Written Answers Nos. 1244-1265
1244. Deputy Claire Kerrane asked the Minister for Health further to Parliamentary Question No. 208 of 6 March 2024, when a service will be available to access adult diagnostic assessments for ADHD in County Roscommon; and if he will make a statement on the matter. [45110/24]
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.
1245. Deputy Pearse Doherty asked the Minister for Health if it is policy for ambulance arrival times not to be shared with callers during emergency calls; if this is the case, the reason for this; and if he will make a statement on the matter. [45112/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
1246. Deputy Sean Sherlock asked the Minister for Health to examine a case involving publicly funded fertility treatment (details supplied). [45116/24]
Amharc ar fhreagraAs the Deputy may be aware, a commitment to “introduce a publicly funded model of care for fertility treatment” is included in the Programme for Government.
The Model of Care for Fertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme (NWIHP) in order to ensure that fertility-related issues are addressed through the public health system at the lowest level of clinical intervention necessary.
This Model of Care comprises three stages, starting in primary care (i.e., GPs) and extending into secondary care (i.e., the six Regional Fertility Hubs located across the country) and then, where necessary, AHR (assisted human reproduction) treatment (e.g., IVF (in-vitro fertilisation) and ICSI (intra-cytoplasmic sperm injection)), with patients being referred onwards through structured pathways.
Phase One of the roll-out of the Model of Care has involved the establishment, at secondary care level, of six Regional Fertility Hubs within maternity networks covering the entire country, in order to facilitate the management of a significant proportion of patients presenting with fertility-related issues at this level of intervention. Patients are referred by their GPs to their local Regional Fertility Hub, which provides a range of treatments and interventions.
Phase Two of the roll-out of the Model of Care relates to the introduction of AHR treatment, including IVF, provided through the public health system at tertiary level.
Appropriate funding has been made available to support access to AHR treatment via HSE-approved private providers. As well as IVF and ICSI, this allocation is also being used to provide, initially through private clinics, IUI (intrauterine insemination), which can, for certain cohorts of patients, be a potentially effective, yet less complex and less intrusive form of treatment.
Referrals for AHR treatment by private providers commenced in September 2023. Criteria prospective patients should meet in order to access fully-funded AHR services and the services to be initially funded were agreed by the Department and the HSE and subsequently approved by Government in July 2023. More details on public fertility services, including information on the publicly-funded AHR treatment initiative, are available from the HSE at: www2.hse.ie/conditions/fertility-problems-treatments/fertility-treatment/ .
It is important to ensure that patients are clinically determined by a consultant in a Regional Fertility Hub for IVF, ICSI or IUI before being referred for such treatment, having undertaken at the Hub, as appropriate, extensive consultation, assessment, and the types of procedures and interventions outlined above which are available at the secondary care level. Therefore, only eligible patients who are referred from a Regional Fertility Hub can avail of the new publicly-funded AHR treatment initiative and there will be no reimbursement for patients who have paid for treatment privately.
It should be noted that a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Arrangements administered by the HSE. Medicines covered by the High Tech Arrangements must be prescribed by a consultant/specialist and authorised for supply to the client’s nominated community pharmacy by the High Tech Hub managed by the Primary Care Reimbursement Service. The cost of the medicines – which I understand in most instances is not insignificant – is then covered, as appropriate, under the client’s eligibility, i.e. Medical Card or Drugs Payment Scheme.
In addition, there is other support available in that patients who access IVF, or other advanced AHR treatment, privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme.
I want to reassure the Deputy that my Department and the Government are focused, through the full implementation of the Model of Care for Fertility, on ensuring that patients receive care at the appropriate level of clinical intervention and then those requiring, and eligible for, advanced AHR treatment such as IVF will be able to access same through the public health system.
1247. Deputy Michael Healy-Rae asked the Minister for Health if an appointment for a person (details supplied) will be expedited; and if he will make a statement on the matter. [45119/24]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In 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.
1248. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [45121/24]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In 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.
1249. Deputy Paul Kehoe asked the Minister for Health if he will outline specific measures planned to address the gap in access to newly approved cancer drugs by the European Medicines Agency between private and public patients; and if he will consider fast-tracking reimbursement timelines for these drugs to ensure equal access for all patients, regardless of insurance status; and if he will make a statement on the matter. [45124/24]
Amharc ar fhreagraThe Health (Pricing and Supply of Medical Goods) Act 2013 provides a rigorous process for the assessment of new medicines for reimbursement. This allows taxpayers to be confident both that the right medicines are chosen, and that those medicines are approved at a price that can sustainably be afforded in a budget-limited health service. Economic assessment is valuable to stretch the funds granted to the HSE as far as possible, allowing them to provide a range of services as well as innovative medicines for all citizens.
The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines, in accordance with 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. In line with the 2013 Act, and the national framework agreed with industry, a company must first submit an application to the HSE to have a new medicine added to the reimbursement list.
The timing of company applications for reimbursement in different countries can vary for a number of reasons, not least the available market share in each country. Once a company responsible for the commercialisation of a new medicine receives market authorisation, it can apply for reimbursement in the country (or countries) of its choice. Ireland, by virtue of its size and market share, may not always be prioritised by a company in the first stages of marketing a new product. Describing timelines for reimbursement from EMA approval to HSE reimbursement approval does not consider this important factor and misrepresents the process, as statutorily the HSE would not be able to approve or assess a drug until an application for reimbursement was received.
In assessing an application to reimburse a medicine, the HSE is required to consider a range of criteria including the magnitude of the clinical effect, cost effectiveness, budget impact, opportunity cost and unmet need. HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds.
In February 2023 I published the Mazars Review which examined the governance arrangements around the HSE’s Drug Pricing and Reimbursement Process. The Report found that the reimbursement process is operating in line with the legislation and that it is delivering results in line with international norms. I fully support the recommendations contained in the Mazars report included improving the process, increasing transparency, providing easier access, and supporting value for money.
In 2024, there was significant investment in additional staff resources to enhance the HSE’s medicines pricing and reimbursement process. This is a recommendation of the working group which I established following the publication of the Mazars Review in February 2023, with funding allocated for an additional 34 WTE for the agencies involved in the HSE’s medicines pricing and reimbursement. The hiring process is ongoing and nearing completion.
Ireland has a voluntary private health insurance market which operates under the principles of community rating (including lifetime community rating), open enrolment, lifetime cover and minimum benefits. Insurers are required to offer a minimum level of cover in every insurance policy. Health insurance companies may exclude or include certain services and providers in their policies, provided they remain in compliance with the Minimum Benefit Regulations. Beyond Minimum Benefits regulations, the Minister has no role to play in the commercial decisions of any health insurer. The Minister for Health regulates the Private Health Insurance Market in Ireland. The Health Insurance Act 1994 (Minimum Benefit) Regulations 1996 require insurers to offer a minimum level of cover to every insured person.
Private Health Insurance companies operate as commercial entities in a competitive private health insurance market. Beyond prescribing under the Regulations the minimum level of coverage that health insurers must provide, the Minister is not in a position to direct any insurer to provide cover for any particular procedure or service, or direct how that cover is to be provided.
1250. Deputy Paul Kehoe asked the Minister for Health further to Parliamentary Question No. 708 of 18 September 2024, when a response will issue; and if he will make a statement on the matter. [45125/24]
Amharc ar fhreagra1251. Deputy Paul Kehoe asked the Minister for Health if he will consider the inclusion of the shingles vaccine in his Department's policy decision following the health technology assessment recently carried out by HIQA on the herpes zoster vaccine (details supplied); and if he will make a statement on the matter. [45127/24]
Amharc ar fhreagraShingles vaccination is not currently provided as part of the national immunisation programme but it is open to any individual who is aged 50 years and older and who wishes to receive the vaccine to consult with their GP or pharmacist.
The shingles vaccine is not available through the medical card or drug payment schemes.
The ages at which vaccines are recommended in the national immunisation programme are chosen by NIAC in order to give each individual the best possible protection against vaccine preventable diseases.
The Health Information and Quality Authority (HIQA) recently carried out a Health Technology Assessment (HTA) on the herpes zoster vaccine which protects against shingles. A HTA is a multidisciplinary research process that collects and summarises information about a health technology. The information can cover a range of fields, including clinical effectiveness and safety, cost-effectiveness and budget impact, organisational and social aspects, and ethical and legal issues. The information is collected and presented in a systematic, unbiased and transparent manner.
HIQA published the HTA on 19 July 2024. The HTA found that adding the shingles vaccine to the schedule is not cost effective and is associated with a substantial budget impact. My Department has considered its findings and determined that the introduction of the vaccine can be reconsidered when cost effectiveness is more favourable.
1252. Deputy Pádraig Mac Lochlainn asked the Minister for Health if provision has been made within the recent Budget announcement for women who are required to take hormone blocking medication such as zoladex and letrozole as part of their cancer treatment, in the same manner that provision has been made for women to receive free HRT; and if he will make a statement on the matter. [45128/24]
Amharc ar fhreagraIn Budget 2025, I was able to secure a €20 million allocation for the introduction of a state-funded Hormone Replacement Therapy measure for women experiencing symptoms of menopause. This measure will come into effect in January 2025 and will mean that where a women has received a prescription for HRT for the treatment of her menopause symptoms by her healthcare provider, the State will meet the cost of those medications or products. This will cover medications and products on the HSE Reimbursement List.
At present, the current provision is for free HRT products for the treatment of menopause symptoms as this is the most commonly used treatment for managing menopausal symptoms and has shown to be the most effective intervention.
It is important to acknowledge that there are women who are contraindicated for the use of HRT in treating their menopause symptoms, and there are women who choose not to take HRT in some instances. In these cases, it is important to discuss options with a GP, or in some cases an oncologist, to decide the best course of action for the treatment of these symptoms.
Some women experiencing more complex symptoms, including those who are contraindicated for the use of HRT, may be referred to one of our Specialist Menopause Clinics for continued care free of charge.
1254. Deputy John Paul Phelan asked the Minister for Health when Ireland intends to align with the NICE recommendations on CGM for certain eligible cohorts of insulin-using individuals with type 2 diabetes (details supplied); and if he will make a statement on the matter. [45138/24]
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 medical products; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
1260. Deputy Robert Troy asked the Minister for Health further to Parliamentary Question No. 311 of 17 October 2024, which was not answered sufficiently, if all National Ambulance Service staff, including those promoted to management positions are being paid fully in line with ruling 19131 of the Labour Court. [45155/24]
Amharc ar fhreagraI have asked the HSE to respond to the deputy on this matter.
1261. Deputy Robert Troy asked the Minister for Health if there are categories of management within the National Ambulance Service that are currently receiving the advanced paramedic allowance; the particular roles which are receiving this allowance; and the number of members of management in the National Ambulance Service receiving the allowance. [45156/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive (HSE) to respond to the Deputy directly as soon as possible.
1262. Deputy Brendan Griffin asked the Minister for Health when a person (details supplied) in County Kerry will be called for an operation; and if he will make a statement on the matter. [45157/24]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In 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.
1263. Deputy Robert Troy asked the Minister for Health if he will expedite an appointment for surgery for a person (details supplied). [45158/24]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In 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.
1264. Deputy Fergus O'Dowd asked the Minister for Health if he will have a separate inquiry led by experienced medical persons, such as the Leas Cross inquiry into what happened in relation to nursing homes taken over by the HSE during the Covid pandemic, such as a nursing home in Dundalk (details supplied); and if he will make a statement on the matter. [45163/24]
Amharc ar fhreagraI recognise how difficult it has been for the families of nursing home residents who died in nursing homes during the pandemic, which presented one of the greatest and most wide-ranging public health challenges internationally in recent history.
Supporting nursing homes to respond to COVID-19 was an ongoing and central element of the State’s overall response throughout all phases of the pandemic. The publication of the COVID-19 Nursing Homes Expert Panel report and recommendations in August 2020 provided the guiding framework not only for the pandemic response in nursing homes but also for a wide-ranging programme of improvement and reform for older persons’ care, which continues today.
The Government has announced that a comprehensive evaluation of how the country managed COVID-19 will be carried out. The Government has agreed on the terms of reference and appointed Professor Anne Scott to chair the evaluation and oversee the process. A multi-disciplinary panel with relevant expertise will undertake the evaluation.
The focus of the evaluation will be on the whole-of-government response to the pandemic and how we might do better and be in a stronger position if another pandemic or other similar type event were to occur. It will include consideration of the health service response along with the wider economic and social response, including the impact on education and businesses.
It has been confirmed in the terms of reference that the evaluation will include a specific module to evaluate the response to COVID-19 in long-term residential care facilities for older persons and to provide an overall assessment of learnings. This module will take particular account of the Nursing Homes Expert Panel report, subsequent implementation progress reports, and any relevant outputs from other documentary analysis and information gathering which will include the lived experience of the bereaved families. It is also intended to have a public consultation element to hear the lived experiences of all society more generally.
1265. Deputy Fergus O'Dowd asked the Minister for Health if he sought the views of other persons or bodies involved in the Covid pandemic; if so, to list them; and if he will make a statement on the matter. [45165/24]
Amharc ar fhreagra
