Written Answers Nos. 608-625
608. Deputy Pádraig O'Sullivan asked the Minister for Health when the replacement general practitioner services for Blarney, County Cork (details supplied), will be in place; and if he will make a statement on the matter. [6634/23]
Amharc ar fhreagraGPs are self-employed practitioners and therefore may establish practices at a place of their own choosing. There is no prescribed ratio of GPs to patients and the State does not regulate the number of GPs that can set up in a town or community.
Under the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. Where a vacancy arises in a practice with a GMS contract, the HSE becomes actively involved in the recruitment process to find a replacement GP. In the interim the HSE puts in place a locum or other appropriate arrangement to maintain GP services to the communities in question.
As the issue of GMS vacancies is a service matter, I have asked the Health Service Executive to respond to the Deputy directly regarding the recruitment process to find a replacement GP in Blarney, County Cork, as soon as possible.
613. Deputy Brendan Howlin asked the Minister for Health further to Parliamentary Question No. 302 of 7 July 2022, if he will provide an update on the results of the deliberation of the HSE of the medicines management programme assessment for the use of the medication, following the reply received from the HSE in relation to the provision of affordable cariban medication for women suffering from hyperemesis; and if he will make a statement on the matter. [6644/23]
Amharc ar fhreagra631. Deputy Jackie Cahill asked the Minister for Health when he expects an outcome of the review he requested from the HSE and his Department on the current approach to the reimbursement of cariban; and if he will make a statement on the matter. [6689/23]
Amharc ar fhreagraI propose to take Questions Nos. 613 and 631 together.
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 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 indicates 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/
614. Deputy Peadar Tóibín asked the Minister for Health if he will list the drugs and medications which are currently in short supply in the State; the public relations and communication practices adopted by the HSE at times when drug and medicine supplies run low or end; and if he will make a statement on the matter. [6650/23]
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
615. Deputy Peadar Tóibín asked the Minister for Health the total number of ambulance drivers currently employed by the HSE; the total number of ambulances currently operational within the HSE; if he will list the points across the State from which ambulances are dispatched; and if he will make a statement on the matter. [6651/23]
Amharc ar fhreagraAs this is an service matter, I have asked the Health Service Executive (HSE) to respond to the Deputy directly with any further information they may have, as soon as possible.
616. Deputy Charles Flanagan asked the Minister for Health if his attention has been drawn to the need for a community neuro-rehabilitation team in CHO8; and if he will make a statement on the matter. [6653/23]
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.
617. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) is waiting so long for her appeal of a special pandemic recognition award that was due in January 2023 and is still not finalised; and if he will make a statement on the matter. [6660/23]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
618. Deputy Michael Ring asked the Minister for Health the reason an urgent query raised with the HSE is not being responded to (details supplied); and if he will make a statement on the matter. [6661/23]
Amharc ar fhreagraAs this question refers to service matters, I have the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
619. Deputy Fergus O'Dowd asked the Minister for Health if a response will issue to queries raised by an organisation (details supplied) in respect of nursing home charges; and if he will make a statement on the matter. [6667/23]
Amharc ar fhreagraThe 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. 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 my Department in preparation for the establishment of a commission on care. In 2023 the scoping and planning for the commission on care will be further advanced as a priority.The correspondence from the organisation in question also refers to the State's legal strategy in relation to long stay litigation. Upon the raising of issues about how the State has approached legal challenges taken against it in relation to pre-2005 legacy nursing home charges, the Government moved quickly to establish the facts surrounding these issues, which go back many decades, by requesting the Attorney General to prepare a Report on the litigation management strategy. This comprehensive Report was produced within a week and was published on 7 February 2023. There has been considerable discussion in the Oireachtas in recent weeks on these issues, including Dáil Statements and attendance by officials from the Department of Health at the Public Accounts Committee last week and officials from the Department will also appear before the Health Committee this week.The Minister for Social Protection and I have undertaken to consider the Attorney General's Report in full and to revert to Government in three months on any further steps required.
621. Deputy Alan Kelly asked the Minister for Health the number of kidney transplant procedures carried out in each of the years of 2021, 2022 and to date in 2023; and the hospitals in which these procedures are carried out. [6677/23]
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.
622. Deputy Alan Kelly asked the Minister for Health if there will be any specialist posts created in community healthcare under the field of maternity care, antenatal clinics, post-natal care and so on. [6678/23]
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.
623. Deputy Alan Kelly asked the Minister for Health the number of WTE consultant paediatric dermatologists attached to University Hospital Limerick in each of the years of 2021, 2022 and to date in 2023, in tabular form. [6679/23]
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.
624. Deputy Alan Kelly asked the Minister for Health the number of Irish patients awaiting initial assessment for a sleep disorder screening appointment in either a respiratory clinic or specific disorder clinic. [6680/23]
Amharc ar fhreagraIt is recognised that waiting times for many scheduled appointments and procedures were too long before and have been made worse by the Covid-19 pandemic. While significant work continues to positively impact on waiting times and improve pathways to elective care, acute hospitals are still impacted by operational challenges arising from the pandemic and the current pressures on Emergency Departments.The Health Service Executive (HSE) has confirmed to the Department that patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols. The Department of Health continues to work with the HSE and the National Treatment Purchase Fund (NTPF) to identify ways to improve access to care, including through increased use of private hospitals, funding weekend and evening work in public hospitals, funding “see and treat” services, providing virtual clinics, and increasing capacity in the public hospital system. The 2022 Waiting List Action Plan set targets to reduce both the number of people waiting for care and the length of time they are waiting. Positive progress was made in 2022 in relation to both targets, despite negative impacts throughout the year on scheduled care from continued COVID-19 surges, emergency department pressures and other operational factors, including staff hiring. In 2022, there were c.1.56m patients removed from the Waiting list and c.1.53m patients added to the waiting list – a net reduction of c.30k (4%). Long waiters were significantly reduced in 2022: the number of patients exceeding the 18-month maximum wait time target for new outpatient (OPD) appointments target decreased by c.59.0k (38.5%) and the number of patients exceeding the 12-month maximum wait time target for in-patient day case (IPDC) procedures and GI Scopes has decreased by c3.8k (22.6%) and c.3.5k (86.5%) respectively.Through the 2022 Plan, €350m funding was allocated to the HSE and the NTPF to provide additional public and private activity to reduce the waiting list backlogs that were exacerbated during the Pandemic, but also as the first stage of an ambitious multi annual approach, to lay the foundations for important reforms that will deliver sustained reductions in waiting lists.For 2023, funding of €443 million is being allocated to tackle Waiting Lists, some €360m of which is targeted at acute hospital waiting lists. The plan to utilise this part of the funding is being developed by the Department of Health in conjunction with the HSE and NTPF. This will include details of new capacity planned for 2023 as well as important reforms that will improve capacity in the public hospital system.
In relation to the particular query raised by the Deputy, the attached document, provided to my Department by the National Treatment Purchase Fund (NTPF), outlines the number of patients waiting for an Inpatient/Day Case appointment for sleep disorder testing at the end of January 2023. The data shows the number of patients waiting by acute hospital and by time-band.
The NTPF has advised my Department that outpatient data only provides the number of patients waiting by specialty and it is not possible to provide a breakdown of the number of patients awaiting an appointment for an outpatient consultation relating to a sleep disorder.
IPDC Sleep Disorder Waiting List as at 26/01/2023
|
0-6 Mths |
6-12 Mths |
12-18 Mths |
18+ Mths |
Small Vol TimeBand |
Grand Total |
|
|
26/01/2023 |
516 |
446 |
170 |
261 |
4 |
1397 |
|
Beaumont Hospital |
8 |
8 |
||||
|
Cavan General Hospital |
7 |
7 |
||||
|
Children's Health Ireland |
283 |
242 |
138 |
230 |
893 |
|
|
Connolly Hospital Blanchardstown |
50 |
50 |
||||
|
Galway University Hospitals |
70 |
106 |
15 |
191 |
||
|
Mercy University Hospital |
6 |
6 |
||||
|
SmallVol Hospitals |
4 |
4 |
||||
|
St. James's Hospital |
12 |
25 |
17 |
31 |
85 |
|
|
University Hospital Limerick |
88 |
65 |
153 |
|||
|
Grand Total |
516 |
446 |
170 |
261 |
4 |
1397 |
625. Deputy Alan Kelly asked the Minister for Health the number of full-time lactation consultants that were appointed in 2022 in CHOs 3 and 5 in 2022; and if any appointments of these consultants in either of these CHOs are scheduled. [6681/23]
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.
