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 Header Item Written Answers Nos. 495-510
 Header Item Hospital Appointments Status
 Header Item Infectious Disease Screening Service
 Header Item National Lottery Funding Applications
 Header Item Orthodontic Services Provision
 Header Item Hospital Appointments Status
 Header Item Mental Health Services Provision
 Header Item Mental Health Services Funding
 Header Item Hospital Appointments Status
 Header Item Hospital Appointments Status
 Header Item Hospital Appointments Status
 Header Item Hospital Appointments Status
 Header Item Services for People with Disabilities
 Header Item Medicinal Products Data
 Header Item Ambulance Service

Tuesday, 11 April 2017

Dáil Éireann Debate
Vol. 946 No. 2

First Page Previous Page Page of 109 Next Page Last Page

Written Answers Nos. 495-510

Hospital Appointments Status

 495. Deputy John McGuinness Information on John McGuinness Zoom on John McGuinness asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the reason the Health Service Executive has not responded to the Dublin Dental Hospital regarding two applications for funding to cover treatment for a person (details supplied); if he will expedite this matter; and if he will make a statement on the matter. [17583/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Infectious Disease Screening Service

 496. Deputy John McGuinness Information on John McGuinness Zoom on John McGuinness asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the reason the results of tests for Lyme disease carried out by a laboratory (details supplied) are not accepted by the Health Service Executive; if the same standard of test can be undertaken here; if so, the location in which; if tests undertaken here are restricted in any way; and if he will make a statement on the matter. [17584/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Lyme disease (also known as Lyme borreliosis) is an infection caused by a spiral-shaped bacterium called Borrelia burgdorferi. It is transmitted to humans by bites from ticks infected with the bacteria. The infection is generally mild affecting only the skin but can occasionally be more severe and highly debilitating. Lyme disease is the commonest cause of tick-borne infection in Europe.

  In general, it is accepted clinical practice in Ireland, the UK, Europe and North America that laboratory confirmation is unnecessary for a confidently-made, clinical diagnosis of erythema migrans (the initial primary skin lesion of Lyme borreliosis). However, this only affects about ¾ of patients. For later presentation Lyme borreliosis, the two-tier system is necessary to ensure that false-positive diagnosis (i.e. the test incorrectly indicates a patient has Lyme disease when, in fact, they do not have the disease) are kept to a minimum. Serological testing for antibodies to Borrelia burgdorferi is the mainstay of diagnostic testing.

  There have been significant improvements in antibody testing in recent years, making diagnosis more certain than in the past. Testing for Lyme borreliosis is currently undertaken in most of the larger hospitals in Ireland. The standard approach to Lyme diagnostics is a two-stage process and involves using a sensitive enzyme immunoassay (EIA – a test to detect proteins found in the Borrelia bacterium) as an initial, screening step. Screening EIAs can be insufficiently specific, giving false-positive reactions (i.e. leading to over diagnosis) in the presence of other infections such as syphilis, and certain, common viral infections including glandular fever. In addition, false-positive results can also occur in patients with autoimmune disorders and other inflammatory conditions including, rheumatoid arthritis, scleroderma, diabetes or ulcerative colitis. Samples giving reactive or equivocal results in Initial screening tests are further investigated in a second-stage, confirmatory immunoblot (such as Western blot) test. Use of immunoblot testing greatly increases specificity (i.e. it reduces the likelihood of these false positive results). Using this two stage approach gives a considerably greater degree of certainty around the diagnosis of Lyme. All clinical (and other) laboratories in Ireland, must undergo continuous quality assurance to ensure that the quality of the laboratory tests they provide is maintained at conform to the highest internationally-accepted standards of microbiological excellence.

  As testing for Lyme borreliosis is widely available in Ireland there is no requirement for people to travel to other EU Member States to access this service. This question refers to a facility in Germany and it would be inappropriate for me to comment on individual health facilities in another EU Member State.

  Question No. 497 answered with Question No. 479.

National Lottery Funding Applications

 498. Deputy Jackie Cahill Information on Jackie Cahill Zoom on Jackie Cahill asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if he will investigate the case of a person (details supplied); and if he will make a statement on the matter. [17593/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The person referred to by the Deputy applied for a grant of €46,000 from the 2016 Department of Health National Lottery fund on behalf of Camphill Community, Grangemockler, Carrick on Suir, Co. Tipperary. Unfortunately it was not possible to provide funding for this application as the applications for lottery funding last year far exceeded the funds that were available to my Department.

  393 applications for National Lottery funding were received in 2016 of which 136 were approved for a grant. A list of all applicants approved for a National Lottery grant was published on my Department's website last November and each successful applicant was notified of their approval for a grant in early December 2016.

  The 257 unsuccessful applicants were informed of the outcome by email between December 2016 and January 2017. In the case of the application in question, a grant approval notification was inadvertently generated and issued to the applicant in January 2017. This notification did not specify any grant amount. As soon as the error was detected my Department contacted the applicant, explained that a grant had not in fact been approved, that the notification she received had been generated and issued in error, and apologised for the confusion and any inconvenience caused. The correct notification was subsequently issued to the applicant advising that all the 2016 lottery funding had been disbursed and that it was not possible to provide funding for the project.

  I regret that I was not in a position to provide the requested funding on this occasion and that an incorrect notification was initially issued to the applicant; however, I am pleased to note that the HSE was in a position to provide grants of €1.149m to Camphill Communities of Ireland during 2016.

  My Department no longer operates a National Lottery Fund. However, the HSE operates a similar scheme and continues to provide grants to health agencies and other organisations from National Lottery funds. Details of the scheme are available at http://www.hse.ie/eng/services/list/1/schemes/National-Lottery-Grants-2017/.

Orthodontic Services Provision

 499. Deputy Barry Cowen Information on Barry Cowen Zoom on Barry Cowen asked the Minister for Health Information on Simon Harris Zoom on Simon Harris when a person (details supplied) can expect an appointment for orthodontic treatment under the HSE, Tullamore, County Offaly.  [17605/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As this is a service matter it has been referred to the HSE for reply to the Deputy.

Hospital Appointments Status

 500. Deputy Barry Cowen Information on Barry Cowen Zoom on Barry Cowen asked the Minister for Health Information on Simon Harris Zoom on Simon Harris when a person (details supplied) can expect an appointment in the Royal Victoria Eye and Ear Hospital, Dublin.  [17606/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, I have asked the HSE to respond to you directly.

Mental Health Services Provision

 501. Deputy Pearse Doherty Information on Pearse Doherty Zoom on Pearse Doherty asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if a person (details supplied) in County Donegal may change consultant with the Donegal mental health service; and if he will make a statement on the matter. [17615/17]

Minister of State at the Department of Health (Deputy Helen McEntee): Information on Helen McEntee Zoom on Helen McEntee As this is a service issue, this question has been referred to the HSE for direct reply.

Mental Health Services Funding

 502. Deputy Pat Buckley Information on Pat Buckley Zoom on Pat Buckley asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the estimated annual cost for providing a mental health nurse in all accident and emergency departments 24 hours a day, in every custody suite, in every Garda station and in every prison. [17630/17]

Minister of State at the Department of Health (Deputy Helen McEntee): Information on Helen McEntee Zoom on Helen McEntee As this is a service issue, this question has been referred to the HSE for direct reply. The Executive will only be in a position to respond in respect of the health service facilities indicated by the Deputy. The other facilities raised in the question will be a matter for the Minister for Justice and Equality.

Hospital Appointments Status

 503. Deputy Mattie McGrath Information on Mattie McGrath Zoom on Mattie McGrath asked the Minister for Health Information on Simon Harris Zoom on Simon Harris when a person (details supplied) in County Tipperary will receive a hospital appointment; if his attention has been drawn to the fact that Our Lady's Children's Hospital, Crumlin has returned referrals to South Tipperary General Hospital due to the fact that the waiting lists are too long; the steps he will take to address the rheumatology waiting lists in Our Lady's Children's Hospital, Crumlin; and if he will make a statement on the matter. [17636/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case and service issues raised, I have asked the HSE to respond to you directly.

Hospital Appointments Status

 504. Deputy Seán Haughey Information on Seán Haughey Zoom on Seán Haughey asked the Minister for Health Information on Simon Harris Zoom on Simon Harris when a person (details supplied) may expect a hospital appointment; and if he will make a statement on the matter. [17637/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, I have asked the HSE to respond to you directly.

Hospital Appointments Status

 505. Deputy Barry Cowen Information on Barry Cowen Zoom on Barry Cowen asked the Minister for Health Information on Simon Harris Zoom on Simon Harris when a person (details supplied) can expect a hospital appointment. [17639/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, I have asked the HSE to respond to you directly.

Hospital Appointments Status

 506. 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 when a person (details supplied) will receive a hospital appointment. [17640/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, I have asked the HSE to respond to you directly.

Services for People with Disabilities

 507. Deputy Pat Casey Information on Pat Casey Zoom on Pat Casey asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the consultation process with persons regarding the residents of a centre (details supplied) due to its upcoming closure; the care plan involved in putting forward alternative residential plans that involves family consultation; and if he will make a statement on the matter. [17645/17]

Minister of State at the Department of Health (Deputy Finian McGrath): Information on Finian McGrath Zoom on Finian McGrath The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Medicinal Products Data

 508. Deputy Gino Kenny Information on Gino Kenny Zoom on Gino Kenny asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his views on the monitoring of trends in the prescription of psychoactive psychotropic drugs here, especially to children, over the past 20 years; if his attention has been drawn to concerns regarding the rise in problems associated with prescribed medications, especially opioid painkillers, in terms of drug dependency and overdose, including fatal overdose; the measures being taken to address the rise in prescription rates and associated problems regarding prescription medications; and if he will make a statement on the matter. [17648/17]

 509. Deputy Gino Kenny Information on Gino Kenny Zoom on Gino Kenny asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his views on the monitoring of trends in the prescription of psychoactive psychotropic drugs here, especially to children, over the past 20 years; if his attention has been drawn to concerns regarding the rise in problems associated with prescribed medications, especially stimulants, anti-depressants and anti-psychotic drugs, in terms of tolerance and withdrawal and the lack of support from systematic reviews of their use in children; the measures being taken to address the rise in prescription rates and associated problems regarding prescription medications; and if he will make a statement on the matter. [17651/17]

Minister of State at the Department of Health (Deputy Catherine Byrne): Information on Catherine Byrne Zoom on Catherine Byrne I propose to take Questions Nos. 508 and 509 together.

I think it is very important to monitor trends in the prescription of psychotropic drugs in Ireland including to children and young adults. It is also important to ensure that prescribing policies are evidence based thereby ensuring safe use of these medicines.

The Deputy will be aware that all medicines have side effects. However before being made available to the public a medicine undergoes an authorisation process where the medicine’s safety, quality and efficacy is assessed, based on the results of clinical trials. It is only when the risk benefit analysis is positive, i.e. that the potential benefits to the patient outweigh the potential risks that the medicine receives an authorisation.

Once available a medicine is then subject to ongoing monitoring and evaluation through a process of pharmacocovigilance which operates at EU wide level to monitor the use of the medicines in large numbers of patients and manage and analyse information on suspected adverse reactions to medicines.

European reviews of certain antipsychotics, antidepressants, stimulants and opioids have resulted in updates to product information in order to support better informed prescribing and use of these medicines in various patient groups including children. Important safety updates are communicated by the Health Products Regulatory Authority (HPRA) to healthcare professionals via their Drug Safety Newsletter. The HPRA, in conjunction with its European counterparts continues to review the safety of authorised medicines and take appropriate regulatory action when necessary.

In Ireland there are a number of sources of prescribing guidelines. More recent guidelines include a Consensus Statement issued by the College of Psychiatry on the use of benzodiazepines in specialist mental health services (2012), Guidance issued by the Irish College of General Practitioners on Child and Adolescent Mental Health: Diagnosis and Management (2013), and the Medical Council Guide to Professional Conduct and Ethics for Registered Medical Practitioners 2016. Section 42 of the Medical Council Guide states for example that doctors should keep up to date with developments in medication safety and seek independent, evidence-based sources of information on the benefits and risk of the medicine. It also states that doctors should be aware of the dangers of drug dependency when prescribing benzodiazepines, opiates and other drugs with addictive potential and should take reasonable steps to make sure they are not inappropriately obtaining drugs from multiple sources.

The Health Service Executive (HSE) has also been actively involved in ensuring appropriate prescribing of psychotropic drugs. Reports are sent to GPs on a regular basis setting out the number of benzodiazepine and ‘z’ drug prescriptions dispensed to their patients and these reports allow GPs to compare their prescribing patterns to their peers. The reports also highlight where patients are on these medications for longer than the recommended period. The HSE Medicines Management Programme has also written to hospital consultants recommending that where a patient is not being treated with benzodiazepines or z drugs on entering hospital that the discharge summary should not contain such medication.

The Misuse of Drugs legislation imposes tight controls on all controlled drugs. A number of changes to the Misuse of Drugs Regulations are due to be implemented shortly. One of the most significant effects of the new Regulation in relation to benzodiazepines and z drugs is that the restrictions in place on the possession of controlled drugs will now apply to these medicines. A form of controlled drug prescription will now be required for these medicines.

Ambulance Service

 510. Deputy Catherine Connolly Information on Catherine Connolly Zoom on Catherine Connolly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris further to Parliamentary Question No. 414 of 7 February 2017, if the decision to be made in quarter 1 of 2017 to go to tender to build the new permanent ambulance base on the Merlin Park site has been taken; and if he will make a statement on the matter. [17653/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As this is a service matter, I have asked the HSE to respond to you directly.


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