Written Answers Nos. 1930-1948
1930. Deputy Róisín Shortall asked the Minister for Health if he will accept the recommendations of the National Radiation Therapist Review Report; and if he will commit to full implementation of said recommendations. [35894/24]
Amharc ar fhreagraFirstly, I would like to acknowledge the incredibly important role of Radiation Therapists in the provision of cancer services in this country.
I am glad that the independent review of the Radiation Therapist profession has been finalised. This strategic review considered important issues such as organisation structure, career development in line with Health and Social Care Professional Frameworks, strategic workforce planning and recruitment and retention strategies.
This review has published 16 recommendations which aim to help and support the Radiation Therapy profession into the future.
As the terms of reference for the review state, the implementation of any recommendations from the review will remain subject to the approval from the Departments of Health and Public Expenditure and Reform.
1931. Deputy Róisín Shortall asked the Minister for Health the reason a department (details supplied) in Crumlin Hospital is not being transferred to the new National Children's Hospital; the plans for the department of clinical genetics following the opening of the new hospital; and if he will make a statement on the matter. [35898/24]
Amharc ar fhreagra1932. Deputy Róisín Shortall asked the Minister for Health if he will include clinical placement coordinators in the revised PHN/CNM2/CNS salary scale pay agreement; the reason this linked grade has been excluded; and if he will make a statement on the matter. [35899/24]
Amharc ar fhreagraFirstly, I would like to acknowledge the important work carried out by all Clinical Placement Coordinators. Their work is of significant value to our services.
Recent increases applied to the Clinical Nurse/ Midwife Manager 2 (CNM/CMM) scale were a result of the implementation of recommendation 45 of the Expert Review Body (ERB) on Nursing and Midwifery and Labour Court recommendation LCR22828.
Recommendation 45 of the ERB set out that the Clinical Nurse Manager 2 and Clinical Midwife Manager 2 pay scales would be extended by an additional scale point making Point 10 the new max of scale. The scale would also gain an LSI at Point 11. As part of the new Public Service Agreement, 2024-2026, it was agreed that the recommendations set out by the Labour Court would be implemented with effect from 1 January 2024.
While it is the case that certain grades in the HSE have similar pay scales, this does not mean that they are linked to one another. LCR22828 refers only to the implementation of recommendations 44-46 of the ERB and their encompassed grades.
1933. Deputy Róisín Shortall asked the Minister for Health the reason health and social care professionals (HSCPs) are the only clinical group excluded from a role in the senior management structure of the new health regions; if his attention has been drawn to a petition (details supplied); if he has engaged with the HSCPs trade union; and if he will make a statement on the matter. [35900/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1934. Deputy Róisín Shortall asked the Minister for Health the reason a maternity hospital is still operating pandemic-related visitor restrictions (details supplied); if there are plans to end this policy; and if he will make a statement on the matter. [35901/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1935. Deputy Róisín Shortall asked the Minister for Health the status of plans for a 60-bed community nursing unit in Cashel, County Tipperary; if a new site has been identified (details supplied); the timeline he is working towards in delivering this new development; and if he will make a statement on the matter. [35902/24]
Amharc ar fhreagraAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
1936. Deputy Ged Nash asked the Minister for Health the days and hours of operation of the Cath Lab at Our Lady of Lourdes Hospital, Drogheda; if the hours of operation have been adjusted recently; and if he will make a statement on the matter. [35906/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1937. Deputy Éamon Ó Cuív asked the Minister for Health the steps being taken to ensure that all those that require dialysis can get it without delay; the steps being taken to ensure as many of these as possible are provided with the option of either home dialysis or outpatient dialysis as appropriate; the main source of logjams in the system; and if he will make a statement on the matter. [35925/24]
Amharc ar fhreagra1938. Deputy Éamon Ó Cuív asked the Minister for Health if there is an adequate provision for dialysis in the Saolta region of hospitals; if not, the steps that could be taken immediately to meet demand and to provide as many persons as appropriate with the option of home dialysis or outpatient dialysis, particularly in view of the scattered nature of settlement in the region and the distance many people live from hospitals; and if he will make a statement on the matter. [35926/24]
Amharc ar fhreagra1939. Deputy Éamon Ó Cuív asked the Minister for Health the number of beds that could be freed up in the hospitals in Galway for other use if all those who are inpatients for dialysis and could be equally treated on a day care basis, were facilitated in doing so; the extra resources that would be needed to achieve such an outcome; and if he will make a statement on the matter. [35927/24]
Amharc ar fhreagraI propose to take Questions Nos. 1937 to 1939, inclusive, together.
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1940. Deputy Denis Naughten asked the Minister for Health further to Parliamentary Question No. 627 of 27 February 2024, the current status of the HSE survey to measure the prevalence of long-Covid in the community; when it will be published; and if he will make a statement on the matter. [35929/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1941. Deputy Aindrias Moynihan asked the Minister for Health for the continuation of entitlement to a medical card to automatically be available to children who turn 16 years old and domiciliary care allowance discontinued; and if he will make a statement on the matter. [35933/24]
Amharc ar fhreagraMedical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold.
Domiciliary Care Allowance (DCA) is a monthly allowance payable to a parent/guardian in respect of a child aged under 16, who has a severe disability or condition and requires continual or continuous care and attention in the home, substantially and above the care and attention normally required by a child of the same age and the child must be likely to require this level of care and attention for at least 12 months.
Since 1st June, 2017, all children for whom a Domiciliary Care Allowance is paid qualify automatically for a medical card without the requirement of a financial assessment.
DCA ceases to be payable when a child reaches 16. A child may transition to Disability Allowance from age 16, even if still attending full-time education, subject to satisfying all qualifying conditions for that scheme, including certain medical criteria and a means test. In circumstances where a person’s sole or full income comes from social welfare payments, they will receive a medical card (even if such income is above the income threshold).
People who have been on a disability payment for at least a year can retain a Medical Card for a further three years on return to work, provided they were in receipt of the payment for a period of at least 12 months prior to commencing employment. Furthermore, the medical card earnings disregard for people in receipt of Disability Allowance is €427 per week.
The issue of granting medical cards on the basis of illness or a disability was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.
I can assure the Deputy that my Department keeps medical card issues under review in order to ensure the medical card system is responsive and sensitive to people's needs. Over the course of 2024 and 2025, we will review the existing eligibility framework to clearly assess what is working well and to inform policy proposals to enhance eligibility and access to services based on robust evidence. This is an important step towards delivering on universal healthcare in Ireland.
1942. Deputy Aindrias Moynihan asked the Minister for Health when investigations will complete on providing approval for a medication (details supplied) on the drugs payment scheme; and if he will make a statement on the matter. [35936/24]
Amharc ar fhreagraUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for decisions on the pricing and reimbursement of medicines.
The HSE must provide access to as many medicines as possible, in as timely a fashion as possible, from the resources available (provided) to it.
The HSE must also robustly assesses applications for pricing and reimbursement to make sure that it can stretch available resources as far as possible and to deliver the best value in relation to each medicine and ultimately more medicines to Irish citizens and patients.
HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds.
There are formal processes which govern applications for the pricing and reimbursement of medicines, and new uses of existing medicines, to be funded and / or reimbursed.
The HSE must consider the following criteria prior to making any decision on pricing / reimbursement in line with the Health (Pricing and Supply of Medical Goods) Act 2013:
(1) The health needs of the public,
(2) The cost effectiveness of meeting health needs by supplying the item concerned rather than providing other health services,
(3) The availability and suitability of items for supply or reimbursement,
(4) The proposed costs, benefits, and risks of the item or listed item relative to therapeutically similar items or listed items provided in other health service settings and the level of certainty in relation to the evidence of those costs, benefits and risks,
(5) The potential or actual budget impact of the item or listed item,
(6) The clinical need for the item or listed item,
(7) The appropriate level of clinical supervision required in relation to the item to ensure patient safety,
(8) The efficacy (performance in trial), effectiveness (performance in real situations) and added therapeutic benefit against existing standards of treatment (how much better it treats a condition than existing therapies) and
(9) The resources available to the HSE
In terms of the specific details of the application for pricing and reimbursement of Fezolinetant (Veoza®) I have asked the HSE the current status of the pricing and reimbursement application of the drug and they have provided the following information:
The HSE received an application for pricing / reimbursement on the 8th February 2024 from Astellas (the applicant) for Fezolinetant (Veoza®) indicated for the treatment of moderate to severe vasomotor symptoms (VMS) associated with menopause.
• The first step in the process is the submission of a Rapid Review dossier (a clinical and economic dossier) to the National Centre for Pharmacoeconomics (NCPE) for assessment. The HSE commissioned the Rapid Review process on the 9th February 2024.
• The NCPE Rapid Review assessment report was received by the HSE on the 12th March 2024. The NCPE advised the HSE that a full Health Technology Assessment (HTA) was recommended to assess the clinical effectiveness and cost effectiveness of Fezolinetant (Veoza®) compared with the current standard of care.
• The HSE commissioned a full Health Technology Assessment (HTA) on the 8th April 2024 as per agreed processes.
• The NCPE publishes details of medicines where the HSE has commissioned a Rapid Review assessment and / or a full health technology assessment on their website. The website is updated at regular intervals and includes assessment outcomes and updates on reimbursement for each individual medicine and indication listed. Details of the assessment(s) of Fezolinetant (Veoza®) are available at www.ncpe.ie/fezolinetant-veoza-hta-id-24005/.
• The HSE Corporate Pharmaceutical Unit (CPU) is the interface between the HSE and the Pharmaceutical Industry in relation to medicine pricing and reimbursement applications.
• The Drugs Group is the national committee which the HSE has in place to make recommendations on the pricing and reimbursement of medicines. The membership of the HSE Drugs Group includes public interest members. The pharmacoeconomic report will be reviewed by the HSE Drugs Group along with the outputs of commercial negotiations, and any patient group submission(s) received. The HSE Drugs Group will consider all of the evidence and make a recommendation to the HSE Senior Leadership Team.
• The decision making authority in the HSE is the HSE Senior Leadership Team. The HSE Senior Leadership Team decides on the basis of all the demands it is faced with (across all services) whether it can fund a new medicine, or new use of an existing medicine, from the resources that have been provided to it in line with the Health (Pricing and Supply of Medical Goods) Act 2013.
As it currently stands a completed Health Technology Assessment (HTA) is required to progress this application, as per the formal processes governing the pricing and reimbursement of medicines.
1943. Deputy Aindrias Moynihan asked the Minister for Health for expansion of women’s health services to include free hormone replacement therapy services/products; and if he will make a statement on the matter. [35937/24]
Amharc ar fhreagraThe Government recognises that menopause is a key health and wellbeing issue for women in Ireland today, and much work has been done in this area which has being driven by the Women’s Health Taskforce and the Women’s Health Action Plans which I launched in 2022 and earlier this year.
I have asked my officials to explore the options available in relation to the provision of state-funded Hormone Replacement Therapy (HRT) to women who require it in treating symptoms of menopause. This work is underway and details will be made available in due course.
Hormone Replacement Therapy is a common and important treatment for the symptoms of menopause. However, not all women experiencing menopause may be clinically eligible for HRT. Additionally, some women may also choose not to take HRT and go on to address their symptoms through alternative therapies and/or lifestyle changes.
To support women through their menopause journeys, we have progressed significantly, through the work of the Women’s Health Taskforce, to enhance holistic and clinician supports available to women. These include:
• 6 specialist menopause clinics are now open for women who have complex experiences of menopause.
• The first of these clinics opened at the National Maternity Hospital in December 2021 with five more clinics now open located in Nenagh, the Rotunda, the Coombe and University Hospital Galway and Cork.
• In the Women’s Health Action Plan 2024-2025 Phase 2: An Evolution in Women’s Health, I have committed to expanding the operating hours of these services so more women can receive necessary treatment.
• A Quick Reference Guide for Menopause launched in October 2022. This guide supports GPs and Practice Nurses in the diagnosis and treatment of menopause symptoms at the primary care level.
• The “It’s My Time” campaign launched in November 2022, in partnership with Sport Ireland, aimed at encouraging women over 40 to increase physical activity levels, which can be helpful in managing symptoms of menopause.
• In October 2022, marking International Menopause Day, I launched a National Menopause Awareness campaign. This was a direct response to the demand from Irish women for greater knowledge and understanding of menopause as well as better access to accurate information and supports so that they can proactively manage their experience. A second phase of the campaign was relaunched in March 2023 as part of the Department of Health’s Women’s Health Week.
• The Menopause Awareness campaign was accompanied by the launch of a dedicated webpage to provide trusted information for anyone affected by the symptoms of menopause.
• In relation to making HRT more accessible and affordable, Budget 2023 announced the removal of VAT from HRT products.
• In October 2023, in partnership with the Department of Public Expenditure, NDP Delivery, Reform, we launched the Menopause in the Workplace Policy Framework to guide all Civil Service departments and bodies in developing their own Menopause in the Workplace Policies.
• My Department has since published our own for supporting colleagues through their menopause journeys.
In conjunction with the Women's Health Taskforce, I look forward to continuing to raise awareness, to remove the stigma associated with menopause and to ensure that women have access to the necessary supports and services to assist them through this time in their lives.
1944. Deputy Róisín Shortall asked the Minister for Health the funding allocated to the director of psychology post in the South West Regional Health Area; the date this was approved; if this allocation impacted funding to other HSE posts in the region; and, if so, to provide details of same. [35938/24]
Amharc ar fhreagraThe allocation of specific funding to individual posts is an operational matter; therefore, I have referred this question to the HSE for direct response.
1945. Deputy Róisín Shortall asked the Minister for Health how the decision to pursue the appointment of a director of psychology post in the South West Regional Health Area is in line with the recruitment cap imposed by the Government's Pay and Numbers Strategy; and if he will make a statement on the matter. [35939/24]
Amharc ar fhreagraHealth Regions, each led by a Regional Executive Officer (REO), are new HSE structures which now have responsibility for the planning and coordinated delivery of health and social care services for their respective populations.
Each Health Region will have an Executive Management Team (EMT) led by the REO. The EMTs are critical structures for each Region. They will provide the governance and organisational arrangements to enable the planning, management, and delivery of integrated care for people and for communities across their region. Their structure must facilitate clear lines of governance, represent an appropriate span of control for the REO, and ensure that services and staff can benefit from swift and accountable decision making. The structure for these teams has now been agreed and phased recruitment is underway.
Officials from my Department and the HSE considered several combinations for the clinical functions on the EMTs. The approved model was for a single discipline neutral clinical leadership role to sit on the Executive Management Team on the basis that this would provide for clarity of governance and support the delivery of integrated care. However, it was recognised that this might take time to achieve. The HSE CEO therefore decided to have a Regional Clinical Director and an Executive Nurse/Midwife on the Executive as an interim measure and to prepare to transfer to a single, discipline neutral, Clinical Officer over a three year period.
The clinical roles which sit on the Health Region EMT do not exist to represent their professions. Rather, they hold executive accountability for a portfolio of work, which includes collaboration and coordination across professions. This is the best way of delivering integrated care in the interests of patients and service users and breaking down professional silos.
Beyond these EMT positions, the HSE are finalising a regional clinical governance model. Each region will have a regional Clinical Executive consisting of a lead from: Population & Public Health; Medical, Executive Nurse/Midwife, Health & Social Care Professionals, General Practice, Chief Academic Officer, and Quality & Patient Safety. Regions will also develop networks of care, which provide a single governance apex and common design to ensure consistency across the system in standards of practice and service models for defined specialties. It has also been agreed that each REO will also have a regional HSCP advisor who reports directly to them.
The agreed structure does not include a role of Director of Psychology on Regional EMTs. The grade of Director of Psychology has existed in the public health service for more than three decades. It is categorised as a Health and Social Professionals grade. The HSE has delegated sanction to fill posts in any pre-existing grade without needing to seek specific sanction from the Department of Health, once the appointment of a person to any pre-existing grade is within the parameters of the HSE’s Pay & Numbers Strategy. Recruitment for Clinical roles are a matter for the HSE and the Department of Health would not normally be consulted for roles of this nature.
I have asked the HSE to reply directly to the Deputies in relation to the additional queries raised concerning the Director of Psychology post in the HSE South West Health Region.
1946. Deputy Pádraig Mac Lochlainn asked the Minister for Health when the two advanced nurse practitioner posts for adult type 1 diabetes care at Letterkenny University Hospital that have been applied for will be agreed to and filled. [35940/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1947. Deputy Paul Kehoe asked the Minister for Health to provide an outline of the current structure and referral pathways of a service (details supplied); and if he will make a statement on the matter. [35942/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
1948. Deputy Robert Troy asked the Minister for Health if a physiotherapy appointment in the Midlands Regional Hospital Mullingar for a person (details supplied) will be expedited. [35945/24]
Amharc ar fhreagra“As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.”
