducing the monthly Drug Payment Scheme threshold from €80 by €2, €5, €10, €15 and €20, respectively is as below:
|
Proposed DPS Threshold |
Cost of Reduction* |
|
€78 |
€1.7m |
|
€75 |
€4.3m |
|
€70 |
€8.7m |
|
€65 |
€13.1m |
|
€60 |
€17.5m |
*This data is subject to the following caveats:
- The source data used for determining costs was the claiming month of March 2021 and was annualised to determine the full year cost.
- The costing excludes the increase for any individuals who were below the threshold level as of March 2021, or €114 per month.
- The costing excludes any impact resulting from an aging demographic.
909. Deputy Colm Burke asked the Minister for Health the estimated full annual cost of making the HPV vaccine available free of charge to all persons up to 25 years of age; and if he will make a statement on the matter. [14308/22]
Amharc ar fhreagraIt is not possible to provide a detailed costing estimate in relation to the implementation of a catch up programme for the HPV vaccine, at this time. You may be aware that my Department has asked the National Immunisation Advisory Committee to consider the clinical effectiveness of providing the HPV vaccine to:
- girls and boys in secondary school who were eligible to receive HPV vaccine in 1st year but who did not receive it; and
- women up to the age of 25 years who have left secondary school and who did not receive the vaccine when eligible.
If NIAC conclude that there is sufficient evidence to support providing the HPV vaccine to one or both groups, HIQA will undertake a cost-effectiveness assessment on that basis. On completion, the cost-effectiveness assessment will inform the costing process.
910. Deputy Maurice Quinlivan asked the Minister for Health if he will address the case of a person (details supplied) and the feasibility of a drip being provided at their home address; and if he will make a statement on the matter. [14314/22]
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.
911. Deputy Pat Buckley asked the Minister for Health if he will visit the Owenacurra Health Centre in Midleton, County Cork and instruct the HSE not to close the centre but to improve it and retain all the services that were present pre-Covid-19; and if he will make a statement on the matter. [14315/22]
Amharc ar fhreagra913. Deputy Pat Buckley asked the Minister for Health if his attention has been drawn to the fact that the two short-term respite beds are closed in the Owenacurra Centre, Midleton, County Cork and all the associated services with those beds have ceased; when these services will be reinstated; and if he will make a statement on the matter. [14317/22]
Amharc ar fhreagra914. Deputy Pat Buckley asked the Minister for Health if his attention has been drawn to the fact that residents of the Owenacurra Health Centre, Midleton, County Cork have told the HSE that they do not want to leave the centre and want to remain in the centre as it is their forever home and want to see all the services retained despite the HSE saying that the centre is not fit for purpose (details supplied); and if he will make a statement on the matter. [14318/22]
Amharc ar fhreagra915. Deputy Pat Buckley asked the Minister for Health if he will obtain assurances from the HSE that the Owenacurra Health Centre, Midleton, County Cork will remain open and that all pre-Covid-19 services will be retained and enhanced; and if he will make a statement on the matter. [14319/22]
Amharc ar fhreagra918. Deputy Pat Buckley asked the Minister for Health the reason that the HSE will not build a new fit-for-purpose mental health centre on the grounds of the Owenacurra Health Centre, Midleton, County Cork retaining all existing pre-Covid-19 services; and if he will make a statement on the matter. [14322/22]
Amharc ar fhreagra919. Deputy Pat Buckley asked the Minister for Health the reason that the HSE would not build a new purpose-built mental health centre to replace the existing Owenacurra Health Centre, Midleton, County Cork on the adjacent grounds at the Midleton Community Hospital and retain all pre-Covid-19 services; and if he will make a statement on the matter. [14323/22]
Amharc ar fhreagra920. Deputy Pat Buckley asked the Minister for Health if the HSE has found an appropriate building or premises in Midleton, County Cork to provide mental health day care services which were suspended in March 2020 and formally administered at the Owenacurra Health Centre if the service is running at 100%; and if he will make a statement on the matter. [14324/22]
Amharc ar fhreagra921. Deputy Pat Buckley asked the Minister for Health the location and name of the proposed premises to provide mental health day care services in Midleton, County Cork due to the removal of services from the Owenacurra Health Centre, Midleton, County Cork in March 2020; if the day-care services have resumed; if the service is running at 100%; and if he will make a statement on the matter. [14325/22]
Amharc ar fhreagraI propose to take Questions Nos. 911, 913 to 915, inclusive, and 918 to 921, inclusive, together.
As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
