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 Header Item Written Answers Nos. 99-113
 Header Item HSE Staff Training
 Header Item Clinical Trials
 Header Item Hospital Services
 Header Item Hospital Beds Data
 Header Item Public Sector Pensions
 Header Item Pharmacy Services
 Header Item Public Sector Pensions
 Header Item Health Care Policy
 Header Item Health Care Policy
 Header Item National Cancer Strategy
 Header Item Mental Health Services Provision
 Header Item Ambulance Service
 Header Item Clinical Trials
 Header Item Hospital Groups
 Header Item Public Sector Pay

Thursday, 2 June 2016

Dáil Éireann Debate
Vol. 911 No. 3

First Page Previous Page Page of 60 Next Page Last Page

Written Answers Nos. 99-113

HSE Staff Training

 99. Deputy Carol Nolan Information on Carol Nolan Zoom on Carol Nolan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the progress being made to date on the European Commission proposal to establish a common training framework for health care assistants; the input his Department has had in this; the actions that have been taken to date; his plans and proposals in respect of registration, ongoing training, budget for recruitment and accountability; and if he will make a statement on the matter. [13712/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I understand that the Health Service Executive has been involved in Ireland’s participation in the European Commission Project on ‘Support for the definition of core competences of health care assistants’. A workshop took place in early April 2016 at which Ireland was represented by a senior manager from the Nursing Midwifery Planning and Development unit in the HSE. The HSE has contributed to the research being conducted by this Group through its questionnaire responses since the initiation of the project. One of the core themes for the research project is the consideration of registration for Health Care Assistants (HCAs). The final report of this EU group will be published in September 2016.

My Department is looking at setting up a working group with an independent Chair to undertake a root and branch review of the role and function of the HCA. The work of this group will examine issues such as qualification requirements, ongoing training needs, standardisation of job descriptions across the health system and whether there is a requirement for HCAs to be registered.

Clinical Trials

 100. Deputy Gerry Adams Information on Gerry Adams Zoom on Gerry Adams asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if any patient not involved in the ongoing clinical trial is currently receiving combined nivolumab-ipilimumab therapy; his plans to make combined nivolumab-ipilimumab therapy available to all suitable cancer patients; and if he will make a statement on the matter.  [13711/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I am aware that various clinical trials are ongoing and I welcome the opportunity for Irish patients to be involved in such trials. However, my Department is not privy to information on the number of people recruited to particular trials, or to detailed information on the progress of these trials.

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. Prior to reimbursing any item, the HSE considers a range of statutory criteria, including clinical need, cost-effectiveness and the resources available.

I have been informed by the manufacturer of the drug Nivolumab that they have provided the medicine to over 200 advanced lung cancer patients to date through Clinicians in a number of hospitals throughout the country under what is known as a compassionate access programme. While such schemes are Clinician driven and are not subject to the same regulations and standards of a clinical trial, I understand that companies engaging in such programmes continue to provide the treatment to patients for the duration of their treatment programme and that access to the medicine for such patients is not impacted by the reimbursement decisions of the HSE or an ending of the compassionate programme by the manufacturer.

I welcome the decision announced yesterday by the manufacturer of this drug to extend this compassionate access programme for patients with advanced lung cancer for a period of 30 days to the end of June 2016.

Hospital Services

 101. Deputy Thomas Pringle Information on Thomas Pringle Zoom on Thomas Pringle asked the Minister for Health Information on Simon Harris Zoom on Simon Harris how the emergency department escalation policy has impacted on elective surgeries, where there are empty beds in surgical wards deemed unsuitable for emergency department patients due to the risk to infection control; the logic of this policy in these circumstances; and if he will make a statement on the matter. [13685/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The Escalation Framework was issued to hospitals in December 2015. It advises hospitals on how best to manage patient flow when there is a surge in demand for emergency care. Central to this approach is that hospitals should avoid the need for escalation where possible, by improving systems and planning.

When necessary, escalated responses are delivered in three stages. It is only at Stage 3 of escalation, where all hospital admissions occur through the ED, that cancellation of all elective surgeries is considered. At Stage 3, because of the pressure for emergency care, the hospital must consider redeploying available medical and nursing staff to facilitate patient flow through the hospital.

Decisions on admissions are taken by hospitals having regard to safe operating limits of the hospital as a whole. At Stage 3, it may not be clinically appropriate for post-operative elective patients to be assigned to beds, even if empty, due to infection control or staffing reasons.

The HSE Special Delivery Unit has conducted reviews at a number of hospitals to date, in order to ensure appropriate implementation of the Escalation Framework.

A number of initiatives are being implemented to reduce ED overcrowding. Under the Winter Additional Capacity Initiative a total of 366 new or re-opened beds have been made available. The Programme for a Partnership Government has also committed to progress new ED facilities for Galway and Beaumont Hospitals.

Further, a review of bed capacity, coupled with the review of the hours of service of Medical Assessment Units are further key commitments of the Programme intended to alleviate ED overcrowding.

Hospital Beds Data

 102. Deputy Seán Crowe Information on Seán Crowe Zoom on Seán Crowe asked the Minister for Health Information on Simon Harris Zoom on Simon Harris why, as of 29 April 2016, only 116 of 154 previously closed hospital beds were reopened; the reason there have not been further reopenings; the progress made to date to increase capacity; and the funding allocated and used to date for this purpose.  [13696/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I am very conscious of the impact that long wait times in Emergency Departments can have on patients and their families.

  In June 2015, additional funding of €18 million was made available to the HSE under the Winter Additional Capacity Initiative. The initiative identified 301 additional winter capacity beds that could be opened.

  In some hospitals, beds have proved more challenging to open than envisaged, owing to difficulties in staff recruitment. However, as of 27 May 2016, 236 of 301 new beds have opened. In addition, 116 closed beds have re-opened, and a further 14 beds have been opened subsequently in Sligo.

  In total, 366 new or re-opened beds have been made available. This extra capacity has enabled similar ED performance to the equivalent period of the previous year, despite a sustained increase in attendance.

  Reviews of bed capacity and Medical Assessment Unit hours of service are key commitments in the Programme for a Partnership Government which are intended to alleviate hospital overcrowding.

  Further, increases in the health budget, measures to increase bed capacity, along with new ED facilities and maximising the potential of units and services to treat patients outside of the hospital setting will all contribute to reducing hospital overcrowding and the time patients have to spend waiting in our EDs.

Public Sector Pensions

 103. Deputy Mick Barry Information on Mick Barry Zoom on Mick Barry asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his views on the closing of the defined benefit pension scheme of the Central Remedial Clinic, given that some of the persons affected were previously Health Service Executive employees who were forced to have their then pension fund transferred into that of the Central Remedial Clinic; and to address the possibility that the executive take over the pension liability. [13678/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The Central Remedial Clinic (CRC) is funded by the Health Service Executive under Section 38 of the Health Act 2004 and employs in the region of 287 employees. It is understood that 47 employees are members of the funded pension scheme in question.

Following receipt of information from the CRC in relation to the wind up of the scheme the CRC was requested, as a matter of urgency, to seek a viable alternative proposal in conjunction with the HSE. This proposal will then be submitted for approval to my Department and the Department of Public Expenditure and Reform. The latter is responsible for Government policy in relation to public service pensions. Pension schemes and pension terms for public servants generally require the consent of the Minister for Public Expenditure and Reform.

The CRC has indicated that it will submit detailed proposals to the HSE shortly in relation to this matter.

Pharmacy Services

 104. Deputy Bríd Smith Information on Bríd Smith Zoom on Bríd Smith asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the potential cost savings and benefits to health of introducing a national pharmaceuticals policy which ensures that persons receive quality drugs at the lowest possible price and that doctors prescribe the minimum of required drugs to treat the patient's illness; and if he will make a statement on the matter.  [13767/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I understand that central procurement is a key element of national pharmaceutical policies in other countries. The Programme for a Partnership Government includes a commitment to examine opportunities for leveraging purchasing power either through national or European initiatives and for making greater use of effective but less costly medicines.

Most drugs and medicines reimbursed by the HSE are supplied to patients through over 1,800 contracted community pharmacies which, in turn, purchase them from wholesalers or, to a lesser extent, directly from manufacturers. The community pharmacist is paid a fee for dispensing medicines to patients.

The HSE maintains a Reimbursement List of all products reimbursed under the Community Drug Schemes, under the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013. The Act permits the HSE to set the prices of all products on the Reimbursement List, subject to certain conditions. All medicines on the list which are off patent are subject to generic substitution and reference pricing.

In relation to High Tech drugs, the HSE purchases these drugs directly from the manufacturer for supply through community pharmacies; pharmacists are paid a patient care fee for dispensing these drugs.

The HSE keeps the price of medicines under ongoing review, and works continuously to achieve greater efficiencies in the areas of drug pricing, supply and distribution. The Executive has a number of initiatives already underway or in development, particularly under the National Drug Cost Management Programme and the Medicines Management Programme, which provides national leadership relating to issues such as the quality of the medicines management process, access to medicines and overall expenditure on medicines.

In addition, my Department has recently created a new Community Pharmacy, Dental, Optical and Aural Policy unit to bring a renewed focus to the development of policy in relation to community pharmacy and the issues associated with achieving maximum benefit to patients.

Public Sector Pensions

 105. Deputy Fiona O'Loughlin Information on Fiona O'Loughlin Zoom on Fiona O'Loughlin asked the Minister for Health Information on Simon Harris Zoom on Simon Harris to provide an updated pension plan for staff of the Central Remedial Clinic; and if he will make a statement on the matter. [12601/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The Central Remedial Clinic (CRC) is funded by the Health Service Executive under Section 38 of the Health Act 2004 and employs in the region of 287 employees. It is understood that 47 employees are members of the funded pension scheme in question.

Following receipt of information from the CRC in relation to the wind up of the scheme the CRC was requested, as a matter of urgency, to seek a viable alternative proposal in conjunction with the HSE. This proposal will then be submitted for approval to my Department and the Department of Public Expenditure and Reform. The latter is responsible for Government policy in relation to public service pensions. Pension schemes and pension terms for public servants generally require the consent of the Minister for Public Expenditure and Reform.

The CRC has indicated that it will submit detailed proposals to the HSE shortly in relation to this matter.

Health Care Policy

 106. Deputy David Cullinane Information on David Cullinane Zoom on David Cullinane asked the Minister for Health Information on Simon Harris Zoom on Simon Harris how the ongoing work being conducted by his Department and the Economic and Social Research Institute's three-year programme on health reform will support in its work the new Oireachtas committee that will be established to develop cross-party consensus on the future of the health service over ten years, as per the programme for Government and Government approval; if the research undertaken to date will be made available to the committee; and if he will make a statement on the matter.  [13705/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I welcome the establishment of the Committee on the Future of Healthcare which is a key commitment in the Programme for a Partnership Government. The staffing and resourcing of the Committee is a matter for the Committee and the Houses of the Oireachtas. My Department will be happy to assist and advise the Houses of the Oireachtas, as appropriate.

Health Care Policy

 107. Deputy Jan O'Sullivan Information on Jan O'Sullivan Zoom on Jan O'Sullivan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if he will make available all of the documentation provided by officials in his Department to Independent Deputies during the course of negotiations for the new programme for Government; the clinical analysis that was undertaken by his officials before any of these measures were agreed; and his views on the impact on national health policy of local agreements, which may not take full cognisance of national health policy considerations and best clinical practice.  [13732/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Officials from the Department of Health met with a wide range of Deputies during the course of negotiations for the Programme for a Partnership Government. The purpose of these meetings was to provide factual information to Deputies and answer technical queries raised by them including, if requested, clinical analysis. No specific briefing documentation was drafted for these meetings.

The Programme for a Partnership Government sets out a number of commitments for the health sector. A key commitment is the establishment of an Oireachtas Committee to develop cross party consensus on the future of the health service. As I have said, I believe the health service would benefit enormously from a single unifying vision that we can all get behind and that can help to drive reform and development of the system over the next ten years.

If the Deputy has a query about a specific measure raised during the meetings, I would be happy to address it on receipt.

National Cancer Strategy

 108. Deputy Brendan Ryan Information on Brendan Ryan Zoom on Brendan Ryan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans to ensure that the process of approving vital medication for the treatment of serious illnesses such as cancer is expedited, and that drugs such as pembrolizumab and nivolizumab are made available to patients in as timely a manner as possible.  [13745/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The HSE has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. Prior to reimbursing any item, the HSE considers a range of statutory criteria, including clinical need, cost-effectiveness and the resources available.

As regards the specific drugs referred to by the Deputy, the HSE confirmed yesterday that Pembrolizumab has been approved for reimbursement. I understand that Nivolumab is still being considered by the HSE under the national medicines pricing and reimbursement assessment process.

Mental Health Services Provision

 109. Deputy Aengus Ó Snodaigh Information on Aengus Ó Snodaigh Zoom on Aengus Ó Snodaigh asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans to support the implementation of a 24-7 crisis support service for mental health; and the timeline for this. [13715/16]

Minister of State at the Department of Health (Deputy Helen McEntee): Information on Helen McEntee Zoom on Helen McEntee The HSE National Service Plan 2016 aims to address the issue of 24/7 response in the Mental Health service through investment in additional liaison psychiatry services, enhanced community-based mental health provision seven days a week, and the development and staffing of crisis houses.

Funding is also being made available this year to facilitate the transfer of some patients from the Forensic Mental Health Services to the community, and for high observation facilities in acute mental health units. These developments are in parallel to the ongoing development of community mental health teams and forensic mental health services, which have been underpinned by substantial additional ring-fenced funding since 2012.

In relation to specific measures to support an improved 24/7 crisis support service at regional and at local level, this question has been referred to the HSE for direct reply. If you have not received a reply within 15 working days, please contact me Private Office and they will follow up the matter with them.

Ambulance Service

 110. Deputy Ruth Coppinger Information on Ruth Coppinger Zoom on Ruth Coppinger asked the Minister for Health Information on Simon Harris Zoom on Simon Harris further to Parliamentary Question No. 494 of 24 May 2016, the number of new staff and level of extra funding that will be invested in the national ambulance service to ensure there is a high-quality and responsive ambulance service; and if he will make a statement on the matter.  [13690/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Last month at my request, the HSE published the National Ambulance Service Capacity Review together with an action plan for implementation which incorporates the recommendations of both the Capacity Review and the 2014 HIQA Report on the National Ambulance Service.

The Capacity Review makes it clear that we need a very significant programme of investment in our ambulance services. In that context, a phased investment in a multi annual programme involving manpower, vehicles and technology is required. While the overall funding requirement remains to be quantified, the direct pay cost is estimated to be in the region of €25 million, and the capital cost of the additional fleet is estimated at €10 million. Additional funding of €7.2 million has been provided for the National Ambulance Service in 2016 which includes €2 million for new developments. The Deputy will also be aware that the Programme for Government commits to additional annual investment in terms of ambulance personnel and vehicles.

It should be noted that many of the key recommendations of both reviews are already being addressed as part of a significant programme of reform and modernisation of the National Ambulance Service which has been underway in recent years. This programme has now achieved many of its key targets including the establishment of the National Emergency Operations Centre, and the creation of an integrated deployment platform which allows the ambulance service to operate as a national fleet, rather than in regional divisions; continued delivery of improved technology to improve response times; and expansion of the Community First Responder scheme.

My Department engages on an ongoing basis with the National Ambulance Service in relation to service requirements and performance and will continue to do so to ensure that the action plan is implemented.

Clinical Trials

 111. Deputy Gerry Adams Information on Gerry Adams Zoom on Gerry Adams asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if he is aware of international trials which have indicated substantial results experienced by patients in receipt of combined nivolumab, Opdivo and ipilimumab, Yervoy cancer treatment; if he is aware of the 20 Irish persons currently participating in a clinical trial, under the direction of a person (details supplied); if he will provide statistical information on the progress of this trial, which has been ongoing since August 2013; and if he will make a statement on the matter.  [13710/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I am aware that various clinical trials are ongoing and I welcome the opportunity for Irish patients to be involved in such trials. However, my Department is not privy to information on the number of people recruited to particular trials, or to detailed information on the progress of these trials.

Hospital Groups

 112. Deputy Brendan Smith Information on Brendan Smith Zoom on Brendan Smith asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the status of the hospital groups; if it is proposed to put these groups on a statutory basis; and if he will make a statement on the matter. [13771/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Seven Hospital Groups have been established on a non-statutory administrative basis. Pending the enactment of legislation, Hospital Groups will continue to operate within existing legislative frameworks governing the health services and the policy and accountability frameworks of the Department of Health and the HSE.

The implementation of Hospital Groups will progress in a phased manner, which will provide for devolved decision-making, fostering flexibility, innovation and local responsiveness, while also adhering to prescribed national service objectives and standards. As Hospital Groups are implemented, of key importance is the early demonstration of progress towards a more co-ordinated approach to the planning and delivery of services within and across the groups.

The establishment of Hospital Groups on a statutory basis is one component of a complex health reform programme. As set out in the Programme for Government, an Oireachtas All-Party Committee is to develop a long-term vision for healthcare over a 10 year period. I intend to progress discussions in this regard before giving further consideration to the issue of establishing Hospital Groups on a statutory basis.

Public Sector Pay

 113. Deputy Bríd Smith Information on Bríd Smith Zoom on Bríd Smith asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the amount saved by having a lower level of pay for new recruits to the public service in his Department; and if he will make a statement on the matter. [13012/16]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As the information could not be collated in the time available, I have asked the HSE to respond to the Deputy directly on this matter. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up on the matter with them. In relation to Non-Commercial State Agencies under the remit of my Department, this information is being sought and will be forwarded to the Deputy when collated.


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