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 Header Item Written Answers Nos. 907-931
 Header Item Information and Communications Technology
 Header Item General Practitioner Services
 Header Item Medical Card Data
 Header Item Prescriptions Charges
 Header Item Emergency Departments Waiting Times
 Header Item Medical Aids and Appliances Provision
 Header Item Medicinal Products Reimbursement
 Header Item Departmental Funding
 Header Item Medicinal Products Reimbursement
 Header Item HSE Reports
 Header Item Emergency Departments Staff
 Header Item Hospital Waiting Lists Data

Tuesday, 12 June 2018

Dáil Éireann Debate
Vol. 970 No. 1

First Page Previous Page Page of 120 Next Page Last Page

Written Answers Nos. 907-931

Questions Nos. 907 to 913, inclusive, answered with Question No. 864.

Information and Communications Technology

 914. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the estimated cost of increasing the HSE information technology budget to bring it to the EU and OECD averages, respectively; the estimated cost of increasing the HSE information technology budget by an average of 2%; and if he will make a statement on the matter. [25525/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris ICT spending is composed of Capital and Revenue but excludes staff costs.  Please note that international comparisons on information technology expenditure are difficult for a variety of reasons due to the different health system arrangements across European and OECD countries.  The 2018 national service plan set out an overall budget of over €14.5 billion for the HSE of which a 2% increase on the current level of HSE capital ICT spending would indicate an capital investment figure of €290m being made available.  Additional investment in eHealth and ICT was secured for the period 2018-2021 as part of the Mid-Term Capital Review. The capital provision for eHealth and ICT for 2018 to 2021 is set out in the table below and will allow for a multi-annual rolling programme of work on multiple projects including the capital ICT elements of the New Children’s Hospital.

2018 2019 2020  2021
€60m €85m €100m €120m 

Question No. 915 answered with Question No. 864.

General Practitioner Services

 916. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if the estimate of the cost of introducing free general practitioner care for all persons was between €330 million and €365 million, excluding those younger than six and older than 70 years of age; and if he will make a statement on the matter. [25527/18]

 917. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the estimated costs of introducing free general practitioner care to all persons based on the current scope, fee structure and payments to general practitioners; and if he will make a statement on the matter. [25528/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I propose to take Questions Nos. 916 and 917 together.

  GMS contractors receive a range of capitation rates, fee per service payments and practice supports.   It is not possible to definitively calculate the cost of universal GP access given the wide range of payments and variables that have to be accounted for.   

  Such a calculation would require a complex and detailed modelling exercise to account for a range of demographic changes, future projections of service demands and variation in the number of GPs and the allowances that could be paid.

  The Deputy will be aware that the Report of the Committee on the Future of Healthcare was published in May 2017 and recommended the phased introduction of universal GP care over the next five years through increased income thresholds.

  The research carried out for that paper estimated the cost of this approach at €91 million per year for five years for a total additional annual cost of €455m.   However, these figures have not been verified and given the time that has elapsed since this research was conducted could under-estimate the cost of this proposal.

  As the Deputy is aware, an implementation plan is being developed in response to the Sláintecare report.   This implementation plan will be comprehensive and it will set out a programme of health reform for the coming years, addressing this and other recommendations in the Sláintecare report.   I expect to bring this implementation plan to Government in the coming weeks.

Medical Card Data

 918. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the estimated cost of awarding medical cards for all adults with disabilities. [25529/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris In relation to the cost of medical card provision to all persons with a disability that do not currently qualify it is noted that the data required to model this is not available and it is therefore not possible to produce an estimate of the cost of such a proposal.  

Medical card provision is primarily based on financial assessment. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. The Act obliges the HSE to assess whether a person is unable, without due 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 and every application must be assessed on that basis. Under the legislation, having a particular illness, in itself, does not establish eligibility for a medical card. Where the applicant's income is within the income guidelines, a medical card or GP visit card will be awarded.  

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 his or her income threshold, where he or she faces difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information documentation to fully take account of all the relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses..

Prescriptions Charges

 919. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the estimated cost of abolishing prescription charges; the estimated cost of the phased abolition of charges by 50 cent; and if he will make a statement on the matter. [25530/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy..

Emergency Departments Waiting Times

 920. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the emergency department waiting times greater than 24 hours for persons over 75 years of age in 2018; if the targets were met; if not, the number of persons over 75 years of age who have had a wait of more than 24 hours in an emergency department in 2018; and if he will make a statement on the matter. [25531/18]

 921. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the number of persons aged 75 years of age or over who experienced an emergency department waiting time of more than 24 hours in 2017 and to date in 2018; the hospital in which this occurred by month; and if he will make a statement on the matter. [25532/18]

 922. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if the HSE target of eliminating emergency department waiting times of greater than 24 hours for persons over 75 years of age was met for 2018; the number of persons over 75 years of age who have had to wait for more than 24 hours in an emergency department in 2018; the hospital in which the wait occurred in each case; and if he will make a statement on the matter. [25533/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I propose to take Questions Nos. 920 to 922, inclusive, together.

  The HSE National Service Plan 2018 requires that no patient over 75 should be waiting more than 24 hours in an Emergency Department (ED).

  Initial year-to-date HSE data for April (which is still to be fully validated by the HSE) indicates that at the end of April 2018 over 88% of patients over 75 presenting in ED's nationally met this target. This equates to a total of 6,166 patients who waited longer than 24 hours in this period.

  The HSE data for 2017 shows a full year compliance with this target of 92.4%.    To note in relation to the particular query raised, I have also asked the HSE to respond to the Deputy directly with the most recent validated figures.

HSE data in relation to Patient Experience Time (PET) for all patients and specifically those over 75 is publically available on the HSE website at the following address:

www.hse.ie/eng/services/publications/performancereports/  

  The Government is, and will continue to, provide increased resources to alleviate the pressure on EDs in the face of rising demand.

Medical Aids and Appliances Provision

 923. Deputy Michael McGrath Information on Michael McGrath Zoom on Michael McGrath asked the Minister for Health Information on Simon Harris Zoom on Simon Harris when a child (details supplied) in County Cork will receive a special needs wheelchair. [25535/18]

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 HSE for direct reply to the Deputy.

Question No. 924 answered with Question No. 896.

Medicinal Products Reimbursement

 925. 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 number of persons (details supplied) who have applied to the scheme since the FreeStyle Libre sensor approval for young persons between four to 21 years of age under the reimbursement scheme; the number who have been approved since 3 April 2018 when the product was approved; the information given to type 1 diabetics regarding the product; the reason he has not approved the product for all type 1 diabetics when the product is tested and proven to be cost effective (details supplied). [25555/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy..

Departmental Funding

 926. Deputy Jonathan O'Brien Information on Jonathan O'Brien Zoom on Jonathan O'Brien asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his Department's capital allocation in each of the years 2019 to 2023; and the areas to which funds will be allocated in each of those years. [25573/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The capital funding for Health in the ten years of the National Development Plan 2018 to 2027 is €10.9 billion which provides the capital investment for a solid, ambitious plan which will improve our health services.

  The National Development Plan outlines capital funding for the Health sector for the next five years (2018 to 2022). 

National Development Plan 2018 2019 2020 2021 2022
Health Sector €493m €667m €724m €780m €825m


  The major priority Government projects currently in development comprise:

  the National Forensic Mental Health Services Hospital at Portrane,

  the new Children’s Hospital along with the Paediatric Outpatient and Urgent Care Centres at Connolly and Tallaght Hospitals,

  the redevelopment of the National Rehabilitation Hospital Phase I 

  the National Plan for Radiation Oncology at Cork University Hospital and University Hospital Galway,

  the Primary Care Centre Infrastructure Programme,

  the relocation of the National Maternity Hospital to the St Vincent’s University Hospital campus,

  the long-term residential accommodation programmes for older people (Community Nursing Home Programme) and peoples with disabilities to address regulatory standards for accommodation.  

  Health capital projects and programmes currently underway will continue and these major priority projects will require the bulk of the notified capital allocation over the initial period of the Plan, 2018-2022.

  It is important to recognise that this is a long-term plan, which will roll out over ten years and includes provision for a large number of developments across the country.

  As is to be expected with a ten-year plan, many other proposals are at an early stage and,  as with all capital development proposals, will require further appraisal, planning, design and tender before a firm timeline or funding required can be established.

  The Health Service Executive's Capital Plan for 2018-2022 is currently the subject of discussions with the Department.

  Question No. 927 answered with Question No. 659.

Medicinal Products Reimbursement

 928. Deputy Eamon Scanlon Information on Eamon Scanlon Zoom on Eamon Scanlon asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if it is accurate to state that patients wait an average of 348 days for a drug to be approved for public funding and in some cases over four years; and if he will make a statement on the matter. [25581/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The HSE has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the 2013 Act. The Act specifies the criteria for decisions on the reimbursement of medicines.

The 2013 Act does not give the Minister for Health any powers in this regard.  The HSE does not require approval or consent from the Minister or Government when making a reimbursement decision.

HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).

The NCPE conducts health technology assessments (HTAs) for the HSE, and makes recommendations on reimbursement to assist HSE decisions. The NCPE uses a decision framework to systematically assess whether a drug is cost-effective as a health intervention. 

The HSE works with the objective of within 180 days of receiving the application (or a longer period if further information is sought from the company), either adding the medicine to the reimbursement list or agreeing to reimburse it as a hospital medicine or refusing to reimburse the medicine.

The HSE strives to reach a decision in as timely a manner as possible and within the 180 days. However, because of the significant monies involved, it must ensure that the best price is achieved, as these commitments are often multi-million euro investments on an on-going basis.  This can lead to a protracted deliberation process, especially when the price sought by a manufacturer poses a very significant affordability challenge.

I am keen to explore ways in which new medicines might be more easily introduced in Ireland.  However, any innovative approaches that may be tabled must be compatible with the statutory provisions which are in place and must also recognise the context of finite Exchequer resources.  .

HSE Reports

 929. Deputy John Lahart Information on John Lahart Zoom on John Lahart asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the reason for the delay in publishing the HSE performance report for quarters in 2017 and to date in 2018. [25584/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The publication of the HSE performance reports was delayed pending finalisation of the HSE's 2017 Annual Financial Statements (AFS). The Department was engaging with the HSE to clarify the reported financial position and its impact on the AFS and the first charge. This process has now been completed and the AFS has been signed off by the Comptroller and Auditor General. I intend to lay a copy of the 2017 HSE Annual Report and Financial Statements before the House of the Oireachtas shortly.

Publication of the performance reports will now proceed. I expect that the 2017 quarter four report will be published imminently and the 2018 first quarter report will be published by the end of June..

Emergency Departments Staff

 930. Deputy Thomas P. Broughan Information on Thomas P. Broughan Zoom on Thomas P. Broughan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the reason no general practitioners will be located in the accident and emergency department of Beaumont Hospital, Dublin 9 after midnight; his plans to extend general practitioner access in this department after midnight; and if he will make a statement on the matter. [25599/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible.

Hospital Waiting Lists Data

 931. Deputy Seán Crowe Information on Seán Crowe Zoom on Seán Crowe asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the length of time a person (details supplied) is awaiting a dermatologist appointment in Tallaght University Hospital; if the waiting time is usual or excessive; the waiting time to see a dermatologist in the hospital; the number of persons awaiting an appointment with a dermatologist; the steps being taken to alleviate the waiting times; and if he will make a statement on the matter. [25601/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Improving waiting times for hospital procedures and outpatient appointments is a key commitment in the Programme for Government.

  Each year 3.3 million patients attend Hospital Outpatient clinics for appointments, with demand for services growing year-on-year. A key component of the management of waiting lists by hospitals is the categorisation of patients by clinical priority to ensure that all patients receive care in timely and clinically appropriate matter.

  A number of steps are being taken to ensure the lists are accurate and these efforts are to intensify in the coming months. The HSE is working with the NTPF and my Department to finalise an Outpatient Waiting List Action Plan focused on improving overall use of resources and ensuring timely access to treatment and care for our patients.

  According to the latest NTPF figures, there are currently 2868 on the Dermatology Outpatient waiting list for Tallaght Hospital and of these 47% are waiting 9 months or less. See table below for breakdown of waiting times.

  I have asked the HSE to respond to the Deputy directly in regard to the individual patient enquiry.

Total 0-3 Months 3-6 Months 6-9 Months 9-12 Months 12-15 Months 15-18 Months Total 18+ Months
2868 672 380 293 311 250 271 691


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