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 Header Item Written Answers Nos. 253-264
 Header Item Medicinal Products Expenditure
 Header Item Cochlear Implants
 Header Item Hospital Waiting Lists
 Header Item Research Funding
 Header Item HSE Funding

Wednesday, 24 April 2013

Dáil Éireann Debate
Vol. 800 No. 4

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Written Answers Nos. 253-264

Medicinal Products Expenditure

 253. Deputy Pearse Doherty Information on Pearse Doherty Zoom on Pearse Doherty asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he approached the British National Health Service to explore if there are further economies of scale or efficiency savings that might be achieved on the cost of medicines by pooling buying and resources with the Health Service Executive. [19352/13]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The major share of HSE expenditure on drugs and medicines is in respect of items supplied under the GMS and community drug schemes. The drugs and medicines are actually purchased by community pharmacists who are in turn recouped by the HSE. As the drugs are purchased by individual pharmacists with no direct input by the HSE, there is no scope for the type of bulk purchasing envisaged by the Deputy.

In recent years, a number of changes to the pricing and reimbursement system have been successfully introduced in Ireland. These have resulted in reductions in the prices of thousands of medicines. Following intensive negotiations involving the Irish Pharmaceutical Healthcare Association (IPHA), the HSE and the Department of Health, a major new deal on the cost of drugs in the State was concluded in October last. It will deliver a number of important benefits, including:

- significant reductions for patients in the cost of drugs,

- a lowering of the drugs bill to the State,

- timely access for patients to new cutting-edge drugs for certain conditions, and

- reducing the cost base of the health system into the future.

The gross savings arising from this deal will be in excess of €400m over 3 years. €210 million from the gross savings will make available new drugs to patients over 3 years. Thus, the deal will result in a net reduction in the HSE expenditure on drugs of about €190m.

The Department and the HSE have successfully finalised discussions with the Association of Pharmaceutical Manufacturers in Ireland (APMI), which represents the generic industry, on a new agreement to deliver further savings in the cost of generic drugs. Under this Agreement, from 1 November 2012, the HSE will only reimburse generic products which have been priced at 50% or less of the initial price of an originator medicine. In the event that an originator medicine is priced at less than 50% of its initial price the HSE will require a generic price to be priced below the originator price. This represents a significant structural change in generic drug pricing and should lead to an increase in the generic prescribing rate.

It is estimated that the combined gross savings from the IPHA and APMI deals will be in excess of €120 million in 2013. The IPHA agreement provides that prices are referenced to the currency adjusted average price to wholesaler in the nominated EU member states in which the medicine is then available. The prices of a range of medicines were reduced on 1 January 2013 in accordance with the agreement.

The Health (Pricing and Supply of Medical Goods) Bill 2012, which is scheduled for Report Stage today, provides for the introduction of a system of generic substitution and reference pricing. The Bill provides that when the HSE is setting a reference price for, or reviewing a reference price set for, a relevant group of interchangeable medicinal products it shall take into account the following criteria:

- the ability of suppliers to meet patient demand for the relevant item;

- the value for money afforded by the relevant item;

- the equivalent prices of the relevant item in all other Member States where the product is marketed;

- the prices of therapeutically similar items; and

- the resources available to the HSE.

It is important to balance achieving best value for money for the taxpayer with assuring continuity of supply for critical medical products, particularly in a small market like Ireland. Consequently, the Bill aims to achieve value for money while avoiding disruption in the availability of medicines on the Irish market. This legislation will promote price competition among suppliers and ensure that lower prices are paid for these medicines resulting in further savings for both taxpayers and patients.

Cochlear Implants

 254. Deputy Robert Troy Information on Robert Troy Zoom on Robert Troy asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when he will make the necessary funding available in order that both ears can benefit from cochlear implants to avoid problems caused by one implant breaking; and if he will make a statement on the matter. [19360/13]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Since the national cochlear implant programme commenced seventeen years ago, over 700 patients have received cochlear implants. I am advised that, in 2012, ninety cochlear implants were carried out with 42 children receiving implants and 48 adults. In addition to providing the surgical services, the programme provides a comprehensive assessment service to potential candidates and a rehabilitative service to those actually implanted.

In 2009 a National Review of Audiology Services was carried out by the HSE, to examine the services provided to children and adults nationwide, and to formulate a national plan for the services. The report of the National Audiology Review Group, published by the HSE in 2011, provides the blueprint for the planning, development and delivery of HSE audiology services, from new-born screening to assessment and management of adults and children with hearing problems, including cochlear implantation. Two of the main recommendations in the report include the national rollout of a universal new-born hearing screening programme and the establishment of a bone anchored hearing aid programme. The report also included a recommendation that continued ring-fenced financial support be provided for the cochlear implant programme but at levels which allow for simultaneous bilateral implantation for children.

The HSE is working closely with Beaumont Hospital to progress plans for both simultaneous and sequential bilateral implantation. The development of the service will require additional resources for Beaumont and these plans will be progressed through the HSE 2014 Estimates process.

Hospital Waiting Lists

 255. 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 if he will examine the case of a person (details supplied) in County Meath awaiting an urgent hip replacement surgery, who requires this surgery in order that he may be allowed home from temporary care in a residential nursing home. [19382/13]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2013, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has recently been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.

   In relation to this particular query raised by the Deputy, I have asked the Health Service Executive to investigate the situation and respond directly to the Deputy in this matter.

Research Funding

 256. Deputy Heather Humphreys Information on Heather Humphreys Zoom on Heather Humphreys asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will provide funding from the Health Research Board for research into the treatment of Rett Syndrome; and if he will make a statement on the matter. [19423/13]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The Health Research Board (HRB) is a statutory body under the aegis of the Department of Health. The HRB is the lead agency in Ireland supporting and funding health research. It provides funding, maintains health information systems, and conducts research linked to national health priorities. The aim is to improve people's health, build health research capacity, and make a significant contribution to Ireland's knowledge economy.

The Health Research Board strategy supports three broad research areas:

-applied biomedical and clinical research

-population health sciences research

-health services research

Within these areas the HRB funds a range of scheme types from PhD scholars programmes, through post-doctoral and health professional fellowships to larger programme awards and support for infrastructure.

The HRB does not ring-fence funding for any particular type of disease or disorder. It does not exclude any field of health research once it meets the HRB's criteria .

Applications for HRB funding derive from bottom-up, open, competitive calls. This means that the idea for the research topic, whether it is for a particular disease area or linked to health services delivery, comes from the researcher. All proposals are evaluated by rigorous international peer review which focuses on the quality of the proposal, track record of the applicant, quality of the research environment, as well as potential outcomes and impacts. This process is very important for ensuring independence and maintaining high standards in the research that the HRB funds. Research proposals deemed to be excellent and in line with the HRB's strategic areas are ranked and matched against the available budget.

The HRB has developed a co-funding arrangement with the Medical Research Charities Group( MRCG) , whereby it can support research into rare diseases and disorders. Each year the MRCG invites proposals for research in diseases and disorders of interest to its members and the HRB manages the rigorous evaluation of these applications through its peer review process to ensure their quality. This partnership commits over €2M in funding each year to this scheme.

HSE Funding

 257. 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 rescind the decision taken by the Health Service Executive to either wholly or partly stop the issue of a research grant provided by his Department to the ISQSH via the HSE; and if he will make a statement on the matter. [19441/13]

 258. 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 advise where the funding for the ISQSH research grant has gone, along with the funds for other organisations such as the Irish Patients' Association, amounting in excess of €300k; if these funds have been transferred back to his Department or if the HSE plans to use them for other purposes; if so, the areas that have received these funds; and if he will make a statement on the matter. [19442/13]

 259. 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 a value for money review or a cost benefit analysis was undertaken in advance of the decision to cut funding to ISQSH; the criteria used; if he will make available a copy of same; and if he will make a statement on the matter. [19443/13]

 260. 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 reason a new non independent organisation (details supplied) has been established within the Health Service Executive despite the existence and work of ISQSH; the reason the ISQSH was not merged with the ISQSH with another suitable organisation; and if he will make a statement on the matter. [19444/13]

 261. 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 reason the Health Service Executive has decided to use the NHS/PICKER tool despite the existence of established resources; the cost to secure the PICKER tool; the reason they did not seek to buy a licence for use from the ISQSH for the tools they have developed that are suitable for Irish healthcare; the reason the HSE is currently in the process of seeking advice and information from a person (details supplied) in the NHS rather than sources available in the ISQSH; and if he will make a statement on the matter. [19445/13]

 262. 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 reason he did not prioritise the retention of an independent organisation like the ISQSH and other independent organisations rather than internalising their work competency within the HSE; and if he will make a statement on the matter. [19446/13]

 263. 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 there was any attempt made to reassign work from overworked areas in hospitals such as patient complaints analysis, patient feedback and patient experience and to give same to dedicated specialised organisations such as the ISQSH who have shown they can do the work at a more economical price than the Health Service Executive; and if he will make a statement on the matter. [19447/13]

 264. 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 reason there was no discussion with ISQSH prior to the decision to withdraw funding; the further reason the ISQSH was not given the opportunity to receive less funding as opposed to no funding at all; and if he will make a statement on the matter. [19448/13]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I propose to take Questions Nos. 257 to 264, inclusive, together.

  Funding decisions in relation to the funding of the Irish Society for Quality and Safety in Healthcare are proper to the Health Service Executive (HSE), as appropriate to its holding of the Health Vote. I have arranged to have the Deputy's questions referred to the HSE for attention and a more detailed response.


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