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 Header Item Written Answers Nos. 481-498
 Header Item Child Abuse
 Header Item Medical Cards
 Header Item Covid-19 Pandemic
 Header Item Covid-19 Tests
 Header Item Hospital Services
 Header Item Health Services Access
 Header Item Medical Cards
 Header Item Covid-19 Pandemic
 Header Item Hospital Appointments Status
 Header Item Covid-19 Pandemic
 Header Item Alcohol Pricing
 Header Item HSE Data
 Header Item National Centre for Pharmacoeconomics
 Header Item Health Services Provision
 Header Item Primary Care Centres
 Header Item Primary Care Centres
 Header Item Disability Services Funding

Tuesday, 13 October 2020

Dáil Éireann Debate
Vol. 999 No. 2
Unrevised

First Page Previous Page Page of 100 Next Page Last Page

Written Answers Nos. 481-498

Child Abuse

 481. Deputy Cian O'Callaghan Information on Cian O'Callaghan Zoom on Cian O'Callaghan asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the percentage of allegations of child sexual abuse that are recommended as unfounded each year by St. Clare’s Unit in Temple Street Hospital in each of the past five years; and if he will make a statement on the matter. [29881/20]

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

Medical Cards

 482. Deputy Matt Shanahan Information on Matt Shanahan Zoom on Matt Shanahan asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the date on which the income limits for medical cards will be increased (details supplied); if there will be further delays; and if he will make a statement on the matter. [29896/20]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly The Health (General Practitioner Service and Alteration of Criteria for Eligibility) Bill 2020, enacted on 2nd August 2020, provided for an increase to the gross medical card income limits for those aged 70 and over to €550 per week for a single person and to €1,050 per week for a couple.

In recent days the Government has approved the necessary funding required to implement this measure and the new increased income limits will take effect from November 1st   2020.

  Officials in my Department are therefore now making the necessary arrangements to commence the relevant section of the Act and are engaging with the HSE's National Medical Card unit to ensure all operational arrangements are in place for implementation of this measure.

Covid-19 Pandemic

 483. Deputy Pa Daly Information on Pa Daly Zoom on Pa Daly asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly further to Parliamentary Question No. 1327 of 8 September 2020, the number of staff redeployed from March 2020 to date from University Hospital Kerry to contact tracing or testing centres. [29898/20]

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

Covid-19 Tests

 484. Deputy Emer Higgins Information on Emer Higgins Zoom on Emer Higgins asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly if rapid antigen testing 15 minutes will be considered as part of the long-term strategy to live with Covid-19; and if he will make a statement on the matter. [29900/20]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly The HSE is not currently using rapid antigen tests. However, it is continuously examining the issues involved in their potential use, including sensitivity, as many of the antigen tests developed to date have low sensitivity.

The HSE advises that antigen testing may well have a potential role in testing of both symptomatic and asymptomatic people in the future. Studies of these tests, similar to the one mentioned, are now starting in order to ensure that if and where deployed they would be of appropriate quality and sensitivity. However, this will not replace the requirement for large scale PCR testing which remains the “gold standard” for community testing for Covid-19.

It is also worth noting the rapid Health Technology Assessment (HTA) which the Health Information Quality (HIQA) has in recent days submitted to NPHET on alternative diagnostic approaches, including antigen tests.

Hospital Services

 485. Deputy Barry Cowen Information on Barry Cowen Zoom on Barry Cowen asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly when a person (details supplied) will receive results from St. Vincent’s Hospital.  [29901/20]

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

Health Services Access

 486. Deputy Pádraig O'Sullivan Information on Pádraig O'Sullivan Zoom on Pádraig O'Sullivan asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly when the health centre in Ballymore Eustace, County Kildare will be reopened; and if he will make a statement on the matter. [29902/20]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

Medical Cards

 487. Deputy Michael Healy-Rae Information on Michael Healy-Rae Zoom on Michael Healy-Rae asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly when the income threshold for over 70s medical card will commence (details supplied); and if he will make a statement on the matter. [29906/20]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly The Health (General Practitioner Service and Alteration of Criteria for Eligibility) Bill 2020, enacted on 2nd August 2020, provided for an increase to the gross medical card income limits for those aged 70 and over to €550 per week for a single person and to €1,050 per week for a couple.

In recent days the Government has approved the necessary funding required to implement this measure and the new increased income limits will take effect from November 1st   2020.

  Officials in my Department are therefore now making the necessary arrangements to commence the relevant section of the Act and are engaging with the HSE's National Medical Card unit to ensure all operational arrangements are in place for implementation of this measure.

Covid-19 Pandemic

 488. Deputy Pa Daly Information on Pa Daly Zoom on Pa Daly asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly his views on the importance of ventilation within Covid-19 prevention guidelines; and if he will make a statement on the matter. [29920/20]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly The Deputy may wish to note that the HSE’s Health Protection Surveillance Centre has produced a range of guidance notes for COVID-19, including Guidance on building ventilation during COVID-19 which provides an overview of the current literature examining the association between ventilation and COVID-19, and provides recommendations based on the literature, specifically for non-healthcare settings.

  Question No. 489 answered with Question No. 478.

Hospital Appointments Status

 490. Deputy Niamh Smyth Information on Niamh Smyth Zoom on Niamh Smyth asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly if appointments will be expedited for a person (details supplied); and if he will make a statement on the matter. [29922/20]

Minister of State at the Department of Health (Deputy Anne Rabbitte): Information on Anne Rabbitte Zoom on Anne Rabbitte The Programme for Government, Our Shared Future,  recognises the need to improve services for both children and adults with disabilities through better implementation and by working together across Government in a better way.

  The Government commits to prioritising early diagnosis and access to services for children and ensuring that the most effective interventions are provided for each child, to guarantee the best outcomes.

  As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Covid-19 Pandemic

 491. Deputy Richard Boyd Barrett Information on Richard Boyd Barrett Zoom on Richard Boyd Barrett asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly if meetings of an organisation (details supplied) are allowed to continue in view of level 3 Covid-19 restrictions; and if he will make a statement on the matter. [29955/20]

Minister of State at the Department of Health (Deputy Frankie Feighan): Information on Frankie Feighan Zoom on Frankie Feighan Restrictions on social interaction, the requirement for self-isolation and the restructuring of services, are particularly difficult for those accessing drug and alcohol services and supports.

  I am fully aware of the vital role played by drug, alcohol support groups and treatment programmes in reducing the harms of substance use and supporting rehabilitation and recovery. They help individuals to build their recovery capital and to avoid relapse into harmful patterns of substance use.

  Earlier this week I published new guidance for drug and alcohol support groups and treatment programmes and other addiction treatment services. This new guidance will ensure that these groups can operate safely, including at levels 3 and 4 of the national framework for living with Covid-19.

  The guidance is available on the Government of Ireland website at: www.gov.ie/en/policy-information/17d32f-drugs-and-alcohol-policy/.

  The main points of the guidance are as follows:

  1. It is recommended to hold meetings and deliver programmes online or outdoors where this is possible, without diluting the benefits for participants

  2. Where it is decided to host a face-to-face group/programme meeting, organisers are advised to undertake a risk assessment to ensure the health, welfare and safety of participants

  3. Facilities used to host support groups and treatment programmes should be for exclusive use, where possible, and not shared with other users

  4. The recommended maximum number of attendees at level 3 is 15 people (including leaders), with 2 metres social distancing

  5. Support groups and programmes should last a maximum of 115 minutes (1 hour and 45 minutes)

6. Individuals at higher risk from Covid-19, or in close contact with such individuals,   should only attend meetings that are conducted online

  I want to acknowledge the input of supports groups and service providers in the formulation of this new guidance. We all share a common goal for the safe resumption of recovery support groups.

Alcohol Pricing

 492. Deputy David Stanton Information on David Stanton Zoom on David Stanton asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the date on which minimum unit pricing for the sale of alcohol will come into effect; and if he will make a statement on the matter. [29956/20]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly The 2013 Government Decision which approved the implementation of minimum unit pricing in Ireland envisaged that it would be introduced in the Republic and in Northern Ireland simultaneously. This was to allay concerns that its introduction in one jurisdiction only would impact on cross-border trade.

Legislation to introduce a minimum unit price has not yet been introduced in Northern Ireland however on 29 July this year the Northern Ireland Health Minister, Robin Swann, committed to a public consultation on the introduction of minimum unit pricing of alcohol in Northern Ireland.

HSE Data

 493. Deputy Duncan Smith Information on Duncan Smith Zoom on Duncan Smith asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly if a copy of the presentation given by the HSE in relation to airport texting will be provided; the date on which the presentation was given and to whom; and if he will make a statement on the matter. [30005/20]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly As this is a service matter, I have asked the HSE to reply to you directly as soon as possible.

National Centre for Pharmacoeconomics

 494. Deputy Alan Farrell Information on Alan Farrell Zoom on Alan Farrell asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly if his Department has examined the use of the quality-adjusted life year in determining drug funding; the conclusions made to its effectiveness; and if he will make a statement on the matter. [30007/20]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly The Quality-adjusted life Years (QALY) is the economic evaluation system which is used to set a threshold of cost-effectiveness when assessing medicines in Ireland. The QALY is a measure of the state of health of a person or group in which the benefits, in terms of length of life, are adjusted to reflect the quality of life. One QALY is equal to 1 year of life in perfect health. QALYs are calculated by estimating the years of life gained for a patient following a particular treatment or intervention and weighting each year with a quality-of-life score (on a 0 to 1 scale). It is often measured in terms of the person’s ability to carry out the activities of daily life, and freedom from pain and mental disturbance.

In March 2018, the Report on Evaluating Orphan Drugs published by the Joint Committee on Health, was received by my Department. The Committee’s report put forward a number of recommendations including the recommendation that ‘the QALY process is revised completely and replaced with a new assessment process. Such a process should be specific and appropriate to orphan drugs’  . This recommendation was carefully considered by my Department, the Health Service Executive and the National Centre for Pharmacoeconomics.

  It was determined that the QALY is the best metric we have in the area of health economics to express health outcomes. The QALY provides a useful way of assessing the value of a health intervention as this system combines mortality and morbidity into a single metric. The use of a generic measure of outcome such as the QALY makes it possible to compare outcomes from different technologies across different activities in the healthcare sector.

  Calculation of cost-effectiveness ratios using QALYs also facilitates characterisation of the value of an intervention by making it possible to compare those ratios with common benchmarks. The value benchmark in Ireland for drugs ranges from €20,000-€45,000/QALY. This benchmark represents the “value” of a QALY; i.e. the “willingness to pay” to gain 1 QALY of health. Interventions with lower cost-effectiveness ratios below the threshold are said to have a favourable value. Interventions with higher ratios are considered to have unfavourable value.

  The NCPE has advised that until such time as a comprehensive, reliable, scientifically validated alternative to the QALY can be found, we should continue to use the QALY to express health outcome benefits from the medicines that we assess for value for money. Removing the QALY would have serious financial implications and currently there is not a comprehensive, reliable and validated methodology to replace it with.

  In this context, it is important to note that the statutory framework in the Health (Pricing and Supply of Medical Goods) Act 2013, which gives full statutory powers to the HSE to assess and make decisions on the reimbursement of medicines, requires the HSE to take account of a range of objective factors and expert opinion as appropriate and not just cost-effectiveness under the QALY system. There is a list of criteria which the HSE is required to consider including the magnitude of the clinical effect, cost effectiveness, budget impact and the unmet need.

Health Services Provision

 495. Deputy Alan Farrell Information on Alan Farrell Zoom on Alan Farrell asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the measures being taken to address the growing number of non-alcohol fatty liver disease; and if he will make a statement on the matter. [30008/20]

Minister of State at the Department of Health (Deputy Frankie Feighan): Information on Frankie Feighan Zoom on Frankie Feighan As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Primary Care Centres

 496. Deputy Alan Farrell Information on Alan Farrell Zoom on Alan Farrell asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the level of service provision at a primary care centre (details supplied); his plans for its future use; if hours at the centre will be expanded; and if he will make a statement on the matter. [30009/20]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

Primary Care Centres

 497. Deputy Alan Farrell Information on Alan Farrell Zoom on Alan Farrell asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the status of the future of community healthcare in Swords, County Dublin; and if he will make a statement on the matter. [30010/20]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

Disability Services Funding

 498. Deputy Alan Kelly Information on Alan Kelly Zoom on Alan Kelly asked the Minister for Health Information on Stephen Donnelly Zoom on Stephen Donnelly the steps he is taking to ensure that the deficits experienced by section 38 and section 39 disability service providers are eliminated; the date on which these deficits will be eliminated; and if he will make a statement on the matter. [30017/20]

Minister for Health (Deputy Stephen Donnelly): Information on Stephen Donnelly Zoom on Stephen Donnelly Disability services focus on enabling people with disabilities to achieve their full potential, living ordinary lives in ordinary places, as independently as possible while ensuring that the voices of service users and their families are heard, and that they are fully involved in planning and improving services to meet their needs.

My primary concern as Minister for Health is to ensure the continuity of these vital services in the interests of the well-being of the children, adolescents and adults who, along with their families, depend on these key services and supports.

Specialist disability services are provided by a range of organisations. In some cases, services are delivered directly by the Health Service Executive (HSE). However the majority of organisations providing services for people with a disability are funded by the HSE, on the basis of service arrangements underpinned by Section 38 and 39 of the Health Act 2004. Section 38 and Section 39 disability service providers have independent boards, who govern the organisations concerned and any deficits accruing are the responsibility of these organisations.

Significant resources have been invested by the health sector in disability services over the past number of years. As set out in the National Service Plan 2020, the 2020 disability budget is €2054.5m. This represents an increase of €138.7m or 7.2% on the 2019 budget.

In the context of COVID-19, the HSE has provided significant supports to Section 38 and Section 39 organisations providing disability specialist services. Through the Community Healthcare Organisations (CHOs), the HSE is actively engaging with any Section 38 and Section 39 disability service providers who are experiencing financial challenges, including access to cash acceleration, where appropriate, to maintain continuity of service provision where cash flow issues arise. Organisations receiving funding from the HSE should raise any concerns in relation to financial issues that may have implications for continuity of service provision with the relevant Community Health Care Organisation (CHO) responsible for the service arrangements.

In addition, the Government has agreed to allocate substantial additional funding to the Health Vote to meet the costs associated with the implementation of the measures outlined in the National Action Plan in response to COVID-19. Specific action has been taken at my request and that of Minister Rabbitte, to relieve Disability service providers of the necessity to achieve a 1% efficiency target in 2020.

The HSE will continue to work in partnership with all service provider organisations to ensure the best level of service possible is provided to people with a disability, and their families, within the resources available. As the Deputy's question deals with organisations providing services to the HSE, I have arranged for the question to be referred to the HSE for direct reply to the Deputy.


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