Written Answers Nos. 411-420
411. Deputy David Cullinane asked the Minister for Health if he supports the inclusion of home-help workers on the critical skills occupations list; if he has engaged with the Department of Enterprise, Trade and Employment on this issue; and if he will make a statement on the matter. [33342/22]
Amharc ar fhreagraI have established a cross-departmental Strategic Workforce Advisory Group to examine factors affecting the care sector workforce.
The structure and membership of the Strategic Workforce Advisory Group was informed by submissions received by my Department from key stakeholders in January 2022 as well as by a short-life scoping exercise to gather initial data and evidence on the extent of the challenges in the sector. Following this, the Department of Enterprise, Trade and Employment was invited to participate in the Group's work. The Department of Enterprise, Trade and Employment accepted the invitation and became an active participant in this process.
At the inaugural meeting of the Group, which was held on 3rd March 2022, the Group's terms of reference and action-timelines were agreed. The terms of reference are available on the Department's website. Areas being considered by the Group include the recruitment, retention, training, pay and conditions, and the career development of front-line carers in home-support and nursing homes.
The Group is currently working with key sectoral stakeholders to further explore and define the issues arising and will submit a report for my consideration by September 2022. The report will outline the Group's key findings and recommendations as well as an action plan for the recommendations' implementation.
412. Deputy David Cullinane asked the Minister for Health if he supports the inclusion of speech and language and occupational therapists, child psychologist and physiotherapist positions on the critical skills occupations list; if he has engaged with the Department of Enterprise, Trade and Employment on this issue; and if he will make a statement on the matter. [33343/22]
Amharc ar fhreagraI am aware that the HSE has submitted a business case to the Department of Health in relation to having a number of specialist roles such as Speech and Language Therapists, Occupational Therapists, Psychologists and Physiotherapist positions included on the Critical Skills Occupations List.
Discussions are ongoing and when finalised a consolidated list will be forwarded to the Department of Enterprise, Trade and Employment with regard to the above roles and allocating them on the Critical Skills Occupation List.
In advance of this, I have also written to the Tánaiste, as the relevant Minister, outlining my support of this initiative.
413. Deputy David Cullinane asked the Minister for Health his plans to change prescribing rules to better empower community pharmacists; and if he will make a statement on the matter. [33344/22]
Amharc ar fhreagraThe system of controls around prescribing and dispending of prescription controlled medicinal products for human use (excepting those products subject to additional parameters under the Misuse of Drugs Acts and Regulations) is derived from the framework of Directive 2001/83/EC and Regulation (EC) No 726/2004, and is implemented nationally by the Medicinal Products (Prescription and Control of Supply) Regulations 2003-2022. These regulations apply an up-to-date and comprehensive system of control to medicinal products and particularise those products which may be supplied on medical prescription, and those that may be supplied without prescription by or under the supervision of a registered pharmacy from a registered retail pharmacy business. I have no current plans to change this framework.
This framework is underpinned by the activity of the Health Products Regulatory Authority, being the competent authority responsible for the designation of the legal supply category for a medicine, with such categorisation being particular to the product and an integral part of the marketing authorisation. A marketing authorisation for any product is granted after an assessment process undertaken to assure the safety, quality and efficacy of the product on the basis of the review of an application submitted by the pharmaceutical company involved.
The Department of Health is committed to the ethos of ensuring that the right care is delivered in the right place and at the right time for all citizens and recognises that all healthcare professionals have a role to play in optimising patient care and service delivery in line with this vision. In delivering on this I recognise that pharmacists are integral to the safe supply of medicines to patients and to the promotion of rational medicines utilisation. Pharmacists provide a clinical service through an accessible network of Registered Retail Pharmacy Businesses operated in accordance with the clinical governance framework outlined in the Pharmacy Act. They work to deliver on specific professional obligations provided for in the Regulation of Retail Pharmacy Business Regulations, SI 488 of 2008, relating to the supply of both prescription controlled and prescription exempt medicinal products to patients, to assure best patient outcomes.
414. Deputy David Cullinane asked the Minister for Health if he will allow pharmacists to substitute hormone replacement therapy products without a prescription and without having to resort to a general practitioner; and if he will make a statement on the matter. [33345/22]
Amharc ar fhreagraColleagues in the department and across the health sector continue to work to resolve the issues around supply of Hormone Replacement Therapies. On 19th May, I met with representatives of Marketing Authorisation Holders (MAHs) of products implicated in the recent HRT shortages, together with Health Products Regulatory Authority (HPRA), Pharmaceutical Society of Ireland (PSI), Health Service Executive, Irish Pharmaceutical Union (IPU) representatives and clinical representative from the National Women and Infants Health Programme (NWIHP). An additional stakeholder meeting was held earlier this month with representatives from the Department, HPRA and HSE to discuss and assess the supply of HRT medicines.
Based on information provided by companies involved in the recent HRT shortages, supply of HRT products has largely been restored with more regular supply to resume on the remaining products from July. Each of these companies has confirmed that they have increased their forecasting to meet increased demand.
The Department plans to continue managing medicines shortages through the established multi-stakeholder medicines shortages framework that is coordinated by the HPRA. This framework was established to prevent, wherever possible, and manage medicines shortages.
The system of controls around prescribing and dispensing of human prescription controlled medicinal products (excepting those products subject to additional parameters under the Misuse of Drugs Acts and Regulations) is derived from the framework of Directive 2001/83/EC and Regulation (EC) No 726/2004, and is implemented nationally by the Medicinal Products (Prescription and Control of Supply) Regulations 2003-2022. These regulations apply an up-to-date and comprehensive system of control to medicinal products and identify those products which may only be supplied on medical prescription. They define what a “prescription” is with reference to those healthcare professionals who are entitled to prescribe.
Pharmacists are experts in medicines and are the professionals optimally placed by virtue of their training to optimise the rational use of medicines in the health system for best patient outcomes, and in partnership with prescribing colleagues, to maximise the benefits and minimise the potential for patient harm when using medicines and pharmacological interventions. Pharmacists supply and dispense prescription controlled medicinal products in accordance with the authority conferred to supply, underpinned by a validly issued prescription.
The Department of Health is committed to the ethos of ensuring that the right care is delivered in the right place and at the right time for all citizens and recognises that all healthcare professionals have a role to play in optimising patient care and service delivery in line with this vision.
415. Deputy David Cullinane asked the Minister for Health if he has plans to allow pharmacists to be able to supply additional drugs and medications without a prescription and without having to resort to a general practitioner; if so, the name of the drug and the medication; and if he will make a statement on the matter. [33346/22]
Amharc ar fhreagraThe Health Products Regulatory Authority (HPRA) is the Competent Authority in Ireland responsible for deciding the legal supply category for a medicine. The supply category is specific to the product and is part of the marketing authorisation.
The system of controls around prescribing and dispending of prescription controlled medicinal products for human use (excepting those products subject to additional parameters under the Misuse of Drugs Acts and Regulations) is derived from the framework of Directive 2001/83/EC and Regulation (EC) No 726/2004, and is implemented nationally by the Medicinal Products (Prescription and Control of Supply) Regulations 2003-2022. These regulations apply an up-to-date and comprehensive system of control to medicinal products and identify those products which may only be supplied on medical prescription. They define what a “prescription” is with reference to those healthcare professionals who are entitled to prescribe.
Pharmacists are experts in medicines and are the professionals optimally placed by virtue of their training to optimise the rational use of medicines in the health system for best patient outcomes, and in partnership with prescribing colleagues, to maximise the benefits and minimise the potential for patient harm when using medicines and pharmacological interventions. Pharmacists supply and dispense prescription controlled medicinal products in accordance with the authority conferred to supply, underpinned by a validly issued prescription.
The Department of Health is committed to the ethos of ensuring that the right care is delivered in the right place and at the right time for all citizens and recognises that all healthcare professionals have a role to play in optimising patient care and service delivery in line with this vision.
416. Deputy David Cullinane asked the Minister for Health if he will develop a scheme to enable women access contraception directly from their community pharmacist without prescription and without charge, regardless of eligibility; and if he will make a statement on the matter. [33347/22]
Amharc ar fhreagraThe Programme for Government, 2020 commits to providing free contraception for women, starting with the 17-25 age cohort. My Department's Contraception Implementation Group was convened in July, 2021 and has been working with partners, including the HSE, towards ensuring that the scheme will commence in Q3, 2022. Funding of approximately €9m has been allocated for this in Budget 2022.
The scheme will provide for:
- The cost of prescription contraception;
- The cost of necessary consultations with medical professionals to discuss suitable contraception for individual patients and to enable prescription of same;
- 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;
- The cost of training and certifying additional medical professionals to fit and remove LARCs;
- The cost of providing the wide range of contraceptive options currently available to GMS (medical) card holders, which will also be available through this scheme, including contraceptive injections, implants, IUS and IUDs (coils), the contraceptive patch and ring, and various forms of oral contraceptive pill, including emergency contraception.
- The scheme will be open to all 17-25 year-olds ordinarily resident in Ireland.
Formal consultations with medical representative bodies with regard to service provision under the scheme have commenced and are ongoing. Following advice from the Attorney General's office regarding the legal framework for the scheme, consideration is being given to providing this by way of primary legislation.
The design of citizen engagement information and publicity campaigns to support and promote the roll out of the scheme will be finalised in the coming months, to be launched in the month preceding and during the initial phase of scheme roll-out.
The regulatory framework in Ireland does not currently permit dispensing the Pill without a prescription; amending this would require expert clinical input. It is not envisaged that this could be considered prior to the launch of the scheme, given the tight timelines involved.
Some access to free contraception is already enabled in some contexts. the National Condom Distribution Service (NCDS), which was established by the HSE Sexual Health and Crisis Pregnancy Programme (SHCPP) in October 2015 and functions as a central point for distributing free condoms and lubricant sachets to HSE services and other organisations working with individuals and groups at increased risk of negative sexual health outcomes. The NCDS was expanded to 3rd level campuses in 2019 and will continue to operate in this context.
It should be noted that, while oral contraception and various forms of long-acting reversible contraception can be more effective at preventing pregnancy, condoms provide protection against STIs that is not provided by non-barrier forms of contraception. It is envisaged that continued expansion of the NCDS will be facilitated in line with demand, in order to support the STI prevention and sexual health promotion needs of people living in Ireland.
417. Deputy David Cullinane asked the Minister for Health his plans to extend the role of pharmacists; and if he will make a statement on the matter. [33348/22]
Amharc ar fhreagraI value the important role community pharmacists play in our Health Service in the delivery of holistic patient care. I also fully acknowledge that community pharmacists have played a vital role in responding to the health needs of the public during the COVID-19 pandemic.
Community pharmacists have ensured the continued availability of a professional, accessible service for the public and have successfully managed to alleviate concerns around continuity of medicine supply. They have also played a central role in the national vaccination rollout – the largest ever undertaken by the State.
During the COVID-19 pandemic the HSE established a Community Pharmacy Contingency Planning working group with relevant stakeholders, including the Irish Pharmaceutical Union and the Pharmaceutical Society of Ireland, to support the implementation of all COVID-19 support measures. This group – now called the Community Pharmacy Planning Forum – had examined the operational and clinical challenges confronting community pharmacists during the COVID-19 emergency and played a key role in resolving them to the benefit of the people of Ireland.
The work of the Forum has now transitioned to discussing the strategic direction of the community pharmacy profession. These discussions will bring clarity to the role to be played by community pharmacy in the context of Sláintecare. The central objective of SláinteCare is providing the right care, in the right place, at the right time. This means providing more care to patients in the communities in which they live. Community pharmacists will play a vital and increasing role in delivering this care.
The ongoing work of the Community Pharmacy Planning Forum will also prove invaluable in the context of future contractual reform. Of course, any publicly funded pharmacy service expansion should address unmet public healthcare needs, improve access to existing public health services, and provide better value for money.
I believe there is a real opportunity to work collaboratively, and with other healthcare providers, to make a significant difference to patient outcomes. I welcome the ongoing work of the Community Pharmacy Planning Forum in that regard.
418. Deputy David Cullinane asked the Minister for Health if he will halt plans to close the emergency department at Navan Hospital; and if he will make a statement on the matter. [33349/22]
Amharc ar fhreagraAs the Deputy will be aware, the HSE has proposed a process of planned service changes at Navan. The HSE advises these changes are necessary to support safe service delivery on a sustained basis, and are driven first and foremost by patient safety considerations and very real clinical concerns.
While recognising the very real clinical concerns identified, the Government is clear that several important issues, including additional capacity in other hospitals impacted and the continued ability of people in the Navan area to access emergency and urgent care, would need to be fully addressed before any proposed transition by the HSE could be considered.
419. Deputy David Cullinane asked the Minister for Health the number of meetings attended by him on the subject of Navan Hospital; the date of such meetings; the title and role of those attending the meetings; and if he will make a statement on the matter. [33350/22]
Amharc ar fhreagraI have had a number of discussions regarding Our Lady’s Hospital Navan in recent weeks. Recently, these include a meeting with consultants based in Our Lady of Lourdes Hospital, Drogheda on 9 June where concern about the potential impact of the reconfiguration of Our Lady’s Hospital Navan on Our Lady of Lourdes, Drogheda was expressed.
On 13 June, I invited local representatives to a briefing by HSE operational and clinical leads. At this meeting, the HSE described the patient safety rationale for the proposed change to a Model 2 hospital and several important issues were discussed.
I will ask my diary team to revert to the Deputy’s office directly regarding details and attendees of other meetings held.
420. Deputy Dara Calleary asked the Minister for Health if the epilepsy drug nifedipine will be added to the medical card scheme. [33351/22]
Amharc ar fhreagraUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
