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 Header Item Written Answers Nos. 472 - 488
 Header Item Medical Card Eligibility
 Header Item Hospital Waiting Lists
 Header Item Hospital Procedures
 Header Item Medicinal Products Licensing
 Header Item Health Services Provision
 Header Item Hospital Waiting Lists
 Header Item Hospital Staff Issues
 Header Item Medicinal Products Licensing
 Header Item Hospital Acquired Infections
 Header Item Hospital Bed Data
 Header Item Nursing Home Accommodation
 Header Item Vaccination Programme
 Header Item Drugs Payment Scheme Coverage
 Header Item Ambulance Service Provision
 Header Item Health Services Provision
 Header Item Long-Term Illness Scheme Applications

Tuesday, 11 December 2012

Dáil Éireann Debate
Vol. 786 No. 1

First Page Previous Page Page of 109 Next Page Last Page

Written Answers Nos. 472 - 488

Medical Card Eligibility

 472. Deputy Billy Kelleher Information on Billy Kelleher Zoom on Billy Kelleher asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if the qualifying medical card criteria for cancer patients has changed in recent times; if not, if he will account for the increasing number of complaints that Deputies are receiving from cancer patients who have had their applications refused; and if he will make a statement on the matter. [55239/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White Medical cards are not awarded to any particular group of patients on the basis of a specific medical condition. Under the provisions of the Health Act 1970, eligibility for health services in Ireland is based primarily on residency and means. There are currently two categories of eligibility for all persons ordinarily resident in Ireland i.e. full eligibility (medical card) and limited eligibility (all others). Full eligibility is determined mainly by reference to income limits, and is granted to persons who, in the opinion of the Health Service Executive, are unable to provide general practitioner, medical and surgical services to themselves and their dependents without undue hardship. There is no automatic entitlement to a medical card for persons who have cancer. There is a provision for discretion to grant a card in cases of "undue hardship" where the income guidelines are exceeded. The HSE recently set up a clinical panel to assist in the processing of applications for discretionary medical cards where there are difficult personal circumstances.

There is an emergency process for a person who is terminally ill, or in urgent need of medical attention and cannot afford to pay for it, that provides a card within 24 hours while the normal application process is completed. Once a letter from the patient's GP or consultant is received, stating that the person is terminally ill, and the required personal details are provided an emergency card is issued to that person for a six-month period.

  Question No. 473 answered with Question No. 459.

Hospital Waiting Lists

 474. Deputy Finian McGrath Information on Finian McGrath Zoom on Finian McGrath asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding a hospital appointment in respect of a person (details supplied). [55244/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch As this is a service matter this question has been referred to the HSE for direct reply.

Hospital Procedures

 475. Deputy Pádraig Mac Lochlainn Information on Pádraig MacLochlainn Zoom on Pádraig MacLochlainn asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding corrective surgery in respect of a person (details supplied) [55269/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly In relation to the specific query raised by the Deputy, as this is a service issue it has been referred to the HSE for direct reply.

Medicinal Products Licensing

 476. Deputy Micheál Martin Information on Micheál Martin Zoom on Micheál Martin asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the reason a company (details supplied) in County Cork which is accredited by the Irish Medicines Board as a pharmaceutical wholesaler and which has made a total of 14 submissions to the Health Service Executive in order to be awarded GMS codes for the 14 products it is trying to register, has not received any definitive response from the HSE regarding its submissions; and if he will make a statement on the matter. [55275/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The Health Service Executive is responsible for awarding GMS codes. The HSE has therefore been asked to examine this matter and to reply to the Deputy as soon as possible.

Health Services Provision

 477. Deputy Caoimhghín Ó Caoláin Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding the future of audiology services at Cootehill, County Cavan; and if he will make a statement on the matter. [55276/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The HSE National Audiology Review Group Report, published in April 2011, made recommendations to address inconsistencies and shortcomings in audiology services. These recommendations are currently being implemented and are expected to provide improvements in audiology services throughout the country. The Health Service Executive has been asked to reply directly to the Deputy regarding the provision of audiology services in Co. Cavan.

Hospital Waiting Lists

 478. Deputy Caoimhghín Ó Caoláin Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when a person (details supplied) in Dublin 11 will receive an appointment for Connolly Hospital, Blanchardstown, Dublin 15 [55279/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The management of inpatient and daycase waiting lists for patients awaiting public health care is based on the principle that after urgent and cancer patients are treated, then clinically assessed routine patients should be seen in chronological order (i.e. longest waiter first).

  Should the patient's general practitioner consider that the patient's condition warrants an earlier rescheduling of an appointment, he/she would be in the best position to take the matter up with the consultant and hospital involved.

  In relation to the specific query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.

Hospital Staff Issues

 479. Deputy Billy Kelleher Information on Billy Kelleher Zoom on Billy Kelleher asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when the replacement consultant orthopaedic surgeon post will be filled at the Mater Hospital Dublin; the reason this post has been left vacant for 18 months despite his campaign to reduce waiting lists; and if he will make a statement on the matter. [55287/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly In relation to this particular issue, I have asked the Health Service Executive to respond directly to the Deputy in this matter.

Medicinal Products Licensing

 480. Deputy Clare Daly Information on Clare Daly Zoom on Clare Daly asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the basis on which anti-epileptic drugs are being included in the list of medications for generic substitutions under the Health Bill 2012 in view of the concerns raised by his Department and the Health Service Executive working group [55295/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White Under the Health (Pricing and Supply of Medical Goods) Bill, the Irish Medicines Board has statutory responsibility for establishing and publishing a List of Interchangeable Medicinal Products.

  In deciding whether to add a group of medicinal products to the List of Interchangeable Medicinal Products, the Board must be satisfied that each medicinal product which falls within the group:

   (a) has the same qualitative and quantitative composition in each of its active substances as each of the other medicinal products which fall within the group;

  (b) is in the same pharmaceutical form as, or in a pharmaceutical form that is appropriate for substitution for, each of the other products in the group; and

   (c) has the same route of administration as each of the other medicinal products which fall within the group.

  In addition, the Bill provides that the Board is not permitted to add a group of medicinal products to the List of Interchangeable Medicinal Products where, for example, any of the medicinal products cannot be safely substituted for any one or more of the other medicinal products in the group. To further enhance the patient safety aspect of generic substitution, Section 13 of the Bill allows a prescriber to indicate on a prescription that a branded interchangeable medicinal product should, for clinical reasons, not be substituted.

  I am satisfied that these provisions address the concerns raised by the Deputy.

  It is important to point out that generic medicines must meet exactly the same standards of quality and safety and have the same effect as the originator medicine. All of the generic medicines on the Irish market are required to be properly licensed and meet the requirements of the Irish Medicines Board.

The Health (Pricing and Supply of Medical Goods) Bill 2012 was published on the 13th of July 2012. The Bill completed its passage through the Seanad on Wednesday, the 19th of September, and is currently continuing its passage through the Dáil. An Implementation Group on Generic Substitution and Reference Pricing has been established and it held its inaugural meeting on the 9th of August 2012. The Group met with the Irish Epilepsy Association, amongst others, on the 20th of November as part of its stakeholder meetings.

Hospital Acquired Infections

 481. Deputy Damien English Information on Damien English Zoom on Damien English asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the number of hospitals here that use copper/silver ionisation as a method of controlling legionella; if he will provide a list of such hospitals here; and if he will make a statement on the matter. [55314/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Both copper and silver are very effective antimicrobial substances and can be used as methods of controlling legionella. There are three HSE hospitals where copper and silver ionisation is being used for the control of legionella in water. These hospitals are St James's in Dublin, Our Lady of Lourdes in Drogheda and St Johns in Limerick.

Hospital Bed Data

 482. Deputy Billy Kelleher Information on Billy Kelleher Zoom on Billy Kelleher asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the progress that has been made to reintroduce the beds at the community hospital of the Assumption Thurles; and if he will make a statement on the matter. [55320/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch As this is a service matter it has been referred to the Health Service Executive for direct reply. However, I would like to advise the Deputy that the Community Hospital of the Assumption is registered with the Health Information and Quality Authority as a designated centre for older people. Service provision at the hospital must be viewed in the context of overall provision of services for older people in North Tipperary.

Nursing Home Accommodation

 483. Deputy Caoimhghín Ó Caoláin Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will detail current and planned Health Service Executive nursing homes facilities in Ballinamore County Leitrim; and if he will make a statement on the matter. [55322/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch I would like to advise the Deputy that all public residential centres for older people in the Sligo/Leitrim area are registered with the Health Information and Quality Authority. In relation to the Ballinamore proposal, as this is a service matter it has been referred to the Health Service Executive for direct reply.

Vaccination Programme

 484. Deputy Billy Kelleher Information on Billy Kelleher Zoom on Billy Kelleher asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will bring forward proposals setting out a package of supports for those who developed narcolepsy as a result of vaccination with Pandemrix; the reason for the delay to date in bringing the proposal to the Dáil Éireann; when he will re-establish meaningful contact with Sufferers of Unique Narcolepsy Disorder; and if he will make a statement on the matter. [55323/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly  My priority is to ensure that children/adolescents affected by narcolepsy with symptom onset post pandemic vaccination are provided with services and supports to meet their health needs.

The HSE and the Department of Education and Skills together provide a comprehensive range of services and supports to those affected. These supports and services include access to rapid diagnosis, clear treatment pathways, temporary medical cards and reimbursement of expenses incurred. Multi-disciplinary assessments which allow for the appropriate individualised health and educational supports to be put in place are ongoing. The National Educational Psychological Service (NEPS) is also engaging with the HSE and with the individual schools and parents of children concerned to identify and provide educational supports for the children and adolescents affected.

I am committed to bringing a Memorandum to Government setting out the full response to the issue. My Department is considering possible supports which may need to be put in place for those affected. Any such supports require my approval and the consent of the Minister for Public Expenditure and Reform. A further meeting with representatives from SOUND will be arranged when the matter has been concluded.

Drugs Payment Scheme Coverage

 485. Deputy Anthony Lawlor Information on Anthony Lawlor Zoom on Anthony Lawlor asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if proposals are in place to extend the drugs payment scheme to include medications that are currently not covered by the scheme; if the nebusal 7 daily nebulizer could be included under the drugs payment scheme;; and if he will make a statement on the matter. [55324/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White NEBUSAL® 7% Nebuliser Solution (sodium chloride 7%) does not meet the criteria for inclusion on the list of items reimbursable under the Drug Payment Scheme. These critieria include the following:

- the product must be a medicinal product authorised by the Irish Medicines Board or the European Commission;

- the product must be such that it is ordinarily supplied to the public only on foot of a medical prescription; and

- the product should not be advertised or promoted to the public.

  There are no proposals in place to extend the coverage of the Drug Payment Scheme to include medications that are not currently within the Scheme’s ambit.

Ambulance Service Provision

 486. Deputy Caoimhghín Ó Caoláin Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will outline air ambulance services in place in this State; if he has plans to extend this service;; and if he will make a statement on the matter. [55330/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The HSE National Ambulance Service (NAS), is responsible for pre-hospital emergency care and for transport of public patients where required, including aeromedical transport.

  The NAS uses existing state assets for aeromedical transfers, through the Irish Air Corps and Irish Coast Guard. The type of support provided is:

- Inter-hospital transfer of patients with spinal or other serious injury or illness;

- Air transport of neonates requiring immediate medical intervention in Ireland;

- Air transport of patients requiring specialised emergency treatment in the UK;

- Air transport of organ retrieval teams within Ireland;

- Air transport of patients from offshore islands to mainland hospitals;

- Air transport of paediatric patients requiring immediate medical intervention in Ireland.

  Under the Treatment Abroad Scheme, the HSE arranges transport, including land and air ambulance transport, through an agreed protocol, for patients requiring treatment in other jurisdictions. Pre-approved commercial providers are used on occasion, where no suitable state asset is available.

  The NAS is currently running, with the Irish Air Corps, a twelve month emergency aeromedical service (EAS) trial. The trial provides dedicated aeromedical support to the NAS in the west of Ireland, specifically where the land transit time from an incident to an appropriate facility may not be clinically appropriate. The purpose of the trial is to determine the extent, if any, of the need for dedicated aeromedical support to emergency ambulances in the region, in light of existing road networks and transit times, and how it might best be provided in the longer term. The primary focus is in the west and northwest, including HSE Clinical Care Programmes such as Acute Coronary Syndrome and Stroke. The service may respond to incidents elsewhere, where aeromedical assistance is appropriate, given the circumstances of the incident.

Health Services Provision

 487. Deputy Billy Kelleher Information on Billy Kelleher Zoom on Billy Kelleher asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if there is a policy document under the remit of his Department, the Health Service Executive or Health Information and Quality Authority which covers the control and administration of medicines by domiciliary care agencies; if so, if he will furnish a copy of this document; and if he will make a statement on the matter. [55333/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White Organisations providing domiciliary care services, either on behalf of the State (i.e. Health Service Executive) or private domiciliary care services, may be involved in the provision of care and support to many types of patients, such as older persons, persons with disabilities and other patients in the patients’ own home. In domiciliary care situations where the patient is receiving care in their own home, prescription medicines must be prescribed for the patient by a medical practitioner or nurse prescriber. The medicines must be dispensed by a pharmacist for the individual patient, and appropriate records must be kept by both the prescriber and the pharmacist. Persons providing domiciliary care services are required by law to administer medicines in accordance with the prescription and the instructions of the patient's prescriber. In addition, for certain patients who are experiencing difficulties in managing their own medicines at home, many pharmacies will dispense medicines in a monitored dosage system which will help the patient to adhere to their particular medication schedule.

Residential care services are services where care is provided to the patient / resident in centres such as nursing homes and other residential facilities. The Health Information and Quality Authority has issued general standards for residential care centres providing care to older persons which set out range of requirements to be complied with including standards on the management of patients' / residents' medicines in these care settings. In addition, An Bord Altranais has issued professional guidance to nurses regarding the appropriate management and administration of medicines to patients in such residential care settings and the Pharmaceutical Society of Ireland has also issued professional guidance to all pharmacists involved in the dispensing and supply of medicines to these patients.

Long-Term Illness Scheme Applications

 488. Deputy Patrick Nulty Information on Patrick Nulty Zoom on Patrick Nulty asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will expedite an application for the long term illness scheme in respect of a person (details supplied) in Dublin 15; the reason for the delay; and if he will make a statement on the matter. [55334/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The Health Service Executive is responsible for the administration of the Long Term Illness Scheme. The HSE has therefore been asked to examine this matter and to reply to the Deputy as soon as possible.


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