Written Answers Nos. 1508-1521
1508. Deputy Duncan Smith asked the Minister for Health the information that is exchanged between the HSE's women's health service and anti-human trafficking team and An Garda Síochána - that is, how often such exchanges happen, demographic figures and so on; and if he will make a statement on the matter. [17015/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1509. Deputy Marian Harkin asked the Minister for Health the plans currently in place to establish a genetics service at Our Lady's Children's Hospital in Crumlin to help diagnose and treat rare diseases. [17018/23]
View answerChildren’s Health Ireland (CHI) at Crumlin is one of the current hospital sites providing a genetic testing service. CHI’s genetics lab conducts Cytogenetic Analysis and Molecular Genetic Analysis, both of which encompass a range of tests. The Government and I are committed to improving and expanding this service, with a number of key developments already under way.
One of the key ambitions the National Strategy for Accelerating Genetics and Genomics Medicine in Ireland, launched in December 2022, is to build a strong national genetics service. This will be a patient and family-centred service that can be accessed equitably across the country and across the lifespan of patients. The Strategy outlines a plan to achieve this ambition by improving the evidence-base and infrastructure supporting genetic testing in Ireland. In 2023, the HSE will begin developing a National Testing Directory for genetics and genomics, which will map the current genetic tests conducted across Ireland and provide a more transparent process to referrals. This development, therefore, will be a key steppingstone to improving national genetic testing and ultimately help reduce wait time. The Strategy also outlines a plan to build a strong genetic workforce for the future. This will be achieved by not only recruiting new staff, but training and development for a future workforce, and professional development for current staff within the health service. To start implementing the Strategy in 2023 I approved €2.7 million including the appointment of key staff. These appointments included a National Director for Genetics and Genomics, a Bioinformatics Lab Director, two clinical genetic consultants and six genetic counsellors.
1510. Deputy Mark Ward asked the Minister for Health the average waiting times for child health visits by public health nurses, by area in Dublin mid-west, by year from 2017 to 2022, and to date in 2023; and if he will make a statement on the matter. [17020/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1511. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [17024/23]
View answerUnder 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.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1512. Deputy Pauline Tully asked the Minister for Health in view of the response from An Tánaiste on 23 March 2023 in relation to the use of the National Treatment Purchase Fund for those seeking an assessment of need, where he stated that while “[p]redominantly, it has been used for inpatient acute treatment... the Minister has indicated in the past that it can be used for disabilities... and also to deal with that very significant outpatient list...”, if he will clarify whether the National Treatment Purchase Fund can be used for those seeking an assessment of need, as the response from An Tánaiste seems to contradict the reply to Parliamentary Question No. 1355 of 21 March 2023 (details supplied); and if he will make a statement on the matter. [17026/23]
View answerFurther to my response to Parliamentary Question No. 1355 of 21 March 2023, I wish to clarify that the statutory remit of the National Treatment Purchase Fund (NTPF) is in respect of the provision of hospital treatment and does not extend to arranging or funding any non-hospital services, including assessments of need.
The NTPF’s commissioning model had previously focused on the procurement of treatment for clinically suitable, long-waiting patients on Inpatient/Day Case hospital waiting lists. The procurement of Outpatient services by the NTPF increased significantly in 2022, and under the 2023 Waiting List Action Plan, the NTPF will arrange 110,000 outpatient appointments in public and private hospitals, for patients who are on acute public hospital waiting lists. The increase in procurement of Outpatient services by the NTPF is in line with its statutory remit.
Outside of the scope of the Waiting List Action Plan and the role of the NTPF, budget 2023 included €80 million allocated to various HSE primary and community care-related activities under the area of Waiting Lists. Of this funding, €11.7 million has been allocated to address backlogs in disability services related to Assessments of Need.
1513. Deputy Duncan Smith asked the Minister for Health his plans to move the drug eltroxin onto the long-term illness core list for people with Down syndrome, and other chromosomal abnormalities; and if he will make a statement on the matter. [17031/23]
View answerThe Health Service Executive (HSE) has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In line with the 2013 Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the reimbursement list. Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.
In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact. HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE). I, as Minister for Health, have no role in these decisions.
The Long-Term Illness (LTI) scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 illnesses covered by the scheme. These are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.
Under the LTI scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
The HSE have advised that the drug Eltroxin (Levothyroxine Sodium) is included on the LTI scheme Core list under the category mental handicap.
1514. Deputy Mark Ward asked the Minister for Health the staffing levels in each of the 73 CAMHS teams; how many CAMHS teams are fully staffed; the vacancy rates per CAMHS team; and if he will make a statement on the matter. [17032/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1515. Deputy Carol Nolan asked the Minister for Health if he will provide an update on the operation of the fair deal scheme and the changes which are being made relating to rental income; and if he will make a statement on the matter. [17041/23]
View answerEffective from 1 November 2022, the amount of rental income that nursing home residents can retain under the Fair Deal from renting their principle private residence increased from 20% to 60%.
Prior to this change being implemented, participants in the Fair Deal scheme were able to rent out their homes or other assets, however rental income was subject to assessment at 80% like all other income (such as pension income).
Recognising that this may act as a disincentive against renting out a property, the Government approved a policy change to the Nursing Homes Support Scheme, “Fair Deal”, to remove a disincentive for applicants to the Scheme to rent out their principal residence after they have entered long term residential care. The rate of assessment for rental income from a principal residence is reduced from 80% to 40%. This means that for someone renting out their principal residence, they retain 60% of the income accrued from that rental and 40% is assessed under Fair Deal.
Under the terms of the amended legislation, this policy change will be reviewed after six months of operation at the end of April 2023, with the intention for further amendment after that point if necessary and examining any unintended consequences and potential safeguarding issues.
It should be noted that rental income accrued from property that is not a principal private residence will continue to be assessed at 80%.
This policy change addresses the commitments made under Housing For All Action 19.8. The change was made through a Committee-Stage amendment to the Department of Housing, Local Government and Heritage’s Regulation of Providers of Building Works and Building Control (Amendment) Bill 2022 which is in operation as of 1 November.
Further details are available at: www2.hse.ie/services/schemes-allowances/fair-deal-scheme/financial-assessment/#rental-income-for-your-home.
In addition, under the provisions under the Civil Law (Miscellaneous Provisions) Act 2022, NHSS clients who are in receipt of Accommodation Recognition Payment are to have this payment disregarded from their financial assessment. This means that nursing home residents who make their principal private residence available to Ukrainian refugees can claim this payment without affecting their contribution to cost of their own care. The payment is paid through the Department of Social Protection. Further details regarding eligibility and how to apply are available at: services.mywelfare.ie/en/topics/ukraine-emergency-supports/accommodation-recognition-payment/.
These measures will allow residents in Fair Deal to keep more of their income and will also help address pressures on the rental market. It is important that residents who choose to rent out their homes do so in a safe and supported way. The well-being, safety and comfort of nursing home residents remains a priority for me.
1516. Deputy Carol Nolan asked the Minister for Health if he will clarify the entitlements that exist for elderly dementia patients living at home; if such entitlement differs around the country (details supplied); and if he will make a statement on the matter. [17042/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly as soon as possible.
1517. Deputy Neasa Hourigan asked the Minister for Health the estimated cost to the State for the drugs payment scheme threshold for single-headed households to be reduced to €72 per month; and if he will make a statement on the matter. [17047/23]
View answerThe Drug Payment Scheme (DPS) provides for the refund of the amount by which expenditure on approved prescribed medicines or medical and surgical appliances exceeds a named threshold in any calendar month.
The DPS is not means tested and is available to anyone ordinarily resident in Ireland. It significantly reduces the cost burden for those not eligible for a medical card but with ongoing expenditure on medicines.
The DPS threshold has been €80 since 1 March 2022.
The estimated cost of reducing the DPS threshold to €72 per month is €12.5m per annum.
1518. Deputy Neasa Hourigan asked the Minister for Health the estimated cost to the State to abolish prescription charges for all medical card holders; and if he will make a statement on the matter. [17048/23]
View answerThe Government is committed to making healthcare more accessible and affordable and has introduced several reductions in the cost of healthcare.
On 1 November 2020, prescription charges under the General Medical Services (GMS) scheme were reduced as follows:
• For persons over 70, the charges were reduced to €1 per item with a maximum monthly charge of €10 per person or family per month.
• For persons under 70, the charges were reduced to €1.50 per item with a maximum monthly charge of €15 per person or family.
It is estimated that the minimum cost of abolishing prescription charges for all eligible persons would be approximately €60m per annum.
This estimation is subject to the following caveats:
• That demographic changes may impact the number of eligible persons.
• That the removal of prescription charges may result in a change in claimant behaviour.
1519. Deputy Neasa Hourigan asked the Minister for Health the amount of funding required to ensure the full financial resourcing and implementation of the National Cancer Strategy 2017-2026 recommendations around genetic services; and if he will make a statement on the matter. [17049/23]
View answerThe implementation of the National Cancer Strategy 2017-2026 is a Programme for Government commitment and is part of the implementation of Sláintecare. We have seen significant progress on the implementation of the Strategy over the past six years, with clear evidence-based policy direction from my Department and strong implementation by the HSE's National Cancer Control Programme (NCCP). The Strategy contains a number of recommendations relating to genetics in cancer services, including the provision of a national genetics service.
The National Strategy for Accelerating Genetics and Genomics Medicine in Ireland was published in December 2022. One of the key ambitions of this Strategy is to build a strong national genetics service. This will be a patient and family-centred service that can be accessed equitably across the country and across the lifespan of patients. The Strategy outlines a plan to achieve this ambition by improving the evidence-base and infrastructure supporting genetic testing in Ireland.
A key step in building a strong genetics service is addressing our current staffing needs in this area and ensuring national genetic testing capacity is strategically delivered. These objectives will be achieved largely through the planned National Testing Directory for genetics and genomics. The HSE will begin developing this Directory by the 2023 year end. It will map the current genetic tests conducted across Ireland, provide a more transparent process to referrals, and provide a more comprehensive understanding of our future genetic staffing needs. This development, therefore, will be a key steppingstone to improving national genetic testing and ultimately help reduce waiting times.
The National Strategy for Accelerating Genetics and Genomics Medicine in Ireland also outlines a plan to build a strong genetic workforce for the future. This will be achieved by not only recruiting new staff, but training and development for a future workforce, and professional development for current staff within the health service. To start implementing the Strategy in 2023, I approved €2.7 million including the appointment of key staff. These appointments included a National Director for Genetics and Genomics, a Bioinformatics Lab Director, two clinical genetic consultants and six genetic counsellors.
1520. Deputy Neasa Hourigan asked the Minister for Health the progress of the recommendations contained in the clinical governance and operational arrangements for supporting a model of care for children with life-limiting conditions towards the end of life in the community in Ireland, in particular recommendations 14 and 15; the proportion of posts that have been filled; which posts remain vacant; and if he will make a statement on the matter. [17050/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1521. Deputy Neasa Hourigan asked the Minister for Health the amount of funding required to ensure that the National Skin Cancer Prevention Plan 2023-2026 is implemented in full; the amount of funding that has been allocated to date; and if he will make a statement on the matter. [17051/23]
View answerAs the implementation of the National Skin Cancer Prevention Plan a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
To note, Action 1.4 of the Plan is "Develop and deliver an annual SunSmart communications plan to raise awareness of skin cancer prevention behaviours". This follows on from a similar action in the first Skin Cancer Prevention Plan. This SunSmart campaign has run in 2021,2022 and has just commenced for 2023. In each of those years Healthy Ireland has co-funded this campaign with the HSE. The Department, through Healthy Ireland, will be providing €60,000 to co-fund the campaign in 2023.
