Written Answers Nos. 814-834
814. Deputy Jennifer Carroll MacNeill asked the Minister for Health if consideration has been given to including reconstruction after a mastectomy in HSE funding; and if he will make a statement on the matter. [36046/22]
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.
815. Deputy David Cullinane asked the Minister for Health the estimated cost of expanding the medical assessment unit at Monaghan Hospital to 12/7; the whole-time equivalent requirement; and if he will make a statement on the matter. [36047/22]
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.
816. Deputy Johnny Mythen asked the Minister for Health the services that are available for those living with Parkinson’s disease in County Wexford; and if he will make a statement on the matter. [36049/22]
Amharc ar fhreagraAs this question refers to service matters, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
817. Deputy Johnny Mythen asked the Minister for Health the number of Parkinson’s disease nurse specialists or an advanced nurse practitioners in County Wexford; and if he will make a statement on the matter. [36050/22]
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.
818. Deputy Jennifer Murnane O'Connor asked the Minister for Health the status of the primary care unit in Tullow, County Carlow; and when this project will be delivered. [36060/22]
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.
819. Deputy Niamh Smyth asked the Minister for Health if the case of a person (details supplied) will be reviewed; and if he will provide an update on this matter. [36062/22]
Amharc ar fhreagraUnder 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.
820. Deputy Seán Haughey asked the Minister for Health when the action plan for the disability capacity review will be published; if this action plan will be considered in the context of preparations for Budget 2023; and if he will make a statement on the matter. [36083/22]
Amharc ar fhreagraThe Department of Health published the Disability Capacity Review in July 2021. This report set out the capacity requirements for health-funded disability services for the period up to 2032. In order to drive the process of implementing the recommendations of the Capacity Review, a Working Group was set up to develop an Action Plan for Disability Services for the period 2022-2025. This Group, whose membership consisted of senior officials from the Departments of DCEDIY, Social Protection, Housing, Further and Higher Education, Health, and the Health Service Executive, has now completed its work and the draft Action Plan is currently being finalised.
821. Deputy Robert Troy asked the Minister for Health if an urgent appointment with CAMHS will be expedited for a child (details supplied). [36085/22]
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.
822. Deputy Michael Healy-Rae asked the Minister for Health if he will compile a comprehensive list of actionable areas to ensure that there is a transparent and robust approach towards mental health care by the State (details supplied); and if he will make a statement on the matter. [36088/22]
Amharc ar fhreagraPublished 30 June 2022, Mental Health Commission’s Annual Report for 2021 provides an important independent insight into where we are performing well and where improvement is required. I am pleased that there has been an overall improvement in compliance in recent years, acknowledging that further improvement is needed. Together with the Department of Health, I will continue to work closely with both the Commission and the HSE to improve mental health services.
The report raises a range of issues around the delivery of mental health services. With regards to the issues raised concerning variance in compliance between independent providers and the HSE, the HSE cannot comment on the performance of private organisations. However, there is a significant case mix difference between patients in Private and Public Approved Centres. Additionally, National Community Mental Health Operation office are working closely with CHO4 in relation to compliance issues, most of which are premises related. CHO4 have a comprehensive capital plan to accelerate the development of new in-patient units, and the national office are working with them to secure funding in this respect.
Importantly, HSE Mental Health Services are committed to the delivery of high quality and safe mental health services. Both the Government and the HSE value the regulation of our mental health services as it provides a framework in which to constantly review and improve our services, so they remain person-centred. The HSE have reviewed the recommendations within the report and are confident that various initiatives currently underway address many of the recommendations made.
The Government and I are committed to improving the quality of mental health services. All aspects of mental health services are being improved and developed, through implementation of our national mental health policy, Sharing the Vision in the short to longer term. Sharing the Vision aims to enhance the provision of mental health services and supports across a broad continuum, from mental health promotion, prevention and early intervention to acute and specialist mental health service delivery, during the period 2020-2030.
The need to build a more accountable and transparent health service is a focus of Sláintecare and is also a key objective for Sharing the Vision. Sharing the Vision has a key focus on Accountability and Continuous Improvement as one of the policy’s four core domains. This domain focuses on the organisational processes needed to implement and track delivery of the reforms proposed with an emphasis on innovation and continuous improvement. Key recommendations include developing a National Population Mental Health and Mental Health Services Research and Evaluation Strategy and the implementation of a national mental health information system. Additionally, the policy recommends that regular surveys of service users and family, carers and supporters be independently conducted to inform assessments of performance against PIs and target outcomes in Sharing the Vision, that mental health services ensure that the principles set out in the National Healthcare Charter, You and Your Health Service, are embedded in all service delivery and that training be provided for service users and staff on making and dealing with complaints.
For the complete list of recommendations to enhance accountability and continuous improvement through the policy implementation, I would direct you to the Sharing the Vision Policy document, and for details on the programme of implementation for the next three years, I would direct you to the Sharing the Vision Implementation Plan 2022 – 2024, which was published earlier this year. Both documents are available here - www.gov.ie/en/publication/2e46f-sharing-the-vision-a-mental-health-policy-for-everyone/ and official reports and analysis on Sharing the Vision Implementation Status are available here - www.gov.ie/en/publication/8f821-national-implementation-and-monitoring-committee-steering-committee/.
In addition, the review of the 2001 Mental Health Act, on which work is ongoing, will help to put in place a more robust framework in which mental health services can be delivered.
As the question also concerns HSE services, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
824. Deputy Peadar Tóibín asked the Minister for Health the amount spent on advertisements including online and in the media in relation to Covid-19 in each month since the start of the pandemic by his Department and by the HSE. [36093/22]
Amharc ar fhreagra825. Deputy Brendan Griffin asked the Minister for Health if a payment will issue to a person (details supplied) in County Kerry; and if he will make a statement on the matter. [36101/22]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
826. Deputy Bernard J. Durkan asked the Minister for Health the extent to which efforts are being made to meet the challenges of rare diseases, early diagnosis and the requirement for rare/orphan disease drugs; and if he will make a statement on the matter. [36103/22]
Amharc ar fhreagraA disease or disorder is defined as rare in Europe when it affects less than 1 in 2000 people. There are approximately 8,000 known rare diseases; 80% of rare diseases are of genetic origin and are often chronic and life-threatening. Up to 1 person in 12 in Ireland may have a rare disease at some stage in their life. Approximately 300,000 persons in Ireland are living with a rare disease.
Many of the recommendations of the National Rare Disease Plan for Ireland (2014 – 2018) have already been implemented including the establishment of a National Rare Disease Office (NRDO) and HSE National Clinical Programme for Rare Diseases which has now been operationalised and incorporated into the NRDO which is the main contact point and driver for National HSE rare disease projects and initiatives.
The National Rare Disease Plan elaborates on Ireland’s participation in European Reference Networks (ERN). ERNs are virtual networks involving healthcare providers across Europe where the networking of knowledge and expertise through reference centres and teams of experts takes place. These links are emphasized in the Plan to address the care of patients with rare diseases at both National and European levels. Significant progress has been made with regard to participation in ERNs with Ireland’s 15 applications for entry to ERNs recently being approved from 5 academic hospitals. Entry to these networks commenced on 1 January 2022 and represents a significant achievement for the Irish Health Service which will drive innovation, training and clinical research for highly specialised care. It is also a very positive development for individuals and families affected with rare diseases.
In order to ensure that the input and the voice of the patient is represented in the ongoing work in relation to Rare Diseases, in 2021 I met with the HSE, NRDO and the Rare Diseases Task force which comprises the main rare disease advocacy groups; Rare Disease Ireland (RDI), the Medical Research Charities Group (MRCP), and the Irish Platform for Patient Organisations, Science and Industry (IPPPOSI). At this meeting priority areas for the future were discussed with a view to building further on the significant progress made to date in implementing the Rare Disease Plan. A number, of priority areas for the coming period were agreed including; patient awareness, European Reference Networks, research and registries, access to services, access to medicines, diagnosis, education, legislation and policy.
The fundamental challenge that applies to consideration of almost all new medicines in Ireland is their price and affordability in a budget-limited health service. The principal factors in determining the speed of reimbursement are therefore the price at which a manufacturer applies for the reimbursement of a product, the outcome of the HSE’s rigorous assessment process as to its clinical and cost-effectiveness, and the availability of Exchequer funding.
This Government is committed to providing timely access to new and innovative medicines to all patients, including for the treatment of rare diseases, as quickly as possible. Budget 2021 allocated €50 million for the reimbursement of new drugs. This enabled the HSE to approve fifty-two new medicines, nineteen of which were for the treatment of rare diseases. Budget 2022 allocated a further €30 million for the reimbursement of new medicines and as of 26 May the HSE has approved thirty new drugs in 2022,including three for the treatment of rare diseases.
827. Deputy Bernard J. Durkan asked the Minister for Health to indicate the incidents of rare diseases reported/diagnosed in this country in the past five years; the extent to which it has been found possible to offer appropriate medication within a short time; and if he will make a statement on the matter. [36104/22]
Amharc ar fhreagraAs this question relates to service matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
828. Deputy Bernard J. Durkan asked the Minister for Health the degree to which research continues into rare diseases in this country by means of the highest possible level of scientific research, reference to centres of excellence globally; the extent to which, in Ireland that it is possible for persons suffering from rare diseases to obtain early diagnoses and remuneration as appropriate; and if he will make a statement on the matter. [36105/22]
Amharc ar fhreagraAs this question relates to service matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
829. Deputy Bernard J. Durkan asked the Minister for Health the degree to which access to various medicines remains equally available to those in this jurisdiction as compared with the rest of the Single Market in Europe and at a similar price; and if he will make a statement on the matter. [36106/22]
Amharc ar fhreagraMy Department does not collate data on the availability of medicines in Ireland as compared with other European countries.
As the Deputy is aware, the Oireachtas put in place a robust legal framework, in the Health (Pricing and Supply of Medical Goods) Act 2013, to give full statutory powers to the HSE to assess and make decisions on the pricing and reimbursement of medicines, taking account of a range of objective factors and expert opinion as appropriate.
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 (the NCPE). They use a decision framework to systematically assess whether a drug is cost-effective as a health intervention.
The Government is committed to making healthcare, including the cost of medicines, more accessible and affordable, and has introduced several reductions in the cost of medicines.
The budget allocation of €50m funding for new medicines in Budget 2021 provided for the reimbursement of 52 new medicines/new indications of existing medicines. A further €30 was allocated in Budget 2022. As of 26 May, the HSE had approved 30 new medicines/new indications of existing medicines in 2022.
830. Deputy Bernard J. Durkan asked the Minister for Health the degree of progress to date on the upgrading/updating of the National Rare Diseases Plan; if specific responsibility has been attributed to any leading team; and if he will make a statement on the matter. [36111/22]
Amharc ar fhreagra831. Deputy Bernard J. Durkan asked the Minister for Health if and when a review of the National Rare Diseases Plan 2014-2018 will be concluded and its findings published; and if he will make a statement on the matter. [36112/22]
Amharc ar fhreagraI propose to take Questions Nos. 830 and 831 together.
A disease or disorder is defined as rare in Europe when it affects less than 1 in 2000 people. There are approximately 8,000 known rare diseases; 80% of rare diseases are of genetic origin and are often chronic and life-threatening. Up to 1 person in 12 in Ireland may have a rare disease at some stage in their life. Approximately 300,000 persons in Ireland are living with a rare disease.
Many of the recommendations of the National Rare Disease Plan for Ireland (2014 – 2018) have already been implemented including the establishment of a National Rare Disease Office (NRDO) and HSE National Clinical Programme for Rare Diseases which has now been operationalised and incorporated into the NRDO which is the main contact point and driver for National HSE rare disease projects and initiatives.
The National Rare Disease Plan elaborates on Ireland’s participation in European Reference Networks (ERN). ERNs are virtual networks involving healthcare providers across Europe where the networking of knowledge and expertise through reference centres and teams of experts takes place. These links are emphasized in the Plan to address the care of patients with rare diseases at both National and European levels. Significant progress has been made with regard to participation in ERNs with Ireland’s 15 applications for entry to ERNs recently being approved from 5 academic hospitals. Entry to these networks commenced on 1 January 2022 and represents a significant achievement for the Irish Health Service which will drive innovation, training and clinical research for highly specialised care. It is also a very positive development for individuals and families affected with rare diseases.
In order to ensure that the input and the voice of the patient is represented in the ongoing work in relation to Rare Diseases, in 2021 I met with the HSE, NRDO and the Rare Diseases Task force which comprises the main rare disease advocacy groups; Rare Disease Ireland (RDI), the Medical Research Charities Group (MRCP), and the Irish Platform for Patient Organisations, Science and Industry (IPPPOSI). At this meeting priority areas for the future were discussed with a view to building further on the significant progress made to date in implementing the Rare Disease Plan. A number, of priority areas for the coming period were agreed including; patient awareness, European Reference Networks, research and registries, access to services, access to medicines, diagnosis, education, legislation and policy.
832. Deputy Bernard J. Durkan asked the Minister for Health the degree to which patients requiring treatment for post-mesh conditions continue to receive support and recognition in the scale required at the earliest possible juncture; and if he will make a statement on the matter. [36113/22]
Amharc ar fhreagraI understand that complications from a mesh implant are very distressing and painful for those women involved and since the emergence of this matter, the ongoing priority focus for the Department of Health has been to ensure that all women experiencing mesh related complications receive high quality, multidisciplinary and patient-centred care. Women’s health remains a key priority for the Government and the Department of Health continue to focus on prioritising the care needs of women affected by mesh related complications.
Uro-Gynaecological (Transvaginal) mesh is used in the surgical treatment of Stress Urinary Incontinence (SUI) and Pelvic Organ Prolapse (POP) in women and such mesh devices have been widely used for this over the past two decades. However, in late 2017, in line with emerging international evidence, concerns were raised at national level regarding the frequency and severity of complications associated with the use of transvaginal mesh devices. The then Minister for Health requested the Chief Medical Officer (CMO) to prepare a report on the clinical and technical issues involved.
In November 2018, the CMO’s Report on The Use of Uro-Gynaecological Mesh in Surgical Procedures was published. The Report contains a number of recommendations regarding the safe and effective provision of mesh procedures in urogynaecology and an appropriate response to women who suffer complications as a result of undergoing such procedures. In July 2018, the CMO had asked the HSE to pause all mesh procedures where clinically safe to do so, pending confirmation of the implementation of specific recommendations in the CMO’s Report. This pause remains in place.
In April 2019 the HSE published a detailed Implementation Plan to progress the recommendations detailed in this report and the National Women and Infants Health Programme continue to lead on this work for the HSE.
In relation to the service provisions and supports in place to support women experiencing mesh related complications, multidisciplinary specialist services for women suffering from mesh complications are available via the HSE National Mesh Complications Service, based at Cork University Hospital (CUMH) and the National Maternity Hospital (NMH) Dublin. This service has been operational since 1st September 2021. There are designated HSE contact points and associated care pathways to ensure that service needs can be identified and provided for and all persons affected by mesh are strongly encouraged to access these services via their clinical consultant.
Trans-labial and transvaginal education and training was carried out in November 2021 by a Consultant Uro-Gynaecologist from Croydon University Hospital in the UK, on site in CUMH. The Mesh Complications Service will have a lead Consultant for this service at the two centres (NMH and CUMH) to facilitate trans-labial scanning.
The HSE has advised the Department of Health of a Treatment Abroad Scheme protocol for mesh removal, for women with certain defined clinical complexities. This protocol aims to ensure timely access to care under the Treatment Abroad Scheme for this patient group where clinically appropriate.
A key priority is that all women affected by mesh are offered care. Consequently, women affected by mesh have been strongly encouraged to engage with the relevant HSE contact points and the associated care pathways, to ensure that their service needs can be identified and provided for. Information on this, and a list of contact points, are available on the HSE website.
833. Deputy Bernard J. Durkan asked the Minister for Health the degree to which cardiovascular research continues to be made available to the service providers with particular reference to ensuring that adequate provision in terms of financial and staffing supports are made available to those providing such services in the shortest possible time; and if he will make a statement on the matter. [36114/22]
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.
834. Deputy Bernard J. Durkan asked the Minister for Health the number of patients throughout the country allegedly suffering from a rare disease but whose condition remains undiagnosed; if such patients are deemed to be suffering from a rare disease; if a sufficiently coordinated action plan will be put in place to meet their requirements in early date; and if he will make a statement on the matter. [36116/22]
Amharc ar fhreagraAs this question relates to service matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
