Written Answers Nos. 690-706
690. Deputy Réada Cronin asked the Minister for Health to provide a detailed plan on addressing hospital overcrowding in Midland Regional Hospital Portlaoise; and if he will make a statement on the matter. [42543/24]
Amharc ar fhreagra691. Deputy Réada Cronin asked the Minister for Health to provide a detailed plan on addressing hospital overcrowding in Naas General Hospital; and if he will make a statement on the matter. [42544/24]
Amharc ar fhreagraI propose to take Questions Nos. 690 and 691 together.
As our health system faces into what is traditionally the most challenging periods of the year, I would like to assure the deputy that every measure is being taken to ensure the smooth running of our hospitals over the winter period including Naas General Hospital and the Midland Regional Hospital Portlaoise.
We are making progress in reducing the number of patients on trolleys nationwide and intensive work is ongoing with the HSE in this regard. This reduction has been achieved despite a significant increase in the number of patients presenting to Emergency Departments, particularly in cohort of patients aged 75 years and older. The improved performance seen thus far in 2024 sustains the improvements achieved with the implementation of the 2023 UEC Operational plan in the latter half of last year. That plan has now been superseded by the UEC 2024-25 Plan, which was presented to Government in July this year. Priority actions are set out under four operational pillars: Hospital avoidance, Emergency Department operations, In-hospital care delivery and Discharge management. The actions are focused on balancing system capacity and demand while optimising patient flow.
Amongst the initiatives involved in the plan are:
• Vaccine Preventable Illness: The HSE is promoting the uptake of Influenza, Measles and COVID-19 vaccinations to improve compliance for all target groups including Healthcare Workers Specialist Care in the Community
• Community Specialist Teams (CSTs) for Chronic Disease Management to deliver 19,000 patient contacts each month. CSTs for Older Persons will deliver 11,750 patient contacts each month
• GP Out of Hours Work with GP Out of Hours Services to maintain/increase GP OOH contacts and reduce the level of GP OOH referrals to EDs
• NAS Care Pathways Maximize usage of existing NAS alternative care pathways
• Injury Units to provide a 7-day service, 8am to 8pm including Bank Holidays
• The operation of 10-bedded Virtual Wards in University Hospital Limerick (UHL) and in St Vincent's University Hospital (SVUH), scaling to 25 virtual beds for each site by year end to deliver 50 virtual beds in total.
• Providing additional and extended hours for senior decision makers and staff integral to supporting 7/7 operations.
692. Deputy Réada Cronin asked the Minister for Health if he will address the significant waiting times for mental health services in County Kildare, particularly for young people; and if he will make a statement on the matter. [42549/24]
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.
693. Deputy Réada Cronin asked the Minister for Health for an update on the availability of GP services in rural areas of Kildare, particularly addressing any shortages in Monasterevin and surrounding areas; and if he will make a statement on the matter. [42558/24]
Amharc ar fhreagraGPs are self-employed practitioners and therefore may establish practices at a place of their own choosing. There is no prescribed ratio of GPs to patients and the State does not regulate the number of GPs that can set up in a town or community.
The Government is actively working to increase the number of GPs practising in the State and thereby improve access to GP services for all patients across the country.
Under the 2019 GP Agreement additional annual expenditure provided for general practice was increased by €211.6m. This provided for significant increases in capitation fees for participating GMS GPs, and new fees for additional services and increased practice supports. The GP Agreement 2023 further increased GP capitation fees, increased the existing subsidy rates for practice staff, and introduced a grant support for additional staff capacity as well a practice staff maternity leave support. These measures make general practice in Ireland a more attractive career choice for doctors.
In addition, specific supports are in place to support GPs in rural areas. The practice support package for rural GP practices was increased by 10% under the 2019 GP Agreement. Practices in receipt of rural practice supports attract the maximum allowable rates for practice staff support subsidies and locum contributions for leave taking. Specific fees are also in place for rural dispensing doctors, these were increased by 28% under the 2019 Agreement, and a ring-fenced fund of €0.6m was provided for under the 2023 Agreement to support the delivery of initiatives to support rural GPs, including assistance sourcing locum cover for leave taking.
Annual intake to the GP training scheme has been increased by approximately 80% over the last 5 years. 347 new entrants commenced training this year, a 21% increase on last year’s intake of 286. Furthermore, the recruitment of GPs from abroad is ongoing under the International Medical Graduate (IMG) Rural GP Programme. 75 IMG GPs commenced in practice under the programme in 2023; recruitment is continuing this year and funding has been provided to recruit up to 250 more GPs from outside Ireland to the country next year.
Lastly, a Strategic Review of General Practice is underway. The review, with input from key stakeholders, is examining the broad range of issues affecting general practice including issues related to GP capacity. When completed, the review will set out the measures necessary to deliver a more sustainable general practice into the future.
As there is a recent GMS GP vacancy in Monasterevin, and as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly with an update on this vacancy.
694. Deputy Réada Cronin asked the Minister for Health the measures being taken to reduce waiting lists for outpatient services at Naas General Hospital; and if he will make a statement on the matter. [42565/24]
Amharc ar fhreagraIt is acknowledged that many patients are still waiting too long for hospital appointments and treatments. I am conscious of the burden this places on patients and their families.
To address the issue, I adopted a multi-annual approach through a series of Waiting List Action Plans. Commencing in late 2021, these plans encompass short-term actions to increase capacity and activity in the short and immediate term, and longer-term reform measures to sustainably reduce both hospital waiting lists and waiting times.
The 2024 Plan with a budget of €360 million, builds on the work of previous plans which have achieved significant progress in overall waiting list reduction and in addressing long waiting times, against a backdrop of significantly increased demand for scheduled care services.
Funding of €420m is being allocated to the Waiting List Action Plan for 2025. This represents an almost 17% increase (€60m) above the significant funding allocated for the Action Plan this year.
The investment clearly demonstrates the Government’s ongoing commitment to sustainably reducing and reforming hospital waiting lists and waiting times. With this significant funding for 2025, we will continue to progress towards a having a public healthcare service in which everyone has timely and transparent access to high-quality scheduled care, where and when they need it.
The National Treatment Purchase Fund (NTPF) have advised my department that they approved In-sourcing Outpatient (OPD) initiatives for funding to date in 2024 for Naas General Hospital which will facilitate treatment for 3,690 patients on Outpatient waiting lists. Details of these initiatives are provided in the following table.
2024 NTPF outpatient insourcing approved proposals Naas hospital to date 17 October 2024
|
Specialty |
Initiative Type |
Volume |
|
General Surgery |
OPD |
160 |
|
Endocrinology |
OPD |
350 |
|
Dermatology |
OPD |
600 |
|
Rheumatology |
OPD |
200 |
|
Orthopaedic |
OPD |
1,300 |
|
Respiratory |
OPD |
350 |
|
Cardiology |
OPD |
250 |
|
Gastro-enterology |
OPD |
480 |
695. Deputy Réada Cronin asked the Minister for Health if the Novavax JN.1 Covid-19 booster will be made available to people who cannot tolerate mRNA or prefer non-mRNA vaccines; and if he will make a statement on the matter. [42585/24]
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.
696. Deputy Réada Cronin asked the Minister for Health his plans to ensure that gene immunotherapy will be made available free of charge to cancer patients; and if he will make a statement on the matter. [42586/24]
Amharc ar fhreagraIn Budget 2025, I have secured €23 million for the National Cancer Strategy. This will deliver additional staff to screening and treatment services, expansion of existing screening programmes, and funding for community cancer supports.
Since its publication in 2017, over €105 million new development funding has been allocated to the National Cancer Strategy for cancer screening, prevention, and treatment services. A further €316 million has been allocated for cancer medicines. For 2025 I have allocated €10 million for cancer medicines, with a full year cost of €14 million.
The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines and medical items, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
The HSE must comply with the relevant legislation when considering investment decisions around new medicines. Pharmaceutical companies are required to submit formal applications to the HSE if they wish their medicines to be added to the list of reimbursable items / funded via hospitals. In order to submit a formal application the medicine must hold a marketing authorisation.
The European Medicines Agency (EMA) is a centralised agency of the European Union (EU) responsible for the scientific evaluation, supervision and safety monitoring of medicines in the EU. The EMA plays an integral role in the authorisation of medicines in the EU.
The national assessment and reimbursement decision process cannot commence in the absence of a marketing authorisation.
The State is committed to providing access to as many medicines and treatments as possible, in as timely a fashion as possible, from the resources available to it.
As per the 2013 Health Act, the HSE 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.
697. Deputy Réada Cronin asked the Minister for Health his plans to ensure that gene immunotherapy is covered by health insurers; and if he will make a statement on the matter. [42587/24]
Amharc ar fhreagraIreland has a voluntary community rated private health insurance market. One of its key principles is minimum benefit, whereby insurers are required, under the Health Insurance Act 1994 (Minimum Benefit) Regulations 1996, to offer a minimum level of cover in every insurance policy. This approach ensures that all consumers obtain an appropriate minimum level of health insurance cover, regardless of what plan they purchase.
Health insurance companies are free to impose certain terms and conditions in their policies, provided that they comply with these Regulations. Beyond this, I have no role to play in the commercial decisions of any health insurer and so am not in a position to direct any insurer to provide cover for any procedure, service or treatment, or how that cover is to be provided. I am not currently considering plans to make changes to the Regulations.
In general, an insurer may refuse to cover any care or treatment if it does not deem it to be medically necessary. If a claim is declined by an insurer, the insured person should initially avail of the insurer’s complaints process and if they are not satisfied with the outcome, they can take a case to the Financial Services Pensions Ombudsman (FSPO).
698. Deputy Darren O'Rourke asked the Minister for Health the number of discretionary medical cards issued to multiple myeloma cancer patients in 2022, 2023 and to date in 2024; the number of refusals for patients with that diagnosis in the same period; and if he will make a statement on the matter. [42599/24]
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.
699. Deputy Marc Ó Cathasaigh asked the Minister for Health if he plans to make the drug fenfluramine (Fintepla), used in the treatment of Dravet syndrome, available for reimbursement through the HSE in line with the recommendations made by the National Centre for Pharmacoeconomics; and if he will make a statement on the matter. [42603/24]
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; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
700. Deputy Cathal Crowe asked the Minister for Health the estimated full-year cost of providing a lifelong medical card for everyone born with a congenital condition, eliminating the biennial review. [42604/24]
Amharc ar fhreagraUnder the Health Act 1970, eligibility for a medical card is based primarily on means. The Act obliges the HSE to assess whether a person is unable, without undue hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure.
The issue of granting medical or GP visit cards based on having a particular disease or illness 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.
Furthermore, the HSE also has a system in place for the efficient provision of medical cards in response to emergency situations i.e., in circumstances where persons are in need of urgent ongoing medical care or are receiving end of life care. In these cases, a medical card is issued within 24 hours of receipt of the required patient details and completed medical report by a healthcare professional. Additionally, patients who have been certified by their treating Consultant as having a prognosis of 24 months or less are also now eligible for a medical card without a means assessment.
With regard to the estimated cost of providing a medical card in the manner sought, the data required to model this proposal is not readily available, and it is therefore not possible to provide an estimate of the cost of the proposal.
701. Deputy John Lahart asked the Minister for Health how an organisation (details supplied) accesses the funding for a number of its services from his Department or the HSE as it is its first occasion to be granted funding and it does not have a direct line to a HSE clinical lead or departmental official; and if he will make a statement on the matter. [42621/24]
Amharc ar fhreagra710. Deputy John Lahart asked the Minister for Health how an organisation (details supplied) will access allocated funding given the absence of a clinical lead for interstitial lung disease (lung fibrosis); and if he will make a statement on the matter. [42652/24]
Amharc ar fhreagraI propose to take Questions Nos. 701 and 710 together.
As the Deputy will recall, I met the Deputy and representatives from the Irish Lung Fibrosis Association to discuss their pre-budget submission to the Department of Health in September this year.
As part of Budget 2025, I was delighted to be able to provide funding of €0.5m for lung fibrosis. Officials in my Department are currently liaising with the HSE on how this funding can be best utilised to provide supports and services to lung fibrosis patients in Ireland.
I have also asked that a meeting be arranged with the Irish Lung Fibrosis Association to gather their views and to ensure that my Department, the HSE, and the Irish Lung Fibrosis Association work collaboratively to ensure this investment provides the most benefit to lung fibrosis patients and their families.
702. Deputy Thomas Pringle asked the Minister for Health the number of persons being treated for eating disorders in Donegal in 2023; and if he will make a statement on the matter. [42623/24]
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.
703. Deputy Maurice Quinlivan asked the Minister for Health the number of outpatient appointments that were cancelled at University Hospital Limerick during the period 8 August 2024 to 29 August 2024; and if he will make a statement on the matter. [42628/24]
Amharc ar fhreagraI fully acknowledge the distress and inconvenience for patients and their families when hospital appointments and procedures are cancelled.
While every effort is made to avoid cancellations or postponements, they can happen for a variety of reasons, including capacity issues due to increased scheduled and unscheduled care demand, and unforeseen circumstances that may impact a service.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically aligned and prioritised way, hospitals follow HSE clinical guidelines and protocols.
Cancelled hospital appointments and procedures are, where appropriate, rescheduled as early as possible with priority given to patients requiring time-sensitive and urgent treatment.
As the Deputy will be aware, an expert support team was assigned to UHL ED in May, led by Grace Rothwell, HSE National Director. Following their review, the Support Team proposed a ‘full reset’ of the UHL site over a two-week period in Summer 2024.
The reset began on 8 August 2024, with suspended services gradually resuming from 19 August.
The HSE has advised that there is a waiting list recovery plan in place to reduce the impact of this ‘reset’ on waiting lists with associated actions to maximise the benefit of the reset. All patients who have had treatment deferred have been contacted directly by HSE staff and are being rescheduled as soon as possible.
In relation to the particular query raised, as this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
704. Deputy Maurice Quinlivan asked the Minister for Health the amount spent by Mid West Community Healthcare and University Hospital Limerick Group with a company (details supplied) during the years 2020 to 2024; and if he will make a statement on the matter. [42629/24]
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.
705. Deputy Maurice Quinlivan asked the Minister for Health when Eve’s Protocols, named after a person (details supplied), will be rolled out across the State; and if he will make a statement on the matter. [42630/24]
Amharc ar fhreagraAs this is a service issue, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
706. Deputy Seán Canney asked the Minister for Health the proposed staffing complement for the adult mental health service in Tuam primary care service, County Galway; the current staffing levels; the plans for recruitment of additional staff; and if he will make a statement on the matter. [42636/24]
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.
