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 Header Item Written Answers Nos. 65-71
 Header Item Alcohol Pricing
 Header Item Tuberculosis Incidence
 Header Item Nursing Homes Support Scheme Oversight
 Header Item Abortion Services
 Header Item Primary Care Services Provision

Wednesday, 19 December 2012

Dáil Éireann Debate
Vol. 787 No. 4

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Written Answers Nos. 65-71

Alcohol Pricing

 65. Deputy Thomas P. Broughan Information on Thomas P. Broughan Zoom on Thomas P. Broughan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly his proposals in relation to the proposed Sale of Alcohol Bill; his views on whether the Bill should contain measures on the labelling of alcohol, a minimum price of alcohol, and a dedicated training programme for all alcohol retailers and their staff before an alcohol licence or an off-licence permit can be renewed; the other measures he is proposing to take to tackle the misuse of alcohol in Irish society; and if he will make a statement on the matter. [56886/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Real and tangible proposals are being finalised on foot of the recommendations in the National Substance Misuse Strategy report. I intend to submit these proposals to the Government for consideration and approval as soon as possible. I emphasise that these proposals cover all of the areas mentioned in the report, including the areas mentioned by the Deputy, such as legislation on minimum unit pricing, which is about setting a statutory floor price per gram of alcohol; access and availability of alcohol, including of course structural separation in retail units where alcohol is sold; and advertising and sponsorship. As part of the process of developing these proposals, my Department is in continuing discussions with various Departments, including the Department of Justice and Equality. Discussions with the latter have been based on the implementation of the recommendations of the National Substance Misuse Strategy report, in so far as they apply to that Department; and in particular to the issue of the structural separation of alcohol from other products in mixed trading outlets. In the meantime, work by officials in my Department on developing a framework for the necessary Department of Health legislation governing, among others, minimum unit pricing and labelling of alcohol, is continuing. For example, in conjunction with Northern Ireland, a health impact assessment is being commissioned as part of the process of developing a legislative basis for minimum unit pricing. Scotland commissioned the same sort of assessment before it drafted its legislation on minimum unit pricing. The health impact assessment will study the impact of different minimum prices on a range of areas such as health, crime and likely economic impact.

Tuberculosis Incidence

 66. Deputy Derek Keating Information on Derek Keating Zoom on Derek Keating asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if his attention has been drawn to the fact that a group of GPs in Dublin recently raised money and brought a mobile TB monitoring unit to the city and carried out random research and to their shock discovered that there was a significant increase in Tuberculosis and particularly an increase in the number of multi-drug resistant Tuberculosis; if his attention has been drawn to the fact that prime time TV carried an extensive programme in which Professor Keane of St. James’s Hospital expressed concern and alert at the rise in Tuberculosis and the fact that there were only a small number of isolation units to treat multi-drug resistant TB; if he will address these issues; and if he will make a statement on the matter. [56968/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly In November 2012, a pilot mobile TB screening programme was carried out among vulnerable groups by the London Find and Treat programme in collaboration with Safetynet Primary Care Network for Homeless People and Northdoc. No new cases of TB have been notified to the HSE as a result of this pilot screening programme. The WHO describes countries with an incidence of less than 10 cases per 100,000 population as low incidence countries.  The annual notification rate of TB has declined in Ireland since 2007 when the rate was 11.3 per 100,000 (480 cases).  In 2010 and 2011, the annual TB notification rates were 9.2 per 100,000 (420 cases in 2010 and 424 cases in 2011) which is the lowest rate recorded since surveillance of TB began in the 1950s and now categorises Ireland as a low incidence country.  The number of TB notifications for 2012, up to the week ending 9 November, was 339, which represents a decrease of 49 cases compared to the same period in 2011 when there were 388 cases.

  However, annual rates of TB remain high in parts of inner city Dublin and North Dublin ranging between 17 per 100,000 to 30 per 100,000 in some areas.  However, LHO 7 (comprising  mainly Dublin 1 and 7) has shown a decline in rates of TB  from 2010 when the rate was 22.9 per 100,000 population (31 cases) to a rate of 14 per 100,000 (19 cases) in 2011.  In 2011, a prison outbreak in Dublin increased the TB rate in that local area to 28/100,000. In addition, in Ireland tuberculosis is increased in other marginalised groups such as prisoners and those involved in substance misuse.   Data from the World Health Organization indicate that TB notification rates always tend to be higher in inner-city locations than in the general population. This is reflected in all major cities worldwide.  In 2010, the most commonly reported risk factors for TB reported in Ireland were being from a country of high TB endemicity (n=92, 43.8%), followed by substance misuse (n=32, 15.2%), contact with a case of TB (n=23, 11.0%) and co-morbidity with an immunosuppressive illness (n=27, 12.9%). Other risk factors reported included treatment with immunosuppressive medication (n=5, 2.4%), co-morbidity with diabetes (n=6, 2.9%) and treatment with anti‐TNF medications (n=4, 1.9%). Other TB risk factors reported included various co-morbidities (including malignancies, respiratory illness and auto-immune disorders), tobacco use, homelessness, previous history of TB and travel to areas of high endemicity.

  In summary, the overall rate of tuberculosis continues to decline in the general population and particularly in the indigenous Irish general population.  As in other low prevalence countries in Europe, the disease is more focussed in marginalised groups such as homeless people, prisoners, substance misusers and immigrants from countries of high endemicity. The number of cases of multidrug resistant TB (MDR-TB) notified in Ireland 1998-2010 is outlined in the following table:

Year Total number of TB cases notified MDR TB cases
1998 424 0
1999 469 2
2000 395 3
2001 381 2
2002 408 0
2003 407 1
2004 432 2
2005 450 2
2006 465 4
2007 480 7
2008 468 2
2009 479 1
2010 420 1
2011 424 N/A

Data taken from the annual reports of the national disease surveillance unit of the Health Protection Surveillance Centre, which are available at

Nursing Homes Support Scheme Oversight

 67. Deputy Michael Colreavy Information on Michael Colreavy Zoom on Michael Colreavy asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the changes made to the fair deal scheme in Budget 2013; if he will advise if the review of the scheme is completed and if and when it will be published; and if he will make a statement on the matter. [57008/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch Two changes to the Nursing Homes Support Scheme were announced in Budget 2013. First, the asset contribution will be increased from 5% to 7.5% per annum. This will be capped at three years, or 22.5%, in the case of the principal private residence. This change will apply to new and existing nursing home residents. However, for existing residents, it should be noted that, in the case of the principal private residence, the higher percentage will only apply for the time remaining of the three-year cap. In the case of all other assets, it will apply for as long as the person remains in receipt of financial support under the scheme. Second, the entitlement for State support to be backdated to 27 October 2009 for people who were in nursing home care prior to the scheme commencing will be abolished. It is important to note that the legislation underpinning the scheme must be amended before these measures can be implemented. Therefore, an effective date will be announced in 2013. Finally, the review of the Nursing Homes Support Scheme will proceed as planned. A considerable amount of preparatory work for the review has already been completed. It will progress within the constraints of available staff and other priorities. It is envisaged that the review will be completed in 2013.

Abortion Services

 68. Deputy Mary Lou McDonald Information on Mary Lou McDonald Zoom on Mary Lou McDonald asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the further action he will now take in response to the Report of the Expert Group on the Judgment in A,B & C vs Ireland; and if he will make a statement on the matter. [57007/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The Government today approved the implementation of the judgment of the European Court of Human Rights in the A, B and C v. Ireland case by way of legislation with regulations, within the parameters of Article 40.3.3° of the Constitution as interpreted by the Supreme Court in the X case. The Joint Oireachtas Committee on Health and Children will hold hearings on this matter in early January 2013.

  Question No. 69 answered with Question No. 64.

Primary Care Services Provision

 70. Deputy Brendan Smith Information on Brendan Smith Zoom on Brendan Smith asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the number of additional primary care posts that will be in place in 2013; and if he will make a statement on the matter. [57084/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White An allocation of €20 million was set aside in the HSE's 2012 National Service Plan for approximately 250 Primary Care posts, including Public Health Nurses, Registered General Nurses, Occupational Therapists, Physiotherapists, Speech and Language Therapists and 17 Integrated Care Diabetes Nurse Specialist posts. The Diabetes Nurse Specialist posts will support the phased roll-out of the national chronic disease management programme for diabetes which is expected to commence shortly. The HSE recently held interviews for the Diabetes Nurse Specialist posts. It is expected that these posts will be filled early in 2013. Due to financial constraints, it was not possible to fill the primary care posts in 2012. It is my firm intention to have these posts filled as soon as possible in 2013.

  Question No. 71 answered with Question No. 21.

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