Written Answers Nos. 751-770
751. Deputy Cathal Crowe asked the Minister for Health the number of persons with diabetes who were funded for the medtronic guardian 4 continuous glucose monitoring CGM sensors by the HSE; the number who were over 18 years-of-age in 2023, in tabular form; and if he will make a statement on the matter. [25004/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
752. Deputy Cathal Crowe asked the Minister for Health the number of persons with diabetes who were funded for the freestyle libre 1 and 2 glucose monitoring CGM sensors by the HSE; the number who were over 18 years-of-age in 2023, in tabular form; and if he will make a statement on the matter. [25005/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
753. Deputy Cathal Crowe asked the Minister for Health the number of persons with diabetes who were funded for the GlucoRx Aidex glucose monitoring CGM sensors by the HSE; the number who were over 18 years-of-age in 2023, in tabular form; and if he will make a statement on the matter. [25006/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible
754. Deputy Róisín Shortall asked the Minister for Health the status of the planned satellite hemodialysis unit at Ennis General Hospital; the timeline for delivery; and if he will make a statement on the matter. [25007/24]
View answerI am advised that the University of Limerick Hospital Group is seeking to develop and expand their dialysis services to Ennis.
The HSE has advised that procurement for an externally contracted satellite haemodialysis unit in Ennis, intended to serve patients from County Clare closer to home, is being progressed. The timeline for delivery is contingent on the completion of this process.
Renal patients from County Clare currently receive care at University Hospital Limerick. They can also receive treatment in the Limerick satellite unit.
This project is being led by the HSE to drive improvements to the services that they are already providing.
755. Deputy Róisín Shortall asked the Minister for Health to respond to matters raised in correspondence (details supplied); the steps he is taking to ensure that patients with chronic auto-immune disorders such as Sjögren's disease have access to appropriate and affordable dental care; his plans to reform the DTSS; and if he will make a statement on the matter. [25008/24]
View answerThe Dental Treatment Services Scheme (DTSS) provides dental care, free of charge, to medical card holders aged 16 and over. Services available annually and on demand include an examination including preventative elements, two fillings, extractions, and a scale and polish. More complex care, such as dentures, and a broader range of treatments for patients with additional needs and patients with high-risk conditions such as Sjögren's syndrome are available subject to the approval of the local HSE Principal Dental Surgeon.
The Government is committed to reforming oral healthcare services, including the DTSS, through the implementation of the National Oral Health Policy, Smile agus Sláinte. The Policy sets out a new model of oral healthcare delivery, moving from episodic care to a life course approach. The policy will enable preventative approaches to be prioritised, improve access, and support interventions appropriate to current and future oral health needs. It is intended that patients with high risk conditions will be provided with additional oral healthcare packages and prioritised for suitable advanced care.
The HSE's Strategic Reform Lead is driving policy implementation across the organisation and moving forward with developing new services in line with the Policy. An implementation plan for the first phase of rollout is being developed between my Department and the HSE, for consultation and then publication in the third quarter of this year.
756. Deputy Cathal Crowe asked the Minister for Health the total number of people attending diabetes clinics in each of the CHI Hospitals Group (CHI Crumlin, CHI Temple Street, CHI Connolly in Blanchardstown and CHI Tallaght) who are using insulin pumps, in tabular form; and if he will make a statement on the matter. [25017/24]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
757. Deputy Cathal Crowe asked the Minister for Health the total number of people attending diabetes clinics in each of the RCSI Hospitals (Our Lady of Lourdes Hospital Drogheda, Connolly Hospital, Cavan General Hospital, Louth County Hospital, Monaghan Hospital and Beaumont Hospital) who are using insulin pumps; how many insulin pump users are attending the paediatric diabetes centre; how many are attending the adult diabetes centre in each hospital, in tabular form; and if he will make a statement on the matter. [25018/24]
View answer758. Deputy Cathal Crowe asked the Minister for Health the total number of people attending diabetes clinics in each of the Dublin Midlands Group Hospitals (Midlands Regional Hospital, Tullamore, Naas General Hospital, Midlands Regional Hospital Portlaoise, Tallaght University Hospital and St. James’s Hospital) who are using insulin pumps; how many insulin pump users are aged between 0-18 years and greater than 18 years, in tabular form; and if he will make a statement on the matter. [25019/24]
View answer759. Deputy Cathal Crowe asked the Minister for Health the total number of people attending the diabetes clinics in each of the Ireland East Group Hospitals (Mater Misericordiae University Hospital, St Vincent’s University Hospital, Midland Regional Hospital Mullingar, St. Luke's General Hospital, Kilkenny, Wexford General Hospital, Our Lady's Hospital, Navan, St Columcille's Hospital and St. Michael's Hospital, Dún Laoghaire) who are using insulin pumps; how many insulin pump users are aged between 0-18 years and greater than 18 years, in tabular form; and if he will make a statement on the matter. [25020/24]
View answer760. Deputy Cathal Crowe asked the Minister for Health the total number of people attending the diabetes clinics in each of the Saolta Hospitals (University Hospital Galway, Merlin Park University Hospital, Sligo University Hospital, Letterkenny University Hospital, Mayo University Hospital, Portiuncula University Hospital and Roscommon University Hospital) who are using insulin pumps; how many insulin pump users are attending the paediatric diabetes centre and how many are attending the adult diabetes centre in each hospital, in tabular form;; and if he will make a statement on the matter. [25021/24]
View answer761. Deputy Cathal Crowe asked the Minister for Health the total number of people attending the diabetes clinics in each of the South/South West Hospitals (Cork University Hospital, University Hospital Waterford, Kerry General Hospital, Mercy University Hospital, South Tipperary General Hospital, South Infirmary Victoria University Hospital, Bantry General Hospital and Mallow General Hospital) who are using insulin pumps; how many insulin pump users are aged between 0-18 years and greater than 18 years, in tabular form; and if he will make a statement on the matter. [25022/24]
View answerI propose to take Questions Nos. 757, 758, 759, 760 and 761 together.
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
762. Deputy Cathal Crowe asked the Minister for Health the total number of people attending the diabetes clinics in each of the UL Hospitals (in each of University Hospital Limerick, Ennis Hospital, Nenagh Hospital and St. John's Hospital) who are using insulin pumps; how many insulin pump users are attending the paediatric diabetes centre and how many are attending the adult diabetes centre in each hospital, in tabular form;; and if he will make a statement on the matter. [25023/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
763. Deputy Marc MacSharry asked the Minister for Health when he will sanction funding for an increase in optometrists' fees, which currently do not meet the actual cost of providing a modern eye examination, given that the fees having not increased for over 20 years; and the timescale for the implementation of a national over 8s public eyecare programme; and if he will make a statement on the matter. [25034/24]
View answerThe Community Ophthalmic Services Scheme (COSS) is a national fee-per-item scheme which was introduced in 1979. Under the COSS, medical card holders aged over 16 years can be seen by ophthalmologists, community ophthalmic physicians, optometrists or dispensing opticians.
Eligible patients can receive an eye examination and be provided with prescribed optical appliances in accordance with a national schedule of approved optical appliances.
All children, including those not covered by a medical card, receive a vision screen while in national school from a Public Health Nurse. The Health Service Executive (HSE) provides optical services free of charge to pre-school children and national school children referred from child health service and school health service examinations who are discovered to have sight problems. These children are referred to the appropriate consultant for treatment. In such circumstances, these services will continue to be provided until the child has reached the age of 16.
The Health Professionals (Reduction of Payments to Ophthalmologists, Optometrists and Dispensing Opticians) Regulations 2013 (SI 274 of 2013) sets the fees for optometrists and dispensing opticians under the Community Optometric Services, Community Spectacle Dispensing Services and Health Amendment Act Card Schemes.
Increasing the fee payable to contractors for a standard eye examination under the COSS (to ensure parity with that payable for the same exam under the Department of Social Protection’s Treatment Benefit Scheme) is a priority for my Department, and work with stakeholders is ongoing in this regard.
The Department has also been meeting with Optometry Ireland to discuss the contribution that optometrists provide to our healthcare service and how this contribution could be further expanded.
The HSE Primary Care Eye Services Review Group Report, published in June 2017, highlighted the limitations of the current model of service delivery and set out the way forward for a significant amount of eye services to be delivered in a primary care setting. The Report estimated that 60% of existing outpatient activity could be moved to primary care thus enabling hospital services to focus on patients who require more specialist diagnostics or treatments.
The National Clinical Programme for Ophthalmology developed a model of care, also published in 2017, detailing how the realignment of eye services from the acute hospitals to the community will be undertaken.
Included in current priorities is transferring the care of children aged 8+ years to the care of local private optometrists. A project team with a wide-ranging membership was established in late 2019 / early 2020 to progress this initiative. The work of the team was paused due to the requirement to focus resources on the COVID 19 pandemic. However, the project team has been reconvened and is progressing matters in relation to this initiative. I have asked the HSE to prepare a detailed implementation plan in regard to this matter.
There will be engagement between my Department and the Department of Public Expenditure, National Development Plan Delivery and Reform during the Estimates 2025 process in regard to the funding needed to progress healthcare priorities, including the provision of eyecare.
I believe that there is a real opportunity to work collaboratively with community optometrists, and with other healthcare providers, to make a significant difference to patient outcomes. Of course, any publicly funded ophthalmic service expansion should address unmet public healthcare needs and improve access to public health services while ensuring value for money.
764. Deputy Pádraig O'Sullivan asked the Minister for Health when a child (details supplied) will receive a date for scoliosis surgery considering she has been waiting for over a year; and if he will make a statement on the matter. [25035/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
765. Deputy Charles Flanagan asked the Minister for Health the circumstances in which puberty blockers can be currently administered to children; and whether, in the light of the recent publication of an expert report (details supplied), it is envisaged that any practical or legislative changes are envisaged [25038/24]
View answerAs this is a service matter I have referred the question to the HSE for direct reply to the Deputy.
766. Deputy Duncan Smith asked the Minister for Health the number of WTE posts allocated to cancer services as per his letter of determination to the HSE outlining his funding priorities following Budget 2024; the overall number of WTE posts allocated to health services for 2024; the number of WTE posts allocated to areas (details supplied) in 2024, in tabular form; and if he will make a statement on the matter. [25042/24]
View answerAs this is an operational matter for the Health Service Executive, the HSE has been asked to respond directly to the Deputy.
767. Deputy Pa Daly asked the Minister for Health if he will consider opening an intake of paramedics into the National Ambulance Service, recruiting from individuals already on panels; and if he will make a statement on the matter. [25049/24]
View answerAs this is an operational matter I have asked the HSE to respond directly to the Deputy
768. Deputy Pádraig O'Sullivan asked the Minister for Health further to Parliamentary Question No. 1282 of 20 March 2024; for an update on the reimbursement of pegvaliase; when a final decision will be made; and if he will make a statement on the matter. [25057/24]
View answerThank you, Deputy O’Sullivan for your question in relation to Pegvaliase (Palynziq®). The Department has reached out to the HSE in relation to this matter.
The HSE has advised that it robustly assesses applications for pricing and reimbursement to make sure that it can stretch available resources as far as possible and to deliver the best value in relation to each medicine and ultimately more medicines to Irish citizens and patients.
HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds.
There are formal processes which govern applications for the pricing and reimbursement of medicines, and new uses of existing medicines, to be funded and / or reimbursed.
The HSE considers the following criteria prior to making any decision on pricing / reimbursement, in line with the Health (Pricing and Supply of Medical Goods) Act 2013:
(1) The health needs of the public,
(2) The cost effectiveness of meeting health needs by supplying the item concerned rather than providing other health services,
(3) The availability and suitability of items for supply or reimbursement,
(4) The proposed costs, benefits, and risks of the item or listed item relative to therapeutically similar items or listed items provided in other health service settings and the level of certainty in relation to the evidence of those costs, benefits and risks,
(5) The potential or actual budget impact of the item or listed item,
(6) The clinical need for the item or listed item,
(7) The appropriate level of clinical supervision required in relation to the item to ensure patient safety,
(8) The efficacy (performance in trial), effectiveness (performance in real situations) and added therapeutic benefit against existing standards of treatment (how much better it treats a condition than existing therapies) and,
(9) The resources available to the HSE.
The HSE has also advised that in terms of the specific details of the application for pricing and reimbursement of Pegvaliase (Palynziq®):
The HSE received an application for pricing / reimbursement on the 10th January 2020 from Biomarin (the applicant) for Pegvaliase (Palynziq®) indicated for the treatment of patients with phenylketonuria aged 16 years and older who have inadequate blood phenylalanine control (blood phenylalanine levels greater than 600 micromol/l) despite prior management with available treatment options.
The first step in the process is the submission of a Rapid Review dossier (a clinical and economic dossier) to the National Centre for Pharmacoeconomics (NCPE) for assessment. The HSE commissioned the Rapid Review process on the 13th January 2020.
The NCPE Rapid Review assessment report was received by the HSE on the 25th February 2020. The NCPE advised the HSE that a full HTA was recommended to assess the clinical effectiveness and cost effectiveness of Pegvaliase (Palynziq®) compared with the current standard of care. The HSE commissioned a full Health Technology Assessment (HTA) on the 26th February 2020 as per agreed processes.
The NCPE Health Technology Assessment Report was received by the HSE on the 29th September 2022. The NCPE recommended that Pegvaliase (Palynziq®) be considered for reimbursement if cost-effectiveness can be improved relative to existing treatments. www.ncpe.ie/pegvaliase-palynziq-hta-id-21057/
The HSE Corporate Pharmaceutical Unit (CPU) is the interface between the HSE and the Pharmaceutical Industry in relation to medicine pricing and reimbursement applications. CPU met with the applicant company (Biomarin) to discuss their application for Pegvaliase (Palynziq®). The Drugs Group is the national committee which the HSE has in place to make recommendations on the pricing and reimbursement of medicines. The membership of the HSE Drugs Group includes public interest members. The HSE Drugs Group consider all of the evidence and make a recommendation to the HSE Executive Management Team. Pegvaliase (Palynziq®) was reviewed by the Drugs Group at the June 2023 meeting. At the June 2023 meeting the Drugs Group requested Patient and Clinician Engagement input via the Rare Diseases Technology Review Committee (RDTRC) to assist the group in making its recommendation to the HSE Executive Management Team regarding reimbursement of Pegvaliase (Palynziq®). The RDTRC Statement was received in December 2023. The totality of clinical and economic evidence for Pegvaliase (Palynziq®) as well as the RDTRC statement was comprehensively and extensively reviewed by the Drugs Group at the January 2024 meeting. The Drugs Group by majority did not recommend in favour of reimbursement of Pegvaliase (Palynziq®).
The decision-making authority in the HSE is the HSE Executive Management Team. The HSE Executive Management Team decides on the basis of all the demands it is faced with (across all services) whether it can fund a new medicine, or new use of an existing medicine, from the resources that have been provided to it in line with the Health (Pricing and Supply of Medical Goods) Act 2013. The HSE Executive Management Team supported the Drugs Group recommendation not to reimburse Pegvaliase (Palynziq®) indicated for the treatment of patients with phenylketonuria aged 16 years and older who have inadequate blood phenylalanine control (blood phenylalanine levels greater than 600 micromol/l) despite prior management with available treatment options.
The application for Pegvaliase (Palynziq®) remains under consideration. The HSE cannot make any comment on possible outcomes from the ongoing process.
769. Deputy Pádraig Mac Lochlainn asked the Minister for Health the reason no response has been received from the HSE in relation to Parliamentary Question Nos 1201, 1202 and 1203 of 9 April 2024 about a child in County Donegal (details supplied); and if he will make a statement on the matter. [25066/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
770. Deputy Pádraig Mac Lochlainn asked the Minister for Health the services currently available in Letterkenny University Hospital for adults and children who have diabetes; and if he will make a statement on the matter. [25067/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
