Written Answers Nos. 352-372
352. Deputy Johnny Mythen asked the Minister for Health if the HSE currently provides any funding to a local service (details supplied) or if the HSE has provided funding to it at any time in the past; if not, whether the HSE would be willing to enter into a service level agreement with the service to provide funding to assist in the day-to-day running of this vital local service; and if he will make a statement on the matter. [43657/24]
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.
353. Deputy Rose Conway-Walsh asked the Minister for Health if HSE staff are entitled to an additional five days of sick pay if they contract Covid; and if he will make a statement on the matter. [43671/24]
Amharc ar fhreagraWhen the pandemic commenced in 2020, the Department of Public Expenditure, National Development Plan and Reform (DPENDPR) introduced 'Special Leave with Pay for COVID-19' (SLWP) in lieu of sick leave for employees across the entire civil and public service with confirmed COVID-19 to assist in the prevention of the possible onward spread of COVID-19 in the work premises. This is a separate leave type to the Public Service Sick Leave Scheme.
The duration of this SLWP has been changed a number of times by DPENDPR since it was introduced. Currently this leave type applies only to newly confirmed cases of COVID-19 as per current public health guidance (currently 5 days stay at home).
354. Deputy Rose Conway-Walsh asked the Minister for Health if there is any assistance for staff working in private residential facilities to access additional sick pay if they contract Covid; and if he will make a statement on the matter. [43672/24]
Amharc ar fhreagraStaff working in private residential facilities are private employees working for private employers.
Any terms and conditions of employment issues, such as sick pay of staff in private employment are a matter between the employer and the employee.
The Deputy may wish to engage with the Minister for Social Protection should she wish to enquire in respect of illness benefits payable.
355. Deputy Pearse Doherty asked the Minister for Health the current staffing levels, current vacancies, and how long these positions have been vacant in HSE home support positions, for each sector in County Donegal, for each area per month in 2024, in tabular form; and if he will make a statement on the matter. [43674/24]
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.
356. Deputy Pearse Doherty asked the Minister for Health the total number of approved home care package applications in County Donegal which remain without home support, per sector and area, per month, to date in 2024; and if he will make a statement on the matter. [43675/24]
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.
357. Deputy Pearse Doherty asked the Minister for Health if a recruitment embargo is in place within the HSE home support service in County Donegal in the older persons service and disability service; and if he will make a statement on the matter. [43676/24]
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.
358. Deputy John McGuinness asked the Minister for Health to confirm the income amount generated by the car park at St Luke's General Hospital, Kilkenny in each of the last five years; the number of vehicles clamped in the car park for the same period; if a more user friendly plan for parking on the hospital campus incorporating emergency drop-off points, 15 minute free parking, parking for the elderly and disabled spaces close to the main hospital is being developed; and if he will make a statement on the matter. [43697/24]
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.
359. Deputy John McGuinness asked the Minister for Health the number of contracts in place in Carlow and Kilkenny for the provision of taxi and transport services for use by hospitals to accommodate patients attending medical and dialysis appointments; the cost of such services in each of the last five years; and if he will make a statement on the matter. [43698/24]
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.”
360. Deputy John McGuinness asked the Minister for Health if an appointment for a scope will be arranged at St Luke's General Hospital, Kilkenny, as a matter of urgency for a person (details supplied). [43700/24]
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.
361. Deputy John McGuinness asked the Minister for Health if a person (details supplied) will be admitted to the National Rehabilitation Hospital, Dún Laoghaire, as his case is said to be urgent. [43708/24]
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.”
362. Deputy John McGuinness asked the Minister for Health if a person (details supplied) will be issued with an emergency medical card immediately based on his critical medical circumstances and urgent need to access services. [43709/24]
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.
363. Deputy Paul Kehoe asked the Minister for Health to confirm the existence of an oversight agreement between his Department and the National Centre for Pharmacoeconomics ((NCPE) as of 1 October 2024 as is required under the code of practice for the governance of State bodies; to outline the details of such an agreement and how it reflects the NCPE's legal framework; to outline their compliance with the agreement; if such an agreement exists, to provide it to the Oireachtas; if it does not exist, the reason; and if he will make a statement on the matter. [43714/24]
Amharc ar fhreagraThe National Centre for Pharmacoeconomics (NCPE) was established in 1998 with the aim of promoting expertise in Ireland for the advancement of the discipline of pharmacoeconomics through practice, research and education. The NCPE is an independent Health Technology Assessment (HTA) Agency responsible for evaluating drug treatments for use in the Irish healthcare setting. The NCPE conducts the HTA of drugs for the health service in Ireland in collaboration with the Health Service Executive's Corporate Pharmaceutical Unit. They assess comparative clinical effectiveness and cost-effectiveness of drugs compared to current standard of care, as well as the budget impact.
The NCPE report to the HSE via the Chief Clinical Officer. All NCPE HTAs are disseminated to the HSE’S Chief Clinical Officer on completion. Therefore, there is full oversight of all HTAs completed by the NCPE. Furthermore, the NCPE responds to all requests from the Minister as and when required.
The NCPE was subject to audit in 2019 as part of a review commissioned by the Department of Health and conducted by Mazars examining the governance arrangements to support the HSE’s drug reimbursement process. In relation to NCPE staffing and governance the report highlighted that: “As their roles are so specialist, we reviewed the qualifications of the staff at the NCPE. We noted that the assessors in the NCPE have all completed or are in the process of completing a PHD programme in Pharmacoeconomics. This is a highly unique skill set and these individuals are highly valuable to this process. The calibre of the staff resources employed in the NCPE is testament to the strong governance in this process”.
The NCPE is highly regarded internationally and is playing a leading role in three international initiatives: the Beneluxa Initiative, International Horizon Scanning Initiative, and the European HTA Regulation. The Regulation on HTA entered into force in January 2022 and will fully apply as of January 2025. Its purpose is to strengthen the quality of HTA in the European Union and ensure efficiency in the evaluation of new medicines and technologies in a consistent way across member states. The HTA Coordination Group is the main governance body established under the EU HTA legislation. The NCPE’s Head of HTA Strategy and External Engagement is the Chair of this Group.
The NCPE also has a research function, with staff holding numerous teaching commitments and affiliations with the School of Medicine in Trinity College Dublin.
364. Deputy Paul Kehoe asked the Minister for Health the number of newly-authorised medicines under the European centralised procedure in 2018 to 2024 in respect of which the Health Information and Quality Authority (HIQA) has discharged its function under Section 8 (1) (h) of the Health Act, 2007 to evaluate clinical and cost effectiveness; if HIQA is capable of delegating this function; if this function is met by the issuance by HIQA of guidelines on health technology assessment for other organisations to use; and if he will make a statement on the matter. [43715/24]
Amharc ar fhreagraThis PQ has been deferred to collate an answer. A response will issue to the Deputy within ten working days.
365. Deputy Carol Nolan asked the Minister for Health to provide an update on the Health (Amendment) (Licensing of Professional Home Support Providers) Bill; the measures taken to date to provide a licensing framework for home support providers, while making it an offence to operate a home support service without a licence and incorporating transitional arrangements for existing home support providers; and if he will make a statement on the matter. [43722/24]
Amharc ar fhreagraEnsuring that all home support users are provided with high quality care is a priority for my Department and the Government as a whole. As such, considerable work has gone into developing a regulatory framework for home support providers. This work comprises of primary legislation for the licensing of home support providers, regulations for home support services which will set out the minimum requirements that a provider must meet to obtain a licence, and HIQA national standards.
In 2024, the Department of Health is focused on developing the regulatory framework for providers of home support services. It aims to ensure that all service users are provided with high-quality, regulated care. The new system of regulation for home support will ensure that the public can be confident that the services provided are of a high standard and will bring Ireland in line with best international practice. This will comprise of primary legislation for the licensing of home support providers, regulations for home support which will set out the minimum requirements that a provider must meet to obtain a licence, and HIQA national standards. Work is ongoing within the Department to progress this commitment.
The Health (Amendment) (Licensing of Professional Home Support Providers) Bill will regulate home support services in Ireland by establishing a licensing system for providers of home support services, under which it will be an offence to operate a service without a license. Under the legislation, HIQA’s Chief Inspector for Social Services will be the licensing authority with responsibility for monitoring and assessing compliance with regulations and HIQA national standards. The Bill will confer on HIQA, the authority to grant, amend and ultimately revoke a license if home support providers fail to meet minimum requirements. The objective of the proposed licensing system is to improve the safety and quality of home support services by ensuring that registered home support providers do not operate below the standard set by Ministerial regulations and that those regulations are applied in a consistent and systematic way. The development of a regulatory framework for providers of home support services will ensure that all service users are provided with high quality care with the same minimum standards wherever and however it is provided.
The legislation to establish a licensing framework for home support providers is at an advanced stage. In May 2024, the General Scheme was approved by Government and has been published on the Department of Health website along with the Regulatory Impact Analysis. The General Scheme includes details of the proposed structure of the regulatory framework and sets out the transitional arrangements for existing home support providers. The Joint Committee for Health has concluded its pre-legislative scrutiny (PLS) of the general scheme with the final report published on the Committee’s website. The General Scheme has now been referred to the Office of Parliamentary Counsel and final drafting is underway.
Draft regulations for providers of home support services set out minimum requirements which have been informed by a public consultation and stakeholder engagement. The Department of Health has been working closely with HIQA, who will act as the regulator under the proposed licensing framework, regarding the scope of regulation and the development of HIQA quality standards which will go out for public consultation in 2024.
366. Deputy Brendan Griffin asked the Minister for Health if he will accept HIQA advice and instruct the HSE to put in place a procurement tender for enhanced flu vaccines for older people; if a decision will be made in a timely manner so that a tender process can be put in place this December for next year’s flu season to allow for a change in vaccine to be procured for the 2025-2026 winter flu season; and if he will make a statement on the matter. [43753/24]
Amharc ar fhreagraThe National Influenza Vaccination Programme ensures that those most vulnerable to the effects of influenza have access to the flu vaccine, free of charge. By providing vaccination to those most at risk, and those most likely to require admission to hospital should they contract influenza, the programme aims to prevent, as far as possible, the need for influenza-related hospital admissions, as well as to reduce the overall spread of influenza in the community.
My Department is currently considering the findings of HIQA's recently published HTA on enhanced inactivated influenza vaccines for over 65s. Once this consideration is complete, a policy decision will be made to inform the influenza vaccination programme.
367. Deputy Alan Farrell asked the Minister for Health the cost of expanding free GP care for children and young people up to 18 years. [43774/24]
Amharc ar fhreagraGP visit card eligibility was expanded last year under the GP Agreement 2023 to all those earning up to the median household income and to all children under the 8 years of age. All persons aged 70 years and over are also eligible for a GP visit card. Following these expansions, over half the population is eligible for GP care without charges under the GMS scheme.
Extending GP visit card eligibility to all children aged 8 to 17 years inclusive would grant eligibility to approximately 460,000 additional children (based on current existing card holder numbers and 2024 CSO population estimates). Based on the average GMS GP cost per card holder prior to last year's expansion of GP visit card eligibility, adjusted for the increase to capitation rates under the GP Agreement 2023, the additional cost of extending GP care without charges at current capitation rates to all children aged 8 to 17 years is estimated at approximately €70 million per annum. This is based on full GP visit card uptake.
However, the provision of GP care without charges to all children aged 8 to 17 years inclusive would require the negotiation of new contractual terms with the IMO, and it is likely that this would give rise to additional costs beyond this figure which cannot be estimated.
Furthermore, as the estimation is based on the average GMS GP cost per card holder, it does not take into consideration possible savings from practices that may reach the maximum payable rates from GMS supports that are calculated by panel size. The estimation also does not account for the costs that may arise from the additional practice supports provided under the GP Agreement 2023. In addition, the estimation is only made in relation to GP costs and does not include additional costs that would be borne by the HSE in order to administer the expansion and the increased level of eligibility.
368. Deputy Alan Farrell asked the Minister for Health the cost of reducing the monthly cost of drugs to €50. [43775/24]
Amharc ar fhreagraThe Drugs Payment Scheme (DPS) provides for the refund of the amount by which expenditure on approved prescribed medicines or medical and surgical appliances exceeds a named threshold in any calendar month. The DPS is not means tested and is available to anyone ordinarily resident in Ireland.
The DPS threshold was reduced twice in 2022:
• From €114 to €100 per month on 1 January 2022.
• From €100 to €80 per month on 1 March 2022.
Therefore, currently, under the DPS, no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS significantly reduces the cost burden for people with ongoing expenditure on medicines.
The estimated full year cost of reducing the DPS threshold to €50 is €67m. This costing does not take account of demographic changes, changes in eligibility (e.g., loss of medical cards), or how a reduction in the DPS threshold may impact claimant behaviour.
369. Deputy Alan Farrell asked the Minister for Health the cost of extending access to free contraception to all women over the age of 35 years. [43776/24]
Amharc ar fhreagraThe free contraception scheme was launched in September 2022, initially for those aged 17-25. It has been gradually expanded and now includes women aged 17-35 from July 1st, 2024.
Approximately 2,400 GPs and 2,050 pharmacies have signed up to provide services and products under the scheme to date. The scheme is open to women, girls and other people identifying as transgender or non-binary, who are ordinarily resident in Ireland and for whom prescription contraception is deemed suitable by their doctors.
The scheme covers the cost of consultations with GPs, primary care, student health and family planning centres and prescriptions for the wide range of contraceptive options available on the HSE Re-Imbursement List, including long-acting reversible contraception (LARCs: injections, intra-uterine devices and systems (coils) and implants) and emergency contraception in addition to the contraceptive Pill, patch and ring. LARC fittings, removals, injections and check-ups are also free of charge under the scheme.
Women who have had coils, IUDs, IUSs or implants inserted while eligible under the scheme remain eligible for subsequent checks and free removal of any devices inserted prior to reaching the eligibility limit (currently their 36th birthday), to ensure continuity of care.
It is estimated that expanding the scheme from 36-40 would cost €8m and above the age of 40, costs are approximated at €1m per year age-cohort. The total cost of full expansion is therefore estimated at €23m.
The Minister has stated that he is committed to the gradual expansion of the free contraception scheme up to and including the age of 55 (after which, prescription of contraception is not typically clinically recommended). There is no public health based reason to limit the age-range that can access the scheme, rather, its phased introduction was undertaken for a number of reasons, as follows:
• A phased approach permits additional training in line with service expansion, allowing time for more medical and other relevant healthcare professionals to be trained to fit, check and remove long acting reversible contraceptives (LARCs). The demand for LARCs is likely to rise with age.
• The Report of the Working Group on Access to Contraception noted risks regarding the number of GPs qualified to undertake these procedures in 2019, versus likely demand once cost barriers were removed.
• A training scheme was funded and is underway, managed by the ICGP, which is increasing the numbers of GPs with the expertise to fit, check and remove coils and implants. As previously stated, it is anticipated that demand for coils and implants will be higher in older age cohorts.
• Budgetary and financial planning guidelines recommend that demand-led schemes, such as the free contraception scheme, should be subject to pilot testing and/or phased implementation, in order to monitor the effectiveness of the scheme and real-world costs.
• As per the recommendations of the Report of the Working Group on Access to Contraception (published in 2019 and available on the Department’s website), it was decided to commence the scheme with younger age cohorts, as they are most likely to experience unplanned pregnancy and least likely to be financially independent. A significant number of people in the 17-25 age cohort are still in full time education and dependent on parents and guardians for income, some of whom may not be willing (or, indeed, in some cases, able) to fund prescription contraception.
It is important to note that prescription contraception, while being very effective at preventing unplanned pregnancy, does not protect against sexually transmitted infections (STIs). The National Condom Distribution Scheme supports both STI prevention and accessible contraception. Free condoms can be accessed through the national network of STI clinics, participating charities and NGO partners and on participating 3rd level campuses. Since 2023, free condoms have also been supplied with orders for free home STI testing kits.
370. Deputy Alan Farrell asked the Minister for Health the cost of increasing each of the medical card income limits by 10%. [43777/24]
Amharc ar fhreagraEligibility for a medical card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970 (as amended). The HSE assesses each medical card application on a qualifying financial threshold. Current medical card income thresholds can be considered generally in terms of cohorts aged 70 or older, and under 70 years of age, with separate thresholds and assessment criteria for each.
The information required to respond to this request is not readily available and it is not feasible to provide an estimate within constrained timeframes available. I have therefore requested officials in my Department to undertake further analysis in this area and to respond to the Deputy directly with additional relevant information as soon as possible.
371. Deputy Brendan Smith asked the Minister for Health if he will ensure that a healthcare facility is facilitated with the allocation of personnel (details supplied); and if he will make a statement on the matter. [43818/24]
Amharc ar fhreagraIn relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
372. Deputy Brendan Smith asked the Minister for Health the progress to date in advancing new accommodation at a healthcare facility (details supplied); and if he will make a statement on the matter. [43819/24]
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.
