Written Answers Nos. 358-379
358. Deputy James Browne asked the Minister for Health the number of children currently waiting to be seen by a HSE psychology service school-age team by local health area in tabular form; and the number waiting less than three months, three to six months, six to 12 months, 12 to 24 months and more than 24 months. [30959/17]
Amharc ar fhreagraAs this is a service issue, this question has been referred to the HSE for direct reply.
359. Deputy Thomas P. Broughan asked the Minister for Health if service users are consulted on the delivery of local mental health services; if so, if this feedback is applied to improve the delivery and provision of those services; and if he will make a statement on the matter. [30960/17]
Amharc ar fhreagraAs this is a service issue, this question has been referred to the HSE for direct reply.
360. Deputy Thomas P. Broughan asked the Minister for Health the budget and delivery for mental health services in 2017; if all mental health budgets provided for in 2015 and 2016 were spent; his plans for this budget in 2018 in view of ongoing concerns regarding the lack of resources for this sector; and if he will make a statement on the matter. [30961/17]
Amharc ar fhreagraThe overall gross non-capital mental health budget for 2017 is €853.1 million. Budget 2017 made allowance for an additional €35 million for services to be initiated in 2017. Key priorities to be addressed in the HSE's 2017 Service Plan include youth mental health, further improvement to child & adolescent (CAMHS) and adult services, older people's services and further enhanced out-of-hours response for those in need of urgent services. Recognising the time lag in new staff taking up posts and the completion of preparations for the introduction of these services, it is estimated that the revenue spend in 2017 associated with this increased allocation will be some €15 million. There will also be a further additional spend of €9.5 million in mental health associated with increased pay rates, bringing the total budget to over €850 million.
The Mental Health Budgets for 2015 and 2016 were €791.8 million and €826.6 million respectively. According to the HSE’s Mental Health Division’s Operational Plan 2017, €787.28 million was spent in 2015, while in 2016, a provisional amount of €824.7 million was spent.
Key priorities being addressed in the HSE's 2017 Service Plan will continue to be prioritised in 2018.
361. Deputy Thomas P. Broughan asked the Minister for Health the additional resources being provided in the provision of mental health services in HSE area 9 during 2017; and if he will make a statement on the matter. [30962/17]
Amharc ar fhreagraAs this is a service issue, this question has been referred to the HSE for direct reply.
362. Deputy James Lawless asked the Minister for Health when an assessment of need will be carried out for a person (details supplied); if his Department can expedite this assessment; and if he will make a statement on the matter. [30963/17]
Amharc ar fhreagraThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
363. Deputy Charlie McConalogue asked the Minister for Health the number of persons travelling for a service (details supplied); the time persons are waiting for their initial consultation; and if he will make a statement on the matter. [30971/17]
Amharc ar fhreagraIn response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
364. Deputy Seamus Healy asked the Minister for Health the position regarding the shortage of the BCG vaccine here; and if he will make a statement on the matter. [30977/17]
Amharc ar fhreagraThere is currently a worldwide shortage of BCG vaccine. The vaccine has not been available in Ireland since the end of April 2015. Consequently, BCG vaccination clinics in HSE Clinics and Maternity hospitals have been postponed.
There is only one licensed supplier of BCG vaccine to Ireland. The manufacturer has had difficulties in the production of the BCG vaccine. Since this problem became apparent, the HSE National Immunisation Office has been in regular contact with the manufacturer to ascertain when the vaccine might be available. The HSE also asked the Health Products Regulatory Authority (HPRA), which licenses and regulates all human medicines in Ireland, to source an alternate supplier of the BCG vaccine. Efforts have been made to find a company who can provide the vaccine for use in Ireland which satisfies all the HPRA requirements on safety and efficacy but no suitable alternative BCG product has been found.
The supplier has indicated that supplies of the vaccine are not expected to be delivered into Ireland until early 2018. When there is confirmation of the date of new supply, the HSE will be guided by the recommendations of the National Immunisation Advisory Committee on its administration.
365. Deputy Louise O'Reilly asked the Minister for Health further to Question No. 210 of 24 May 2017, the hospitals in which the 128 doctors working as consultants but not on the Medical Council’s specialist register are operating; the specialties that they are covering; and if he will make a statement on the matter. [30990/17]
Amharc ar fhreagraI have asked the HSE to respond to the Deputy directly on this matter.
366. Deputy Louise O'Reilly asked the Minister for Health the medicines that his Department has approved but are not in a position to purchase as a result of a lack of funding; the number of persons these medicines would benefit; the illnesses for which they are prescribed; the reason these medicines have not yet been purchased; the funding issues associated with same; and if he will make a statement on the matter. [30991/17]
Amharc ar fhreagra434. Deputy Margaret Murphy O'Mahony asked the Minister for Health if the timelines in the IPHA agreement regarding the reimbursement process for new medicines are being met; and if he will make a statement on the matter. [31352/17]
Amharc ar fhreagra435. Deputy Margaret Murphy O'Mahony asked the Minister for Health the number of medicines that have been submitted for reimbursement to the HSE that are now exceeding timelines as set out in the IPHA agreement; and if he will make a statement on the matter. [31353/17]
Amharc ar fhreagra436. Deputy Margaret Murphy O'Mahony asked the Minister for Health the number of medicines that have been referred by the HSE leadership team to his Department for reimbursement approval; and if he will make a statement on the matter. [31354/17]
Amharc ar fhreagraI propose to take Questions Nos. 366 and 434 to 436, inclusive, together.
The Health Service Executive (HSE) has statutory responsibility for decisions on the pricing and reimbursement of medicines in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. The 2013 Act specifies the criteria to be applied in the making of decisions on the reimbursement of medicines.
Part 4 of the 2013 Act provides, inter alia, for the establishment and maintenance of a "Reimbursement List" for the purposes of section 59 of the Health Act 1970.
Section 18 of the 2013 Act allows a supplier of an item to apply to the HSE requesting the HSE to add the item to the Reimbursement List.
In considering an application, the HSE will also have regard to Part 1 and Part 3 of Schedule 3 of the 2013 Act.
Section 19(4) of the 2013 Act prohibits the HSE from making a relevant decision under section 18 "except in accordance with the criteria specified in Schedule 3". Schedule 3 sets out nine general criteria, of which one is the resources available to the Executive.
Under the 2016 Framework Agreement on the Supply and Pricing of Medicines, in a situation where the HSE wishes to reimburse a medicine but cannot do so from within existing resources, it may inform my Department of its decision in this respect. The Minister for Health may, as he deems appropriate, bring a Memorandum to Government in relation to the funding implications and requesting consideration of same.
Prior to the introduction of the Framework Agreement one treatment, Ibrutinib, was referred to my Department in 2016.
In line with the Framework Agreement and since its introduction in July 2016, the HSE has referred ten treatments to my Department for consideration, one of which was Orkambi (including Kalydeco).
Following consideration by my Department and Government of the funding implications, the HSE decided, in line with the 2013 Act to reimburse Ibrutinib and Orkambi (including Kalydeco).
The funding implications of the other nine treatments are currently under consideration by my Department. These are outlined in Table 1.
Table 1: Treatments referred to the Department of Health
|
Product |
Brand |
Indication |
|
Vismodegib |
Erivedge |
Basal Cell Carcinoma |
|
Vortioxetine |
Brintellix |
Depression |
|
Sacubitril / Valsartan |
Entresto |
Heart Failure |
|
Olaparib |
Lynparza |
Ovarian Cancer |
|
Obinutuzumab |
Gazyvaro |
Follicular Lymphoma |
|
Vedolizumab |
Entyvio |
Crohns & Ulcerative Colitis |
|
Nivolumab |
Opdivo |
Renal Cell Carcinoma |
|
Nivolumab |
Opdivo |
Hodgkins Lymphoma |
|
Apremilast |
Otezla |
Psoriasis & Psoriatic Arthrithis |
Each of these treatments were referred to my Department because the HSE decided to support the reimbursement application but considered that this could not be funded from within its current budgetary envelope and also taking account of the cumulative costs over a 5 year period. The HSE advise that the cumulative cost over 5 years of these treatments is approximately €120 million.
It should be noted that the final decision in relation to the reimbursement of all medicines remains the statutory responsibility of the HSE.
The National Centre for Pharmacoeconomics (NCPE) conducts health technological assessments on behalf of the HSE, a summary of which are available on the NCPE website www.ncpe.ie. These assessments include details of the estimated patient numbers and costs associated with each of these treatments.
As outlined in the IPHA agreement, and in line with the 2013 Act, within 180 days of receiving the application (or such longer period which may arise if further information is sought from the Company), the HSE will decide to either:
- add the medicine to the Reimbursement List / agree to reimburse it as a hospital medicine,
or,
- will refuse to reimburse the medicine.
While the HSE strives to reach a decision regarding drug approval in as timely a manner as possible and within the 180 days, because of the significant monies involved, there is an onus on the HSE to ensure that the best price is achieved as these commitments often feature multi million euro investments on an ongoing basis. The achievement of more successful price negotiations also allows for further drugs to be approved within the finite budget available.
I have asked the HSE to refer directly to the Deputy in relation to the timelines for the individual medicines.
367. Deputy Louise O'Reilly asked the Minister for Health the provisions being made by his Department to preserve and protect access to shared facilities in Northern Ireland for persons here and vice versa in view of Brexit; and if he will make a statement on the matter. [30992/17]
Amharc ar fhreagraThe Government has made clear that Northern Ireland is one of its main priorities in relation to Brexit. This includes protecting all the provisions of the Good Friday Agreement, maintaining EU support for the Peace Process, having an invisible border on the island and supporting continued North-South co-operation.
The acknowledgement of Ireland’s unique circumstances by both the EU and the UK has been the result of a major Government campaign of engagement with EU partners and the EU institutions to ensure our specific concerns were fully recognised. Our ongoing engagement with EU partners has shown that there is good understanding of our unique concerns, notably regarding the Peace Process and the Common Travel Area (CTA) and reciprocal rights.
Both the Irish and British Governments have indicated their intention to maintain the CTA after the UK withdraws from the EU. The CTA pre-dates Ireland and the UK joining the EU and is not dependent on EU membership. The CTA is particularly important in the context of the Northern Ireland Peace Process and relations on the island of Ireland. It facilitates the vast numbers of people who commute across the border and to and from Great Britain for work, business, trade, education, family, health or other reasons.
There is close cooperation between Ireland and Northern Ireland in the area of health. This cooperation occurs both within the framework of our common EU membership and on a bilateral basis, including at service-to-service level. A key priority of the Department of Health in addressing the implications of Brexit is to ensure continuity of health services and to preserve and protect current co-operation arrangements on a cross-border, all-island and Ireland-UK basis. This is being pursued on both a bilateral and EU-wide basis as appropriate. Of course, Ireland will be part of the EU27 team and looks forward to working with our fellow Member States in delivering the best possible result for Ireland and for the EU.
My Department and its agencies have been conducting detailed analysis on the potential impacts of Brexit. Ensuring continuity in cross-border health services has been identified as a priority and forms part of wider contingency planning being undertaken to address the implications of Brexit in the area of health. I would like to assure the Deputy that I am fully committed to preserving and protecting cross-border health co-operation and access to shared services.
368. Deputy Louise O'Reilly asked the Minister for Health the provisions being made by his Department to protect the work of the All-Ireland Cooperative Oncology Research Group group in view of Brexit; and if he will make a statement on the matter. [30993/17]
Amharc ar fhreagraCancer Trials Ireland (formerly the All-Ireland Cooperative Oncology Research Group) conducts cancer clinical trials in Irish hospitals and currently has over 150 trials in progress. While the vast majority of these trials are carried out in Cancer Trials Research Units in the Republic of Ireland, some trials have participation from research units in the UK, France and Denmark.
The terms of a UK exit from the EU are unknown at this stage as negotiations between EU Member States and the United Kingdom commence. In the short-term, cancer clinical trials are not impacted by uncertainties over Brexit.
The Health Research Board, who part fund Cancer Trials Ireland, is planning an interim review of Cancer Trials Ireland in 2018. This will look at the Irish and international context within which Cancer Trials Ireland can sustain and further develop its portfolio. The potential impacts of Brexit will be considered as part of that review.
369. Deputy Michael McGrath asked the Minister for Health further to Parliamentary Question No. 239 of 24 May 2017, if he will clarify the respective role of the HSE and of the service provider in the allocation of residential places when they become available; if places are offered based on a person's position on the waiting list; if the personal circumstances of each case are considered; and if he will make a statement on the matter. [31004/17]
Amharc ar fhreagraThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
370. Deputy Mattie McGrath asked the Minister for Health if a person (details supplied) can recoup expenses incurred for their child's dental treatment under the National Treatment Purchase Fund; and if he will make a statement on the matter. [31018/17]
Amharc ar fhreagraReducing waiting times for the longest waiting patients is one of this Government's key priorities. Consequently, Budget 2017 allocated €20 million to the NTPF, rising to €55 million in 2018.
In order to reduce the numbers of long-waiting patients, I asked the HSE to develop Waiting List Action Plans for 2017 in the areas of Inpatient/Daycase, Scoliosis and Outpatient Services. These plans have been published and their implementation is ongoing. The Inpatient / Daycase and Outpatient Plans focus on reducing the number of patients waiting 15 months or more for inpatient and daycase treatment or for an outpatient appointment by the end of October. The Scoliosis Action Plan aims to ensure that no patient who requires scoliosis surgery will be waiting more than four months for surgery by the end of 2017.
In addition, the NTPF is currently rolling out its Daycase Waiting List Initiative focused on those waiting longest for daycase treatment, with a view to ensuring that in excess of 2,000 patients waiting more than 18 months for a daycase procedure will have received an offer of an appointment for their procedure by the end of June. The NTPF has advised that to date over 2900 patients files have been transferred to private hospitals under this Initiative, over 800 patients have accepted an offer of treatment in a private hospital and that 278 patients have received their procedure.
It is not envisaged that the Waiting List initiatives implemented by the NTPF and the HSE under its Waiting List Action Plans will include dental treatment carried out in dental clinics.
Under 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 HSE to respond to you directly.
371. Deputy Pat Breen asked the Minister for Health when a person (details supplied) will be facilitated; and if he will make a statement on the matter. [31034/17]
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.
372. Deputy Thomas P. Broughan asked the Minister for Health if the external cladding used on Grenfell Tower has been used on health services buildings or hospitals; if cladding on such buildings is being urgently checked; if cladding on Beaumont Hospital is composed of safe materials; and if he will make a statement on the matter. [31061/17]
Amharc ar fhreagraYour question has been referred to the Health Service Executive for direct reply as the management of the healthcare property estate is a service matter.
373. Deputy Thomas P. Broughan asked the Minister for Health the estimated full-year cost of recruiting an additional 285 midwives; and if he will make a statement on the matter. [31062/17]
Amharc ar fhreagraI have asked the HSE to respond to the Deputy directly on this matter.
374. Deputy Thomas P. Broughan asked the Minister for Health the estimated full-year cost of recruiting an additional 30 dental surgeons; and if he will make a statement on the matter. [31063/17]
Amharc ar fhreagraI have asked the HSE to respond to the Deputy directly on this matter.
375. Deputy Thomas P. Broughan asked the Minister for Health the estimated full-year cost of completing the recruitment required for the full implementation of A Vision for Change; and if he will make a statement on the matter. [31064/17]
Amharc ar fhreagraA Vision For Change, our national Mental Health Policy, was introduced in 2006. Among its recommendations were that approximately 10,650 Mental Health Whole Time Equivalents were required to fully implement the policy.
This figure was based on Ireland’s then population of 3.917 million, as indicated in the 2002 census. The population of Ireland today, based on the most recent confirmed Census figures in 2016, is 4.7 million. Taking into account this demographic change, the required number of Mental Health Whole Time Equivalents is now 12,760.
According to the HSE, as of April 2017, there are 9,815 Mental Health Whole Time Equivalents. In addition, there are 300 being recruited and over 700 posts in development from Programme For Government funding. This brings the total to 10,815, a gap of 1,945. Using an average figure of €66,000 per Whole Time Equivalent, the additional funding required to fill the gap is €128 million.
Since 2012, €140 million in additional funding has been allocated to the Mental Health services. This has increased the total Mental Health Budget from €711 million in 2012 to over €850 million today.
376. Deputy Shane Cassells asked the Minister for Health the reason for the delay in processing a medical card application for a person (details supplied); and if he will make a statement on the matter. [31066/17]
Amharc ar fhreagraThe 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 was issued to Oireachtas members.
377. Deputy Marcella Corcoran Kennedy asked the Minister for Health if the agreed home care package can be appealed for persons (details supplied); and if he will make a statement on the matter. [31069/17]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply.
378. Deputy Niamh Smyth asked the Minister for Health if his attention has been drawn to a matter (details supplied); if he will intervene and increase the time being provided to persons from counties Cavan and Monaghan attending Drogheda; and if he will make a statement on the matter. [31075/17]
Amharc ar fhreagraIn response to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
379. Deputy James Lawless asked the Minister for Health the status of a matter relating to a person (details supplied); and if he will make a statement on the matter. [31076/17]
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 National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
