Written Answers Nos. 513-534
513. Deputy Patrick Costello asked the Minister for Health further to Parliamentary Question No. 805 of 9 May 2024, to confirm that the requests mentioned in the clinical governance committee minutes of the National Gender Service (details supplied) to provide training to the NHS have been rejected. [37768/24]
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.
514. Deputy Patrick Costello asked the Minister for Health how the National Gender Service ensures that those it refers for surgery abroad have access to appropriate aftercare when they are back in Ireland. [37769/24]
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.
515. Deputy Patrick Costello asked the Minister for Health how the subject matter expert colleagues who are assisting the clinical lead for transgender services in reviewing the Cass review were selected. [37770/24]
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.
516. Deputy Steven Matthews asked the Minister for Health the position regarding the addition of metachromatic leukodystrophy to newborn screening testing; the actions he has taken since his initial request to amend the testing system to include this disease (details supplied); and if he will make a statement on the matter. [37772/24]
Amharc ar fhreagra535. Deputy Neasa Hourigan asked the Minister for Health if he will provide an update on the expansion of the newborn bloodspot screening programme; his plans to roll out the programme to detecting for metachromatic leukodystrophy; and if he will make a statement on the matter. [37873/24]
Amharc ar fhreagraI propose to take Questions Nos. 516 and 535 together.
Currently, all newborn babies (between 3 and 5 days old) are offered newborn bloodspot screening (generally known as the ‘heel prick’) for nine rare but serious conditions that are treatable if detected early in life.
In line with the commitment in the Programme for Government, a successor to the National Rare Disease Plan 2014-2018, is currently being developed. A National Rare Disease Steering Group was established in December 2023 and has been tasked with developing the new National Rare Disease Strategy for Ireland. The Steering Group has met eleven times since it was established and has considered a number of issues, including Newborn Screening.
A Rare Disease Patient Forum was also established in February 2024 to ensure that voice of patients and families was central to the development of this new Strategy. Furthermore, a public consultation to gather the views of the public, including industry, on the development of the new Strategy has recently closed, with approximately 600 submissions received.
It is expected that the new Strategy will be finalised by Q4 2024, however, this is dependent on the work of the Steering Group in the development of the Strategy.
The expansion of the National Newborn Bloodspot Screening (NBS) Programme continues to remain a key objective of mine as Minister for Health, and I am pleased to note that the National Screening Advisory Committee (NSAC) has been actively progressing work in this regard.
NSAC is an independent expert group that considers and assesses evidence in a robust and transparent manner, and against internationally accepted criteria. It is important that we have rigorous processes in place to ensure our screening programmes are effective, quality assured, validated and operating to safe standards, and that the benefits of screening outweigh the harms.
Significant progress continues to be made on the expansion of the NBS Programme. As the Deputy will be aware, last year I approved two recommendations from NSAC for the addition of Severe Combined Immunodeficiency (SCID) and Spinal Muscular Atrophy (SMA) to the NBS programme. This will bring the number of conditions screened for as part of what is commonly known as the ‘heel prick’ test in Ireland to 11, once implemented. I would highlight that this will represent a 37% increase achieved under the lifetime of this Government.
I can confirm that work commenced at the start of this year, with ongoing collaboration between officials in my Department and the HSE National Children’s Screening Programme on implementing an ambitious timeline for the introduction of screening for SMA and SCID.
In February of this year, I was pleased to allocate €1.4m of new development funding in 2024 to support the expansion of the NBS programme. This funding will allow for the rollout of testing for both SCID and SMA and represents a significant funding increase in a single year. The announcement further demonstrates my ongoing commitment to reducing the impact of these rare but serious diseases in children and infants. This investment will be crucial to providing additional funds for new equipment, staff recruitment, validation, quality assurance and training to facilitate addition of new conditions to NBS programme.
In terms of further expansion of our newborn screening programmes, Ireland has always evaluated the case for commencing a national screening programme against international accepted criteria – collectively known as the Wilson- Jungner criteria and Metachromatic Leukodystrophy (MLD) is one of over 30 newborn conditions currently on the NSAC work programme which will be carefully considered by the Committee.
The evidence bar for commencing a screening programme should and must remain high. Uptake rates for the NBS programme are enviably high with an estimated of 99.9% and maintaining confidence in and trust of the programme is key to its success. This ensures that we can be confident that a programme is effective, quality assured and operating to safe standards. There is no doubt that newborn screening programmes have the potential to be rapidly transformed by new technologies and new therapies, but this highlights the need to continue with a robust, methodologically sound and detailed analysis of the evidence in each and every case against internationally accepted screening criteria.
Nevertheless, I am acutely aware of how difficult it is for parents, families and children who have received a diagnosis of a rare disease, and how challenging daily life can be for them. This is why I remain committed to the further expansion of screening in Ireland in accordance with internationally accepted criteria and best practice.
517. Deputy Duncan Smith asked the Minister for Health the reason private health insurance companies only cover the cost of a stay in psychiatric hospitals for a maximum of 100 days, with unwell and vulnerable patients in the middle of a treatment plan having to be discharged on the 100th day; and if he will make a statement on the matter. [37775/24]
Amharc ar fhreagraHealth insurance in Ireland is provided according to four principles: open enrolment, lifetime cover, minimum benefit and community rating. Minimum benefit means that all health insurance contracts must provide a certain minimum level of cover for inpatient hospital treatment. This approach is designed to be equitable and fair by ensuring that all consumers obtain an appropriate minimum level of health insurance cover regardless of what plan they purchase.
The Health Insurance Act, 1994 (Minimum Benefit) Regulations 1996 require insurers to offer a minimum benefit to customers in every insurance policy. Regulation 5(3) of the 1996 Regulations provides that health insurers are required to pay for a minimum of 100 days in-patient treatment in a calendar year for an insured person in respect of any psychiatric condition (except for those set out in Regulation 5(4)). Regulation 5(4) reduces that period to 91 days in-patient treatment in 5 years for treatment for alcoholism, drug or other substance abuse. The in-patient services in respect of psychiatric disorders can be provided as a private patient in a publicly funded hospital or in a private psychiatric hospital.
A health insurer is free to provide additional benefits outside of the minimum benefits. This is done on the basis of commercial decision-making and I do not have a role in the commercial decision making of any private health insurer. Customers should check with an insurance company in advance of purchasing a policy to ensure that it meets their needs and requirements.
518. Deputy Denis Naughten asked the Minister for Health the projects and programmes with his Department which have been allocated funding under the EU's Recovery and Resilience Programme; the funds drawn down to date in each instance; the profiled drawdown in each of the forthcoming years of the programme; the steps he is taking to ensure that projects and programmes are completed within the specified timeframe; and if he will make a statement on the matter. [37789/24]
Amharc ar fhreagraIreland will receive approximately €1.15 billion in funding from the Recovery and Resilience Facility (RRF) in respect of measures included in our National Recovery and Resilience Plan (NRRP).
The NRRP is pre-funded through the estimates process and the National Development Plan. RRF allocated funding is then recouped from the EU after the agreed milestones and targets within the Plan have been achieved and verified.
The RRF allocation will be paid to Ireland in five instalments. Following the successful submission of our first payment request, Ireland received €324m in July 2024 from the EU’s Recovery and Resilience Facility.
The Department of Health has two projects included in the NRRP:
• Project 2.6 Suite of e-health projects – ePharmacy
• Project 3.9 Health
These projects have very clearly defined milestones and verifiable targets.
• Department of Health projects under 2.6 include the (i) ePharmacy Programme (Hospital Medicines Management System component), and (ii) the Integrated Financial Management System. The indicative allocation for these projects is €75m.
• While there is no allocation set against the reform projects under 3.9, failure to meet their targets will result in financial corrections and impact on overall RRF funding. These reform projects are tied to the 2019 and 2020 Country Specific Recommendations determined through the European Semester process. Department of Health projects under this heading include the (i) Chronic Diseases Management Programme, (ii) Operationalisation of Community Health Networks, and (iii) Sláintecare Consultant Contract.
More information on each of these five projects can be provided to the Deputy by my Department, if required.
As of September 2024, three milestones have been achieved for the Department of Health projects, i.e.:
award of the contracts for ePharmacy systems;
completion of building and configuration of the integrated financial management system (funded project); and
entry into operation of Sláintecare Consultant Contract (non-funded).
These three milestones were included in Ireland’s first payment request. The five remaining milestones and targets will be included in Ireland’s second, third and fifth payment requests.
DPENDR is the Implementing Body of the NRRP in Ireland and oversees its implementation. Further precisions on exact drawdown can be addressed to the Implementing Body.
The Department is fully committed to the implementation of the National Resilience and Recovery Plan:
• The North-South, EU and International Unit coordinates reporting requirements under the NRRP for Department of Health Projects.
Projects leads and coordinators attend regular meetings, including technical meetings with the Commission, and the quarterly Delivery Committee on the NRRP (at Assistant Secretary Level.) Accountable Departments are obliged to provide appropriate reports on a regular basis through the RRF IT system.
• For all funded programmes, appropriate governance is in place to ensure the appropriate oversight is there to ensure programme schedules and funding allocates are adhered to.
519. Deputy Louise O'Reilly asked the Minister for Health if he is aware that patients in Beaumont Hospital A&E who are left on chairs awaiting admission do not have access to pillows or blankets; if he will ask the HSE to ensure that these are provided; and if he will make a statement on the matter. [37819/24]
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.
520. Deputy Michael Ring asked the Minister for Health when a position will be filled (details supplied); and if he will make a statement on the matter. [37820/24]
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.
521. Deputy Peadar Tóibín asked the Minister for Health the payments made by the HSE to the Royal College of Physicians of Ireland to manage the various national clinical programmes in each of the years 2020 to 2023, in tabular form (details supplied). [37824/24]
Amharc ar fhreagraThis PQ is more suitable for the HSE to respond, It has been referred.
522. Deputy Pa Daly asked the Minister for Health the initiatives he or the HSE promote in relation to breastfeeding; and if he will make a statement on the matter. [37825/24]
Amharc ar fhreagraEncouraging mothers to breastfeed is a priority, both for the Department of Health and for the HSE . The Healthy Ireland Framework, Healthy Ireland Strategic Action Plan, the National Maternity Strategy, the Obesity Policy and Action Plan, and the National Cancer Strategy, emphasise the importance of supporting mothers who breastfeed, as well as taking action to increase breastfeeding rates in Ireland.
The HSE Breastfeeding in a Healthy Ireland Action Plan 2016-2021 is the framework for progressing supports for breastfeeding in Ireland. A HSE Breastfeeding Action Plan Implementation Group was established to oversee delivery of the plan and a national breastfeeding co-ordinator was appointed as lead. The Department of Health works closely with the HSE National Breast-Feeding co-ordinator in the implementation of the HSE Breastfeeding Action Plan 2016-2021, which has been extended out to 2025.
The HSE has developed a comprehensive suite of communication and health promotion resources to support breastfeeding. It provides evidenced based impartial information and support for feeding options in infants and young children on the mychild.ie website and through social media channels. Resources are available for parents to-be and new parents, including print and online information. Breastfeeding information is integrated into all mychild publications and there are a number of specific breastfeeding publications available. The website and breastfeeding supports available (online and in-person) are promoted through paid and organic social media advertising throughout the year alongside TV, radio and media campaigns at certain times of the year e.g. National Breastfeeding Week. Other information support such as MyPregnancy, MyChild 0-2, Mychild 2-5 are provided directly by practitioners to compliment content available online.
In the last 4 years, the HSE has invested in a promotional campaign for parents aged 25 to 45 on mychild.ie and, as one of the most popular topics, breastfeeding features strongly in this ongoing campaign. The website experienced huge growth during the pandemic with website visits rising from 1.4 million in 2019 to 5.6 million in 2021. It has had five million visits in 2022.
Parents can contact the HSE’s online breastfeeding support service through the ‘Ask our breastfeeding expert’ service on mychild.ie. The service was established in 2014 and is provided by a team of lactation consultants. It is available seven days a week with the live chat service available Monday to Friday from 10am to 3pm.
Breastfeeding support groups were restricted from meeting in person during the Covid-19 pandemic, but many are back operating as in person support groups. Voluntary organisations offer breastfeeding support groups in addition to the HSE, there are over 220 breastfeeding supports nationwide available in every county and the number is increasing. The vast majority of support groups meet in person, but online options are available to individuals where in-person groups are not accessible.
All nineteen maternity hospitals provide antenatal education and breastfeeding preparation classes. A new National Antenatal Education Programme for Women and their Chosen Birth Partners in line with National Standards for Antenatal education in Ireland (links.uk.defend.egress.com/Warning?crId=6605bb7dc5024bf7524f0117&Domain=health.gov.ie&Lang=en&Base64Url=eNpFi0EOgDAIwF7EuPsbdCgkOJYNQ_y9Jh68NWkrEX0uiJlZZHJRRm4H0upXYIqjMFlIstnK-hq_BvShPjTuF_wYdJ48cRO1Cl8N1Cr8C7XgRkEGXEuv-wMQBSwo&@OriginalLink=https://www.hse.ie/eng/about/who/healthwellbeing/our-priority-programmes/child-health-and-wellbeing/antenatal-ed.pdf) is being implemented across all maternity hospitals in 2024.
There is a blended approach with in-person and online delivery of antenatal education in line to meet the demand for antenatal education services and service user requests. In situations where a woman is likely to need additional support to breastfeed, the pregnant woman will also have the opportunity to have a consultation with an infant feeding/lactation midwife or nurse during her pregnancy. Over the last three years, the number of lactation consultants across community and acute services has doubled to improve access to breastfeeding supports to all new parents.
Research indicates that breastfeeding gives a child the optimum start in life and that increasing our breastfeeding rates will contribute to improvements in child and maternal health and can contribute to the reduction of childhood obesity and chronic diseases. Currently the HSE are evaluating the implementation of the Breastfeeding Action plan and consideration will be given to how best to support mothers to breastfeed and increase breastfeeding rates in Ireland in the coming years.
523. Deputy Fergus O'Dowd asked the Minister for Health the total number of times the HSE has written to Members of the Oireachtas, including Ministers, seeking a correction to the record of the House, over the past ten years; and if he will make a statement on the matter. [37827/24]
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.
524. Deputy Fergus O'Dowd asked the Minister for Health the details of the total amount the HSE has spent on litigation, howsoever arising, against families of persons with disabilities where the person is a ward of court, over the past ten years; the breakdown of the category of litigation, to include injunctions, defamation proceedings and any other relevant details; and if he will make a statement on the matter. [37828/24]
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.”
525. Deputy Alan Kelly asked the Minister for Health if he will consider adding the injection ozempic to the drugs payment scheme (details supplied); and if he will make a statement on the matter. [37854/24]
Amharc ar fhreagra538. Deputy David Cullinane asked the Minister for Health if he has considered the inclusion of ozempic in the drug payment scheme for purposes other than management of type 2 diabetes; if he has considered this in the context of its application in managing patients with insulin resistance; and if he will make a statement on the matter. [37877/24]
Amharc ar fhreagraI propose to take Questions Nos. 525 and 538 together.
The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013. Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority (HPRA).
In line with the 2013 Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the reimbursement list, or to have a new indication for a medicine added to the list. In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact.
Ozempic® (Semaglutide) is indicated for the treatment of adults with insufficiently controlled type 2 diabetes as an adjunct to diet and exercise. Ozempic® (Semaglutide) is not licensed or reimbursed for the treatment of weight management in a non-diabetic population.
Therefore, reimbursement support for Ozempic® (Semaglutide) for the licensed indication only is available to those with eligibility under the General Medical Services (GMS) Scheme or the Long-Term Illness (LTI) Scheme. Ozempic® (Semaglutide) is not available on the Drugs Payment Scheme.
526. Deputy Eoin Ó Broin asked the Minister for Health for an update on the provision of a primary care centre at a location (details supplied). [37855/24]
Amharc ar fhreagraAs the Health Service Executive (HSE) holds responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have asked the HSE to respond to the Deputy directly, as soon as possible.
527. Deputy Eoin Ó Broin asked the Minister for Health the actions his Department is taking to progress the provision of GP services to the Adamstown and Lucan areas of Dublin mid-west given the rapid expansion in residential development and the serious difficulties experienced by non-GMS patients in accessing a GP in the local and surrounding areas; and if he will make a statement on the matter. [37856/24]
Amharc ar fhreagra528. Deputy Eoin Ó Broin asked the Minister for Health if there is a mechanism through which an individual with a diagnosis of a long-term illness but who is not in possession of a medical card can be appointed to a GP in their local area; and if so, if the process will be outlined. [37857/24]
Amharc ar fhreagraGPs are private practitioners, most of whom hold a GMS contract with the HSE for the provision of GP services without charge to medical card and GP visit card holders.
Eligibility for a medical card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970. The HSE assesses each medical card application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card. It is specific to the individual’s own financial circumstances.
Persons aged 70 or older are assessed under medical card income thresholds which are based on gross income. Persons under 70 are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. Certain expenses are also taken into account. Detailed guidelines are available from the HSE website.
Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card - in particular, to take full account of difficult circumstances in the case of applicants who may be in excess of the income guidelines. In such circumstances, the HSE may exercise discretion and grant a medical card, for example:
• Discretionary medical cards issued to patients with significant medical expenses but who do not satisfy the means test.
• Emergency medical cards issued to patients that are terminally ill, or are seriously ill, and in urgent need of medical care that they cannot afford.
• Medical cards issued to patients who are terminally ill with a prognosis of 24 months or less do not require subsequent means assessment and are not reviewed.
Eligibility for a GP visit card for those aged between 8 and 69 years of age is also primarily based on a financial assessment. The qualifying threshold calculation takes into consideration the applicant’s particular expenses as well as their income, allowing for those who have a higher income but also experience high expenses to potentially qualify. All children under 8 years of age and persons aged 70 years and over are eligible for a GP visit card on the basis of their age.
Further information on how the HSE assesses GP visit card eligibility and information regarding persons who are automatically eligible for a GP visit card is available from the HSE website.
Where a person who holds a medical card or GP visit card, experiences difficulty in finding a GP to accept them as a patient, that person having unsuccessfully applied to at least three GPs in the area (or fewer if there are fewer GPs in the area) can apply to the HSE National Medical Card Unit which has the power to assign a GMS patient to a GP's GMS patient list in accordance with the GMS contract.
People who do not hold a medical card or GP visit card access GP services on a private basis and can make enquiries directly to any GP practice they wish to register with. As private practitioners, it is a matter for each individual GP to decide whether to accept additional private patients. Where a GP practice has a full list of patients and cannot take on new patients, patients should contact other GP practices in the surrounding areas. The HSE website provides a "Find a GP" facility which can assist in finding nearby GP practices.
529. Deputy Cathal Crowe asked the Minister for Health if he will intervene in the matter of respite care offered to a person (details supplied); and if he will make a statement on the matter. [37858/24]
Amharc ar fhreagraAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
530. Deputy Róisín Shortall asked the Minister for Health his plans for increasing the number of persons accrued to cancer clinical trials given that the 6% target outlined in the National Cancer Strategy is not being met; and if he will make a statement on the matter. [37861/24]
Amharc ar fhreagraClinical trials are a fundamental component of high-quality care and improving patient outcomes. Over the last 15 years, my Department has invested more than €150 million in clinical trials and research support services in all healthcare areas including oncology through the Health Research Board (HRB). My Department established a National Clinical Trials Oversight Group in July of this year. This group is tasked with developing recommendations on increasing the number of trials taking place in Ireland and improving access for patients to participate in more clinical trials across a range of priority healthcare areas, including oncology clinical trials.
In recent years, my Department has made significant progress in improving clinical trial infrastructure. In an effort to improve transparency, streamline approval mechanisms, and provide a robust framework for ethical approval process for clinical trials, my Department established the National Office for National Research Ethics Committees (NREC). This office, which plays a critical role in providing expertise and guidance on research ethics, hosts three NRECs in key clinical trial areas of medical products, medical devices, and in vitro diagnostics. The Department has also invested in the expansion of an HSE research infrastructure across the Health Regions to promote an equitable national research service within the public health sector.
The HRB, as the leading funder of health research in Ireland, has been driving the growth of clinical trials in Ireland and putting in place the supporting research infrastructure with the overall aim of facilitating clinical trials that can benefit patients, the healthcare system, and the economy. In 2021, the HRB Board approved a multi-year €21.6m investment in cancer trials in Ireland, comprising support for a National Cancer Clinical Trials Network and funding for six cancer trials groups. Additionally, the HRB manages the only dedicated funding stream (i.e., Definitive Interventions and Feasibility Awards, DIFA) for clinical trials and interventions in Ireland, which supports studies evaluating a full scale, definitive trial of an intervention to provide high quality evidence on the efficacy, effectiveness, cost, and broad impact of the intervention. To date the HRB has made a total investment of €32m across 45 studies. In 2022, the HRB opened a specific cancer stream with €3m available for cancer clinical trials and interventions in the DIFA scheme.
Under the Ireland-Northern Ireland-US Cancer Consortium, €1.2m has been allocated in funding for North-South cancer research in 2024, which includes access to clinical trials on an all-island basis as a priority objective.
In line with the National Cancer Strategy 2017-2026, a National Cancer Research Group has been established. The Group aims to improve co-ordination and oversight of cancer research nationally and provide a forum for the agreement of research priorities. The Group also seeks to achieve continuity of funding and to ensure that funding allocations are linked to the agreed research priorities.
531. Deputy Róisín Shortall asked the Minister for Health the number of persons who attended an urgent colonoscopy in each of the years since 2019 including to date in 2024, in tabular form. [37862/24]
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.
532. Deputy Róisín Shortall asked the Minister for Health the number of persons who attended an urgent colonoscopy appointment within the recommended timeframe in each of the years since 2019, and to date in 2024, in tabular form; and if he will make a statement on the matter. [37863/24]
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.
533. Deputy Fergus O'Dowd asked the Minister for Health if a pre-Budget 2025 submission by an organisation (details supplied) has been received and reviewed; and if he will make a statement on the matter. [37868/24]
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
534. Deputy Robert Troy asked the Minister for Health when a person (details supplied) will be called for treatment in the National Rehabilitation Hospital. [37870/24]
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.
