Written Answers Nos. 1228-1249
1228. Deputy Ken O'Flynn asked the Minister for Health if the HSE records cases in which a patient’s clinical condition significantly deteriorated while a reimbursement application remained under assessment. [39073/26]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for decisions on the pricing and reimbursement of medicines and medical devices; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
1229. Deputy Ken O'Flynn asked the Minister for Health if the HSE has conducted an international benchmarking on timelines for reimbursement decisions relating to orphan medicines and rare neurological conditions. [39074/26]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for decisions on the pricing and reimbursement of medicines and medical devices; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
1231. Deputy Ken O'Flynn asked the Minister for Health to provide, for each of the past five years, the total expenditure by the HSE and Section 38 voluntary hospitals on temporary agency and locum staffing, broken down by supplier name, staff category, Health Region, hospital, community healthcare organisation, and service site. [39097/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1232. Deputy Ken O'Flynn asked the Minister for Health to provide, for each HSE hospital, approved mental health centre, CAMHS service, and community healthcare service, the total whole-time equivalent staffing complement, the number represented by agency or locum staff, and the percentage agency dependency, broken down by staff category, Health Region, and year. [39098/26]
View answerAs this is a service matter, I have asked the HSE to respond to the Deputy directly, as soon as possible.
1233. Deputy Ken O'Flynn asked the Minister for Health whether the HSE maintains a centralised national system for recording complaints, safeguarding concerns, removals from placement, “do not return” notifications, credentialing concerns, disciplinary concerns, or repeated performance issues relating to agency or locum healthcare workers across HSE-funded services. [39099/26]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy
1234. Deputy Ken O'Flynn asked the Minister for Health whether an agency or locum healthcare worker removed from one HSE-funded site due to performance, conduct, safeguarding, or patient safety concerns can subsequently be redeployed elsewhere within the HSE system without a central restriction mechanism. [39100/26]
View answerAs this is a service matter we have asked the HSE to respond directly to the Deputy on this matter
1235. Deputy Ken O'Flynn asked the Minister for Health how staffing agencies supplying workers to HSE-funded services are performance monitored nationally, including whether complaints, patient safety incidents, missed shifts, cancelled placements, credentialing failures, Garda vetting issues, contract breaches, or supplier sanctions are centrally tracked and performance scored. [39101/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1236. Deputy Ken O'Flynn asked the Minister for Health whether the HSE maintains a national supplier performance framework for healthcare staffing agencies and whether any suppliers have, within the past five years, been suspended, sanctioned, financially penalised, removed from frameworks, or subject to corrective action requirements. [39102/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1237. Deputy Ken O'Flynn asked the Minister for Health to provide, for each of the past five years, the total expenditure on agency and locum staffing within public mental health services, broken down by approved mental health centre, CAMHS, community mental health team, staff category, and Health Region. [39103/26]
View answerAs this is a service matter, I have asked the HSE to respond to the Deputy directly, as soon as possible.
1238. Deputy Ken O'Flynn asked the Minister for Health whether continuity of clinician care within public mental health services is measured as a service quality or patient safety indicator and, if not, whether the absence of such measurement has been identified as a governance or clinical risk. [39104/26]
View answerAs this is a service matter, I have asked the HSE to respond to the Deputy directly, as soon as possible.
1239. Deputy Ken O'Flynn asked the Minister for Health the number of unfilled permanent consultant psychiatry posts currently vacant within the public health system, broken down by specialty, service type, and Health Region. [39105/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1240. Deputy Ken O'Flynn asked the Minister for Health whether the Department or HSE has carried out any assessment of the relationship between consultant psychiatry vacancies, agency dependency, clinician turnover, and continuity of patient care within public mental health services. [39106/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1241. Deputy Malcolm Byrne asked the Minister for Health the progress on the public-only consultant contract; the number of consultants now signed to the system; and if she will make a statement on the matter. [39125/26]
View answerI have asked the HSE to respond directly to the Deputy on this matter
1242. Deputy Ken O'Flynn asked the Minister for Health whether any expenditure threshold exists within the treatment abroad scheme above which additional managerial, financial, legal or executive approval is required prior to authorisation of treatment abroad. [39141/26]
View answer1243. Deputy Ken O'Flynn asked the Minister for Health whether the treatment abroad scheme operates any formal distinction between clinical eligibility approval and financial expenditure approval; and if so, to provide details of the separate approval pathway. [39136/26]
View answer1244. Deputy Ken O'Flynn asked the Minister for Health the grade, title or officeholder responsible for final authorisation of individual treatment abroad scheme applications involving projected expenditure above €100,000. [39137/26]
View answer1245. Deputy Ken O'Flynn asked the Minister for Health whether any internal audit, value-for-money review or external governance review of high-cost treatment abroad scheme approvals has been conducted since 2020; and if so, to provide details and findings. [39138/26]
View answer1246. Deputy Ken O'Flynn asked the Minister for Health whether the HSE maintains a register of the highest-cost treatments approved annually under the treatment abroad scheme and the aggregate annual expenditure associated with such approvals. [39139/26]
View answer1247. Deputy Ken O'Flynn asked the Minister for Health whether her Department receives routine reporting on high-cost approvals under the treatment abroad scheme, including cumulative expenditure, approval volumes and exceptional-case expenditure. [39140/26]
View answer1248. Deputy Ken O'Flynn asked the Minister for Health whether the 2022 Comptroller and Auditor General audit referenced in relation to the treatment abroad scheme constituted a full scheme audit or a sample-based review; and if she will provide the scope, methodology and findings of same. [39135/26]
View answer1250. Deputy Ken O'Flynn asked the Minister for Health whether the treatment abroad scheme appears on any HSE or Departmental corporate risk register, strategic risk register, or internal assurance framework; and if so, the risks identified. [39143/26]
View answer1251. Deputy Ken O'Flynn asked the Minister for Health whether the treatment abroad scheme operates any formal benchmarking process comparing the cost of equivalent procedures across jurisdictions prior to authorisation approval. [39144/26]
View answer1253. Deputy Ken O'Flynn asked the Minister for Health whether any fraud-prevention, duplicate-payment detection, or abnormal expenditure-monitoring system is operated in respect of the treatment abroad scheme. [39146/26]
View answer1254. Deputy Ken O'Flynn asked the Minister for Health whether any internal threshold, trigger mechanism or anomaly detection system exists within the treatment abroad scheme to identify unusually high-cost invoices received from healthcare providers in other EU/EEA states. [39149/26]
View answer1255. Deputy Ken O'Flynn asked the Minister for Health whether the HSE has ever formally disputed, queried, challenged or sought clarification regarding the cost of treatment invoiced under the treatment abroad scheme by another EU/EEA healthcare system; and if she will provide the number of such cases since 2020. [39150/26]
View answer1256. Deputy Ken O'Flynn asked the Minister for Health whether the HSE maintains any comparative database or benchmarking framework examining the average cost of equivalent procedures between different EU/EEA healthcare systems under the treatment abroad scheme. [39151/26]
View answer1257. Deputy Ken O'Flynn asked the Minister for Health whether any value-for-money analysis has been conducted comparing expenditure under the treatment abroad scheme against the cost of developing equivalent treatment capacity domestically. [39153/26]
View answer1259. Deputy Ken O'Flynn asked the Minister for Health whether the treatment abroad scheme operates under any internal delegated financial authority limits; and if she will provide the approval thresholds applying at local, national and departmental level. [39155/26]
View answer1260. Deputy Ken O'Flynn asked the Minister for Health the number of treatment abroad scheme cases since 2020 where the total expenditure exceeded €100,000, €250,000, €500,000 and €1 million respectively. [39156/26]
View answer1261. Deputy Ken O'Flynn asked the Minister for Health whether her Health receives routine reporting regarding exceptionally high-cost treatment abroad scheme cases; and if so, the format and frequency of such reporting. [39157/26]
View answer1262. Deputy Ken O'Flynn asked the Minister for Health whether any value-for-money assessment, benchmarking exercise or cost comparison is undertaken before approval of high-cost treatment abroad scheme referrals. [39158/26]
View answer1263. Deputy Ken O'Flynn asked the Minister for Health whether any internal risk assessment has been carried out regarding financial exposure under the treatment abroad scheme arising from the absence of expenditure thresholds or cost ceilings. [39159/26]
View answer1265. Deputy Ken O'Flynn asked the Minister for Health whether the HSE maintains formal written financial approval thresholds for expenditure under the treatment abroad scheme; and if she will provide the monetary values applicable at each approval level. [39161/26]
View answer1266. Deputy Ken O'Flynn asked the Minister for Health whether any treatment abroad scheme applications since 2020 required escalation beyond the Treatment Abroad Office in Kilkenny for approval; and if she will provide the number of such cases by year. [39162/26]
View answer1267. Deputy Ken O'Flynn asked the Minister for Health whether the HSE maintains a formal escalation framework for exceptionally high-cost, novel, clinically complex or non-routine treatment abroad scheme referrals. [39163/26]
View answer1268. Deputy Ken O'Flynn asked the Minister for Health whether any treatment abroad scheme approvals since 2020 required review or sign-off by senior HSE management above Grade VIII level; and if she will provide details by year and grade level involved. [39164/26]
View answer1269. Deputy Ken O'Flynn asked the Minister for Health whether the Department of Health receives routine reporting relating to high-cost treatment abroad scheme approvals, aggregate expenditure trends or exceptional financial exposures arising under the scheme. [39165/26]
View answer1270. Deputy Ken O'Flynn asked the Minister for Health whether any Ministerial approval, notification or Departmental sanction process exists for treatment abroad scheme cases exceeding specified expenditure thresholds. [39166/26]
View answer1271. Deputy Ken O'Flynn asked the Minister for Health the highest individual expenditure amount approved under the treatment abroad scheme in each year since 2020. [39167/26]
View answer1272. Deputy Ken O'Flynn asked the Minister for Health whether internal audit has examined the governance, approval controls or financial oversight arrangements of the treatment abroad scheme since 2020; and if she will provide the dates and titles of any such audits. [39168/26]
View answer1273. Deputy Ken O'Flynn asked the Minister for Health whether any external value-for-money review, governance review or expenditure-control assessment of the treatment abroad scheme has been conducted since 2020. [39169/26]
View answer1275. Deputy Ken O'Flynn asked the Minister for Health whether the HSE maintains written procedures governing approval authority for treatment abroad scheme applications by staff grade or management level. [39171/26]
View answer1276. Deputy Ken O'Flynn asked the Minister for Health whether all treatment abroad scheme approvals are processed solely within the National Treatment Abroad Office in Kilkenny; and if not, the circumstances under which applications are referred elsewhere within the HSE. [39172/26]
View answer1277. Deputy Ken O'Flynn asked the Minister for Health whether the HSE applies different governance or oversight procedures to Treatment Abroad Scheme applications involving experimental, highly specialised or unusually costly procedures. [39173/26]
View answer1280. Deputy Ken O'Flynn asked the Minister for Health whether any dedicated value-for-money review has been conducted in relation to the treatment abroad scheme since 2020; and if so, to provide details of the review, its conclusions and any resulting policy changes. [39182/26]
View answer1281. Deputy Ken O'Flynn asked the Minister for Health whether the Department of Health maintains a formal risk register relating to the treatment abroad scheme; and if so, the categories of risk monitored including financial, clinical, governance and patient safety risks. [39183/26]
View answer1282. Deputy Ken O'Flynn asked the Minister for Health whether any external clinical governance framework exists for treatments funded under the treatment abroad scheme; and if not, whether consideration is being given to establishing such a framework. [39184/26]
View answer1284. Deputy Ken O'Flynn asked the Minister for Health whether the Department has examined the establishment of an independent oversight or inspection mechanism for the treatment abroad scheme, comparable to governance arrangements applying in other areas of publicly funded healthcare expenditure. [39186/26]
View answer1286. Deputy Ken O'Flynn asked the Minister for Health the total annual expenditure under the treatment abroad scheme for each year from 2020 to 2026, inclusive, and the proportion of that expenditure subject to formal audit review. [39188/26]
View answer1287. Deputy Ken O'Flynn asked the Minister for Health whether the HSE conducts any comparative benchmarking of treatment costs between different EU or EEA jurisdictions under the treatment abroad scheme; and if she will provide details of the methodology used. [39189/26]
View answer1289. Deputy Ken O'Flynn asked the Minister for Health whether any central register exists recording the total annual cost per treatment category funded under the treatment abroad scheme. [39191/26]
View answer1291. Deputy Ken O'Flynn asked the Minister for Health whether the Department of Health has carried out any review assessing whether certain procedures regularly funded abroad under the treatment abroad scheme could be developed domestically within the public health system. [39193/26]
View answer1292. Deputy Ken O'Flynn asked the Minister for Health whether any maximum financial approval thresholds apply under the treatment abroad scheme before additional senior management or Departmental approval is required. [39194/26]
View answer1295. Deputy Ken O'Flynn asked the Minister for Health whether the treatment abroad scheme is currently subject to any formal risk assessment relating to expenditure growth, cost escalation, or dependency on overseas treatment provision. [39197/26]
View answer1296. Deputy Ken O'Flynn asked the Minister for Health whether any external consultancy, economic review, or health technology assessment has been commissioned in relation to expenditure under the treatment abroad scheme since 2020. [39198/26]
View answer1299. Deputy Ken O'Flynn asked the Minister for Health whether any structured patient follow-up programme exists for persons returning to Ireland following procedures funded under the treatment abroad scheme. [39201/26]
View answer1301. Deputy Ken O'Flynn asked the Minister for Health whether any value-for-money framework exists comparing the clinical outcomes and costs associated with overseas procedures funded under the treatment abroad scheme against equivalent treatment pathways domestically. [39203/26]
View answer1302. Deputy Ken O'Flynn asked the Minister for Health whether the HSE maintains any provider-level performance monitoring system in respect of overseas hospitals or clinics receiving treatment abroad scheme referrals. [39204/26]
View answer1303. Deputy Ken O'Flynn asked the Minister for Health whether any formal patient safety governance framework exists specifically governing procedures funded under the treatment abroad scheme. [39205/26]
View answer1306. Deputy Ken O'Flynn asked the Minister for Health whether the absence of structured clinical outcome monitoring under the treatment abroad scheme has been identified on any Departmental or HSE risk register. [39208/26]
View answer1307. Deputy Ken O'Flynn asked the Minister for Health whether the HSE maintains a category-specific expenditure breakdown for procedures funded under the treatment abroad scheme; and if so, whether gender affirmation surgeries are separately identifiable within those records. [39210/26]
View answer1308. Deputy Ken O'Flynn asked the Minister for Health whether any value-for-money assessment has been conducted regarding overseas gender affirmation surgeries funded under the treatment abroad scheme since 2020. [39211/26]
View answer1309. Deputy Ken O'Flynn asked the Minister for Health whether any risk assessment, governance review or assurance process has been undertaken specifically relating to overseas gender affirmation surgery approvals under the treatment abroad scheme. [39212/26]
View answer1313. Deputy Ken O'Flynn asked the Minister for Health whether the HSE records the total annual number of gender affirmation surgery applications approved under the treatment abroad scheme since 2020, by year. [39216/26]
View answer1336. Deputy Ken O'Flynn asked the Minister for Health whether the treatment abroad scheme maintains any dataset identifying the highest-cost individual referrals funded annually; and if she will provide the ten highest annual individual treatment costs since 2020 in anonymised form. [39341/26]
View answer1337. Deputy Ken O'Flynn asked the Minister for Health whether the HSE maintains a central register of high-cost treatment abroad scheme approvals; and if so, the criteria used to classify cases as high-cost. [39345/26]
View answer1409. Deputy Ken O'Flynn asked the Minister for Health whether any national policy exists setting minimum audit, outcome-monitoring or data-governance requirements before new healthcare pathways, treatment programmes or overseas referral arrangements are operationally supported by the State. [39758/26]
View answer1416. Deputy Ken O'Flynn asked the Minister for Health whether any Departmental or HSE official holds specific national responsibility for governance oversight of minors referred abroad under the Treatment Abroad Scheme; and if she will provide details. [39775/26]
View answer1422. Deputy Ken O'Flynn asked the Minister for Health whether any national framework exists governing audit, quality assurance and value-for-money assessment of overseas referrals funded through the Treatment Abroad Scheme. [39781/26]
View answerI propose to take Questions Nos. 1242 to 1248, inclusive, 1250, 1251, 1253 to 1257, inclusive, 1259 to 1263, inclusive, 1265 to 1273, inclusive, 1275, 1276, 1277, 1280, 1281, 1282, 1284, 1286, 1287, 1289, 1291, 1292, 1295, 1296, 1299, 1301, 1302, 1303, 1306 to 1309, inclusive, 1313, 1336, 1337, 1409, 1416 and 1422 together.
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1249. Deputy Ken O'Flynn asked the Minister for Health whether any internal audit reports, governance reviews, expenditure-control assessments, or value-for-money evaluations relating to the treatment abroad scheme have been conducted by the HSE, Department of Health, Internal Audit, National Financial Regulations Office, or any external body since 2020; and if she will provide details of same. [39142/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
