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 Header Item Written Answers Nos. 385 - 394
 Header Item Generic Drugs Substitution
 Header Item Mobility Allowance Eligibility
 Header Item Dental Services Waiting Lists
 Header Item Medical Card Appeals
 Header Item Departmental Properties
 Header Item Long-Term Illness Scheme Coverage
 Header Item Thalidomide Victims Compensation
 Header Item Hospital Acquired Infections
 Header Item Alcohol Pricing
 Header Item Cochlear Implants

Tuesday, 7 May 2013

Dáil Éireann Debate
Vol. 802 No. 1

First Page Previous Page Page of 89 Next Page Last Page

Written Answers Nos. 385 - 394

Generic Drugs Substitution

 385. Deputy Olivia Mitchell Information on Olivia Mitchell Zoom on Olivia Mitchell asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly f direction can be given to pharmacists or doctors to preclude substitution of the anti-epileptic drugs under the Health (Pricing and Supply of Medical Goods) Bill 2012 when it is enacted; and if he will make a statement on the matter. [21197/13]

 395. Deputy Terence Flanagan Information on Terence Flanagan Zoom on Terence Flanagan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding the generic substitution of epilepsy medication (details supplied) in Dublin 13; and if he will make a statement on the matter. [21391/13]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White I propose to take Questions Nos. 385 and 395 together.

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:

- there is a difference in bioavailability between the medicinal products and the interchangeable medicinal products which currently fall within the group of interchangeable medicinal products which may lead to a clinically significant difference in efficacy between them, and

- any of the medicinal products cannot be safely substituted for any one or more of the other medicinal products in the group.   

I would like to emphasise that in making a decision to add a medicinal product to a group of interchangeable medicinal products or a group of medicinal products to the List of Interchangeable Medicinal Products the Board is obliged to have regard to the criteria as set out in the Bill and that these criteria fully reflect the recommendations set out in the Joint Department of Health/HSE report 'Proposed Model of Reference Pricing and Generic Substitution' (the Moran Report, 2010) regarding criteria for interchangeability.     

  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. I met with the Irish Epilepsy Association in January and explained this position.

  It is also 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.

Mobility Allowance Eligibility

 386. Deputy Nicky McFadden Information on Nicky McFadden Zoom on Nicky McFadden asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when a decision on an alternative method to the mobility allowance and motorised transport grant in order to provide for the needs of people in a manner that does not run counter to the Equal Status Acts will be made; and if he will make a statement on the matter. [21202/13]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch A Project Group to review the Mobility Allowance and Motorised Transport Grant has been established to seek an alternative method to provide for the priority transport needs of people with a disability in a manner that does not run counter to the Equal Status Acts. The Group, who will report to Government later this month, have met five times, with the next meeting scheduled for 7th May 2013. The results of the review will be presented to the Government before any final decisions are made on future arrangements. At this stage, I am not in a position to pre-empt the outcome of the review or the decision of the Government.

Dental Services Waiting Lists

 387. Deputy Jack Wall Information on Jack Wall Zoom on Jack Wall asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when a child (details supplied) in County Kildare wil receive a dental appointment at the dental clinic in Athy, County Kildare; and if he will make a statement on the matter. [21209/13]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White Dental services to children up to 16 years are provided by the Public Dental Service of the HSE. The service is targeted at children at key stages in their development. Children are given dental examinations and any follow-up treatment required at these stages. When required, emergency dental treatment is available to all children up to 16 years. The HSE has been asked to examine the specific query raised by the Deputy and to reply to him as soon as possible.

Medical Card Appeals

 388. Deputy Jack Wall Information on Jack Wall Zoom on Jack Wall asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding an appeal of a medical card application in respect of a person (details supplied) in County Donegal; and if he will make a statement on the matter. [21226/13]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible. The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has recently reissued to Oireachtas members.

Departmental Properties

 389. Deputy Dara Calleary Information on Dara Calleary Zoom on Dara Calleary asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if his Department and agencies under its aegis who own or rent property in commercial developments are in compliance with their responsibilities under the Multi-Unit Development Act 2011; if he will outline those agencies who have representation on the boards of owners management companies; if he will provide a list of the agency, the relevant management company and its associated property but not the name of the individual representing the said agency; and his views on the implementation process of the Multi-Unit Development Act within his Department.  [21247/13]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The Office of Public Works has responsibility for Hawkins House where my Department is accommodated. The sourcing of property on behalf of Government Departments / Offices and Agencies is a matter for the Office of Public Works (OPW). The information sought in respect of Agencies under the aegis of my Department is not routinely collected. Given the resources and time involved in sourcing such information, if the Deputy has a particular Agency in mind my Department would be happy to provide such information on request. The Deputy's question has been referred to the HSE in respect of properties the Executive may have leased in multi-unit developments.

Long-Term Illness Scheme Coverage

 390. Deputy Pat Deering Information on Patrick Deering Zoom on Patrick Deering asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will provide a progress report on an application to have Fibromyaliga listed on the long term illness list based on the groups submission last year. [21260/13]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White There are no plans to extend the list of conditions covered by the Long Term Illness Scheme.

Under the Drug Payment Scheme, no individual or family pays more than €144 per calendar month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals incurring ongoing expenditure on medicines.

In addition, people who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. In the assessment process, the Health Service Executive can take into account medical costs incurred by an individual or a family. Those who are not eligible for a medical card may still be able to avail of a GP visit card, which covers the cost of GP consultations.

Thalidomide Victims Compensation

 391. 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 reason the recommendations of the Heldelbery study into the survivors of thalidomide have not been implemented here; and his proposals for same [21279/13]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The Heidelberg Study is a survey of nearly 900 German survivors of thalidomide, carried out by the University of Heidelberg on behalf of the German Thalidomide Foundation. The report identifies the individual's deterioration in health, their increasing loss of independence and an increased requirement for supports and assistance including medical services, aids and appliances, environmental adaptations, transport.

The Department of Health commissioned a report from the State Claims Agency in 2010 which recommended additional financial and other supports to Irish survivors of thalidomide. The offer was rejected by Irish survivors of thalidomide.

31 Irish thalidomide survivors currently received financial support from the German Foundation and the Irish State. Combining the Irish and German payments, most individuals receive over €2,500 per month, or €575 per week, tax free. Each Irish thalidomide survivor has a medical card and it is open to each individual to apply for the numerous public supports available to people with a disability provided by other Departments such as housing adaptation grants, disabled drivers tax concessions and disability allowance.

Hospital Acquired Infections

 392. Deputy Alan Farrell Information on Alan Farrell Zoom on Alan Farrell asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the reasons five hospitals were found to have lapses in standards for infection control; and if he will make a statement on the matter. [21335/13]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I am pleased to inform the Deputy that MRSA rates are at a 6-year low and I would like to assure the Deputy that the management of Healthcare Acquired Infections (HCAIs) is a key patient safety issue for my Department and the Health Service Executive (HSE) and a number of significant initiatives have been developed to address the issue. These include the HSE's National Infection Control Action Plan, launched in 2007 and a National Surveillance System to collect data and provide information to monitor HCAIs; the establishment of the Clinical Care Programme for HCAIs also supports this aim.

In relation to the recent Health Information and Quality Authority (HIQA) reports on four hospitals my Department and the HSE recognise that the HIQA inspection of hospitals against the National Infection Prevention and Control Standards is an important element of the overall strategy to reduce HCAIs in the delivery of healthcare in Ireland. With regard to hand hygiene the findings of the Authority suggest that hand hygiene best practice needs to become more operationally embedded at all levels. I must emphasise that it is of vital importance that healthcare workers recognise their personal responsibility to protect patients by maintaining their own good hand hygiene.

To improve hand hygiene a series of actions are in place, a key element of which is the HSE's continuing bi-annual hand hygiene audits which occur both in the acute sector and in the long stay area as well. Additionally, from July this year it will be mandatory for all staff to receive hand hygiene training as part of staff induction and a hand hygiene education programme as continuous training.

Other actions include:

- the existing 2005 guidelines on hand hygiene are being revised and will be published this year;

- a hand hygiene e-learning programme is being piloted in Dublin North East;

- a training video for staff on the WHO 5 Moments for hand hygiene concept and national participation in the WHO's annual Hand Hygiene Day on 5th May 2013 with all hospitals engaging in local initiatives;

- revised hand hygiene posters were introduced across the system in the summer of 2012;

- a major section on website on hand hygiene;

- in collaboration with the Department of Education an educational programme for schools - E-Bug;

- a monthly national HCAI implementation group monitors and reviews all HCAI activity in the health system.

The four hospitals audited by HIQA are now being asked to develop quality improvement plans that prioritise changes necessary to fully meet the National Standards for the Prevention and Control of Healthcare Associated Infections. These plans must be published by the hospitals concerned on the Internet within six weeks of the publication of HIQA's reports. The hospitals in question will receive a letter indicating general outcomes and lessons to be learned.

With regard to the prevention of the spread of MRSA it should be noted that the number of cases of MRSA has fallen by 55% between 2006 and 2011 (from 592 to 263 cases) and the downward trend is holding per statistical returns to date (a drop to 242 cases (59% decrease) to end-2012 (provisional figures)). Individual hospital MRSA rates are also collected and published – annually for 2006 and 2007 and quarterly from 2008 onwards. These results provide a good benchmark into the future to enable us to measure effectively the progress of each hospital on their performance in infection prevention and control. The data can be used by individual hospitals to monitor their progress in the control of HCAIs and the regular reports allow for public assessment of that progress.

Finally, officials of my Department are currently working on the Licensing of Health Facilities Bill which will provide for a mandatory system of licensing for public and private health service providers. The legislative proposals are being prepared broadly in line with recommendations made in the Report of the Commission on Patient Safety and Quality Assurance and are designed to improve patient safety by ensuring that healthcare providers do not operate below core standards which are applied in a consistent and systematic way. The intention is to have a proportionate system which has the confidence of the public. Standards and other requirements will be enforceable through inspection and imposition of sanctions as necessary. Licensing will be targeted at areas which are not currently subject to regulation. It is expected that outline proposals for the new system of licensing should be finalised in the near future.

Alcohol Pricing

 393. Deputy Róisín Shortall Information on Róisín Shortall Zoom on Róisín Shortall asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the steps, if any, he proposes to take to influence a reduction in the price of non-alcoholic beer on sale in the on and off-trade in view of the relatively high price of such products here and the positive contribution lower prices would have on the demand for alcohol and hence on the very significant costs associated with alcohol-related harm here. [21343/13]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White My Department has no direct powers to reduce the price of non-alcoholic beer; its price is largely a function of private market forces. The National Substance Misuse Strategy envisaged a minimum unit price for alcohol products only - complemented by a range of other measures in the supply and prevention areas - in order to deal with the misuse of alcohol. It is likely therefore, that these would have a positive influence on the demand for non-alcohol products relative to alcohol products.

Cochlear Implants

 394. Deputy Gerry Adams Information on Gerry Adams Zoom on Gerry Adams asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the steps that have been taken to put in place a bilateral cochlear implant programme in the State; when he expects such a programme to become operational; if resources have been secured for the programme; the contacts he or his Department had with the Happy New Ear Campaign group in this regard; and if he will make a statement on the matter. [21378/13]

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.

While no dedicated programme for simultaneous or sequential implantation is being carried out in Ireland at this time, some bilateral implantation has already occurred for patients, mainly very young children with certain medical conditions such as a history of meningitis or blindness. It is estimated that there are approximately 200 children in Ireland today who may be suitable for a second implant. The HSE has advised that it 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.

I can confirm that Minister of State, Kathleen Lynch intends to meet with the Happy New Ear campaign group later on this month.


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