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 Header Item Written Answers Nos. 428-454
 Header Item Lobbying Data
 Header Item Maternal Mortality
 Header Item Health Services Reform
 Header Item Hospital Staff
 Header Item Health Services Provision
 Header Item Dental Services Provision
 Header Item General Practitioner Services Provision
 Header Item Medicinal Products Reimbursement
 Header Item Hospital Waiting Lists Data
 Header Item Health Services Staff Recruitment
 Header Item Health Services
 Header Item Mobility Allowance
 Header Item Cancer Services Provision
 Header Item Services for People with Disabilities
 Header Item General Practitioner Data
 Header Item General Practitioner Data
 Header Item Nursing Homes Support Scheme Review
 Header Item Occupational Therapy Staff
 Header Item Hospital Accommodation Provision

Tuesday, 10 October 2017

Dáil Éireann Debate
Vol. 960 No. 1

First Page Previous Page Page of 95 Next Page Last Page

Written Answers Nos. 428-454

Lobbying Data

 428. Deputy Róisín Shortall Information on Róisín Shortall Zoom on Róisín Shortall asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the number of occasions on which he has been lobbied in respect of the Public Health (Alcohol) Bill since March 2016; the persons he has met with; the dates of these meetings; the details of the basis of the lobbying; his views on the issues raised; and if he will make a statement on the matter. [42293/17]

: Information on Catherine Byrne Zoom on Catherine Byrne The Minister for Health is a Designated Public Official under the Regulation of Lobbying Act 2015. Information on meetings between Designated Public Officials and lobbyists is available at: https://www.lobbying.ie/.

  The Public Health Alcohol Bill is in the Programme for a Partnership Government and is a priority. It is intended that it pass through both the Dáil and Seanad in this session of the Oireachtas.

Maternal Mortality

 429. Deputy Róisín Shortall Information on Róisín Shortall Zoom on Róisín Shortall asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the number of maternal deaths in hospitals; the age of the women; if they were born here or outside the State, in tabular form; and if he will make a statement on the matter. [42299/17]

 430. Deputy Róisín Shortall Information on Róisín Shortall Zoom on Róisín Shortall asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if he will report on the availability of interpretative services within the maternity services; and if he will make a statement on the matter. [42300/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I propose to take Questions Nos. 429 and 430 together.

  As the issues raised are operational matters, I have asked the HSE to respond to the Deputy directly.

Health Services Reform

 431. Deputy Róisín Shortall Information on Róisín Shortall Zoom on Róisín Shortall asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the timeframe to which he is working to establish an implementation office for Sláintecare; when the post of senior executive to lead that office will be advertised; and if he will make a statement on the matter. [42301/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As the Deputy is aware, I supported the establishment of the cross-party Committee on the Future of Healthcare and have consistently supported its work. I have welcomed the publication of the Sláintecare report and in particular I have been encouraged by the level of cross-party consensus and stakeholder support that it has attracted.

I am committed to making tangible and sustainable improvements in our health services and the Committee’s work now provides a framework to do this. I have briefed Government colleagues on the report and I have received approval to move ahead with the establishment of a Sláintecare programme office. This office will be tasked with implementing a programme of reform, as agreed by Government, arising from the Sláintecare report. It will be led by a senior executive with the appropriate experience and skillset including a strong track record in implementing reform. My Department and the Department of Public Expenditure and Reform have sought to ensure that we are positioned to attract candidates of this calibre in what will be one of the largest public service reform processes ever undertaken in this State. It is essential, therefore, that we get this recruitment process right. I expect the recruitment to be advertised very shortly.

In parallel, work is underway to develop a detailed response to the report. The report is wide-reaching and it is important that appropriate time is allowed for it to be fully considered and for implementation arrangements to be properly designed. I will report back to Government in December on the work we are doing on translating the Sláintecare report into a programme of action..

Hospital Staff

 432. Deputy Pearse Doherty Information on Pearse Doherty Zoom on Pearse Doherty asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the progress being made to secure the allocation of two additional advanced nurse practitioners to diabetes services at Letterkenny University Hospital; and if he will make a statement on the matter. [42303/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris In response to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Health Services Provision

 433. Deputy Pearse Doherty Information on Pearse Doherty Zoom on Pearse Doherty asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if a step down bed at a community hospital will be made available for a person (details supplied) in County Donegal subsequent to discharge from Letterkenny University Hospital; and if he will make a statement on the matter. [42304/17]

: Information on Jim Daly Zoom on Jim Daly As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Dental Services Provision

 434. Deputy Robert Troy Information on Robert Troy Zoom on Robert Troy asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if dental treatment for a person (details supplied) will be expedited; and if he will make a statement on the matter. [42306/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.

General Practitioner Services Provision

 435. Deputy Pat Deering Information on Patrick Deering Zoom on Patrick Deering asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if his attention has been drawn to the fact that if a person does not have a medical card a doctor will not be assigned by the HSE; if his attention has been further drawn to the fact that no private general practitioner practices in County Carlow are accepting new persons; and the way in which a person is expected to live and work if they do not have access to basic healthcare, such as a visit to a general practitioner. [42311/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Persons who do not hold a medical card or GP visit card access GP services on a private basis. Details of the numbers of private patients attending particular GPs are not collected by the Department of Health or the HSE.

GPs are private contractors and issues relating to the acceptance of private patients or payment of fees outside the terms of the GMS contract are a matter of private contract between the clinician and his or her patients. While I have no role in relation to such matters, I would expect clinicians to consider the importance of patients having access to a GP service close to home when deciding whether or not to accept private patients.

The HSE Primary Care Unit in Community Healthcare Organisation 5 has advised that it has not been made aware of any issues regarding the assignment of private patients to GPs in County Carlow. I welcome the news that the HSE has recruited a new Open Entry GP in Tullow, County Carlow, in recent months, and that this GP commenced seeing patients in his new practice on 14 August 2017. I am also pleased to advise the Deputy that there are no vacant GMS panels in County Carlow at present..

Medicinal Products Reimbursement

 436. Deputy Marc MacSharry Information on Marc MacSharry Zoom on Marc MacSharry asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if a High Court appeal as set out under section 27 of the Health (Pricing and Supply of Medical Goods) Act 2013 is the only mechanism for a pharmaceutical company to seek reimbursement of a medicine in circumstances in which the HSE has decided not to reimburse the medicine; and if he will make a statement on the matter. [42313/17]

 437. Deputy Marc MacSharry Information on Marc MacSharry Zoom on Marc MacSharry asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans to establish an independent review mechanism to review appeals by pharmaceutical companies in circumstances in which the HSE has decided not to reimburse their medicinal products; and if he will make a statement on the matter. [42314/17]

 438. Deputy Marc MacSharry Information on Marc MacSharry Zoom on Marc MacSharry asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the difference in approach taken by Irish and other European assessors of a medicine's clinical and cost effectiveness with regard to treatments for rare disease in circumstances in which certain medicines are readily available in over 22 other European countries but have been refused access here; and if he will make a statement on the matter. [42315/17]

 439. Deputy Marc MacSharry Information on Marc MacSharry Zoom on Marc MacSharry asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the role the US Food and Drug Administration, FDA, has in assessing a medicine for reimbursement here under the Health (Pricing and Supply of Medical Goods) Act 2013; if a conflicting position between the FDA and the European Medicines Authority has a material role in assessing such medicines; and if he will make a statement on the matter.  [42316/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I propose to take Questions Nos. 436 to 439, inclusive, together.

  The assessment process for medicines in Ireland is a statutory process in line with the Health (Pricing and Supply of Medical Goods) Act 2013 ("the 2013 Act"). Other European countries assess treatments in line with the statutory or administrative approaches in place in their individual country and there is no single model in place across Europe.

  The 2013 Act, provides, inter alia, for the establishment and maintenance of a publicly accessible list of all medicines which may be reimbursed by the HSE pursuant to the various community drugs schemes.

  The process and procedures which apply when the HSE receives an application from a manufacturer to add a medicine to the list are also set out in the 2013 Act. Section 18 of the 2013 Act allows a supplier of an item to apply to the HSE requesting the HSE to add the item to the Reimbursement List. The HSE shall determine the application after consulting such experts (if any) as it thinks fit by adding the item to the Reimbursement List or refusing to add the item, the subject of the application to the Reimbursement List.

  Section 19(4) of the 2013 Act prohibits the HSE from making a relevant decision under section 18, "except in accordance with the criteria specified in Schedule 3", that apply to the item the subject of the relevant decision.

  Schedule 3 sets out the criteria applicable to items and listed items for the purposes of the HSE making a relevant decision under section 18.

  Part 3 of schedule 3 requires the HSE to have regard to the following criteria:

  1. the health needs of the public;

  2. the cost-effectiveness of meeting health needs by supplying the item concerned rather than providing other health services;

  3. the availability and suitability of items for supply or reimbursement;

  4. the proposed costs, benefits and risks of the item or listed item relative to therapeutically similar items or listed items provided in other health service settings and the level of certainty in relation to the evidence of those costs, benefits and risks;

  5. the potential or actual budget impact of the item or listed item;

  6. the clinical need for the item or listed item;

  7. the appropriate level of clinical supervision required in relation to the item to ensure patient safety;

  8. the efficacy (performance in trial), effectiveness (performance in real situations) and added therapeutic benefit against existing standards of treatment (how much better it treats a condition than existing therapies); and

  9. the resources available to the HSE.

  Section 27 of the 2013 Act allows that a, "relevant person aggrieved by a relevant decision may, within 30 days from the date on which the relevant person was given the relevant notification, appeal to the High Court against the relevant decision".

  In legislating for the establishment and maintenance of a Reimbursement List under the 2013 Act, the Oireachtas did not legislate for an alternative independent review mechanism and I have no plans to amend the 2013 Act to provide for the establishment of one at this time.

Hospital Waiting Lists Data

 440. Deputy Fiona O'Loughlin Information on Fiona O'Loughlin Zoom on Fiona O'Loughlin asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the number of persons with diabetes requiring inpatient treatment for diabetic foot ulceration from County Kildare; and if he will make a statement on the matter. [42319/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As this is a service issue, this question has been referred to the Health Service Executive for direct reply.

Health Services Staff Recruitment

 441. Deputy Fiona O'Loughlin Information on Fiona O'Loughlin Zoom on Fiona O'Loughlin asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if funding for a further podiatrist in Dublin will be made available in Budget 2018; and if he will make a statement on the matter.  [42320/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As this is a service issue, this question has been referred to the Health Service Executive for a direct reply.

Health Services

 442. Deputy Fiona O'Loughlin Information on Fiona O'Loughlin Zoom on Fiona O'Loughlin asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the reason there is a sudden increase in persons requiring inpatient treatment for diabetic foot ulceration; and if he will make a statement on the matter. [42321/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As this is a service issue, this question has been referred to the Health Service Executive for a direct reply.

Mobility Allowance

 443. Deputy Fiona O'Loughlin Information on Fiona O'Loughlin Zoom on Fiona O'Loughlin asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if the mobility allowance will be reintroduced for new applicants in 2018; and if he will make a statement on the matter. [42323/17]

Minister of State at the Department of Health (Deputy Finian McGrath): Information on Finian McGrath Zoom on Finian McGrath Conscious of the reports of the Ombudsman in 2011 and 2012 regarding the legal status of both the Mobility Allowance and Motorised Transport Grant Scheme in the context of the Equal Status Acts, the Government decided to close both schemes in February 2013.

  The Government is aware of the continuing needs of people with a disability who rely on individual payments that support choice and independence. In this regard, monthly payments of up to €208.50 have continued to be made by the Health Service Executive to 4,700 people who were in receipt of the Mobility Allowance.

  The Government decided that the detailed preparatory work required for a new Transport Support Scheme and associated statutory provisions should be progressed by the Minister for Health, and the Programme for a Partnership Government acknowledges the ongoing drafting of primary legislation for a new Transport Support Scheme. I can confirm that work on the policy proposals for the new Scheme is at an advanced stage. The proposals seek to ensure that:

  - There is a firm statutory basis to the Scheme's operation;

  - There is transparency and equity in the eligibility criteria attaching to the Scheme;

  - Resources are targeted at those with greatest needs; and

  - The Scheme is capable of being costed and is affordable on its introduction and on an ongoing basis.

  The next step is to seek Government approval to the drafting of a Bill for the new Scheme.

Cancer Services Provision

 444. Deputy Carol Nolan Information on Carol Nolan Zoom on Carol Nolan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the reason some supports for women with breast cancer such as breast prosthesis and post mastectomy bras have been reduced; and if he will make a statement on the matter. [42329/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.

Services for People with Disabilities

 445. Deputy Carol Nolan Information on Carol Nolan Zoom on Carol Nolan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris when the new legislation to provide for transport supports for persons with disabilities will be brought before Dáil Éireann; and if he will make a statement on the matter. [42330/17]

Minister of State at the Department of Health (Deputy Finian McGrath): Information on Finian McGrath Zoom on Finian McGrath Conscious of the reports of the Ombudsman in 2011 and 2012 regarding the legal status of both the Mobility Allowance and Motorised Transport Grant Scheme in the context of the Equal Status Acts, the Government decided to close both schemes in February 2013.

  The Government is aware of the continuing needs of people with a disability who rely on individual payments that support choice and independence. In this regard, monthly payments of up to €208.50 have continued to be made by the Health Service Executive to 4,700 people who were in receipt of the Mobility Allowance.

The Government decided that the detailed preparatory work required for a new Transport Support Scheme and associated statutory provisions should be progressed by the Minister for Health, and the Programme for a Partnership Government acknowledges the ongoing drafting of primary legislation for a new Transport Support Scheme. I can confirm that work on the policy proposals for the new Scheme is at an advanced stage. The proposals seek to ensure that:

  - There is a firm statutory basis to the Scheme's operation;

  - There is transparency and equity in the eligibility criteria attaching to the Scheme;

  - Resources are targeted at those with greatest needs; and

  - The Scheme is capable of being costed and is affordable on its introduction and on an ongoing basis.

  The next step is to seek Government approval to the drafting of a Bill for the new Scheme.

General Practitioner Data

 446. Deputy Carol Nolan Information on Carol Nolan Zoom on Carol Nolan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the number of general practitioners availing of a rural general practitioner allowance by county; and if he will make a statement on the matter. [42331/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply.

General Practitioner Data

 447. Deputy Carol Nolan Information on Carol Nolan Zoom on Carol Nolan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the ratio of general practitioners to population by HSE area, in tabular form; and if he will make a statement on the matter. [42332/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply.

Nursing Homes Support Scheme Review

 448. Deputy Carol Nolan Information on Carol Nolan Zoom on Carol Nolan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the steps he plans to take to eliminate the discrimination against farmers under the fair deal scheme; the timeframe for same; and if he will make a statement on the matter. [42333/17]

Minister of State at the Department of Health (Deputy Jim Daly): Information on Jim Daly Zoom on Jim Daly The Nursing Homes Support Scheme, NHSS, is a system of financial support for those in need of long-term nursing home care. Participants contribute to the cost of their care according to their income and assets while the State pays the balance of the cost.

The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.

When the NHSS commenced in 2009, a commitment was made that it would be reviewed after three years. The Report of the Review was published in July 2015. Arising out of the Review, a number of key issues have been identified for more detailed consideration across Departments and Agencies.

An Interdepartmental/Agency Working Group has been established to progress the recommendations contained in the review. This Group is chaired by the Department of Health and includes representatives from the Department of the Taoiseach, the Department of Public Expenditure and Reform, the HSE, the Revenue Commissioners, and when required, the National Treatment Purchase Fund, NTPF. These recommendations include examining the treatment of business and farm assets for the purposes of the financial assessment element of the Scheme. The programme for a Partnership Government has also committed to reviewing the NHSS to remove any discrimination against small businesses and family farms. It is important to remember that the NHSS is largely underpinned by primary legislation and changes to the NHSS will require legislative implementation.

On this basis, I have requested legal advice from the office of the Attorney General regarding potential changes to the legislation that will address this matter. My Department has also been cognisant of this matter in the context of this year's Estimates process. I have recently met with representatives from the I.F.A. to discuss various strategies that may assist with addressing their members concerns and have apprised them of the current progress. We agreed to meet again in the near future for further discussions. I am committed to this review of the position with regard to family farms and small businesses for the purposes of the financial assessment of the scheme, and I hope to be able to clarify proposed changes before the end of this year..

Occupational Therapy Staff

 449. Deputy Sean Sherlock Information on Seán Sherlock Zoom on Seán Sherlock asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the number of occupational therapists that would be needed to clear the waiting lists of children awaiting assessment of needs and long term plans, by CHO and LHO, in tabular form; and the amount it would cost over the next five years. [42368/17]

Minister of State at the Department of Health (Deputy Finian McGrath): Information on Finian McGrath Zoom on Finian McGrath The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity; and improving the quality of life for people with disabilities.

As the Deputy's question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive, HSE, for direct reply to the Deputy..

Hospital Accommodation Provision

 450. Deputy Peadar Tóibín Information on Peadar Tóibín Zoom on Peadar Tóibín asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if he will support, fund and direct the HSE to develop a rehabilitation ward in empty buildings on the site of Our Lady's Hospital, Navan, County Meath, in order to allow for the treatment of persons that are clinically discharged from hospital and still forced to occupy beds due to a blocked pathway for treatment.  [42386/17]

 451. Deputy Peadar Tóibín Information on Peadar Tóibín Zoom on Peadar Tóibín asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if he will start to fund the ten-bed escalation ward that has been operating within Our Lady’s Hospital, Navan, County Meath, for the past number of years in view of the fact this ward is key in order to prevent overcrowding and for the safe delivery of healthcare in County Meath.  [42387/17]

 452. Deputy Peadar Tóibín Information on Peadar Tóibín Zoom on Peadar Tóibín asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if he or the HSE plans to close or part close the 24-hour emergency department service in Our Lady's Hospital, Navan, County Meath, in the next 12 months in view of the level of pressure experienced by the hospital network in the region.  [42388/17]

 453. Deputy Peadar Tóibín Information on Peadar Tóibín Zoom on Peadar Tóibín asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his views on whether Our Lady's Hospital, Navan, County Meath, can function safely into the future in view of the fact the conditions in the emergency department have not changed since it was opened in 2015.  [42389/17]

 454. Deputy Peadar Tóibín Information on Peadar Tóibín Zoom on Peadar Tóibín asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the estimated cost to facilitate 24-hour emergency department consultant cover in Our Lady's Hospital, Navan, County Meath.  [42390/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I propose to take Questions Nos. 450 to 454, inclusive, together.

Our Lady’s Hospital, Navan, is part of the Ireland East Hospital Group. Every hospital in that group, large and small, has a vital role to play within the group, with smaller hospitals managing routine, urgent or planned care locally and more complex care managed in the larger hospitals.

Currently, the Hospital Group is engaged in a programme of re-design work to further integrate and enhance the role of Navan hospital within the group and to ensure that it will provide more services safely and appropriately. A key development has been efforts to promote better integration between the Mater and Navan Hospitals, in relation to day surgical activity in Navan, with surgeons from the Mater carrying out surgery in Navan. Recent capital investments include upgrade of general theatres and the Sterile Services Unit and refurbishment of the Emergency Department.

The Hospital Redesign Working Group includes representation from local GPs, the National Ambulance Service, the Mater and Navan Hospitals and from the Ireland East Hospital Group. It is intended that the Hospital Group will continue to engage closely with all interested parties to ensure that the needs of patients, staff, the local and wider community are addressed.

I can assure the Deputy that there are no immediate plans to change Emergency Department services at Navan. Any proposed changes to Emergency Department services will only take place after stakeholder consultation in the context of overall service reorganisation in the Hospital Group and will be undertaken in a planned and orderly manner.

In relation to the specific service queries raised by the Deputy, I have asked the HSE to respond to the Deputy directly..


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