Richard O'Donoghue
Ceist:263. Deputy Richard O'Donoghue asked the Minister for Health if he will bring an immediate end to permitting remote-consultation home abortions; and if he will make a statement on the matter. [21500/22]
Amharc ar fhreagraAbortion Services
Ceisteanna (263)
Freagraí scríofa
As part of the Government’s ongoing efforts to protect public health and limit the spread of Covid-19, the Department of Health and the HSE worked together in 2020 to put arrangements in place to allow termination of pregnancy services in early pregnancy to be provided remotely. For the duration of the Covid-19 public health emergency, where the need for social distancing, reducing personal contacts and reducing the burden on medical practitioners are paramount, it became possible for a woman to access a termination under section 12 of the Health (Regulation of Termination of Pregnancy) Act 2018 (i.e., before 12 weeks) from her medical practitioner by telephone or video conference consultation.
There is ongoing engagement between the Department of Health and the HSE to monitor service provision, facilitate the smooth-running of the service and resolve any issues that may arise. However, with restrictions eased, the Department is currently reviewing whether remote consultation as part of a blended approach to termination of pregnancy care should be continued post the COVID-19 public health emergency period.
At the request of the Department, the HSE conducted a review of the Revised Model of Care for Termination of Pregnancy. The findings of this review are currently being examined as part of a deliberative process. The consideration of appropriate next steps will form part of this process.
It is important to reflect that COVID-19 is still with us and Health Protection Surveillance Centre (HPSC) guidance on Managing Risk of Transmission of Respiratory Viruses including COVID-19, continues to advise, amongst other things, to limit footfall in General Practice settings and support telephone consultations where care that meets the needs of the patient can be delivered - this helps to eliminate the risk of transmission of viral infection. As such the arrangements for remote access to this service in the context of COVID-19 remain in place.
Health Services
Ceisteanna (264)
Claire Kerrane
Ceist:264. Deputy Claire Kerrane asked the Minister for Health the reason that a critical health service (details supplied) is no longer available in County Leitrim; if his attention has been drawn to the difficulty this is causing for persons in the county in relation to accessing the service, especially those who do not drive; and if he will make a statement on the matter. [21504/22]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
Mental Health Services
Ceisteanna (265)
Claire Kerrane
Ceist:265. Deputy Claire Kerrane asked the Minister for Health the current waiting times to be seen by CAMHS in counties Roscommon and Galway; and the current number of young persons on waiting lists in both counties. [21508/22]
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.
Health Services Staff
Ceisteanna (266)
Claire Kerrane
Ceist:266. Deputy Claire Kerrane asked the Minister for Health the current number of vacancies across the HSE in County Roscommon; the area each vacancy relates to; and the length of time each position has been vacant, in tabular form. [21509/22]
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.
Medicinal Products
Ceisteanna (267)
Peadar Tóibín
Ceist:267. Deputy Peadar Tóibín asked the Minister for Health the reason for the shortage of HRT medication for women in this country at the present time. [21510/22]
Amharc ar fhreagraFreagraí scríofa
Unfortunately, medicine shortages have become increasingly prevalent worldwide over the past decade and are a feature of modern health systems around the world. There are many reasons for such shortages including shortages of raw materials, manufacturing difficulties, logistical/transport issues or product recalls due to potential quality defects.
Medicines shortages can therefore originate at any point in the supply chain and can involve and impact on many different stakeholders. Accordingly, medicines shortages require a multi-faceted, multi-stakeholder response to ensure patient safety, continuity of care and protection of public health. Ireland has a multi-stakeholder medicines shortages framework in place, coordinated by the Health Products Regulatory Authority (HPRA), to prevent, wherever possible, and manage medicine shortages when they occur.
The HPRA is aware of the current challenges regarding the intermittent supply of some hormone replacement therapies (HRT). The HPRA has had regular and ongoing engagement with suppliers in this regard. The companies that place the products on the market have indicated that the current supply difficulties are due to a significantly increased demand for these medicines in Ireland in recent years. To illustrate, the supply of one range of HRT patches has increased by between 77% and 117%, for the three most-used strengths, compared to 2020. In addition, based on demand in recent months, the company expects a similar increase in the demand for all strengths during 2022. This would mean that the usage of this patch in Ireland would be approximately 4.5-7.5 times higher in 2022 (depending on the strength) compared to 2019.
Regarding the HRT patches, the suppliers have confirmed that they have increased the planned supply of HRT patches to Ireland during 2022 in response to this increased demand. In the case of one brand (Evorel/Evorel Conti), the supply of HRT patches has resumed. For another brand (Estradot), some strengths are available currently and, based on manufacturing availability, the re-supply of the full range is expected to be in July. With respect to the gels, Divigel was received by the wholesaler on 25th March and was released for sale the following week. An alternative gel product (Oestrogel) has recently gone short and is expected to resume supply in late April/early May. In the interim, the company is working to find solutions to the immediate supply issues.
The current supply situation has arisen due to significant increases in demand for HRT medicines and is not linked to regulatory matters. However, the HPRA continues to review available options within their regulatory remit to facilitate increased supply where at all possible. In particular, the HPRA has advised the companies that they are open to providing accelerated regulatory approval to supply a product originally intended for other markets if available. The HPRA are awaiting further information from the companies in this regard.
The HPRA publishes a medicinal product shortages list on its website, with the reason for the shortage, the expected dates for the return of supply and in some cases, such as HRT shortages, the HSE’s clinical guidance on the management of patient treatment in response to medicine shortages. The information is made available to assist healthcare professionals in managing medicine shortages when they do arise and reduce their impact on patients. The information relating to shortages on the HPRA website is dynamic and changes depending on the current information the HPRA has to hand, including removal from the list when a shortage has been resolved.
The HPRA will continue to liaise with suppliers of HRT medicines over the coming weeks with a view to securing updates and commitments regarding the restoration of normal supplies for patients as soon as possible.
Health Services
Ceisteanna (268)
Peadar Tóibín
Ceist:268. Deputy Peadar Tóibín asked the Minister for Health the cost per adult between 18 and 23 years of age on the step-down programme. [21512/22]
Amharc ar fhreagraFreagraí scríofa
I understand that the Oireachtas Co-ordination Unit within my Department is in contact with the Deputy regarding specific details of the information which he requires.
Health Services
Ceisteanna (269)
Peadar Tóibín
Ceist:269. Deputy Peadar Tóibín asked the Minister for Health the amount of Government funding that is provided per adult for 28 days in a treatment centre. [21513/22]
Amharc ar fhreagraFreagraí scríofa
I understand that the Oireachtas Co-ordination Unit within my Department is in contact with the Deputy regarding specific details of the information which he requires.
Medical Cards
Ceisteanna (270)
Mark Ward
Ceist:270. Deputy Mark Ward asked the Minister for Health if a medical card application by a person (details supplied) will be reconsidered on compassionate grounds; and the options that are available to them. [21516/22]
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.
Disease Management
Ceisteanna (271)
Danny Healy-Rae
Ceist:271. Deputy Danny Healy-Rae asked the Minister for Health if consideration will be given to an urgent matter in relation to the case of a child (details supplied) with diabetes; and if he will make a statement on the matter. [21525/22]
Amharc ar fhreagraFreagraí scríofa
As the Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines and medical devices under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013, I have asked the HSE to respond to the deputy directly, as soon as possible.
Disability Services
Ceisteanna (272)
Charles Flanagan
Ceist:272. Deputy Charles Flanagan asked the Minister for Health the reason for the decision to transfer a patient (details supplied) with significant additional needs to a nursing home given that a nursing home environment is an inappropriate environment for persons with an intellectual disability needing additional supports; the measures that are being taken to address the lack of suitable nurse-led intellectual disability services to prevent older persons with an intellectual disability being put forward for nursing home care; and if he will make a statement on the matter. [21526/22]
Amharc ar fhreagraFreagraí scríofa
As the question relates to an operational matter, I am forwarding the PQ to the HSE for direct reply to the Deputy.
Suicide Prevention
Ceisteanna (273)
Gerald Nash
Ceist:273. Deputy Ged Nash asked the Minister for Health the funding provided for suicide prevention services in CHO 8 and in County Louth, respectively, from 2017 to 2021, in tabular form; and if he will make a statement on the matter. [21527/22]
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.
Suicide Prevention
Ceisteanna (274)
Gerald Nash
Ceist:274. Deputy Ged Nash asked the Minister for Health the resources that are provided for suicide prevention and the implementation of the national suicide prevention strategy Connecting for Life implementation plan in County Louth; and if he will make a statement on the matter. [21528/22]
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.
Hospital Appointments Status
Ceisteanna (275)
Robert Troy
Ceist:275. Deputy Robert Troy asked the Minister for Health if he will expedite an appointment for a person (details supplied). [21545/22]
Amharc ar fhreagraFreagraí scríofa
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.
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.
Emergency Departments
Ceisteanna (276)
David Cullinane
Ceist:276. Deputy David Cullinane asked the Minister for Health the estimated direct and indirect impact on mortality rate of patient experience times for emergency department admissions in excess of 12, 24 and 36 hours, in tabular form; the increased rate per 1,000; and if he will make a statement on the matter. [21547/22]
Amharc ar fhreagraFreagraí scríofa
The Department is not aware of any study or body of research that has been conducted in Ireland on the correlation between mortality rate and patient experience times for emergency department admissions.
While there has been a recent publication in the Emergency Medicine Journal on this topic, using a cross-sectional, retrospective observational study carried out of patients admitted from every type 1 (major) ED in England between April 2016 and March 2018, making any international comparisons must be treated with caution due to possible differences in the methods of data collection, the scope of data collection, the quality of data collected, definitions and coding practices in different jurisdictions.
From an Irish perspective, it is not possible to link attendances at EDs with records created on the Hospital In-Patient Enquiry (HIPE) Scheme due to the lack of an individual health identifier, making it challenging to replicate the methodology of the EMJ study and link a person's ED attendance with their episode of care on HIPE. It is also currently not possible to link hospital records with vital statistics data from the CSO to establish the 30-day mortality.
Despite the absence of the requisite data to replicate such a study, the Department is committed to the improvement of Patient Experience Times (PET) in line with the National Service Plan 2022. The NSP set a target to have 75% of all attendees aged 75 or over admitted or discharged within 6 hours of registration. The target increases to 99% at 9 hours.
Investment of €1.1bn was provided in budget 2021 to expand capacity, increases services and support reform and this level of investment has been maintained in budget 2022.
Medical Aids and Appliances
Ceisteanna (277)
Joe O'Brien
Ceist:277. Deputy Joe O'Brien asked the Minister for Health the status of his plans to provide access to the Freestyle Libre flash glucose monitoring system to persons with diabetes over 21 years of age based on clinical need; and if he will make a statement on the matter. [21548/22]
Amharc ar fhreagraFreagraí scríofa
The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines and medical devices under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
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.
In February 2017, the company Abbott, applied to the HSE for the reimbursement of the FreeStyle Libre flash glucose monitoring system in Ireland. The HSE’s Health Technology Assessment Group (HTAG) carried out an appraisal of the evidence submitted with this application. The HTAG is a medical technology evaluation group that includes expertise in medicine, pharmacy, health economics, devices and procurement. It reviews the clinical and cost effectiveness of innovative medical devices. It recommended that reimbursement for the device should be considered, subject to certain conditions.
In line with the recommendations outlined by the HTAG, access to the Freestyle Libre flash glucose monitoring system was made available to children and young adults, aged 4 - 21 years, by means of an online process operable since April 2018. However, the online application process does also cater for applications in very exceptional circumstances for type 1 diabetic patients outside this age group.
In 2021, the HSE requested that the National Centre for Pharmacoeconomics (NCPE) carry out a full Health Technology Assessment (HTA) on Freestyle Libre. Abbott were formally notified of this on 13 April 2021. Abbott had a scoping meeting with the NCPE in July 2021 and committed to submitting their HTA dossier by end October 2021. However, on 15 November 2021, Abbott informed the HSE that they would not be submitting the HTA dossier because they did not have the level of Randomized Controlled Trials (RCT) evidence that they stated was required for a full HTA process. The HSE have emphasized the importance of engaging with the HTA to progress the process.
The HSE have now written to the Health Information and Quality Authority (HIQA) to ask if it would consider a system wide HTA across diabetes care. The HSE are awaiting the outcome of this request. In the absence of a full value assessment of the product, the HSE is not in a position to remove the current age restriction.
Hospital Staff
Ceisteanna (278)
Denis Naughten
Ceist:278. Deputy Denis Naughten asked the Minister for Health when the post of Parkinson's disease nurse specialist in University Hospital Galway will be advertised; the interim measures that will be put in place prior to the filling of this post; and if he will make a statement on the matter. [21549/22]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, it has been referred to the HSE for direct reply to the Deputy.
Research Funding
Ceisteanna (279)
Catherine Murphy
Ceist:279. Deputy Catherine Murphy asked the Minister for Health the amount of funding and grants that have been provided to third level institutions in the past ten years to date in 2022 for research and development purposes, by year, amount and recipient, in tabular form. [21554/22]
Amharc ar fhreagraFreagraí scríofa
The Health Research Board (HRB) is a state agency, funded by the Department of Health, to support research across the healthcare sector. The Health Research Board commissions (a) researcher(s) (project leads) to complete research at approved research bodies (host institutions). These research bodies include third-level institutions and research organisations.
The attached excel workbook presents a summary of all Health Research Board funding from 2012 to the present day. This workbook contains two spreadsheets. The first spreadsheet presents two tables: a total of all award spending by year and a total of all award spending by host institution. The second spreadsheet is an individual breakdown of each award by year, scheme type, scheme title, host institution, project lead, project title, and award total.
Medical Aids and Appliances
Ceisteanna (280, 281)
Eoin Ó Broin
Ceist:280. Deputy Eoin Ó Broin asked the Minister for Health if he will remove the current age restriction for Freestyle Libre device with immediate effect following the recent survey by an organisation (details supplied); and if he will make a statement on the matter. [21573/22]
Amharc ar fhreagraEoin Ó Broin
Ceist:281. Deputy Eoin Ó Broin asked the Minister for Health if he will investigate the current impasse that seems to be preventing the undertaking of a health technology assessment for the Freestyle Libre device; if not, if he will offer a different process to enable this to take place; and if he will make a statement on the matter. [21574/22]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 280 and 281 together.
The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines and medical devices under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
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.
In February 2017, the company Abbott, applied to the HSE for the reimbursement of the FreeStyle Libre flash glucose monitoring system in Ireland. The HSE’s Health Technology Assessment Group (HTAG) carried out an appraisal of the evidence submitted with this application. The HTAG is a medical technology evaluation group that includes expertise in medicine, pharmacy, health economics, devices and procurement. It reviews the clinical and cost effectiveness of innovative medical devices. It recommended that reimbursement for the device should be considered, subject to certain conditions.
In line with the recommendations outlined by the HTAG, access to the Freestyle Libre flash glucose monitoring system was made available to children and young adults, aged 4 - 21 years, by means of an online process operable since April 2018. However, the online application process does also cater for applications in very exceptional circumstances for type 1 diabetic patients outside this age group.
In 2021, the HSE requested that the National Centre for Pharmacoeconomics (NCPE) carry out a full Health Technology Assessment (HTA) on Freestyle Libre. Abbott were formally notified of this on 13 April 2021. Abbott had a scoping meeting with the NCPE in July 2021 and committed to submitting their HTA dossier by end October 2021. However, on 15 November 2021, Abbott informed the HSE that they would not be submitting the HTA dossier because they did not have the level of Randomized Controlled Trials (RCT) evidence that they stated was required for a full HTA process. The HSE have emphasized the importance of engaging with the HTA to progress the process.
The HSE have now written to the Health Information and Quality Authority (HIQA) to ask if it would consider a system wide HTA across diabetes care. The HSE are awaiting the outcome of this request. In the absence of a full value assessment of the product, the HSE is not in a position to remove the current age restriction.
Question No. 281 answered with Question No. 280.
Medical Aids and Appliances
Ceisteanna (282, 283)
Gino Kenny
Ceist:282. Deputy Gino Kenny asked the Minister for Health if he will remove the current age restriction for the Freestyle Libre device with immediate effect following a survey by an organisation (details supplied); and if he will make a statement on the matter. [21618/22]
Amharc ar fhreagraGino Kenny
Ceist:283. Deputy Gino Kenny asked the Minister for Health if he will investigate the current impasse that seems to be preventing the undertaking of a health technology assessment for the Freestyle Libre device or offer a different process to enable same to take place; and if he will make a statement on the matter. [21619/22]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 282 and 283 together.
The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines and medical devices under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
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.
In February 2017, the company Abbott, applied to the HSE for the reimbursement of the FreeStyle Libre flash glucose monitoring system in Ireland. The HSE’s Health Technology Assessment Group (HTAG) carried out an appraisal of the evidence submitted with this application. The HTAG is a medical technology evaluation group that includes expertise in medicine, pharmacy, health economics, devices and procurement. It reviews the clinical and cost effectiveness of innovative medical devices. It recommended that reimbursement for the device should be considered, subject to certain conditions.
In line with the recommendations outlined by the HTAG, access to the Freestyle Libre flash glucose monitoring system was made available to children and young adults, aged 4 - 21 years, by means of an online process operable since April 2018. However, the online application process does also cater for applications in very exceptional circumstances for type 1 diabetic patients outside this age group.
In 2021, the HSE requested that the National Centre for Pharmacoeconomics (NCPE) carry out a full Health Technology Assessment (HTA) on Freestyle Libre. Abbott were formally notified of this on 13 April 2021. Abbott had a scoping meeting with the NCPE in July 2021 and committed to submitting their HTA dossier by end October 2021. However, on 15 November 2021, Abbott informed the HSE that they would not be submitting the HTA dossier because they did not have the level of Randomized Controlled Trials (RCT) evidence that they stated was required for a full HTA process. The HSE have emphasized the importance of engaging with the HTA to progress the process.
The HSE have now written to the Health Information and Quality Authority (HIQA) to ask if it would consider a system wide HTA across diabetes care. The HSE are awaiting the outcome of this request. In the absence of a full value assessment of the product, the HSE is not in a position to remove the current age restriction.
Question No. 283 answered with Question No. 282.
Alcohol Pricing
Ceisteanna (284)
Niamh Smyth
Ceist:284. Deputy Niamh Smyth asked the Minister for Health if matters raised in correspondence by a person (details supplied) will be reviewed; and if he will make a statement on the matter. [21642/22]
Amharc ar fhreagraFreagraí scríofa
In October 2013, a Government Decision approved the drafting of legislation to address alcohol as a public health issue, as recommended by the 2012 National Substance Misuse Strategy. In this Government Decision it was agreed that Minimum Unit Pricing of alcohol products would be introduced simultaneously with Northern Ireland to allay concerns about negative impacts on cross-border trade.
Over time it became apparent that simultaneous implementation on both sides of the border would not be possible within a reasonable timeframe. A revised Government Decision agreed the introduction of Minimum Unit Pricing in January of this year, in recognition of the urgent need to reduce the health harms of alcohol use in this jurisdiction through preventing the sale of strong alcohol products at very low prices.
There has been, and continues to be, ongoing engagement with Northern Ireland on this measure. Cooperation with colleagues in Northern Ireland takes place in the context of the North-South Ministerial Council and the British-Irish Council. In particular, the North-South Alcohol Policy Advisory Group is an important forum for sharing learnings and experiences on alcohol policy issues across the island on an ongoing basis. Engagement with Northern Ireland will continue as that jurisdiction moves towards the introduction of Minimum Unit Pricing.