Written Answers Nos. 415-429
415. Deputy Colm Burke asked the Minister for Health if a child (details supplied) who is currently attending Crumlin Children’s Hospital who urgently requires physiotherapy in Cork will be provided with this care in a hospital; if so, when this will occur; and if he will make a statement on the matter. [31741/23]
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.
416. Deputy Mairéad Farrell asked the Minister for Health further to Parliamentary Question No. 633 of 20 June 2023, if he is aware of patients who cannot switch to alternatives of the medications noted in his reply; how similar supply issues will be avoided in future; if he is aware of other countries in Europe which have not been impacted by the same supply issues as Ireland and the reason for this; and if he will make a statement on the matter. [31745/23]
View answerLaboratoires Besins International has advised of a shortage of Imvaggis 0.03 mg Pessary, impacting multiple markets. The company stated the reason is manufacturing delays and supply is expected towards the end of July 2023. Multiple countries, not just Ireland, are affected.
Novartis Ireland Limited, the company responsible for placing Estradot 100mcg/24 hour transdermal patch on the market, has notified of a shortage of this medication due to continued unexpected increased demand. The company has not yet provided information to confirm if this shortage impacts other markets. The expected return date for supply is the week ending 6 August 2023.
The supply Utrogestan Vaginal 200mg Vaginal Capsule which had been in short supply resumed on 20 June 2023.
Alternatives are available. Many Hormone Replacement Therapies (HRT) are authorised for use in Ireland in various formulations (e.g., oral tablets, transdermal patches, gels, and sprays) and strengths. For the vast majority of HRT products authorised, including transdermal patches and gels, the Health Products Regulatory Authority (HPRA) has not received any notifications of current shortages. This includes all but two of the above mentioned authorised products outlined in the HSE’s clinical guidance for HRT (hyperlink below).
MMP guidance for prescribers on HRT shortages – September 2022 (hse.ie)
Unfortunately, medicine shortages are a feature of modern health systems worldwide which have been exacerbated by recent worldwide events. There are a multitude of reasons why a medicine may not be available including: shortages of raw materials; manufacturing difficulties; sudden unexpected increase in demand; or product recalls due to potential quality issues. Ireland has a multi-stakeholder medicine shortage framework in place, coordinated by the HPRA, to prevent, wherever possible, and to manage medicine shortages when they occur. The Department of Health maintains regular contact with the HPRA regarding medicines shortages.
The HPRA publishes a list of medicines currently in short supply on its website (Medicines Shortages (hpra.ie) with the reason for the shortage and expected dates for the return of supply. The information is available to assist healthcare professionals in managing medicine shortages when they arise and reduce their impact on patients.
The HPRA will continue to liaise with suppliers of HRT medicines over the coming weeks with a view to securing updates and commitments regarding the restoration of normal supplies for patients as soon as possible.
It is important to note that the decision to prescribe or not prescribe any treatment for an individual patient is strictly a decision for the treating clinician, in consultation with their patient. The Minister for Health has no role in this clinical decision-making process and cannot interfere in the clinical decisions of a medical practitioner. Patients are advised to discuss their treatment and alternative options with their doctor, pharmacist or other healthcare professional as applicable.
417. Deputy Brendan Griffin asked the Minister for Health if a child (details supplied) will be considered for an urgent appointment; and if he will make a statement on the matter. [31760/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
418. Deputy Brendan Griffin asked the Minister for Health If he will provide clarification on a matter (details supplied); and if he will make a statement on the matter. [31761/23]
View answer437. Deputy Carol Nolan asked the Minister for Health if he has engaged with an organisation (details supplied) as he is obliged to do under Public Pay and Pensions Act 2017 legislation, to review the nature of community pharmacies services before the end of June 2023; the reasons for the delay in meeting the organisation and the lack of response to requests for a meeting from the organisation; and if he will make a statement on the matter. [31881/23]
View answer438. Deputy Fergus O'Dowd asked the Minister for Health if he will respond to concerns raised in correspondence (details supplied); and if he will make a statement on the matter. [31882/23]
View answerI propose to take Questions Nos. 418, 437 and 438 together.
I recognise the significant role community pharmacists play in the delivery of patient care and acknowledge the potential for this role to be developed further in the context of healthcare service reform.
In that regard, various approaches to extending the scope of practice of community pharmacists are being progressed by my Department. The implementation of these necessitates engagement with a range of stakeholders and full consideration of all the relevant legislative and operational issues involved.
The regulations governing the pharmacy fee structure are set out in the Public Service Pay and Pensions Act 2017 (No. 34 of 2017) and in S.I. No. 639 of 2019, the Public Service Pay and Pensions Act 2017 (Payments to Community Pharmacy Contractors) Regulations 2019, which put the current fee structure in place, with effect from 1 January 2020.
Under Section 42(14) of the Public Service Pay and Pensions Act 2017 the pharmacy fee structure must be reviewed every third year after 2020. My Department is currently carrying out a review and Department officials have held a meeting with the Irish Pharmacy Union in that regard.
I believe that there is a real opportunity to work collaboratively with community pharmacists, and with other healthcare providers, to make a significant difference to patient outcomes. Of course, any publicly funded pharmacy service expansion should address unmet public healthcare needs, improve access to existing public health services, and provide better value for money.
419. Deputy Colm Burke asked the Minister for Health the home support waiting list for funding and for carers in each month of 2018, 2019, 2020, 2021, 2022 and 2023, for each LHO and CHO, broken down by those waiting for a new package and those with an existing package waiting for additional hours; and if he will make a statement on the matter. [31762/23]
View answer420. Deputy Colm Burke asked the Minister for Health the number of home support hours delivered in each LHO and CHO in 2018, 2019, 2020, 2021, 2022 and 2023, compared to the targeted hours delivered, including the split between directly and indirectly delivered care; and if he will make a statement on the matter. [31763/23]
View answer421. Deputy Colm Burke asked the Minister for Health the average number of hours allocated per week to a client receiving HSE home support in 2023; and if he will make a statement on the matter. [31764/23]
View answerI propose to take Questions Nos. 419 to 421, inclusive, together.
As these are operational matters, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
422. Deputy Jennifer Whitmore asked the Minister for Health for an update on the HSE review of the availability of medication for hyperemesis; when the review will be completed; what will happen upon completion of the review; and if he will make a statement on the matter. [31781/23]
View answer423. Deputy Jennifer Whitmore asked the Minister for Health the number of women who have been approved for cariban on a month-by-month basis to date in 2023; the cost accrued by the State to date for the provision of this medication via the community drug scheme; and if he will make a statement on the matter. [31782/23]
View answerI propose to take Questions Nos. 422 and 423 together.
The Health Service Executive (HSE) has statutory responsibility for medicine reimbursement decisions under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
Budget 2023 provided funding of €1.3m to allow reimbursement support for Cariban® (doxylamine/pyridoxine), for women suffering hyperemesis gravidarum, a severe form of nausea during pregnancy. Cariban® is not licensed in Ireland. It is classed as an Exempt Medicinal Product and cannot be added to the formal reimbursement list.
Following a review of the available evidence, the HSE considered the potential for a time-limited, quantity-dependent reimbursement arrangement for women with hyperemesis gravidarum, to access Cariban®, when prescribed by a consultant obstetrician and in line with clear clinical criteria, as set out by the HSE.
The HSE, therefore, put in place an exceptional arrangement which requires that the initial prescriber of Cariban must be a consultant. The HSE will thereafter accept GP prescriptions for approved patients. This arrangement has been in operation since 1 January 2023.
On the recognition that women suffering hyperemesis gravidarum may need access to Cariban® before their first consultation with their specialist/obstetrician, and in light of the fact that GPs prescribe Cariban to private patients without an initial prescription from a specialist, I have asked the HSE to review the current arrangement and report back to me.
The HSE have confirmed that the current review involves an analysis of the exceptional arrangement and of the access to Cariban provided to patients since January 2023. The review also includes engagement with clinical leads, the HSE Primary Care Reimbursement Service and relevant advocates.
The HSE have advised that this review will be completed by July 2023. The Department will then consider the findings of the review.
As of 31 May 2023, expenditure on the reimbursement arrangement for Cariban® is €0.23 million. The number of women approved for the product at that time was 1,376. The full cost associated with these approvals will depend on the dosage prescribed and the length of use.
The below table sets out the number of approvals for Cariban on a month-by-month basis. As of 27 June 2023, 1,621 women have been approved for reimbursement support for Cariban.
|
Month |
Number of women approved for Cariban® |
|
January |
250 |
|
February |
331 |
|
March |
329 |
|
April |
204 |
|
May |
262 |
|
June* |
245 |
|
Total* |
1,621 |
*As of 27 June 2023
424. Deputy Rose Conway-Walsh asked the Minister for Health to provide, in tabular form, a list of Section 39 organisations; and if he will make a statement on the matter. [31796/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
425. Deputy Rose Conway-Walsh asked the Minister for Health the estimated number of Section 39 employees; and if he will make a statement on the matter. [31797/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly.
426. Deputy Carol Nolan asked the Minister for Health if his Department purchased or produced any memorabilia such as pens, stationery, pins, badges, mugs or other types of souvenirs to mark or celebrate Pride 2023; if so, the costs incurred; and if he will make a statement on the matter. [31812/23]
View answerDepartment of Health employees participated in Pride 2023, along with colleagues from other Departments, under the banner of “Proud to Work for Ireland”.
The Department of Health purchased t-shirts and flags for those representing this Department at the parade at a total cost of €433.94 (including VAT).
427. Deputy Martin Browne asked the Minister for Health to provide an update on the status of the allocation of staffing resources to secure extended service provision at Nenagh MAU; the targets set to meet these commitments; and if he will make a statement on the matter. [31823/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
428. Deputy Éamon Ó Cuív asked the Minister for Health if it is intended to appoint a dermatologist in a county (details supplied) to ensure this service is available in the county; and if he will make a statement on the matter. [31834/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
