Thomas Gould
Question:410. Deputy Thomas Gould asked the Minister for Health if he has identified gaps in service provision through the interactive map; and how he intends to resolve these. [26881/24]
View answerHealth Services
Questions (410, 437)
Jennifer Murnane O'Connor
Question:437. Deputy Jennifer Murnane O'Connor asked the Minister for Health to provide a map of drug and alcohol services in provision in each county, in tabular form; and if he will make a statement on the matter. [26933/24]
View answerWritten answers
I propose to take Questions Nos. 410 and 437 together.
This month, I launched an interactive map of publicly-funded drug treatment and drug-related family support services, which can be accessed www.drugsandalcohol.ie/services_map
The online tool is a partnership between the Department of Health and the Health Research Board and marks the first time a visual database of services has been produced. It features 442 services in receipt of public funding, including services provided directly by the Health Service Executive (HSE) or community-based organisations and residential services funded via the HSE.
The map provides easily navigable information on local services for people looking to access services to address their drug or alcohol use, and for families and concerned others who are struggling to deal with a loved one’s drug or alcohol use. The map complements existing resources such as the drug and alcohol helpline and the drugs.ie website.
The publication of this interactive map of drug services is phase one of the audit of drug services being undertaken by the Dept of Health and the HRB. The audit is an action to support the implementation of the strategic action plan 2023-2024 for the national drugs strategy.
Phase two involves an analysis of current funding of drug treatment and drug related family support services and demand for same, based on
• Analysis of NDTRS, NDRDI and NDAS data to assess service demand.
• Data merge with Pobal depravation index as a proxy predictor of service demand.
• Geomapping of data to provide funding offices with information to plan service delivery.
Drug services are provided by the HSE and community and voluntary organisations. Many services have developed as a response to local demand, often under the auspices of drug and alcohol task forces. As a result, the model of service provision is fragmented and uneven. Access to services can often depend on geographical factors.
The intention is to engage statutory agencies that fund drug treatment services to (i) provide a snapshot of current funding levels and activities, and (b) to assist with gathering more detailed data on what is being provided in relation to the funding. NDTRS figures will also provide a measurement of activity levels.
The audit will map existing service provision against predicted treatment demand based on the Pobal depravation indices and NDTRS figures. Statistics from the National Drug & Alcohol Survey and the National Drug-Related Deaths Index will also inform this work. This information can then be used to inform the planning and funding of drug treatment and family support services in the HSE health regions.
I am committed to enhancing access to and delivery of drugs services in the community under the national drug strategy. Considerable resources have been invested in
Healthcare Infrastructure Provision
Questions (411)
Eoin Ó Broin
Question:411. Deputy Eoin Ó Broin asked the Minister for Health to provide an update on the funding for, and delivery of, the new clinical unit for the central remedial clinic co-located within a school (details supplied). [26894/24]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Dental Services
Questions (412)
Michael Healy-Rae
Question:412. Deputy Michael Healy-Rae asked the Minister for Health when an appointment for orthodontic treatment will be facilitated for a child (details supplied); when an appointment will be given; and if he will make a statement on the matter. [26898/24]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
Sexually Transmitted Infections
Questions (413, 414, 415, 416)
Cian O'Callaghan
Question:413. Deputy Cian O'Callaghan asked the Minister for Health if there will be an increase in funding and capacity for public PrEP services, such as those at the GUIDE clinic at St. James’s Hospital; and if he will make a statement on the matter. [26899/24]
View answerCian O'Callaghan
Question:414. Deputy Cian O'Callaghan asked the Minister for Health the plans in place to allow GPs to provide PrEP to their existing patients; and if he will make a statement on the matter. [26900/24]
View answerCian O'Callaghan
Question:415. Deputy Cian O'Callaghan asked the Minister for Health if the existing network of sexual health clinics and HIV-AIDS volunteer groups, such as (details supplied), will be used to increase availability of PrEP; and if he will make a statement on the matter. [26901/24]
View answerCian O'Callaghan
Question:416. Deputy Cian O'Callaghan asked the Minister for Health if there are plans to allow online pharmacies to prescribe and deliver PrEP to customers in Ireland; and if he will make a statement on the matter. [26902/24]
View answerWritten answers
I propose to take Questions Nos. 413 to 416, inclusive, together.
Sexual health is a priority for this Government. The National Sexual Health Strategy, 2015-2020, (NSHS), was launched in October 2015 and is implemented by the HSE Sexual Health and Crisis Pregnancy Programme (SHCPP). The NSHS aims to support sexual health and wellbeing across the lifecourse.
Following stakeholder consultation and an independent review, the Strategy is currently being re-drafted by an expert Group; a refreshed version is scheduled to be published in Q3-4, 2024. An independent Review by Crowe Ireland, published in 2023 on the Healthy Ireland website, identified 56 Priority Actions, of which 49 were assessed as having been successfully progressed. The Review also provides recommendations with regard to the future direction of the next NSHS.
Current priority sexual health deliverables include:
• Providing sexually transmitted infection (STI) and HIV prevention, diagnosis and treatment services, through the national network of 23 STI clinics and expansion of the nationwide home HIV and STI testing scheme
• HIV prevention, including HIV Fast-Track Cities, the Pre-Exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis (PEP) programmes, research, campaigns and supports to counter stigma for people living with HIV.
• Expanding access to free contraception, through the free contraception scheme for women and National Condom Distribution Service (NCDS).
• Prioritising monitoring, evaluation and research regarding sexual health, including progressing a comprehensive population survey on sexual health.
• Monitoring emerging STIs and changes in pathogenicity and/or transmissibility of existing pathogens (close links maintained with the Health Protection Surveillance Centre (HPSC) that collates STI incidence and trends, and the Health Information and Quality Authority (HIQA)).
• Improving sexual health education, training and resources, including schools, higher and further education, through www.sexualwellbeing.ie, in partnership with relevant NGOs
A national HIV pre-exposure prophylaxis (PrEP) programme commenced in November 2019, following a HIQA HTA, which concluded that its introduction would be safe, effective, and cost saving.
Free PrEP medication is available to individuals who meet clinical eligibility criteria, attending HSE approved PrEP services. These include public PrEP services, delivered through the public network of STI clinics, and some general practice (GP) services and private providers. There are currently 13 approved public PrEP services, located in public STI clinics, and 17 private or general practitioner (GP) PrEP providers. Appointments at the 13 public PrEP services are free of charge, however, the private providers charge for consultations.
The number of people eligible to access PrEP has been expanding since inception, with the number of individuals re-imbursed for PrEP at least once expanding from 1763 in 2020 (the first full year of service delivery), to 3388 in 2022 and 3802 by the end of Q4, 2023.
Clinical criteria for PrEP eligibility have been widened in recent years, increasing the number of people eligible for the programme. While the PrEP service continued to grow in 2023, many PrEP services are reaching (or have reached) capacity and service users are reporting challenges accessing appointments. By Q4, 2024, 6,070 individuals were approved for free PrEP medication.
Additional work is required to understand the extent of the unmet need/demand for PrEP, which has been estimated as circa 30%. Additional funding of €600,000 has been allocated in 2024 to further support delivery of the PrEP scheme, bringing the total allocation to €5.9m.
In order to increase capacity, a number of additional measures have been deployed and are being developed, including administrative efficiencies, the use of telephone consultations and use of the free home STI testing scheme for routine tests. In order to increase the number of providers, a PrEP competency framework and eLearning platform has been developed; these can be accessed by GPs with an interest in providing PrEP. The home STI testing scheme has received additional funding of €720,000 in 2024, bringing total funding for this to €4.22m
It is of vital importance that people at risk of HIV and living with HIV (PLHIV) are promptly linked to care, for prevention of onward transmission and for clinical benefit. It is also vital that those at risk are encouraged to access regular testing and preventive programmes such as PrEP. These measures are key elements towards achieving UN and WHO aims of ending the HIV/AIDS epidemic in Europe by 2030 and supporting wider national and international commitments.
In addition to further funding for both PrEP and for home STI testing in 2024, we are progressing further development of HIV Fast-Track Cities in Dublin, Cork, Limerick and Galway. We are also supporting people living with HIV and countering the stigma they may experience. To mark Pride Week, I will be launching a Community Garden, supported by the Department, at HIV Ireland’s HQ in Dublin, as part of Pride Week.
Additional capacity for PrEP delivery, through the public system, its partnerships and through primary care, are being considered as part of the wider ongoing work to redraft the National Sexual Health Strategy; it is envisaged that the new Strategy will be published in late Q3, 2024. Measures included for consideration will include a Model of Care for sexual health, to examine capacity and delivery, nationwide, in the context of HIV and STI rates that are rising both nationally and internationally. Additional capacity planned for 2025 will be considered as part of the Estimates process leading to Budget 2025.
Expanding the role of pharmacists is being actively progressed by the Minister for Health; primary legislation to support this is passing through the Houses of Oireachtas currently. The Expert Taskforce on Pharmacy are finalising their recommendations to the Minister, which further will inform development of both primary and secondary legislative frameworks and regulation to support the expansion of pharmacy.
The capacity for community sexual health partners to support PrEP delivery in line with clinical governance and frameworks for delivery; the feasibility of expanding the proportion of public STI clinics delivering PrEP and the clinical advisability (or otherwise) of allowing online pharmacies to prescribe and/or deliver PrEP are matters requiring significant expert clinical consideration and are therefore service matters for which the input of our HSE colleagues is essential.
As these are service matters, I have also asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Question No. 414 answered with Question No. 413.
Question No. 415 answered with Question No. 413.
Question No. 416 answered with Question No. 413.
Sexually Transmitted Infections
Questions (417, 418, 419, 420)
Pádraig O'Sullivan
Question:417. Deputy Pádraig O'Sullivan asked the Minister for Health the plans to increase funding and capacity for public PrEP services (details supplied); and if he will make a statement on the matter. [26903/24]
View answerPádraig O'Sullivan
Question:418. Deputy Pádraig O'Sullivan asked the Minister for Health the plans to allow GPs to provide PrEP to their existing patients (details supplied); and if he will make a statement on the matter. [26904/24]
View answerPádraig O'Sullivan
Question:419. Deputy Pádraig O'Sullivan asked the Minister for Health the plans to utilise the existing network of sexual health clinics and HIV-AIDS volunteer groups (details supplied) to increase availability of PrEP; and if he will make a statement on the matter. [26905/24]
View answerPádraig O'Sullivan
Question:420. Deputy Pádraig O'Sullivan asked the Minister for Health the plans to allow online pharmacies to prescribe and deliver PrEP to customers in this jurisdiction (details supplied); and if he will make a statement on the matter. [26906/24]
View answerWritten answers
I propose to take Questions Nos. 417 to 420, inclusive, together.
Sexual health is a priority for this Government. The National Sexual Health Strategy, 2015-2020, (NSHS), was launched in October 2015 and is implemented by the HSE Sexual Health and Crisis Pregnancy Programme (SHCPP). The NSHS aims to support sexual health and wellbeing across the lifecourse.
Following stakeholder consultation and an independent review, the Strategy is currently being re-drafted by an expert Group; a refreshed version is scheduled to be published in Q3-4, 2024. An independent Review by Crowe Ireland, published in 2023 on the Healthy Ireland website, identified 56 Priority Actions, of which 49 were assessed as having been successfully progressed. The Review also provides recommendations with regard to the future direction of the next NSHS.
Current priority sexual health deliverables include:
• Providing sexually transmitted infection (STI) and HIV prevention, diagnosis and treatment services, through the national network of 23 STI clinics and expansion of the nationwide home HIV and STI testing scheme
• HIV prevention, including HIV Fast-Track Cities, the Pre-Exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis (PEP) programmes, research, campaigns and supports to counter stigma for people living with HIV.
• Expanding access to free contraception, through the free contraception scheme for women and National Condom Distribution Service (NCDS).
• Prioritising monitoring, evaluation and research regarding sexual health, including progressing a comprehensive population survey on sexual health.
• Monitoring emerging STIs and changes in pathogenicity and/or transmissibility of existing pathogens (close links maintained with the Health Protection Surveillance Centre (HPSC) that collates STI incidence and trends, and the Health Information and Quality Authority (HIQA)).
• Improving sexual health education, training and resources, including schools, higher and further education, through www.sexualwellbeing.ie, in partnership with relevant NGOs
A national HIV pre-exposure prophylaxis (PrEP) programme commenced in November 2019, following a HIQA HTA, which concluded that its introduction would be safe, effective, and cost saving.
Free PrEP medication is available to individuals who meet clinical eligibility criteria, attending HSE approved PrEP services. These include public PrEP services, delivered through the public network of STI clinics, and some general practice (GP) services and private providers. There are currently 13 approved public PrEP services, located in public STI clinics, and 17 private or general practitioner (GP) PrEP providers. Appointments at the 13 public PrEP services are free of charge, however, the private providers charge for consultations.
The number of people eligible to access PrEP has been expanding since inception, with the number of individuals re-imbursed for PrEP at least once expanding from 1763 in 2020 (the first full year of service delivery), to 3388 in 2022 and 3802 by the end of Q4, 2023.
Clinical criteria for PrEP eligibility have been widened in recent years, increasing the number of people eligible for the programme. While the PrEP service continued to grow in 2023, many PrEP services are reaching (or have reached) capacity and service users are reporting challenges accessing appointments. By Q4, 2024, 6,070 individuals were approved for free PrEP medication.
Additional work is required to understand the extent of the unmet need/demand for PrEP, which has been estimated as circa 30%. Additional funding of €600,000 has been allocated in 2024 to further support delivery of the PrEP scheme, bringing the total allocation to €5.9m.
In order to increase capacity, a number of additional measures have been deployed and are being developed, including administrative efficiencies, the use of telephone consultations and use of the free home STI testing scheme for routine tests. In order to increase the number of providers, a PrEP competency framework and eLearning platform has been developed; these can be accessed by GPs with an interest in providing PrEP. The home STI testing scheme has received additional funding of €720,000 in 2024, bringing total funding for this to €4.22m
It is of vital importance that people at risk of HIV and living with HIV (PLHIV) are promptly linked to care, for prevention of onward transmission and for clinical benefit. It is also vital that those at risk are encouraged to access regular testing and preventive programmes such as PrEP. These measures are key elements towards achieving UN and WHO aims of ending the HIV/AIDS epidemic in Europe by 2030 and supporting wider national and international commitments.
In addition to further funding for both PrEP and for home STI testing in 2024, we are progressing further development of HIV Fast-Track Cities in Dublin, Cork, Limerick and Galway. We are also supporting people living with HIV and countering the stigma they may experience. To mark Pride Week, I will be launching a Community Garden, supported by the Department, at HIV Ireland’s HQ in Dublin, as part of Pride Week.
Additional capacity for PrEP delivery, through the public system, its partnerships and through primary care, are being considered as part of the wider ongoing work to redraft the National Sexual Health Strategy; it is envisaged that the new Strategy will be published in late Q3, 2024. Measures included for consideration will include a Model of Care for sexual health, to examine capacity and delivery, nationwide, in the context of HIV and STI rates that are rising both nationally and internationally. Additional capacity planned for 2025 will be considered as part of the Estimates process leading to Budget 2025.
Expanding the role of pharmacists is being actively progressed by the Minister for Health; primary legislation to support this is passing through the Houses of Oireachtas currently. The Expert Taskforce on Pharmacy are finalising their recommendations to the Minister, which further will inform development of both primary and secondary legislative frameworks and regulation to support the expansion of pharmacy.
The capacity for community sexual health partners to support PrEP delivery in line with clinical governance and frameworks for delivery; the feasibility of expanding the proportion of public STI clinics delivering PrEP and the clinical advisability (or otherwise) of allowing online pharmacies to prescribe and/or deliver PrEP are matters requiring significant expert clinical consideration and are therefore service matters for which the input of our HSE colleagues is essential.
As these are service matters, I have also asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Question No. 418 answered with Question No. 417.
Question No. 419 answered with Question No. 417.
Question No. 420 answered with Question No. 417.
Health Services Staff
Questions (421)
Joan Collins
Question:421. Deputy Joan Collins asked the Minister for Health if his Department has found a way to expedite the hiring of new public health nurses; and the status of childhood developmental checks across the Dublin 8 and Dublin 12 area (details supplied). [26908/24]
View answerWritten answers
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
Questions (422, 443)
Joan Collins
Question:422. Deputy Joan Collins asked the Minister for Health if he plans to address the two-tiered system in cancer treatments (details supplied). [26909/24]
View answer
Neasa Hourigan
Question:443. Deputy Neasa Hourigan asked the Minister for Health his plans to address the longer timelines public patients experience accessing novel cancer drugs, an average of two years, compared to private patients; and if he will make a statement on the matter. [26952/24]
View answerWritten answers
I propose to take Questions Nos. 422 and 443 together.
The State is committed to providing timely access to new and innovative medicines to all patients. Budgets 2021 - 2023 provided almost €100 million of dedicated funding for new drugs. This enabled the HSE to approve 148 new drugs, 61 of which are for cancer. This brings the total spend on Cancer drugs in the last 3 years to over €600 million.Budget 2024 made €30 million available for new drugs. €20 million of this will be invested directly by the Government and a further €10 million will come from efficiencies to be identified by the HSE. Efficiencies were identified as a priority for 2024 by the Minister, with a joint HSE-Department of Health Taskforce established to address medicine expenditure. This has enabled the HSE to approve reimbursement for 13 medicines to date in 2024. Three of these medicines are for use in treating cancers and will have a substantial cost over the next five years. The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the 2013 Act. Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority. In line with the 2013 Act, and the national framework agreed with industry, a company must first submit an application to the HSE to have a new medicine added to the reimbursement list.The timing of company applications for reimbursement in different countries can vary for a number of reasons, not least the available market share in each country. Once a company responsible for the commercialisation of a new medicine receives market authorisation, it can apply for reimbursement in the country (or countries) of its choice. Ireland, by virtue of its size and market share, may not always be prioritised by a company in the first stages of marketing a new product. Describing timelines for reimbursement from EMA approval to HSE reimbursement approval does not consider this important factor and misrepresents the process, as statutorily the HSE cannot add a medicine to the reimbursement list until an application is received from the company holding the market authorisation.When an application is made to have a product added to the reimbursement list in Ireland, the HSE is required, under the 2013 Act, to decide within 180 days of receiving the application, to either add the medicine to the reimbursement list or refuse to reimburse the medicine. In assessing the application, the HSE is required by statute to consider a range of criteria including the magnitude of the clinical effect, cost effectiveness, budget impact, opportunity cost and unmet need.In 2024, there will be significant investment in additional staff resources to enhance the HSE’s medicines pricing and reimbursement process. This is a recommendation of the working group established following the publication of the Mazars ‘Review of the Governance Arrangements and the Resources in place to support the HSE’s reimbursement and pricing decision-making process’ in February 2023.Funding has been allocated for an additional 34 WTE for the agencies involved in the HSE’s medicines pricing and reimbursement system has been granted. This will enable them to conduct timely and efficient evaluations of medicines for reimbursement. It will also maximise the use of this substantial public investment to support access to more medicines for more people. Funding has also been approved for an online tracker which will allow patients and industry to follow the progress of an application through the assessment process. This will enhance transparency for all stakeholders. Investing in this capacity will support agencies to operate to the fullest of their ability, providing timely and efficient evaluation of medicines for reimbursement.As Minister for Health, I regulate the private health insurance market. This is a voluntary market, which is underpinned by certain principles, including minimum benefit, that are set out in law. The Health Insurance Act 1994 (Minimum Benefit) Regulations 1996 require insurers to offer a minimum level of cover to every insured person. I do not have a role in the commercial decision-making of any private health insurer.Private Health Insurance companies operate as commercial entities in a competitive private health insurance market. Beyond prescribing under the Regulations the minimum level of coverage that health insurers must provide, I am not in a position to direct any insurer to provide cover for any particular procedure or service or medicine, or direct how that cover is to be provided.
Medical Cards
Questions (423)
Richard Boyd Barrett
Question:423. Deputy Richard Boyd Barrett asked the Minister for Health if a child under 16 years with a full medical card is entitled to free dental fillings; if not, where a parent who cannot afford a private dentist can seek this care; and if he will make a statement on the matter. [26914/24]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
Health Services
Questions (424)
Richard Boyd Barrett
Question:424. Deputy Richard Boyd Barrett asked the Minister for Health the length of the waiting list for physiotherapy for bone and joint issues at St. Vincent’s University Hospital; if it is correct that a referred patient has been told that the list is ‘on hold’ by staff; and if he will make a statement on the matter. [26915/24]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Nursing Homes
Questions (425)
Eoin Ó Broin
Question:425. Deputy Eoin Ó Broin asked the Minister for Health to provide an update on engagements surrounding a nursing home in Dublin mid west (details supplied); if the HSE is considering taking charge of the nursing home; and if he will make a statement on the matter. [26917/24]
View answerWritten answers
Ensuring the welfare and safety of residents is secured is of the utmost importance, and work to alleviate the concerns of residents, their families and staff continues to be a priority during this difficult time.The HSE was notified on Thursday 16th May 2024 by the Health Information and Quality Authority (HIQA), that HIQA had cancelled the registration of Lucan Lodge Nursing Home with the agreement of the Directors of Passage Healthcare International (Ireland) Limited, who was the registered provider of Lucan Lodge Nursing Home. Since 10am on Friday 17th May, the HSE, in accordance with its statutory requirement under Section 64 of the Health Act 2007, is required to take charge of the nursing home and carry on its business as if it were still registered, pending alternative arrangements. The HSE are very conscious of the speed of this change and the urgency with which the HSE was required to take charge and acknowledge that this is a concern for residents, families and staff.The main priority for the HSE at this time is to ensure that care being provided by the existing care team at Lucan Lodge continues, and that the HSE support the ongoing needs of the residents.
As part of its ongoing assessment, the HSE is currently assessing the nursing home and is engaging with all relevant parties to explore all options.The HSE has commenced engaging with residents, their nominated contacts and staff.
The continuity of care to residents supported by the existing care team at Lucan Lodge remains our highest priority.
Health Services Staff
Questions (426)
Eoin Ó Broin
Question:426. Deputy Eoin Ó Broin asked the Minister for Health for an update regarding the public health nurse service in the Lucan area of Dublin mid-west; if staff shortages are still impacting service delivery; if child developmental checks for all children of age in the area have been fully reinstated; and if he will make a statement on the matter. [26918/24]
View answerWritten answers
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 Staff
Questions (427)
Eoin Ó Broin
Question:427. Deputy Eoin Ó Broin asked the Minister for Health for an update regarding the public health nurse service in the Newcastle area of Dublin mid-west; if staff shortages are still impacting service delivery; if child developmental checks for all children of age in the area have been fully reinstated; and if he will make a statement on the matter. [26919/24]
View answerWritten answers
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 Staff
Questions (428)
Charles Flanagan
Question:428. Deputy Charles Flanagan asked the Minister for Health for an update regarding the public health nurse service in the Newcastle area of Dublin mid-west; if staff shortages are still impacting service delivery; if child developmental checks for all children of age in the area have been fully reinstated; and if he will make a statement on the matter. [26920/24]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Addiction Treatment Services
Questions (429)
Jennifer Murnane O'Connor
Question:429. Deputy Jennifer Murnane O'Connor asked the Minister for Health the number of persons to contact the HSE for assistance with problem gambling, by county, in tabular form; and if he will make a statement on the matter. [26925/24]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.