Written Answers Nos. 594-613
596. Deputy Patricia Ryan asked the Minister for Health the number of medicines that are in short supply; the name of each in tabular form; the reason for the shortage of each medicine; and if he will make a statement on the matter. [3966/23]
Amharc ar fhreagraThe Health Products Regulatory Authority (HPRA) publishes a list of medicines currently in short supply on its website with the reason for the shortage and expected dates for the return of supply. This information 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 list of shortages in tabular form is publicly available and can be found here: www.hpra.ie/homepage/medicines/medicines-information/medicines-shortages
597. Deputy Patricia Ryan asked the Minister for Health the number of persons who died by suicide by county, in 2021 and 2022, in tabular form; and if he will make a statement on the matter. [3974/23]
Amharc ar fhreagraIn Ireland, national suicide statistics are provided by the Central Statistics Office (CSO) through their Vital Statistics publications which provide statistics on births, deaths and marriages.
Legally, in Ireland, a death can be registered up to three months after the date of occurrence. In addition, all unnatural deaths, including deaths from intentional self-harm must be referred to the Coroner's Office. Deaths assigned an underlying cause of death of ‘External causes of injury and poisoning (including deaths from intentional self-harm and suicide)’, are therefore likely to be underrepresented in data for 2021 and 2022 as such deaths are reported to the Coroner’s Office for further investigation. This can then result in such deaths being registered late and they may not yet have been reported to the CSO.
In addition, public hearings in the Coroner's Court were limited as a consequence of the restrictions imposed due to the COVID-19 pandemic and this may also have resulted in deaths being registered late. In May 2021 the HSE also suffered a major cyber-attack which meant the General Register Office (GRO) was unable to register deaths, births or marriages for a number of weeks during 2021.
Data on deaths registered in 2021 and 2022 is currently provisional. The most recent final data on deaths by cause of death is for 2020 (published in the Vital Statistics Annual Report 2020, October 2022). Final data on deaths by cause of death for 2021 will be published by the CSO in October 2023 and for 2022 in October 2024.
In the case of suicides, following publication of final data on deaths by cause of death in the Vital Statistics Annual Report, the CSO subsequently publish data on Late Registrations for suicides and a ‘revised’ total number of suicides for each year. Data on Late Registrations is currently available for suicides registered up to 2020.
Based on the official Vital Statistics publications of the CSO the total number of deaths assigned an underlying cause of death of ‘suicide and intentional self-harm’ in 2021 was 399. This data is provisional. Data on suicide by area of residence has been published by the CSO for 2021. Data by area of residence is not yet available for 2022. Table 1 below shows the number of deaths by suicide and intentional self-harm published by the CSO by area of residence for 2021. This data is provisional and as noted above is likely to be an underestimate.
Table 1: Number of deaths (provisional) with an underlying cause of death of suicide or intentional self-harm by area of residence, 2021
|
Area of Residence |
No. of deaths (Provisional) |
|
Area of Residence |
No. of deaths (Provisional) |
|
Carlow |
8 |
|
Dublin City |
31 |
|
South Dublin |
15 |
|
Fingal |
10 |
|
Dun Laoghaire-Rathdown |
6 |
|
Kildare |
24 |
|
Kilkenny |
1 |
|
Laois |
15 |
|
Longford |
1 |
|
Louth |
16 |
|
Meath |
12 |
|
Offaly |
8 |
|
Westmeath |
3 |
|
Wexford |
17 |
|
Wicklow |
8 |
|
Clare |
14 |
|
Cork City |
7 |
|
Cork County |
30 |
|
Kerry |
17 |
|
Limerick City |
5 |
|
Limerick County |
8 |
|
Tipperary |
25 |
|
Waterford City |
1 |
|
Waterford County |
11 |
|
Galway City |
7 |
|
Galway County |
25 |
|
Leitrim |
1 |
|
Mayo |
15 |
|
Roscommon |
11 |
|
Sligo |
8 |
|
Cavan |
14 |
|
Donegal |
13 |
|
Monaghan |
12 |
|
State |
399 |
Source: CSO, Vital Statistics, data.cso.ie/product/VSDO Table VSD30
Note: All unnatural deaths, which includes deaths from intentional self-harm must be referred to the Coroner's Office. This can result in the registration of these types of deaths being delayed and the number of deaths by suicide in 2021 will be an underestimate.
To date, data for Quarter 1 and Quarter 2 of 2022 has been published. A total of 191 deaths were registered with a cause of death of ‘suicide and intentional self-harm’ in the first two quarters of 2022. Data by area of residence is not yet available.
598. Deputy Willie O'Dea asked the Minister for Health if he will provide funding for the proposal by St. John's Hospital, Limerick, to build a new bed block which would address the critical requirement to decompress the UHL site by accommodating more medical patient transfers to St John’s; his views on whether this proposed new bed block is essential in order to tackle public waiting lists, (details supplied); and if he will make a statement on the matter. [3983/23]
Amharc ar fhreagraThere has been, and continues to be, substantial investment in the University of Limerick Hospital Group. In October 2022, I broke ground on the new 96-bed inpatient block project at University Hospital Limerick. This €90m capital project will deliver a 4-storey, 96 single bed acute inpatient ward block, which will go some way toward addressing capacity issues in the region.
In 2021, a new 60-bed modular ward block opened at UHL, which provides modern, single-room inpatient accommodation with improved infection prevention and control capabilities as well as patient flow throughout the hospital. This follows the completion of two separate rapid-build projects, constructed in response to the Covid-19 emergency, which provided an additional 38 inpatient beds on site at UHL.
The new €2m Injury Unit at Ennis Hospital opened last April bringing an immediate improvement in the clinical environment and experience for healthcare staff and the thousands of patients who use this service every year. In addition, a €9.95m theatre upgrade was approved for Ennis Hospital as part of the HSE’s Capital Programme for 2022.
A modern state-of-the-art ward complex, with 24 en-suite single rooms opened at Croom Orthopaedic Hospital in March 2021. A new €15m theatre suite, complete with four new operating theatres, a first stage recovery room and reception area, as well as a new Sterile Services Department and other ancillary support spaces also opened during 2021.
On 7th December 2022, the Government approved the next stage of the Enhanced Provision of Elective Care Programme. As part of this Programme, new national Elective Hospitals will be delivered in Cork, Dublin, and Galway. The new Elective Hospitals will provide significant additional capacity, enabling the separation of scheduled and unscheduled care. The introduction of this new delivery capability into the Public Healthcare System will benefit the whole population, including those who do not fall within the immediate traditional geographical catchment. It is envisaged that the new Cork and Galway facilities combined (which will treat patients from the mid-west) will cater for up to 350,000 patients/procedures annually.
Complementary to the development of the new Elective Hospitals, the HSE also plans to work with Hospital Groups and forthcoming Regional Health Areas to progress proposals for a shorter-term measure by developing ‘Surgical Hubs’ in Cork, Galway, Limerick, Waterford and Dublin with a narrower scope of procedures. This intervention will also support efforts to consider the necessary reforms and enablers needed to separate unscheduled and scheduled care pathways that will be required by the longer-term provision of the Elective Care programme. Planning for these Surgical Hubs is at an early stage, but I have asked the HSE to expedite their development as I want them to be operational as soon as possible.
The UL Hospitals Group comprises six hospitals, led by University Hospital Limerick, which is a Model 4 Hospital. There are two Model 2 Hospitals, Ennis, and Nenagh Hospitals, while St John's Hospital is classified as a Model 2S Hospital, i.e., St. John's can carry out intermediate surgery, which requires in-patient stay and accommodation in addition to day case surgery. The UL Group also includes Croom Orthopaedic Hospital, and University Maternity Hospital Limerick. The model 2 hospitals accept transfers of appropriate patients from UHL daily. These patients can either be stepped down from an inpatient ward in UHL or they may, where a clinician has decided it is appropriate, transfer to Ennis, Nenagh or St John's directly from the ED in UHL.
A recent development in Ennis Hospital and for the Mid-West region has been the introduction of the Medical Assessment Unit (MAU) pathway for 112/999 patients, which commenced on January 9th. It allows patients that meet the agreed clinical criteria to be treated in a Model 2 hospital. This pathway will result in patients receiving medical treatment in a hospital closer to their home, will reduce patient presentations to Emergency Departments and will release ambulances more quickly to respond to other emergency calls. The MAU in Ennis Hospital treats patients referred by GPs, ShannonDoc, and now National Ambulance Service paramedics. 112/999 patients that do not meet these clinical criteria will continue to be transported to Emergency Departments for assessment and treatment.
On the back of recent investments in the ULHG, consideration is also being given to future capacity requirements. It is noted that ULHG has developed proposals in this regard. These proposals will be considered by the hospital group and the HSE in line with their governance processes.
I would like to assure the Deputy that my Department continues to work closely with the HSE to ensure that the UL Hospitals Group is fully supported and that the necessary improvements to address capacity issues are actioned in a timely manner.
599. Deputy Matt Carthy asked the Minister for Health the reason Corlough health centre, County Cavan was sold by the HSE; if efforts were made to re-establish health services at the centre; the sale price agreed for the property; and if he will make a statement on the matter. [3987/23]
Amharc ar fhreagraAs the Health Service Executive is responsible for the management of the public healthcare property estate, I have asked the HSE to respond directly to you in relation to this matter.
600. Deputy Peadar Tóibín asked the Minister for Health if there has been a change in where patients are sent for a cardiologist outpatient appointment (details supplied); and if he will make a statement on the matter. [3991/23]
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.
601. Deputy Brendan Howlin asked the Minister for Health if he will set out the level of consultation with private nursing homes to determine the ratio, in relation to statements made by his Department concerning dependency levels within private nursing homes; if he will set out the average cost per resident in HSE-operated nursing homes for 2022; and if he will make a statement on the matter. [3993/23]
Amharc ar fhreagraIn December 2021, the Department of Health published the independently chaired Value for Money (VFM) review on nursing home costs. The VFM Review sought to identify, quantify and analyse the in reasons for any cost differential between private/voluntary and public nursing homes and, following analysis, to make recommendations for improving the value for money obtained by the Health sector.
Among the issues raised were the pay costs of staff in nursing homes, the dependency levels of residents, energy costs, and medical supplies charges to the NHSS. The report found that the cost differential is largely driven by variances in staff-to-resident ratios and the skill mix in public and private nursing homes. However, the review also found that establishing like-for-like comparisons was complex and not always possible, especially when considering differences in dependency levels. The review found that the cost differential is largely driven by variances in staff-to-resident ratios and the skill mix in public and private nursing homes.
Regarding the compilation of the VFM review it should be understood that, as outlined by the review, the study ‘would not be statistically representative, the Steering Committee were of the view that it would provide useful insight on a micro level into the care needs of residents in nursing homes, and whether any preliminary findings would highlight differences in care needs that would explain cost differentials.’ The VFM review goes further and states that it ‘must also be reiterated that this data cannot be interpreted as being a representative sample of either a public or private provision, as the sample included in this study is extremely small (<1%) and is not statistically relevant.’ Therefore, whilst the information gleaned by the VFM review provides a valuable snapshot of dependency levels across public, private and voluntary nursing homes, a clear picture of the actual differing dependency levels remains uncertain.
I recognise that, in many cases, private and voluntary nursing homes also deliver very complex levels of care to residents.
However, it should also be noted that the HSE has a statutory responsibility to act as operator of last resort. The HSE will always step in where a resident’s needs are sufficiently complex that they are not able to be cared for elsewhere in the community and needs to be staffed to deliver that kind of complex care. This function of the HSE extends beyond long-term residential care provision.
The VFM Review made nine recommendations which the Department continues to take forward. As per Recommendation 7, the HSE has committed to publishing detailed additional information in respect of costs from 2022 onwards. According to data published by the HSE, in 2022 there was a minor increase in the average cost of care from €1,674 per week in 2021 to €1,698 per bed per week in 2022.
This 1.4% increase was influenced by pay increases provided under the Lansdowne Road Agreement (funded separately to NHSS funds allocated within the HSE Service Plan 2022). Further information can be found on the HSE website by following this link: www.hse.ie/eng/services/news/media/pressrel/annual-updated-cost-of-providing-care-in-public-residential-care-centres-for-older-people-published.html
It should be noted that under the Fair Deal scheme, regardless of whether a person resides in a public or a private/voluntary nursing home, the contribution to the cost of their own care will be the same.
Regarding any existing disparity in dependency levels, it is anticipated that the rollout of the InterRAI Single Assessment Tool in the community, as per Recommendation 3 of the VFM Review, will provide data sufficient to draw more accurate conclusions. This rollout has already commenced and is fully operational across four sites. In addition, funding has been approved for 128 InterRAI care needs facilitators and the Department intends that InterRAI will be rolled out to long-term residential care.
602. Deputy Brendan Howlin asked the Minister for Health if his attention has been drawn to concerns raised by private nursing home operators at the recruitment by the HSE of trained staff from their sector who have been recruited by private nursing homes from abroad and have had their visas and travel arrangements processed at a considerable cost to the private nursing homes concerned; the steps he has taken to ensure that attractive terms and conditions are available for nurses and care workers in both the private and public sectors; and if he will make a statement on the matter. [3994/23]
Amharc ar fhreagraPrivate Nursing Homes are privately owned and run. Their terms and conditions of employment, once in line with employment legislation, are strictly between the employer and the employee.
The terms and conditions available for nurses and care workers in the public sector are set by their individual employers and are currently covered by national wage agreement, Building Momentum.
603. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [4016/23]
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.
604. Deputy Duncan Smith asked the Minister for Health the services currently in place or that are planned to provide professional support to persons who are suffering with long-Covid and who are having difficulties with a return to work; and if he will make a statement on the matter. [4017/23]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to reply to the Deputy directly
605. Deputy Jennifer Whitmore asked the Minister for Health the number of child flu vaccine doses acquired by the HSE for the 2022-2023 winter period; and if he will make a statement on the matter. [4029/23]
Amharc ar fhreagraAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
606. Deputy Jennifer Whitmore asked the Minister for Health the number of child flu vaccine doses distributed by the HSE for flu for the 2022-2023 winter period; and if he will make a statement on the matter. [4030/23]
Amharc ar fhreagraAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
607. Deputy Jennifer Whitmore asked the Minister for Health the number of child flu vaccines which expired in January 2023; the number disposed of; the means of disposal; and if he will make a statement on the matter. [4031/23]
Amharc ar fhreagraAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
608. Deputy Jennifer Whitmore asked the Minister for Health the number of childhood flu vaccines distributed by GPs, pharmacists and walk-in clinics in the winter 2022-2023 period; and if he will make a statement on the matter. [4032/23]
Amharc ar fhreagraAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
609. Deputy Jennifer Whitmore asked the Minister for Health if he will provide an update on the payment of pay increases under the terms of the public pay deal to home care assistants in County Wicklow; and if he will make a statement on the matter. [4035/23]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
610. Deputy Jennifer Whitmore asked the Minister for Health if the HSE has calculated the additional cost burden on the healthcare system due to an increase in hyperemesis gravidarum patients presenting at emergency services to get an initial cariban prescription from an obstetrician consultant instead of their GP (details supplied); and if he will make a statement on the matter. [4039/23]
Amharc ar fhreagraAs part of Budget 2023, I announced €32.2 million in funding for Women’s Health Initiatives in 2023, to include dedicated funding for Cariban® (doxylamine/pyridoxine).
The dedicated funding for Cariban® will help women who experience hyperemesis gravidarum, a severe form of morning sickness, during pregnancy. Cariban® is an Exempt Medicinal Product, i.e., it is not licensed with the Health Products Regulatory Authority (HPRA) in Ireland.
The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
Following the recommendations of the HSE Medicines Management Programme, Cariban® is now available on an individual patient basis for those patients who meet the criteria under the community drug schemes – the General Medical Services scheme (GMS) and the Drugs Payment Scheme (DPS) – where Consultant Obstetrician initiated.
Under the community drug schemes, Exempt Medicinal Products must be Consultant initiated. However, whilst the original prescriber of Cariban® must be a consultant and specialist in the relevant field, the HSE will accept a GP prescription subsequent to the initial hospital prescription for approved patients.
This reimbursement arrangement has been in operation since 1st of January 2023. The potential additional cost arising from patients presenting at emergency departments to access this arrangement has not been included in the associated HSE cost calculations.
611. Deputy Jennifer Whitmore asked the Minister for Health if his Department will engage directly with an organisation (details supplied) the Irish College of General Practitioners and other expert bodies on the best way to implement the cariban reimbursement scheme in a manner which prioritises and maximises hyperemesis gravidarum patient care; and if he will make a statement on the matter. [4040/23]
Amharc ar fhreagraThe Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines and medical items, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In line with the 2013 Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the formal Reimbursement list. Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.
In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact. 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 (NCPE). I, as the Minister for Health, have no role in these decisions.
As part of Budget 2023, I announced €32.2 million in funding for Women’s Health Initiatives in 2023, to include dedicated funding for Cariban® (doxylamine/pyridoxine).
The dedicated funding for Cariban® will help women who experience hyperemesis gravidarum, a severe form of morning sickness, during pregnancy. Cariban® is an Exempt Medicinal Product, i.e., it is not licensed with the Health Products Regulatory Authority (HPRA) in Ireland.
Only licensed products are added to the formal HSE Reimbursement List in line with the 2013 Act. There are three products containing doxylamine/pyridoxine licensed in Ireland:
- Xonvea® gastro-resistant tablets.
-Exeltis® gastro-resistant tablets.
-Navalem® modified-release hard capsules.
To date the market authorisation holder of Xonvea® has not progressed the pricing and reimbursement application further with the HSE. The market authorisation holders for Exeltis® and Navalem® have not submitted pricing and reimbursement applications to the HSE.
Following the recommendations of the HSE Medicines Management Programme, and to address the unmet need of patients with hyperemesis gravidarum, an exceptional arrangement was put in place to support the reimbursement of Cariban®.
This treatment is now available under the community drug schemes – the General Medical Services (GMS) and the Drugs Payment Scheme (DPS) – on an individual patient basis for those patients who meet the criteria for the treatment of nausea and vomiting in pregnancy.
Under the community drug schemes, Exempt Medicinal Products such as Cariban, must be Consultant initiated. However, whilst the original prescriber of Cariban® must be a consultant and specialist in the relevant field, the HSE will accept a GP prescription subsequent to the initial hospital prescription for approved patients.
If a licensed product was subsequently approved for reimbursement this arrangement could then be reviewed or revised.
The HSE therefore encourages clinicians, along with the Institute of Obstetricians and Gynaecologists and the National Clinical Programme for Obstetrics and Gynaecology, and other healthcare professionals to encourage the market authorisation holders of the licensed medicinal products (Xonvea®, Exeltis® and Navalem®) to progress with the formal pricing and reimbursement process in Ireland.
612. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [4043/23]
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.
613. Deputy Niall Collins asked the Minister for Health if funding is available to assist a person (details supplied) in receiving treatment in the United States; and if he will make a statement on the matter. [4045/23]
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.
