Written Answers Nos. 227-252
227. Deputy Patricia Ryan asked the Minister for Health if the HSE can continue to operate a nursing home (details supplied) on an interim basis in order to allow a timeframe for prospective purchasers/investors to put plans in place to buy the home and secure it for residents. [39266/24]
View answerI am aware of the developing situation concerning nursing homes formerly operated by Aperee Ltd. Aperee Camp/Ocean View is the sixth nursing home from the Aperee group which has been de-registered by HIQA due to non-compliance with regulations. The Chief Inspector has identified significant levels of non-compliance including management of the centre, protection of resident’s finances and fire safety.
In line with the provisions of Section 64 of the Health Act 2007, the Health Service Executive (HSE) has taken temporary responsibility for continuing services at the nursing home from 11 September 2024.
I met with senior HSE leadership from the South West Health Region, including the Regional Executive Officer on September 20, to discuss the situation at Ocean View. Ensuring the welfare and safety of residents, their families and staff was the key focus of our discussions.
The HSE is seeking to provide safe care to residents, families and staff against a background of serious concerns about fire safety at the home. The HSE have duties as provider of last resort under Section 64 the Health Act 2007.
The HSE team on site is committed to continue working closely with each resident individually, where appropriate supported by family members, to discuss their options in line with their wishes or ascertainable will and preference.
Representatives of SAGE advocacy are available to provide independent support and guidance.
The HSE does not own Ocean View and is currently supporting its operation on a specific and limited basis. If there are private investors interested in the nursing home, every effort will be made to facilitate any potential interest. The HSE has advised Ocean View nursing home staff that should they be interested in employment with the HSE, they would welcome their applications for employment across various public units in the region.
The HSE continues to ensure that staff will be paid in the interim.
Any engagement re. a potential takeover or purchase can only be facilitated via the Head of Older Persons Services, CHO4, and the owners/receivers of Aperee Camp/Ocean View.
Under the Health Act, the day-to-day operational responsibility for the management and delivery of health services is a matter for the HSE, and you will understand that as Minister I cannot become involved in the situation at Aperee. This is an evolving situation, and the Department of Health and HSE are keeping me updated.
228. Deputy Patricia Ryan asked the Minister for Health if the HSE will undertake necessary actions to ensure fire safety for residents in a nursing home (details supplied) in the interim period, to ensure residents’ safety. [39267/24]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
229. Deputy Patricia Ryan asked the Minister for Health the number of children in CHO7 currently waiting on dental and orthodontic treatment and the length of time spent on the list for treatment. [39269/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
230. Deputy Patricia Ryan asked the Minister for Health the measures HIQA will take to ensure the safety and well-being of vulnerable residents in a nursing home (details supplied). [39271/24]
View answerI must remind the Deputy of the independence of the Chief Inspector of Social Services and of the Health Information Quality Authority (HIQA) as the national independent regulator of designated centres for older people including public community nursing units and private nursing homes.
HIQA has significant and wide-ranging powers up to and including withdrawing the registration of a nursing home facility, which means that it can no longer operate as a service provider. This responsibility is underpinned by a comprehensive quality framework comprising of Registration Regulations, Care and Welfare Regulations and National Quality Standards.
HIQA, in discharging its duties determines, through examination of all information available to it, including site inspections, whether a nursing home meets the regulations in order to achieve and maintain its registration status. Should a nursing home be deemed to be non-compliant with the Regulations and the National Quality Standards, it may either fail to achieve or lose its registration status. In addition, the Chief Inspector has wide discretion in deciding whether to impose conditions of Registration on nursing homes.
My Department directed this query to the Health Information Quality Authority the following is their response;
"Using the HIQA Chief Inspector’s regulatory framework, the HIQA inspectors of social services are maintaining close oversight of this designated centre to ensure that residents receive safe and appropriate care. Repeat inspections were carried out in July and August with the reports of these inspections currently being finalised."
231. Deputy John Paul Phelan asked the Minister for Health that actions that are being immediately taken to ensure that a person (details supplied) can have access to their prescribed medication within the State; and if he will make a statement on the matter. [39276/24]
View answerDear Deputy Phelan,
Your query relates to the treatment of an individual patient. It would not be appropriate for me or my Department or to comment on the treatment of a patient, which would be a matter for the patient and their healthcare professional(s).
In relation to the availability of the medications which are referenced in ‘details supplied’, both of these medicinal products are not licensed in Ireland. This means that they have not been granted a marketing authorisation in Ireland by our medicines regulator, the Health Products Regulatory Authority (HPRA), or in Europe by the European Medicines Agency, and they would not be assessed by the HPRA for quality, safety or efficacy.
There is a mechanism in Ireland that allows for the supply of unauthorised medicines: the Exempt Medicinal Product (EMP) route. EMPs can be supplied in response to a bona fide unsolicited order, formulated in accordance with the specifications of a practitioner for use by their individual patients on their direct personal responsibility to fulfil the special needs of those patients.
If sourced in response to a bona fide unsolicited order as a licensed product from another market, these medicines will have undergone an evaluation of their safety, quality, and efficacy for the granting of their marketing authorisation in that country, carried out by the respective competent authority for medicines in that state.
The legislation underpinning EMPs is set out in Schedule 1 of the Medicinal Products (Control of Placing on the Market) Regulations, 2007, as amended, and also in the Medicinal Products (Control of Wholesale Distribution) Regulations, 2007, as amended. If a valid prescription is issued for an EMP in line with the above Regulations, an appropriately authorised wholesaler can source that product from another market for supply to the patient via their pharmacy in line with that prescription. Paragraph 2 of Schedule 1 of the Control of Placing on the Market regulations refers to a personal responsibility undertaken by the prescriber when prescribing an EMP.
The supply of EMPs in Ireland must be notified to the HPRA. The availability of this information is used for the purpose of allowing the HPRA to react very quickly to reports of quality defects received about medicines from other competent authorities and to identify whether the batch of concern has come to Ireland as an EMP. The HPRA then ensures that the necessary risk-mitigating actions, such as product recall actions, are undertaken in Ireland promptly to protect patients from the risks presented by such quality defects.
An exempt product may not be prescribed or supplied in situations where an authorised equivalent (i.e. same active substance(s), strength and dosage form) is available in Ireland.
As these two products are not regulated by the HPRA, they can not provide information on supplies or availability of these products.
I understand that shortages of medicines can cause a great deal of stress for patients and their healthcare professionals alike. Thusly, my Department would advise that patients, or their carers, who are concerned about their medicine(s) and their availability speak to their prescribing physician, who will be able to discuss alternatives for them.
232. Deputy Patrick Costello asked the Minister for Health further to Parliamentary Question No. 512 of 24 September 2024, the Irish legislation which states that pharmacists in Ireland are not authorised to supply unlicensed medicines from a prescription that is written by a registered practitioner practising in another EEA Member State. [39280/24]
View answerThank you for your question.
As indicated in Parliamentary Question No. 512 of 24 September 2024 Directive 2011/24/EU on patients’ rights in cross-border healthcare sets out the conditions under which a patient may travel to another EU country to receive medical care and reimbursement, and also covers the prescription and delivery of medications and medical devices. The provisions of this Directive are transposed nationally in respect of the dispensing of prescriptions nationally in the Medicinal Products (Prescription and Control of Supply) Regulations 2003 as amended, and the provisions of Regulation 7(1A) (inserted by the 2014 Amendment (No.2) Regulations and amended by 2020 Amendment (No. 6) Regulations) refer.
Medicines placed on the Irish market must be authorised by the HPRA or, in the case of centrally authorised products, by the European Commission. Medicines are categorised in accordance with the requirements specified in Directive 2001/83/EC and nationally by the Medicinal Products (Control of Placing on the Market) Regulations 2007, as amended. This is a permissive rather than restrictive authorisation system.
In line with Directive 2011/24/EU, pharmacists in Ireland are authorised to dispense from a prescription that is issued by a registered practitioner practising in another European Economic Area (EEA) Member State provided certain conditions are met.
Article 11 of the 2011/24/EU Directive notes that “If a medicinal product is authorised to be marketed on their territory, in accordance with Directive 2001/83/EC or Regulation (EC) No 726/2004, Member States shall ensure that prescriptions issued for such a product in another Member State for a named patient can be dispensed on their territory in compliance with their national legislation in force…”
In line with Article 5 of Directive 2001/83/EC, Schedule 1 of the Medicinal Products (Control of Placing on the Market) Regulations 2007 (S.I. No.540 of 2007) (as amended) includes an exemption for the supply of an unauthorised medicinal product in response to a bona fide unsolicited order, formulated in accordance with the specifications of a practitioner for use by his individual patients, on his direct personal responsibility in order to fulfil the a special need of this patient. Such products are defined as ‘exempt’ medicinal products and are also known as ‘unauthorised’ or ‘unlicensed’ medicinal products.
In these regulations ‘practitioner’ means a registered dentist, a registered medical practitioner, a registered nurse prescriber or a registered midwife prescriber;
• ‘registered dentist’ means a person registered in the register established under the Dentists Act 1985 (No. 9 of 1985);
• ‘registered medical practitioner’ means a person registered in the register established under the Medical Practitioners Act 1978 (No. 4 of 1978);
• ‘registered nurse prescriber’ means a person registered in the nurse prescribers division of the register of nurses and midwives;
Pharmacists operate and practice under a statutory framework of legislative and governance controls with the best interest of the patient being the inherent primary principle. The dispensing of any prescription to a patient includes considering the legislative framework, the guiding principles of any supporting guidance issued and the application of the Code of Conduct for pharmacists. It is worth noting that in supplying any medication a pharmacist has an obligation to assess any prescription presented and dispense in the patient’s best interest which may include, to refuse, for ethical reasons, to dispense a product that was prescribed in another Member State (where the pharmacist would have the right to refuse to dispense, had the prescription been issued in the Member State of affiliation), and the legislation and the guidelines in place do not affect this.
This will assure the application of competence and expertise in making an informed decision regarding the safety and appropriateness of supplying a particular medicine to a patient, based on an authorising prescription, issued either nationally or in another EEA member state.
233. Deputy Michael Healy-Rae asked the Minister for Health to provide an update on the case of a person (details supplied); and if he will make a statement on the matter. [39285/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
234. Deputy Claire Kerrane asked the Minister for Health to provide additional funding to an organisation (details supplied) which can currently only provide 20 hours of day care at home for people with Alzheimer’s in County Roscommon, through HSE funding; and if he will make a statement on the matter. [39298/24]
View answerSince my appointment as Minister of State with responsibility for Mental Health and Older People in 2020, I have worked to progressively increase funding for dementia services and supports so that every person with dementia, and their families, has the support that they need to live as well and as independently as possible.
€17million has been invested in new dementia services and supports since 2021, and the Government is increasing this investment in 2025 through the provision of a further €2 million to improve access to dementia diagnosis and care. This brings the total new investment in a range of dementia services and supports since 2021 to €19 million.
€1 million in new funding will be provided for Consultant posts in Memory Assessment and Support Services, while €200,000 will be allocated for the implementation of a National Dementia Registry. €0.8m in new development funding will be provided to the Alzheimer Society of Ireland (ASI) for 2025. This includes €250,000 to increase the provision of dementia day care at home, €150,000 to provide 3 new dementia day care services (each service operating one day per week), and €400,000 to recruit 5 new dementia advisers. In addition, €0.3 million that was allocated to ASI in 2024 to commence activity clubs for people with young onset dementia has now been mainstreamed.
Dementia day care, both in the home and in day care centres, has the dual benefit of providing social stimulation for people with dementia, tailored to their needs and interests, and a break for family carers. The allocation of an additional €250,000 for dementia day care at home brings the total budget for this important initiative to €2.55 million for 2025.
The HSE will work with the Alzheimer Society of Ireland to determine where the additional funding for dementia day care at home should be prioritised, based on need.
235. Deputy Sean Sherlock asked the Minister for Health further to Parliamentary Question No. 2092 of 23 July 2024, the reason only €61.9 million of the €98 million allocated to new medicines was spent during 2021, 2022 and 2023, according to the answer provided by the HSE; the way the unspent funds were utilised; and if he will make a statement on the matter. [39312/24]
View answerAs medicines expenditure is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
236. Deputy Sean Sherlock asked the Minister for Health the number of meetings his Department’s working group (details supplied) has held in 2024; the specific date of the last online or in-person meeting of the working group members; if a report has been shared with him or his advisers; if so, the date this occurred; and if he will make a statement on the matter. [39313/24]
View answer237. Deputy Louise O'Reilly asked the Minister for Health if there are pathways available for individuals with advanced qualifications such as a masters in chaplaincy to become registered wedding and funeral celebrants without completing an additional course; and if not, if he will outline the required courses and qualifications necessary to fulfil this role, including any allowances for HSE employees to serve as celebrants while employed. [39314/24]
View answerAs this is an operational matter for the HSE, the HSE has been asked to respond directly to the Deputy.
238. Deputy Frankie Feighan asked the Minister for Health if he could re-examine the waiting times for a patient to be considered under the access to care scheme for urgent medical procedures, from the current 36 months’ wait to the previously used three to six months’ wait, especially for time critical procedures such as heart valve replacements; and if he will make a statement on the matter. [39318/24]
View answerIn 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.
239. Deputy Niamh Smyth asked the Minister for Health if a hospital appointment will be urgently expedited for a person (details supplied); and if he will make a statement on the matter. [39319/24]
View answerUnder 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.
240. Deputy Catherine Murphy asked the Minister for Health the amount expended by the HSE and the National Paediatric Hospital Development Board on external communications advice or training for its senior leadership team in 2022, 2023 and to date in 2024; the external companies engaged; and the topics or issues that the training or advices related to, in tabular form. [39327/24]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
241. Deputy Louise O'Reilly asked the Minister for Health if he will accept the recommendations of the National Radiation Therapist Review report; and if he will commit to full implementation of the recommendations on adequate staffing levels to safeguard vital cancer services into the future. [39328/24]
View answer251. Deputy Catherine Connolly asked the Minister for Health his views on a report (details supplied); if he will accept and implement the recommendations of the report; in particular, his plans to fully implement the recommendations on adequate staffing levels to safeguard vital cancer services into the future; and if he will make a statement on the matter. [39381/24]
View answerFirstly, I would like to acknowledge the incredibly important role of Radiation Therapists in the provision of cancer services in this country.
I welcome the review of the Radiation Therapist profession. This strategic review considered important issues such as organisation structure, career development in line with Health and Social Care Professional Frameworks, strategic workforce planning, and recruitment and retention strategies.
This review has published 16 recommendations which aim to help and support the Radiation Therapy profession into the future.
As the terms of reference for the review state, the implementation of any recommendations from the review will remain subject to the approval from the Departments of Health and Public Expenditure and Reform.
Since 2017, there has been additional investment in cancer services, including €81m on cancer prevention, screening, and treatment; €316m on cancer medicines; and €59m on cancer research grants through the Health Research Board. Seven years into the ten-year National Cancer Strategy, 40 of the 52 recommendations are implemented and the remainder are being progressed.
Capital funding of over €140m has been used to provide state of the art radiation oncology facilities in Galway and Cork, to update cancer infrastructure in chemotherapy wards and lab facilities for the benefit of patients, and as investment in the new National Cervical Screening Laboratory.
New development funding has enabled the recruitment of more than 670 staff to our national cancer services since 2017, including an additional 200 nursing staff, 100 consultants, and 180 health and social care professionals in designated cancer centres. This means that our national cancer services have been strengthened, that more patients are receiving treatment, and that waiting times to access treatment are reduced.
In Budget 2025 I have allocated funding for advanced practice posts for radiation therapists, which will help to advance one of the recommendations of the Review.
242. Deputy Richard Boyd Barrett asked the Minister for Health if a CT scanner has ever been considered or approved for installation in St. Michael’s Hospital, Dún Laoghaire; if so, the outcome; where the scanner is now; and if he will make a statement on the matter. [39330/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
243. Deputy Sean Sherlock asked the Minister for Health the name and location of each section 38 and section 39 organisation; the number of staff employed at that location and their grades; and the disparity between those staff and directly employed HSE staff at the same grade, in tabular form. [39332/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
244. Deputy Denise Mitchell asked the Minister for Health if the new national drugs strategy will definitively address alcohol in a comprehensive manner, or if a standalone national alcohol strategy is needed; and if he will make a statement on the matter. [39335/24]
View answer247. Deputy Róisín Shortall asked the Minister for Health if the new national drugs strategy will pay due attention to alcohol relative to its impact on Irish life, on the health service, on the criminal justice system, on education, on road safety and on workplace productivity; if he believes a standalone national alcohol strategy would be a better means of addressing these issues; and if he will make a statement on the matter. [39343/24]
View answerI propose to take Questions Nos. 244 and 247 together.
The national drugs strategy, Reducing Harm, Supporting Recovery, is a health-led response to drug and alcohol use, and it runs from 2017 to 2025. The Strategic action plan for 2023-2024, contains 34 actions across six strategic priorities. Three of the strategic priorities have a focus on alcohol use:
• strengthen the prevention of drug and alcohol use and the associated harms among children and young people,
• enhance access to and delivery of drug and alcohol services in the community and
• develop harm reduction responses and integrated care pathways for high risk drug users.
The Department intends to commission an independent evaluation of the strategy in Q4 2024. It is expected that the evaluation will be completed in early 2025.
The recommendations of the Citizens Assembly will be critical in shaping the future development of drugs policy. Policy will also be guided by a) the views of people with lived and living experience of drug use and b) international collaboration on evidence-based policies and practices on drugs
The proposed timeframe for the finalisation of the new national drugs strategy is the first quarter of 2025.
Information on the Department's alcohol policy is set out here .
I am fully aware of the harms of alcohol use and the overlap with other forms of drug use. It is my ambition that the next national drugs strategy will address the reasons why people use drugs and alcohol, reduce the harms associated with problematic drugs and alcohol use and support recovery from drug and alcohol addiction.
245. Deputy Christopher O'Sullivan asked the Minister for Health if he would consider extending RSV immunisation to babies who were due on or after 1 September 2024 but were born prematurely; and if he will make a statement on the matter. [39337/24]
View answerAs you are aware, an infant Respiratory Syncytial Virus (RSV) Immunisation Pathfinder Programme will run between September 2024 and February 2025.All newborn infants born during the programme will be offered immunisation against RSV after birth on site in Irish maternity hospitals. This immunisation will protect newborn infants when they are most vulnerable to the complications of RSV during the winter period when infection rates are at their highest.As well as protecting newborn infants, this programme will help maintain health service capacity during this coming winter season. The programme is based on NIAC advice and is a temporary programme put in place as an interim measure pending the outcome of a Health Technology Assessment on RSV immunisation currently being undertaken by the Health Information and Quality Authority (HIQA).A HTA is a multidisciplinary research process that collects and summarises information about a health technology. The information can cover a range of fields, including clinical effectiveness and safety, cost-effectiveness and budget impact, organisational and social aspects, and ethical and legal issues. The information is collected and presented in a systematic, unbiased and transparent manner.As well as protecting infants against serious illness, this pathfinder programme also offers the HSE an opportunity to establish working mechanisms and to evaluate the programme. It is a strategic initiative designed to explore innovative approaches to improving health outcomes within a community or population. Such programmes often serve as pilots or models that, if successful, can be scaled up and replicated in other settings.The outcome of the HTA, and learnings from the pathfinder programme once complete, will inform the development of any longer-term programme and future decision making on this matter.
246. Deputy Brendan Griffin asked the Minister for Health when a child in County Kerry will receive a date for an appointment (details supplied); and if he will make a statement on the matter. [39338/24]
View answerUnder 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.
248. Deputy John Lahart asked the Minister for Health the details of clinical trials that are taking place in Ireland; the rate of clinical trials that have taken place over the past four to five years; the collaboration between pharma or academics, north and south on the island; the joint work being done to promote clinical trials across the island on a cooperative basis; the obstacles there may be to such trials being undertaken given Ireland’s reputation as a strong pharma base; and if he will make a statement on the matter. [39345/24]
View answerThis response requires data input from the Health Products Regulatory Authority, we will follow up directly with the Deputy once the data tables have been collated and verified.
249. Deputy Verona Murphy asked the Minister for Health for an update on capital funding for the approved 97-bed ward extension at Wexford General Hospital; and if he will make a statement on the matter. [39348/24]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
250. Deputy Michael Healy-Rae asked the Minister for Health when pay for community pharmacies will be restored (details supplied); and if he will make a statement on the matter. [39376/24]
View answerI recognise the significant role community pharmacists play in the delivery of patient care and acknowledge the potential for this role to be developed further in the context of healthcare service reform.
There has been ongoing engagement between Department officials and the Irish Pharmacy Union in regard to the potential to extend the scope of practice of community pharmacists and the contract enablers needed to implement that.
My Department has been carrying out a comprehensive review of the pharmacy fee structure in the context of its engagement with the IPU and the intended expansion of the scope of pharmacy practice.
I believe that there is a real opportunity to work collaboratively with community pharmacists to make a significant difference to patient outcomes. Of course, any publicly funded pharmacy service expansion should address unmet public healthcare needs, improve access to existing public health services, and provide better value for money.
252. Deputy Catherine Connolly asked the Minister for Health the staffing deficit at the radiation oncology centre for radiation therapy treatment in Saolta Centre Galway; the reason only three of the four linear accelerators are operating at full capacity; the reason only one of two CT scanners are operating to full capacity; his plans to ensure that all machines are operating at full capacity; and if he will make a statement on the matter. [39382/24]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
