Martin Heydon
Ceist:116. Deputy Martin Heydon asked the Minister for Arts, Heritage and the Gaeltacht her views on an all-party national cultural policy; and if she will make a statement on the matter. [15300/16]
Amharc ar fhreagraCultural Policy
Ceisteanna (116)
Freagraí scríofa
Significant progress has been made in drafting the first National Cultural Policy - Culture 2025. This followed a major public consultation process in 2015, including a national cultural workshop held in October at the Royal Hospital Kilmainham. Work by my Department, the expert steering group and a wider expert committee continued on the document in early 2016 and is currently ongoing.
The Programme for a Partnership Government commits to the publication of Culture 2025 as a priority and I intend to submit the draft policy to Government for consideration in the coming weeks. As I have stated previously, this first such policy will be a living document and will form the basis of an ongoing dialogue with all who are interested in cultural policy. I look forward to consideration of Culture 2025 by the Oireachtas following its publication and would very much welcome the adoption of an all-party approach in this matter.
Self-Harm Prevention
Ceisteanna (117)
Bernard Durkan
Ceist:117. Deputy Bernard J. Durkan asked the Minister for Health the degree to which assistance remains available for children deemed to be at risk of self-harm; the support available to their families; and if he will make a statement on the matter. [15221/16]
Amharc ar fhreagraFreagraí scríofa
In 2014, the National Registry for Deliberate Self-Harm recorded 11,126 presentations to hospital due to self-harm, involving 8,708 individuals. The self-harm rate, 200 per 100,000 of the population, was essentially unchanged from 2013. This levelling off follows three successive decreases in the rate of persons presenting to hospital following self-harm from 2011 – 2013. The only significant change in the rate of hospital-treated self-harm by age was among boys aged 10-14 years, where the self-harm rate increased by 44% from 34 to 49 per 100,000. The upward trend in self-harm among young boys is concerning. In this regard, the HSE in its National Service Plan for 2016 has prioritised the development of early intervention and prevention services for children and young people. Funding is also being provided this year for the provision of new Jigsaw youth mental health services in Cork, Dublin and Limerick.
The HSE Mental Health Division has a multifaceted response to people at risk of self-harm and includes referral by GP to Community Mental Health Teams, liaison psychiatry services on-site in Model 3 and 4 and acute hospitals, a comprehensive mental health on-call service in Emergency Departments for people presenting in crisis during the on-call period, and self-harm clinical specialist nurses in a number of Emergency Departments. In addition, a HSE initiative enables GPs to refer directly to a Suicide Crisis Assessment Nurse for assessment and advice on management of their patients who present with suicidal ideation. In each of these settings, a comprehensive biopsychosocial assessment is carried out together with an assessment of mental state and a risk assessment for suicide. On the basis of this, a care plan is drawn up. Next steps depend on the psychosocial stresses identified along with the presence or absence of a mental illness such as depression.
Community Child and Adolescent Mental Health teams are the first line of specialist mental health services for children and young people. There are currently 67 such teams and 3 liaison services nationally. The multi-disciplinary team, under the clinical direction of a Consultant Child and Adolescent psychiatrist, includes junior medical staff, psychologists, social workers, nurses, speech & language therapist, occupational therapist and child care workers. The assessment and intervention provided by such teams is determined by the severity and complexity of the presenting problem(s). This range of disciplines and skills offer a care and treatment package geared to individual needs. The HSE’s National Office for Suicide Prevention supports a range of services for teenagers, young people and their families, including Pieta House, SpunOut.ie, ReachOut.com/Inspire Ireland and BeLongTo. They also fund the 24-hour call services provided by the Samaritans and 'Childline'. The National Office also works closely with the Department of Education and Skills in the application of the Guidelines for Mental Health Promotion and Well-Being in Primary and Post Primary Schools.
Mental Health Services
Ceisteanna (118)
Bernard Durkan
Ceist:118. Deputy Bernard J. Durkan asked the Minister for Health the extent to which child psychiatric services remain adequate to meet modern challenges; and if he will make a statement on the matter. [15225/16]
Amharc ar fhreagraFreagraí scríofa
The additional ring-fenced mental health funding of €160 million provided over 2012-16 inclusive, has contributed significantly to the implemention of A Vision for Change. Implementation of this policy takes place in the context of annual HSE Service Plans, in line with service priorities and resource availability. Funding for mental health in 2016 will increase from the 2015 outturn of €785m, to a projected budget of €826m in the 2016 National Service Plan, an increase of €41m or 5.2%, including €35m ring-fenced for new developments this year.
All aspects of Child and Adolescent Mental Health Services are being developed, A Vision For Change recommends 80 additional child and adolescent psychiatric inpatient beds nationally. The HSE Operational Plan for Mental Health 2016 indicates that there are 76 Child and Adolescent Mental Health Service beds in the system, of which 66 are operational at present. As recruitment issues are addressed, the potential exists to further increase bed capacity.
The HSE National Service Plan objective for this year aims for 78% or greater of accepted referrals to Child and Adolescent Community Mental Health Teams to be seen within three months. A priority target is to address the needs of those waiting over 12 months, while maintaining targets for first appointments and seeing individuals within three months. In addition, the Executive aims to improve the delivery of services in a more consistent and transparent manner, reflecting the identified clinical needs of the child. Additional resources and facilities mean that we now have 67 Child and Adolescent Mental Health Service Teams, and 3 Paediatric Liaison Teams, with further teams planned.
Other initiatives being progressed include the new Jigsaw mental health services in Cork, Dublin and Limerick; new early intervention counselling services for under 18s via Primary Care; improved 24/7 response and Liaison Services; improved Perinatal Mental Health, and two new mental health Clinical Programmes, specifically relating ADHD in Adults and Children, and Dual Diagnosis of those with Mental Illness and Substance Misuse.
In light of the Government's additional funding allocation for mental health in 2016, I am satisfied that the HSE is committed to further improving its child psychiatric services.
General Medical Services Scheme
Ceisteanna (119)
Noel Rock
Ceist:119. Deputy Noel Rock asked the Minister for Health the status of an application by a person (details supplied) under the general practitioner visiting card scheme. [15078/16]
Amharc ar fhreagraFreagraí scríofa
The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has recently issued to Oireachtas members.
If the Deputy has not received a reply from the HSE within 15 working days, please contact my Private Office who will follow up the matter with them.
Medical Card Eligibility
Ceisteanna (120)
Michael D'Arcy
Ceist:120. Deputy Michael D'Arcy asked the Minister for Health why antibody blood tests costs for systemic lupus erythematosus, Sjögren's syndrome and Wegener's disease are not covered under the medical card scheme (details supplied). [15080/16]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the HSE to respond directly to the Deputy on this issue. If you have not received a reply from the HSE within 15 working days, please contact my private office and they will follow up the matter with them.
Health Services Staff Remuneration
Ceisteanna (121)
Robert Troy
Ceist:121. Deputy Robert Troy asked the Minister for Health further to previous parliamentary questions, his views on unequal pay for health care assistants (details supplied). [15082/16]
Amharc ar fhreagraFreagraí scríofa
The Deputy is aware that the Haddington Road Agreement made provision for the introduction of an Intern Scheme for Health Support Staff. Under the Scheme 1,000 Intern places were provided for Health Care Assistants (HCA), Multi Task Attendants (MTA) and Support Grades. The grade of MTA is a generic grade that covers staff working as porters, in catering or as HCAs. Therefore a new grade of Intern MTA was introduced under the Public Service Agreements (PSA). These were 2 year contracts with a starting salary of 85% of the normal starting salary in Year 1 and 90% in Year 2. This Intern grade was considered to be outside of the normal employment level restrictions. When discussion took place once again on this grade under the Lansdowne Road Agreement, it was agreed to provide that where Interns had completed 18 months of satisfactory service, they would be regularised into permanent positions.
Separately and outside of the PSA process, the National Recruitment Service for the HSE in Manorhamilton resumed the process of filling a number of vacancies on a permanent basis from panels that had been in place for some time. It is possible that given the timeframes involved in the Intern scheme that there could be interns who have not yet completed their 18 months satisfactory service working alongside new recruits to these support grades recently employed by the HSE. I am advised that this situation is unusual and the issues involved are being examined by the HSE.
Hospitals Building Programme
Ceisteanna (122)
Mary Lou McDonald
Ceist:122. Deputy Mary Lou McDonald asked the Minister for Health the evaluation that formed the basis for selecting the Connolly Hospital site for the replacement of the Rotunda Hospital in County Dublin. [15087/16]
Amharc ar fhreagraFreagraí scríofa
In determining the host hospital for the proposed new Rotunda Hospital, my Department carried out a review which considered clinical criteria, hospital site capacity and existing maternity attendance patterns. The process was also informed by inputs from the HSE National Clinical Programme in Obstetrics and Gynaecology, HSE Intelligence, HSE Estates and the hospital itself, as well as by Government policy on Hospital Groups. An overview of the review process and findings is available on the Department's website at http://health.gov.ie/wp-content/uploads/2015/11/Re-location-of-the-Coombe-and-Rotunda-Hospitals1.pdf.
Departmental Properties
Ceisteanna (123)
Mary Lou McDonald
Ceist:123. Deputy Mary Lou McDonald asked the Minister for Health if he has established a plan for the Rotunda building in Dublin 1, once the services have been transferred to the new site; and if he will make a statement on the matter. [15088/16]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
Medical Products
Ceisteanna (124, 162)
Tony McLoughlin
Ceist:124. Deputy Tony McLoughlin asked the Minister for Health when he will begin new negotiations with the manufacturer to provide the Orkambi drug to cystic fibrosis sufferers; and if he will make a statement on the matter. [15090/16]
Amharc ar fhreagra
Darragh O'Brien
Ceist:162. Deputy Darragh O'Brien asked the Minister for Health if he will enter into further negotiations with a company (details supplied) in relation to the drug Orkambi, if he will call on the company to significantly reduce the price of Orkambi as part of these negotiations; and if he will make a statement on the matter. [15154/16]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 124 and 162 together.
The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. Prior to deciding whether to reimburse a medicine, the HSE considers a range of statutory criteria, including clinical need, cost-effectiveness and the resources available.
The decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds by the HSE, on the advice of the National Centre for Pharmacoeconomics (NCPE). The NCPE conducts health technology assessments (HTAs) of pharmaceutical products for the HSE, and can make recommendations on reimbursement to assist the HSE in its decision-making process. The NCPE used a decision framework to systematically assess whether the drug is cost-effective as a health intervention
I am informed that, following a request from the HSE, the NCPE carried out an assessment of the manufacturer's economic dossier submitted in March 2016 on the cost effectiveness of lumacaftor/ivacaftor (Orkambi). This dossier included details on all relevant costs and relevant cost offsets including hospitalisation, disease management costs, intravenous antibiotics, adverse events and any additional costs arising in patients not taking Orkambi.
The NCPE has completed its HTA and submitted it to the HSE. The NCPE determined, following an evaluation of the economic dossier, that the manufacturer failed to demonstrate cost-effectiveness or value for money from using the drug. The NCPE have confirmed that all relevant costs were included in the analysis.
A summary of the HTA has been published on the NCPE website and is available at: www.ncpe.ie/wp-content/uploads/2015/12/Website-summary-orkambi.pdf.
The HSE will now enter into negotiations with the manufacturer, to seek very significant price reductions. The HSE will then consider the outcome of these negotiations, together with the NCPE recommendation, in making a final decision on reimbursement.
Hospital Equipment
Ceisteanna (125)
Tony McLoughlin
Ceist:125. Deputy Tony McLoughlin asked the Minister for Health when the Health Service Executive or the hospital group will sanction a fixed cardiac catheterisation laboratory for the north west region; and if he will make a statement on the matter. [15091/16]
Amharc ar fhreagraFreagraí scríofa
An important new cross-Border cardiology service which gives Co. Donegal patients suffering from a STEMI heart attack direct access to services in Altnagelvin Hospital in Derry began on 4 May 2016.
Up to 60 patients suffering from a STEMI heart attack will be treated in Altnagelvin every year. Previously, patients from the region had to be transported to University Hospital Galway so this represents a significant improvement for patients in terms of treatment time and also distance.
Patients within 90 minutes’ travelling distance of Altnagelvin Hospital will now have access to 24/7 primary Percutaneous Coronary Intervention (pPCI) at the Hospital, meaning that STEMI heart attack patients will have rapid access to high quality services on their doorstep.
In a further development, the Saolta Group has appointed a Consultant Interventional Cardiologist at Letterkenny University Hospital, who will help to deliver the pPCI service from Altnagelvin.
Patients will be repatriated to Letterkenny University Hospital or Sligo University Hospital post-procedure for recovery.
In relation to the specific question raised, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.