Tuesday, 14 Feb 2023

Home Care Packages

Ceisteanna (570)

Patricia Ryan

Ceist:

570. Deputy Patricia Ryan asked the Minister for Health the number of people who are awaiting on the provision of additional home care hours; and if he will make a statement on the matter. [6550/23]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health

As this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Home Care Packages

Ceisteanna (571)

Patricia Ryan

Ceist:

571. Deputy Patricia Ryan asked the Minister for Health the number of people awaiting assessment for home care; and if he will make a statement on the matter. [6551/23]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health

As this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Covid-19 Tests

Ceisteanna (572)

Patricia Ryan

Ceist:

572. Deputy Patricia Ryan asked the Minister for Health if he will make triple antigen tests that allow people to check if their illness is Covid-19, flu, or RSV available at reduced or zero cost; and if he will make a statement on the matter. [6552/23]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

Under the current COVID-19 Testing, Tracing and Surveillance advice which I accepted from the Chief Medical Officer, which was also been approved by the Government, the HSE is adopting a targeted approach for COVID-19 testing based on a clinical assessment where a clinician requires the result to contribute to the diagnosis and management of an individual patient.

Since 9 December 2022, GPs are providing swabbing for COVID-19 where the result is required to contribute to the diagnosis and management of an individual patient, such as for patients for whom treatment with Paxlovid is currently recommended. Based on the revised public health advice, community swabbing will no longer be a feature of our COVID-19 response as testing will no longer be recommended for the general population. Testing will also take place where deemed necessary by Public Health in relation to the management of an outbreak or specific public health risk. In this regard, I have no current plans in relation to the matter raised by the Deputy.

The approach to COVID-19 testing is facilitated by the high level of vaccine-induced and naturally acquired population immunity in Ireland. This is mitigating against the worst impacts of infection.

I have also provided additional resources to the HSE to ensure enhancements are put in place to existing infectious disease surveillance systems. This will ensure effective monitoring and signalling of what is happening with the virus at population level, and so that we can understand disease transmission and severity along with population immunity and risk.

The pandemic is not over, and COVID-19 is still a concern so testing remains an important part of our ongoing response to the disease for individuals vulnerable to its effects and for whom testing is indicated. For everybody, continuing to follow our public health advice available on hse.ie is still important. Anybody who has symptoms of COVID-19 should self-isolate until 48 hours after the symptoms are mostly or fully gone. Anybody who has concerns about an underlying condition or their level of risk in relation to COVID-19 is advised to seek advice from their GP or treating clinician.

My Department, the Health Protection Surveillance Centre (HPSC) and the National Virus Reference Laboratory (NVRL), overseen by the Chief Medical Officer, continue to review the COVID-19 epidemiological situation in Ireland and internationally. This includes the on-going close monitoring of emerging SARS-CoV-2 variants and assessment of any potential threat to population health.

I currently have no plans in relation to the proposal raised by the Deputy.

Question No. 573 answered with Question No. 568.

Question No. 574 answered with Question No. 550.

Medicinal Products

Ceisteanna (575)

Patricia Ryan

Ceist:

575. Deputy Patricia Ryan asked the Minister for Health the reason the drug cariban cannot be prescribed by a GP through the drug payment scheme; and if he will make a statement on the matter. [6555/23]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

As part of Budget 2023, funding of €32.2 million was announced for Women’s Health Initiatives in 2023.

This included dedicated funding of €1.3m for Cariban® (doxylamine/pyridoxine) to help women who experience hyperemesis gravidarum, a severe form of nausea and vomiting, during pregnancy. Hyperemesis gravidarum is expected to affect about 1% of the pregnant population.

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 Good s) Act 2013. Only licenced indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority (HPRA) can be added to the formal reimbursement list.

Within the European Union (EU), the pricing and reimbursement of medicines is a national competence. As EU Member States operate different pharmaceutical reimbursement systems across the EU, a direct comparison of the reimbursement of products is not possible. The competent authority for pricing and reimbursement in Ireland is the HSE.

Cariban® is an Exempt Medicinal Product (EMP), i.e., it is not licensed in Ireland and, therefore, cannot be added to the formal reimbursement list.

However, following the recommendations of the HSE Medicines Management Programme, and to address the unmet need of patients with hyperemesis gravidarum, reimbursement support for Cariban® (doxylamine/pyridoxine), an unlicensed Exempt Medicinal Product, has now been made available on an individual patient basis for those patients who meet the criteria and 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.

The relevant HSE circular regarding the exceptional arrangement for Cariban® is available at:

www.hse.ie/eng/staff/pcrs/circulars/pharmacy/pharmacy-circular-001-23-cariban.pdf.

In order to obtain reimbursement support for Cariban® under this exceptional arrangement, the prescribing consultant must confirm whether the following apply:

- The individual has nausea and vomiting of pregnancy (NVP) which requires systemic treatment.

- The individual has been assessed using the pregnancy unique quantification of emesis and nausea (PUQE) assessment tool and the appropriate treatment algorithm has been followed.

- The individual has not responded to conservative management.

The consultant must also make an Unlicensed Product Declaration and submit the completed application form by email to the Primary Care Reimbursement Service (PCRS).

Once reviewed by the PCRS, the prescriber and dispensing pharmacy are emailed (via secure email) with the reimbursement decision. The community pharmacy then dispenses the product under the specific patient’s community drug schemes eligibility and submits the claim using the relevant administrative code in their monthly submission to PCRS.

While reimbursement support is offered on the basis of the patient’s eligibility under the General Medical Services (GMS) Scheme or the Drugs Payment Scheme (DPS), Cariban® is not on the formal reimbursement list.

This exceptional arrangement has been put in place to ensure that those patients suffering from hyperemesis gravidarum have access to Cariban®. The dedicated funding that has been allocated is based on 1% of the pregnant population requiring treatment for hyperemesis gravidarum. The number of approved applications to date is in line with expectations and indicate that the budget allocated will be used in 2023. As of 10th February 2023, the number of applications received by the Primary Care Reimbursement Service (PCRS) stands at 384.

There are three other products containing doxylamine/pyridoxine, which are licensed in Ireland:

- Xonvea® gastro-resistant tablets.

- Navalem® modified-release hard capsules.

- Exeltis® gastro-resistant tablets.

The market authorisation holder of Xonvea® has not progressed the pricing and reimbursement application further with the HSE at this stage. The market authorisation holders for Exeltis® and Navalem® have not submitted pricing and reimbursement applications to the HSE.

The HSE therefore encourages clinicians, along with the Institute of Obstetricians and Gynaecologists and the National Clinical Programme for Obstetrics and Gynaecology, other healthcare professionals, and relevant representative bodies 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.

Finally, the HSE provides general advice on treatments for hyperemesis gravidarum at:

www2.hse.ie/conditions/hyperemesis-gravidarum/treatment/

Medicinal Products

Ceisteanna (576)

Patricia Ryan

Ceist:

576. Deputy Patricia Ryan asked the Minister for Health the options open to pregnant women experiencing extreme nausea and vomiting in the first trimester given the fact that they are unlikely to have a consultant's appointment until the end of this period; and if he will make a statement on the matter. [6556/23]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Question No. 577 answered with Question No. 541.

Question No. 578 answered with Question No. 537.

Hospital Services

Ceisteanna (579)

John McGuinness

Ceist:

579. Deputy John McGuinness asked the Minister for Health the reason for the delay in providing colposcopy and cervical check results to patients attending UHW; and if all those affected by the unacceptable delay will be contacted and updated on their tests. [6559/23]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Care of the Elderly

Ceisteanna (580)

Patricia Ryan

Ceist:

580. Deputy Patricia Ryan asked the Minister for Health the supports available to enable older people to age in place; and if he will make a statement on the matter. [6561/23]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health

Ireland’s population is ageing rapidly, and for the most part, our older population clearly indicates their preference to age in place, in their own homes, for as long as possible. One of the Government's key priorities, as outlined in the Programme for Government, is to support older people to live in dignity and independence in their own homes and communities for as long as possible. This is in line with the Sláintecare vision for receiving the right care, in the right place, and the right time.

The Government remains committed to supporting people to age in place at home in their community with access to wraparound supports, including day care and dementia-specific day care services, Meals on Wheels, and home care.

Improving access to home support is a priority for the Government. Since 2021 we have provided an additional €207 million in funding. In 2023 the overall homecare budget will be more than €700 million, with a target to deliver 23.67 million hours. The dementia-specific proportion of new home support hours will increase from 5% in 2021 to 15% in 2023, valued at €5.2 million. Delivering this enhanced capacity requires substantial recruitment and strategic workforce challenges are in evidence in the sector.

The Government has published the findings of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Healthcare Assistants. The Group made 16 recommendations spanning the areas of recruitment, pay and conditions of employment, barriers to employment, training and professional development, sectoral reform, and monitoring and implementation. Implementation of the findings has begun and from January 2023 and 1,000 General Employment Permits are now available for home support workers. As recommended by the Advisory Group, this will enable the employment within Ireland of non-EU/EEA citizens as home support workers.

We are also pursuing a significant reform programme for home care, which will see the introduction of a regulatory framework for the first time, and which will deliver equitable access to high-quality services based on a person’s assessed care needs. This will comprise primary legislation for the licensing of providers, secondary legislation in the form of regulations and HIQA national standards.

In 2021, the HSE commenced the implementation of the Enhanced Community Care (ECC) Programme which aims to deliver increased levels of healthcare with service delivery reoriented towards general practice, primary care, and community-based services. The ECC programme will ensure maximum impact for citizens in avoiding hospital admission as far as possible through initiatives that will see care delivered within the community, at or near a person’s home, where appropriate.

The National Integrated Care Programme for Older Persons (ICPOP) forms part of the ECC Programme and seeks to ensure older people with complex care needs can access care quickly, at or near home, through care pathways specifically designed for older people and targeting Frailty, Falls, and Dementia. As of the end of 2022, 21 of the proposed 30 Community Specialist Teams for Older Persons have been established. Recruitment to the teams is ongoing, with the HSE targeting implementation of the full 30 teams by end Q2 2023. HSE and ALONE Support Coordination Service.

The Healthy Age Friendly Homes Programme is an innovative partnership between the local government sector (through Age Friendly Ireland) and Sláintecare in the Department of Health that commenced at the beginning of 2021 and saw the introduction of a new person-centric, robust, support coordination service. The overall objectives of the programme are to prevent early or premature admission to long term residential care; enable older people to continue living in their homes or in a home more suited to their needs; help older people to live with a sense of independence and autonomy and support older people to be and feel part of their communities.

The interim report of phase 1 of the Healthy Age Friendly Homes programme was published in June last year and details the significant progress of the programme over its first 12 months pilot phase. In 2022, 3,691 supports were provided through this programme in the areas of health, housing, community/social supports, and technology. I was pleased to announce in Budget 2023 that funding of €5.2 million has been allocated to roll-out the initiative nationally. Age Friendly Ireland will deliver this programme in partnership with Sláintecare.

In 2023 the overall funding available to the HSE for Older Persons will exceed €2.4 billion. This includes nearly €1.1 billion for Fair Deal. I am committed to the development of improved community and home-based services, shifting care to closer to home and offering greater choice for older people. This year a wide range of core services will be provided for older persons including home support, day care, dementia day care, and meals on wheels in partnership with voluntary groups. There are over 2,000 voluntary organisations that receive funding from the HSE, spanning almost all areas of health and social care. These services operate alongside intermediate care options such as respite and convalescent care as well as long-stay residential care when remaining at home is no longer feasible.

Care of the Elderly

Ceisteanna (581)

Patricia Ryan

Ceist:

581. Deputy Patricia Ryan asked the Minister for Health the services available to older people, excepting daycare services, that have yet to return having being suspended during the Covid-19 pandemic; and if he will make a statement on the matter. [6562/23]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health

As this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Care of the Elderly

Ceisteanna (582)

Patricia Ryan

Ceist:

582. Deputy Patricia Ryan asked the Minister for Health his plans to update the National Positive Ageing Strategy; and if he will make a statement on the matter. [6564/23]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health

The Government is committed to supporting healthy and positive ageing as well as to ensuring that older persons can continue to live independently in their homes and communities for as long as possible. At present, this objective is supported by the National Positive Ageing Strategy (2013), which, as a blueprint for whole of government policy making and service delivery in partnership with the community and voluntary sector, retains its broad relevance.Acknowledging the disproportionately negative impact of the pandemic on older persons, the Programme for Government: Our Shared Future (2020) commits to the establishment of a commission on care that will ‘assess how we care for older people and examine alternatives to meet the diverse needs of our older citizens’, learning the lessons from COVID 19.In 2022 preliminary desk research was undertaken within the Department of Health in preparation for the establishment of a commission on care. In 2023 the scoping and planning for the commission will be further advanced as a priority. Accordingly, the commission's scope has yet to be determined. However, it is envisaged that it will support a whole of government examination of the plethora of existing policies and strategies which are of relevance to supporting healthy and positive ageing, and make recommendations to effectively address gaps which currently exist in this domain in the policy landscape.

Hospital Services

Ceisteanna (583)

Patricia Ryan

Ceist:

583. Deputy Patricia Ryan asked the Minister for Health when in-person obesity clinics will resume in Loughinstown Hospital; and if he will make a statement on the matter. [6567/23]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Health Services Waiting Lists

Ceisteanna (584)

Patricia Ryan

Ceist:

584. Deputy Patricia Ryan asked the Minister for Health the current waiting times for adult ADHD clinics in CHO 7; and if he will make a statement on the matter. [6568/23]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health

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

Ceisteanna (585, 591)

James Lawless

Ceist:

585. Deputy James Lawless asked the Minister for Health if he will examine an issue (details supplied); and if he will make a statement on the matter. [6570/23]

Amharc ar fhreagra

Réada Cronin

Ceist:

591. Deputy Réada Cronin asked the Minister for Health if he will outline the pathway to access treatment and support for people suffering from avoidant restrictive food intake disorder, a new diagnosis in the DSM-5, previously referred to as selective eating disorder; when a clinical lead will be appointed in this area; and if he will make a statement on the matter. [6586/23]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health

I propose to take Questions Nos. 585 and 591 together.

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 (586)

Richard Bruton

Ceist:

586. Deputy Richard Bruton asked the Minister for Health if a drug (details supplied) can be prescribed by a GP, or only by a consultant; and if so, if this has resulted in very low usage of a medication of considerable efficacy. [6581/23]