Written Answers Nos. 336-353
336. Deputy John Lahart asked the Minister for Health if he will consider developing a national strategy for those suffering from colitis and Crohn's disease, with particular focus on equitable access to inflammatory bowel disease nurses, self care and patient empowerment and sustainable funding models; and if he will make a statement on the matter. [38549/16]
Amharc ar fhreagraCrohn's Disease is an Inflammatory Bowel Disease that can affect any part of the gastrointestinal system. The diagnosis of Crohn's Disease often requires a range of tests including endoscopy, radiology and blood tests relating to anaemia and inflammation. Management of the condition may require antibiotics and medication to reduce inflammation.
The diagnosis and management of Crohn's Disease takes place in an acute hospital setting with follow up in primary care as appropriate. These services are available in hospitals and primary care settings.
While the development of plans for a specific programme for Crohn's Diseases is not envisaged, the Health Service Executive is leading a large scale work-programme to develop a system of integrated care within Ireland’s health and social care services. The Integrated Care Programmes, which includes a programme for the Prevention and Management of Chronic Disease, place clinical leadership at the centre of these reform measures in order to improve patient experiences and outcomes and to overcome the current fragmentation in the way health and social care is currently delivered.
337. Deputy Peter Burke asked the Minister for Health further to Parliamentary Question No. 218 of 17 November 2016, when he will make a decision regarding a new acquired brain injury unit in County Longford (details supplied); and if he will make a statement on the matter. [38551/16]
Amharc ar fhreagraThe Programme for Partnership Government includes a commitment to publish "a plan for advancing neuro-rehabilitation services in the community". A National Steering Group, chaired by the Head of the Health Service Executive's (HSE's) Disability Reform Team, has completed an implementation framework in respect of the recommendations from the National Policy and Strategy for the Provision of Neuro-rehabilitation Services in Ireland 2011 - 2015. The Group is currently considering feedback on the framework, which was circulated to wider stakeholder interest groups. The HSE intends to finalise and progress implementation of the framework for the Neuro-rehabilitation Strategy in 2017.
Under the Health Act 2004, the HSE is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. I understand that the HSE will consider proposals for specialised residential services for people with acquired brain injury, such as that referred to by the Deputy, in the broader context of the finalisation of the implementation framework and available resources.
338. Deputy Niamh Smyth asked the Minister for Health if a site has been chosen for the primary care centre in Carrickmacross; if so, the timeline for works commencing; and if he will make a statement on the matter. [38553/16]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
339. Deputy Bobby Aylward asked the Minister for Health further to Parliamentary Question No. 432 of 18 October 2016, if he will provide a further update as to when the national steering group established by him to develop policy on a major trauma system for Ireland will publish its first report; the status of the group's recommendations in respect of St. Luke's Hospital, County Kilkenny; and if he will make a statement on the matter. [38556/16]
Amharc ar fhreagraAs I have previously informed the Deputy, the development of the trauma policy is a joint initiative from the Department of Health and the HSE, in recognition that we do not have a co-ordinated trauma network structure in Ireland. The focus for the development of a policy direction in relation to the strategic organisation of Ireland’s trauma service is to ensure that patients have access to the specific safe, high quality trauma services they need. The primary aim will be to improve patient outcomes and lead to a reduction in preventable death and disability.
The development of the policy is still work in progress and the group has not yet made any recommendations. It is expected the Group's report will be completed in early 2017.
340. Deputy Marc MacSharry asked the Minister for Health if there is significant under reporting of HPV vaccine adverse reactions to the Health Products Regulatory Authority, HPRA; his plans to provide an advertising campaign to draw the attention of families that may be suffering in silence to contact the HPRA (details supplied); and if he will make a statement on the matter. [38558/16]
Amharc ar fhreagra341. Deputy Marc MacSharry asked the Minister for Health if there is significant under reporting of HPV vaccine adverse reactions to the Health Products Regulatory Authority, HPRA, by doctors and consultants failing to report suspicions of side effects even when parents had pointed out the connection; his plans to investigate the stage at which the medical profession consider reporting the conditions of the girls as listed on the HPRA website; and if he will make a statement on the matter. [38559/16]
Amharc ar fhreagra342. Deputy Marc MacSharry asked the Minister for Health his views on the safety of the Gardasil HPV vaccine (details supplied); his plans to follow the Danish model or if the HSE will deal with the issue; and if he will make a statement on the matter. [38560/16]
Amharc ar fhreagraI propose to take Questions Nos. 340 to 342, inclusive, together.
The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). NIAC is a committee of the Royal College of Physicians of Ireland comprising of experts in a number of specialties including infectious diseases, paediatrics and public health. The committee's recommendations are informed by public health advice and international best practice.
Each year in Ireland around 300 women are diagnosed with cervical cancer. The HPV vaccine protects against two high risk types of HPV (16 & 18) that cause 73% of all cervical cancers. Vaccinated women and girls will still be at risk from other high risk types of HPV that can cause cervical cancer and will therefore need to continue to have regular cervical smear tests. NIAC recommended that the human papillomavirus (HPV) vaccine be given to all girls aged 12-13 in 2009 and in September 2010 the HPV vaccination programme was introduced for all girls in first year of second level schools.
Gardasil is the HPV vaccine used in Ireland in the context of the HSE schools immunisation programme. By January 2016, over 200 million doses of Gardasil had been distributed worldwide. In Ireland over 620,000 doses of Gardasil have been administered and over 220,000 girls have been fully vaccinated against HPV since it was introduced in 2010.
The European Medicines Agency (EMA) is a decentralised agency of the European Union responsible for the scientific evaluation, supervision and safety monitoring of medicines developed by pharmaceutical companies for use in the EU. It would not be appropriate to comment on data submitted by manufacturers of a medicinal product to the EMA as part of their market authorisation processes or monitoring of its safety following authorisation for use.
No medicine, including vaccines, is entirely without risk, there is therefore on-going pharmacovigilance and monitoring of medicinal products once they are authorised for use. The safety profile of Gardasil has been continuously monitored since it was first authorised both nationally and at EU level. In Ireland, the Health Products Regulatory Authority (HPRA) is the statutory regulatory authority for medicines in Ireland. The HPRA and the European Medicines Agency (EMA) in Europe continually monitor adverse events to vaccination.
As part of its monitoring of the safety of medicines, the HPRA operates an adverse reaction reporting system, with healthcare professionals and patients encouraged to report adverse reactions they consider may be associated with their treatment, through the range of options in place for reporting. All reports received are evaluated and considered in the context of the safety profile of the product concerned, with reports followed up as necessary for further information, that may assist in the assessment of the case.
In addition, pharmaceutical companies are obliged, as a condition of the authorisation to market a medicine, to submit reports of adverse reactions received directly, to the HPRA. At EU level, regulators continuously monitor this cumulative reporting experience as part of the ongoing assessment of the safety of HPV vaccines. In accordance with its reporting obligations, the HPRA provides anonymised details of reports received to the EMA, the WHO and to the relevant pharmaceutical companies.
The fact that a suspected adverse reaction has been reported does not necessarily mean that the vaccine has caused the observed effect, this may also been caused by a new disease the patient developed. Further data are usually needed to complete the picture. In the context of monitoring the safety of vaccines, new information on a possible risk is called a signal. Signals may arise from various data sources, including spontaneous reports, clinical trials and epidemiological studies. Once a signal has been identified, investigations are undertaken to consider the likelihood that a medicine may have caused or contributed to the effect, try to identify risk factors and estimate the frequency of occurrence. Following the assessment, a decision on the most appropriate regulatory action is taken by the competent authorities. The regulatory action is communicated to healthcare professionals, patients and the general public through established channels, and timelines reflect the degree of urgency.
The EMA completed its detailed scientific review in November 2015 of the evidence surrounding reports of two conditions. In line with its initial recommendations, the EMA confirms that the evidence does not support a causal link between the HPV vaccine sand development of the two conditions studied. Therefore there is no reason to change the way the vaccines are used or to amend the current product information. The Agency’s Committee for Medicinal Products for Human Use concurred that the available evidence and did not recommend any changes to the terms of licensing or the product information for these medicines. On 12 January 2016 the European Commission endorsed the conclusions of the EMA, that there is no change to the way HPV vaccines are used, or to amend the current product information. This final outcome by the Commission is now binding in all members states.
The review recognised that, at that time, more than 80 million girls and women worldwide have now received these vaccines, and in some European countries they have been given to 90% of the age group recommended for vaccination. Use of these vaccines is expected to prevent many cases of cervical cancer (cancer of the neck of the womb, which is responsible for over 20,000 deaths in Europe each year) and various other cancers and conditions caused by HPV.
I am aware of claims of an association between HPV vaccination and a number of conditions experienced by a group of young women. An illness that occurs around the time a vaccine is given and is already known to be common in adolescence does not imply the vaccine caused the problem. As there is no scientific evidence that the vaccine causes long term illnesses, the HPV vaccine cannot be held responsible for these illnesses. It appears that some girls first suffered symptoms around the time they received the HPV vaccine, and understandably some parents have connected the vaccine to their daughter’s condition. It is important to reassure people that anyone who is suffering ill health is eligible to seek medical attention, and to access appropriate health and social care services, irrespective of the cause of their symptoms. The individual nature of the needs of some children may require access to specialist services. The HSE are currently working to put in place a clinical care pathway appropriate to the medical needs of this group.
I am aware of media reports that the authorities in Demark and Japan have taken some measures concerning HPV immunisation in their countries. However, it would be inappropriate for me to comment on the arrangements put in place by the health authorities these countries.
The benefits of HPV vaccines outweigh the known side effects. The safety of these vaccines, as with all medicines, will continue to be carefully monitored and will take into account any future new evidence of side effects that becomes available. I encourage the parents of all eligible girls to ensure that their daughters receive this important cancer preventing vaccine.
343. Deputy Charlie McConalogue asked the Minister for Health further to Parliamentary Questions Nos. 614 of 15 November 2016 and 536 of 29 November 2016, if the capital programme for nursing home facilities 2016 to 2021 is an issue of responsibility for the Government and him rather than a service matter for the HSE; if that is the case, if the funding for a new community hospital in Letterkenny is to provide additional bed capacity or to replace existing bed capacity in the county; and if he will make a statement on the matter. [38577/16]
Amharc ar fhreagraThe Government’s “Building on Recovery: Infrastructure and Capital Investment Plan 2016-2021” which was published on 30 September 2015 included an investment programme in health infrastructure. Based on this, the HSE prepared its Capital Plan and on 26 January 2016 details of the programme of investment in public nursing home facilities were announced.
The programme includes the replacement of 33 existing facilities and refurbishment/extension of 57 others. This programme of investment will deliver 215 additional beds in centres being built or refurbished in locations identified as having particular capacity issues. Under the Programme it is proposed to deliver a 130 bed replacement CNU at Letterkenny by end 2021 through a PPP or alternative funding mechanism. Operational responsibility for delivering the programme is a matter for the HSE.
344. Deputy Michael Ring asked the Minister for Health further to Parliamentary Question No. 1386 of 16 September 2016, the reason no reply has issued. [38600/16]
Amharc ar fhreagraI understand that the HSE has recently issued a reply to the Deputy.
345. Deputy Louise O'Reilly asked the Minister for Health the private hospitals and health providers that are under contract with the National Treatment Purchase Fund, his Department and the HSE with respect to the provision of services and surgeries that are not being met publicly or where there are extensive waiting lists; and if he will make a statement on the matter. [38601/16]
Amharc ar fhreagra348. Deputy Louise O'Reilly asked the Minister for Health the type of contracts that exist between his Department, the HSE, the National Treatment Purchase Fund and private hospitals in relation to treatments commissioned by the private sector; if contracts are awarded en bloc either in terms of funding allocated, speciality and so on or on a case by case basis; and if he will make a statement on the matter. [38605/16]
Amharc ar fhreagraI propose to take Questions Nos. 345 and 348 together.
The NTPF was established on a statutory basis in 2004 and previously arranged for the provision of hospital treatment to classes of persons determined by the Minister. Since 2011 this function has been suspended.
Budget 2017 provides for the treatment of our longest waiting patients. €20m is being allocated to the NTPF, rising to €55m in 2018.
On foot of this allocation the NTPF recently issued a Prior Information Notice stating that commissioning will recommence and they will be engaging with suppliers through competitive dialogue on the required optimum approach for future outsourcing of public patients. Controls to ensure quality patient treatment, value for money and efficient processes will be determined by this process. No formal contracts have been signed to date.
The NTPF launched the 2016 Endoscopy Initiative in June which includes outsourcing from a list of approved private providers. These are Clane General Hospital, Galway Clinic, Aut Even Hospital, Bon Secours Hospital, Beacon Hospital, Hermitage Medical Clinic, Whitfield Clinic, St. Vincent's Private Clinic, Blackrock Clinic and St. Francis Private Hospital.
In relation to contracts entered into by the HSE, as this is a service matter I have asked the HSE to respond to you directly.
346. Deputy Louise O'Reilly asked the Minister for Health the number of treatments commissioned from the private sector by the National Treatment Purchase Fund in each year since its inception in tabular form; the number of treatments commissioned from the private sector by his Department or the HSE in each of the past ten years if applicable; and if he will make a statement on the matter. [38603/16]
Amharc ar fhreagraTreatments have been commissioned from the private sector by both the National Treatment Purchase Fund (NTPF) and the HSE in targeted initiatives to reduce waiting list numbers.
The NTPF was established on a statutory basis in 2004 and previously arranged for the provision of hospital treatment to classes of persons determined by the Minister. Since 2011 this function has been suspended.
I include with the official report a tabular statement setting out details of the annual budget of the NTPF and the number of patients treated per annum since its inception.
Budget 2017 provides for the treatment of our longest-waiting patients. €20m is being allocated to the NTPF, rising to €55m in 2018. Planning for these initiatives is currently being finalised with the NTPF. As part of this process, I have requested that the NTPF put in place a robust monitoring and evaluation process of the outputs and outcomes to ensure that the learning gleaned informs future initiatives.
In relation to treatments commissioned from the private sector by the HSE, as this is a service matter I have asked the HSE to respond to the Deputy directly.
|
Year |
Total Patient Numbers |
NTPF Care Expenditure (€m) |
Revenue Grant from Department of Health (€m) |
|
2016 (Forecast) |
3,000 |
2.0 |
5.1 |
|
2015 |
1,092 |
1.0 |
5.1 |
|
2014 |
1,002 |
0.5 |
5.1 |
|
2013 |
1,950 |
4.8 |
17.4 |
|
2012 |
2,012 |
41.9 |
40.6 |
|
2011 |
19,217 |
57 |
85.6 |
|
2010 |
33,639 |
84 |
90.1 |
|
2009 |
28,758 |
90 |
90.4 |
|
2008 |
36,269 |
94 |
104.6 |
|
2007 |
32,638 |
95 |
91.7 |
|
2006 |
24,411 |
75 |
78.6 |
|
2005 |
18,994 |
60 |
64.0 |
|
2004 |
13,627 |
42 |
44.0 |
347. Deputy Louise O'Reilly asked the Minister for Health the number of drugs where, following the NCPE, National Centre for Pharmacoeconomics, assessment of the manufacturer's economic dossier on the cost effectiveness of a drug (details supplied), the NCPE found a drug not to be cost effective; if this information will be provided for each of the past five years with a breakdown of whether additional price reductions were successfully negotiated and agreed upon; and if he will make a statement on the matter. [38604/16]
Amharc ar fhreagraUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply.
349. Deputy Louise O'Reilly asked the Minister for Health the status of the implementation of the 48 recommendations of the national steering group on rare diseases; the specific actions being taken on access to medication and technology; and if he will make a statement on the matter. [38606/16]
Amharc ar fhreagraThe National Rare Disease Plan for Ireland (2014 - 2018) recommended that an Oversight Implementation Group of relevant stakeholders, including patients' groups, be established to oversee and monitor implementation of the plan's recommendations. This group was established by my Department in 2015 and it has met on a number of occasions.
One of the principal recommendations in the Plan was the establishment of a National Clinical Programme for Rare Diseases. This programme was to be responsible, over time and among other functions, for assisting with mapping and developing care pathways for rare diseases; facilitating timely access to centres of expertise – nationally and internationally; and developing care pathways with European Reference Centres for those ultra-rare disorders where there may not be sufficient expertise in Ireland.
In line with this recommendation, a National Clinical Programme for Rare Diseases was established in 2013 under the National Clinical Strategy and Programmes Division of the HSE. The programme is a joint initiative between the HSE and the Royal College of Physicians of Ireland. This clinical programme is a channel for assisting with the advancement of a number of other recommendations in the plan, such as those on National Centres of Expertise for rare diseases; and in this vein, the programme designed a framework for the designation of Irish Centres of Expertise in cooperation with HSE Acute Hospitals Division in line with the recommendations stipulated in the national plan.
The Rare Diseases National Plan also recommended that ‘the National Clinical Programme for Rare Diseases through a National Office for Rare Diseases develop the clinical and organisational governance framework that would underpin care pathways and access to treatment for rare disease patients, particularly in the context of transition from paediatric to adult care'.
As such the National Clinical Programme has developed a draft transition model of care which will be entering a consultation stage very shortly.
The National Clinical Programme for Rare Diseases and the Department of Health encouraged designated Centres of Expertise to participate in European Reference Networks (ERNs) for Rare Diseases in line with the national plan. ERNs are European networks connecting health care providers and centres of expertise so that international expertise on specific rare diseases may be pooled together for the benefit of patients. Any centre applying for membership of an ERN must have strategies in place to ensure that care is patient-centred; that patients' rights and preferences are respected; and must show a research component to their work.
Hence, the recommendations in the national plan that related to empowering and protecting patients and carers, and research on rare diseases will be fulfilled in part through this process. It is expected that ERNs will have a major structuring effect by linking thematic expert centres across the EU.
With the encouragement of the National Clinical Programme for Rare Diseases, Acute Hospital Divisions in the HSE and the Department of Health, five centres of expertise were designated in June this year during the first round of calls from the European Commission for participation in European Reference Networks. Three of these designated centres applied for membership of ERNs.
In 2014, the Minister for Health announced €850,000 for investment into charity-led research priorities, which particularly benefits rare disease research. Five charities were to provide matching funding bringing the total investment to €1.9 million. They were to share €850,000 in State funding to take part in international research into rare medical conditions. In 2016, the next cohort of projects was funded by the State with €1.686 million, matched by charity funding of €1.224 million. The total funding of €2.91 million is shared between 14 charities. The next round of this joint funding initiative will open in 2017. The EU commission now intends to explore the possibility to further strengthen the collaboration between Member States and the Commission in the area of research on rare diseases.
The establishment of a National Rare Disease Office (NRDO) featured prominently in the recommendations of the Rare Disease plan. The national office was established by the HSE in June 2015. Its work is currently led by the NCPRD Clinical Lead, supported by an Information Scientist, part-time Administrative Officer, part-time Genetic Counsellor and by a 0.2FTE Consultant Geneticist. It is, among other functions, providing up-to-date information regarding new treatment and management options, including clinical trials. In addition, the post of Information Scientist for the office is being funded jointly by the HSE and the EU Commission.
The NRDO has already performed a preliminary situation analysis of the existing rare disease registries and is in the process of assigning these known registries on our national Orphanet site, which is the international rare disease reference and information portal funded by the EU. The EU Commission has started the development of a European Platform on Rare Diseases Registration. Its principal goal is to enable sharing and use of rare diseases' patient data across Europe, among the multitude of existing patient registries, within and across rare diseases.
A number of recommendations about access to appropriate drugs and technologies were contained in the plan. One chief recommendation in this regard refers to the HSE developing a Working Group to bring forward appropriate decision criteria for the reimbursement of orphan medicines and technologies; and that the approach should include an assessment system similar to that for cancer therapies established under the National Cancer Control Programme. The HSE has advised my Department that its Acute Hospitals Division is developing the terms of reference, required membership and reporting relationship for this committee which will parallel the National Cancer Control Programme Technology Review Committee.
This Committee will also be supported by the National Clinical Programme for Rare Diseases Clinical Advisory Group.
The national plan for Rare Diseases recommended that the Health Identifiers Bill and the Health & Patient Safety Bill be published. The former was published in 2013 and enacted in 2014. It is now being implemented by the HSE. A revised and much expanded General Scheme of a Health Information and Patient Safety Bill was approved by the government in November 2015 and published on the Department's website.
Two recommendations referred to training in rare diseases for healthcare professionals. The Department of Health has contacted formally the various healthcare representative and professional bodies about implementing these recommendations.
Finally, rare diseases have already been tabled on the agenda for North-South meetings. Therefore, future work to deepen cooperation between both jurisdictions on rare diseases is anticipated.
350. Deputy Louise O'Reilly asked the Minister for Health further to the budget 2017 announcement of additional funding being made to the NTPF, the evaluation mechanisms that are in place to ensure value for money in terms of the spend; the evaluation mechanisms in place to ensure satisfactory outcomes and number of treatments in accordance with the funding allocation; and if he will make a statement on the matter. [38607/16]
Amharc ar fhreagraBudget 2017 provides for the treatment of our longest waiting patients. €20m is being allocated to the NTPF, rising to €55m in 2018.
On foot of this allocation the NTPF recently issued a Prior Information Notice stating that commissioning will recommence and they will be engaging with suppliers through competitive dialogue on the required optimum approach for future outsourcing of public patients. Controls to ensure quality patient treatment, value for money and efficient processes will be determined by this process.
351. Deputy Louise O'Reilly asked the Minister for Health the reason the number of available inpatient beds has reduced from 12,051 in 2006 to 10,473 in 2015 and 10,629 in 2016 to date; the number of psychiatry and long term care beds that have been excluded since 2006 to show only acute beds in the 2015 and 2016 figures; the factors that determine the reason an inpatient bed in 2006 is no longer available in 2015 and 2016; if the physical infrastructure still exists for these beds and if not the details of same; and if he will make a statement on the matter. [38608/16]
Amharc ar fhreagraIn relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
352. Deputy Louise O'Reilly asked the Minister for Health if data is being collected in relation to the type of treatment, the cost of treatment and the patient outcome for services commissioned from the private sector by the NTPF; the details of same; and if he will make a statement on the matter. [38610/16]
Amharc ar fhreagraThe NTPF was established on a statutory basis in 2004 and previously arranged for the provision of hospital treatment to classes of persons determined by the Minister. Since 2011 this function has been suspended.
I include with the official report a tabular statement setting out details of the annual budget of the NTPF and the number of patients treated per annum since its inception.
Budget 2017 provides for the treatment of our longest-waiting patients. €20m is being allocated to the NTPF, rising to €55m in 2018. Planning for these initiatives is currently being finalised with the NTPF. As part of this process, I have requested that the NTPF put in place a robust monitoring and evaluation process of the outputs and outcomes to ensure that the learning gleaned informs future initiatives.
Finally, the NTPF launched the 2016 Endoscopy Initiative in June and I receive monthly reports on the overall progress of this initiative, which is on track to achieve its target of no patients waiting more than 12 months for a routine scope by the end of the year. The NTPF will be submitting a final report to me by the end of January 2017 which will set out the overall performance of the initiative including; number of patients referred number of patients who received a procedure, a total cost of procedures and a breakdown of where these procedures were provided.
|
Year |
Total Patient Numbers |
NTPF Care Expenditure (€m) |
Revenue Grant from Department of Health (€m) |
|
2016 (Forecast) |
3,000 |
2.0 |
5.1 |
|
2015 |
1,092 |
1.0 |
5.1 |
|
2014 |
1,002 |
0.5 |
5.1 |
|
2013 |
1,950 |
4.8 |
17.4 |
|
2012 |
2,012 |
41.9 |
40.6 |
|
2011 |
19,217 |
57 |
85.6 |
|
2010 |
33,639 |
84 |
90.1 |
|
2009 |
28,758 |
90 |
90.4 |
|
2008 |
36,269 |
94 |
104.6 |
|
2007 |
32,638 |
95 |
91.7 |
|
2006 |
24,411 |
75 |
78.6 |
|
2005 |
18,994 |
60 |
64.0 |
|
2004 |
13,627 |
42 |
44.0 |
353. Deputy Robert Troy asked the Minister for Health if he will expedite an appointment for hip surgery for a person (details supplied); and if he will make a statement on the matter. [38613/16]
Amharc ar fhreagraUnder 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.
The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, I have asked the HSE to respond to you directly.
