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 Header Item Written Answers Nos. 141-159
 Header Item Emergency Departments Staff
 Header Item Hospital Waiting Lists
 Header Item Emergency Departments Staff
 Header Item Nursing and Midwifery Board of Ireland
 Header Item Nursing and Midwifery Board of Ireland
 Header Item Nursing and Midwifery Board of Ireland
 Header Item Non-Consultant Hospital Doctors Recruitment
 Header Item General Practitioner Data
 Header Item Nursing Staff Data
 Header Item HSE Staff Data
 Header Item Nursing Home Beds Data
 Header Item Maternity Services
 Header Item Emergency Departments
 Header Item Health Services Data
 Header Item Medicinal Products Reimbursement
 Header Item National Children's Hospital Expenditure
 Header Item Pharmaceutical Sector
 Header Item Primary Care Centres
 Header Item Cross-Border Health Services Provision

Wednesday, 20 February 2019

Dáil Éireann Debate
Vol. 979 No. 6

First Page Previous Page Page of 86 Next Page Last Page

Written Answers Nos. 141-159

Emergency Departments Staff

 141. Deputy Mary Butler Information on Mary Butler Zoom on Mary Butler asked the Minister for Health Information on Simon Harris Zoom on Simon Harris further to Parliamentary Question No. 372 of 29 January 2019, the rota of consultant presence for the emergency department on Saturdays and Sundays at University Hospital Waterford, UHW, from January to December 2018. [8552/19]

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

Hospital Waiting Lists

 142. Deputy Niamh Smyth Information on Niamh Smyth Zoom on Niamh Smyth asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the length of time a person (details supplied) will be waiting for cataract surgery; and if he will make a statement on the matter. [8553/19]

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 National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, 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 been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Emergency Departments Staff

 143. Deputy Mary Butler Information on Mary Butler Zoom on Mary Butler asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if consultant cardiologists provided consultant presence on Saturdays and Sundays in the emergency department at Univeristy Hospital Waterford, UHW, from January to December 2018. [8555/19]

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

Nursing and Midwifery Board of Ireland

 144. Deputy Clare Daly Information on Clare Daly Zoom on Clare Daly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if his attention has been drawn to the length of time it has taken to fill the CEO post in the Nursing and Midwifery Board of Ireland following the departure of a person (details supplied) and the stepping down of another person pending a recruitment campaign; and the person holding the post at present. [8559/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I am aware that the position of Chief Executive Officer is currently filled on an acting basis. Under section 28 of the Nurses and Midwifes Act 2011 the appointment of a CEO is a matter for the Board of the NMBI.

Nursing and Midwifery Board of Ireland

 145. Deputy Clare Daly Information on Clare Daly Zoom on Clare Daly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the amount spent on legal fees by the Nursing and Midwifery Board of Ireland since 2015 on fitness to practice and industrial relations issues. [8560/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The Nursing and Midwifery Board of Ireland (NMBI) is an independent, self funded, regulatory body. The amount spent on legal fees is a matter for the Board and I have asked it to supply the information directly to the Deputy.

Nursing and Midwifery Board of Ireland

 146. Deputy Clare Daly Information on Clare Daly Zoom on Clare Daly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if his attention has been drawn to evidence provided in early January 2019 by a person (details supplied) at a constructive dismissal case taken against the Nursing and Midwifery Board of Ireland, NMBI; and the steps he will take to investigate the allegations. [8561/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Responsibility for ensuring that the Nursing and Midwifery Board of Ireland complies with its statutory and governance obligations, including those of employment law, rests with the Board.

I understand that the constructive dismissal case to which the Deputy refers was considered by the Labour Court. In that regard, the Labour Court is an independent, statutory body. Given its statutory independence, it would be inappropriate for me to intervene when the Labour Court exercises its quasi-judicial functions in relation to industrial relations disputes or employment law complaints.

Non-Consultant Hospital Doctors Recruitment

 147. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the estimated cost of employing one, ten and 100 non-consultant hospital doctors, respectively, in tabular form. [8568/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I have asked the HSE to respond directly to the Deputy on this matter.

General Practitioner Data

 148. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the estimated cost of reversing financial emergency measures in the public interest, FEMPI, for general practice. [8569/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Under the General Medical Services (GMS) contract, GPs are reimbursed for a range of services they provide to medical card and GP visit card holders. GPs are remunerated for these services primarily on a capitation basis, with a range of additional support payments and fees for specific items of service. GPs are also remunerated for services they provide on behalf of the HSE under other public health schemes, such as the Maternity and Infant Care Scheme, Primary Childhood Immunisation Scheme, etc.

The Financial Emergency Measures in the Public Interest (FEMPI) Act 2009 imposed a range of adjustments to health contractor payments. These included different levels of reductions to various GP fees and allowances and the elimination of certain payments, resulting in savings of approximately €120 million per annum.

Despite reductions to the payment rates of health contractors made under FEMPI legislation, the total fees paid to GPs under the GMS scheme have increased from just over €472 million in 2009 to approximately €525 million in 2017. This increase in fees is largely due to significant developments and investment in GP services introduced in recent years, with more services being made available to our citizens and additional financial support provided by the HSE.

The Public Service Pay and Pensions Act 2017 now allows the setting and varying of contractor payments on a non-emergency statutory basis. It is my intention to put in place a new multiannual approach to fees in return for service improvements and contractual reforms based upon health policy considerations and engagement with representative bodies.

Officials from my Department and the HSE are currently engaged in talks with the Irish Medical Organisation in relation to the reform and modernisation of the GMS contract. Agreement on the delivery of service improvements and contractual reform has the potential to facilitate a substantial increase in the resourcing of general practice on a multiannual basis. Of course, any agreement must benefit patients and provide value for the taxpayer.

In line with the long-established approach to such processes, and by agreement of the parties concerned, I am not in a position to give further details while engagement between the parties is under way.

Nursing Staff Data

 149. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the number of public health nurses employed by the HSE in each of the years 2011 to 2018, in tabular from. [8571/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I have asked the HSE to respond directly to the Deputy on this matter.

HSE Staff Data

 150. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the estimated cost of employing one, ten and 100 public health nurses, respectively. [8572/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I have asked the HSE to respond directly to the Deputy on this matter.

Nursing Home Beds Data

 151. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the capital cost of a nursing home bed; the estimated fully absorbed cost of a nursing home bed including staff, ancillary services and running costs; and the capital costs associated with opening new nursing home beds. [8575/19]

Minister of State at the Department of Health (Deputy Jim Daly): Information on Jim Daly Zoom on Jim Daly The costs associated with a nursing home bed in the public sector is a matter for the Health Service Executive and I have asked the Executive to respond to the Deputy as soon as possible.

Maternity Services

 152. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the estimated cost of funding and implementing the national maternity strategy. [8576/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The HSE National Women & Infants Health Programme has developed a detailed Implementation Plan for the National Maternity Strategy which will see the Strategy implemented on a phased basis over the coming years. The funding requirement will vary from year to year and the Implementation Plan will inform the annual estimates process.   

  The Deputy’s query regarding the estimated overall cost of implementation has been referred to the HSE for direct reply.

Emergency Departments

 153. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the estimated cost of abolishing the €100 charge for the use of emergency departments and the €75 per day charge for inpatient care, in tabular form. [8574/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris In 2018, €29.3 million was raised through the statutory inpatient charge, and a further €18.6m was raised through the outpatient charge in the Acute Hospitals.

  Therefore, it would cost approximately €47.9 million to abolish these charges.

Health Services Data

 154. Deputy Louise O'Reilly Information on Louise O'Reilly Zoom on Louise O'Reilly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the amount paid out under the European health insurance scheme in each of the years 2011 to 2018. [8573/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I will answer in respect of those elements of reimbursement made direct by my Department and I have asked the HSE to respond to you directly in respect of the payments it processes.

  Ireland and the United Kingdom operate a bilateral healthcare reimbursement arrangement in respect of health services provided under EU Regulations, covering temporary visitors between the two countries, pensioners of one country and their dependants residing in the other country, and the dependant family members of persons employed in the other country.

  Under the arrangement net liability between the two countries is calculated on a lump sum basis rather than an individual basis. The amount payable in any one year is based on an estimate of the number of persons falling within categories eligible for reimbursement and for whom each country is liable and an estimate of the average cost of providing healthcare treatment. The amount payable is agreed following compilation of the necessary data and agreement between the two administrations. An initial payment on account is made for the relevant year and is subject to final settlement once all necessary statistical and financial information is complete. The finalisation of accounts is normally some years in arrears to facilitate collation of relevant statistics and for the approval of the average cost prepared by each country for the year concerned at EU level.

  Ireland’s liability to the United Kingdom in respect of reference years 2011 to 2014 represent final settled amounts and are as follows:

2011 2012 2013 2014
Stg £19,905,304 Stg £17,939,525 Stg £15,077,925 Stg £13,239,222


  Accounts for years 2015 to 2018 have not yet been finalised.

Medicinal Products Reimbursement

 155. Deputy Kevin O'Keeffe Information on Kevin O'Keeffe Zoom on Kevin O'Keeffe asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the position regarding the approval of the drug Spinraza in respect of persons suffering from spinal muscular atrophy. [8578/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The Health Service Executive has statutory responsibility for decisions on pricing and reimbursement of medicines, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.

The Act specifies the criteria to be applied in the making of reimbursement decisions which include the clinical and cost effectiveness of the product, the opportunity cost and the impact on resources that are available to the HSE.

I am advised by the HSE that the application for the reimbursement of Nusinersen (Spinraza) was considered by HSE Leadership at a meeting on 12 February 2019 and that the HSE is in the process of communicating its decision to the relevant company.

National Children's Hospital Expenditure

 156. Deputy Róisín Shortall Information on Róisín Shortall Zoom on Róisín Shortall asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the contacts which were made by an office (details supplied) in respect of cost overruns of the national children’s hospital. [8583/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris There were no contacts made by the Office (details supplied) in relation to cost overruns in the National Children's Hospital. I am advised that the Secretary General of my Department arranged a discussion with the individual concerned, in his capacity as a Board member of the National Paediatric Hospital Development Board, on 18 October 2018, relating to the completion of the Guaranteed Maximum Price process for the National Children's Hospital, which was under way.

Pharmaceutical Sector

 157. 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 the proposals by a society (details supplied) to make major changes to the position of pharmacy assistant, which it is lodging with his Department again, will be rejected in view of the fact that it will make the position of many assistants nationally untenable; and if he will make a statement on the matter.  [8590/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The Pharmacy Act 2007 established the Pharmaceutical Society of Ireland (PSI) and the functions of the Society are set out in the Act. The functions of the PSI are carried out on its behalf by the Council of the Society.

Section 30 of the Pharmacy Act 2007 provides for an exception to the general provision in the Act which requires the sale and supply of medicines at a pharmacy to be conducted under the personal supervision of a registered pharmacist, and specifies that no offence is committed where a registered pharmaceutical assistant “acts on behalf of a registered pharmacist during the temporary absence of the registered pharmacist”.

Section 30 also permits the Council to make rules as to:

1. What may or may not be done by a registered pharmaceutical assistant when acting on behalf of a registered pharmacist; and

2. What constitutes the temporary absence of a registered pharmacist.

Following a period of public consultation, the Council of the PSI considered the proposed draft Pharmaceutical Society of Ireland (Temporary Absence of Pharmacist from Pharmacy) Rules 2018 at its meeting of 20 September 2018, where the Council approved the draft rules without amendment. Following this, the PSI undertook to redraft the Rules in relation to what may or not be done by a registered pharmaceutical assistant when acting on behalf of a registered pharmacist.

On 6 December, the Council of the PSI approved a revised draft of the Pharmaceutical Society of Ireland (Temporary Absence of Pharmacist from Pharmacy) Rules 2018 for issuance for public consultation. This public consultation commenced on 13 December 2018 and ran until 11 January 2019, affording any interested party the opportunity to make representations on the matter directly to the PSI.

Following completion of the public consultation phase, the Council of the PSI considered the proposed draft Pharmaceutical Society of Ireland (Temporary Absence of Pharmacist from Pharmacy) Rules 2018 at its meeting on 14 February 2019.

My role in relation to this process is limited to the consideration of any such Rules once submitted for my consent. I must consider any Rules presented to me from a fair and impartial perspective, without prejudice or prejudgment.

I await the receipt of the Rules for my consideration from the PSI and, until that time, I am unfortunately not in a position to comment any further on the matter raised.

Primary Care Centres

 158. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris when the next tranche of publicly advertised primary care centres for third party operation lease will be announced; when a centre will open at a location (details supplied); and if he will make a statement on the matter. [8605/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris 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.

Cross-Border Health Services Provision

 159. Deputy Eugene Murphy Information on Eugene Murphy Zoom on Eugene Murphy asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans and the preparations that have been made by his Department and his counterparts in Northern Ireland in relation to the EU cross-Border directive as part of Brexit preparedness; and if he will make a statement on the matter.  [8607/19]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The HSE operates the EU Cross Border Directive (CBD) in Ireland. Patients in Ireland can seek to be referred to another EU/EEA member state for medical treatment that is available in the public health service in Ireland. The patient may access the overseas service in either the public or private health sector of the EU/EEA member state they choose to receive the service in. The patient pays for the treatment and claims reimbursement from the HSE at the cost of that treatment in Ireland or the cost of it abroad, whichever is the lesser.

As part of a whole of Government response to Brexit, the Department of Health is working to ensure a comprehensive and coordinated set of preparations to ensure continuity of health services post-Brexit.

Work is ongoing to ensure that insofar as possible there is minimum disruption to health services and that essential services are maintained on a Cross-Border, all-island and Ireland-UK basis.

It should also be noted that post-Brexit, patients in Ireland can continue to seek to be referred to the remaining EU/EEA member states for treatment under the CBD.


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