Dr Reilly said he lost his brother, a doctor and smoker, to lung cancer and his father, another smoker, suffered a stroke and was prematurely blind for the last 14 years of his life.
Ireland will become the second country in the world, after Australia, to remove branding from tobacco product packaging.
The cabinet signed off on Dr Reilly’s proposal today and it is expected legislation will be in place by early next year.
All forms of branding, including trademarks, logos, colours and graphics, will be removed from cigarette packets, while brand name will be presented in a uniform typeface for all brands and the packs would all be in one plain neutral colour. Health warnings will be given more prominence.
The Department of Health said there is strong evidence that standardised packaging will increase the effectiveness of health warnings; reduce false health beliefs about cigarettes and reduce brand appeal particularly among youth and young adults.
Dr Reilly was critical of the recent meeting involving the Taoiseach, Minister for Finance and Minister for Justice with the tobacco industry, but he expressed satisfaction with the substance of the meeting.
“The minutes of the meeting will show very clearly that all that was discussed was smuggling and nothing else,” he said.
“The Taoiseach and the Minister for Finance have duties broader than mine in relation to health. I can tell you this much – the fact that the cabinet has passed a motion to pursue a law to bring this bill in is sign enough for me that I have got huge support from the Taoiseach and the Government.
“For me as a professional, this (smoking) is something that is intolerable. We have to protect our children from it. As adults we make our own decisions, but when you are an adult and you are addicted it is very hard to give them up.”
Dr Reilly said the measure has been so successful in Australia that tobacco companies have had to release statements saying that their cigarettes had not changed in taste as many of its customers were complaining about the taste.
A fierce critic of the tobacco industry, Dr Reilly said the industry needed to replace those who have died from tobacco-related illnesses, one-in-two who smoke, with young people who start smoking.
Dr Reilly said he was certain that the tobacco industry would seek to challenge the plain packaging in the courts.
However, he said such a move would be a measure of their desperation and also of the effectiveness of the measure.
The Irish Tobacco Manufacturers Advisory Committee said the initiative was a huge boost to the illegal tobacco industry, claiming the proposed legislation would make all packs look the same allowing counterfeiters to produce all brands of illegal cigarettes with greater ease.
Dr Reilly countered by stating there was “no research, none” to back up assertions by the tobacco industry that plain packaging would lead to increases in smuggling.
“Let’s call a spade a spade. What would you call a product that kills one in two users? Purveyors of death – I really do feel very strongly about this. I don’t know any smoker who wants their child to smoke. How can we support this industry?”
As he left the conference hall following his address, some delegates chanted: “no more cuts.”
One delegate, Bolatito Aderemi from the Dublin South West branch, started to sing: “All we are saying is enough is enough.
As he passed her Dr Reilly said she should “stick to her day job”.
A number of delegates objected to the Minister’s comments and said the union should seek an apology.
Dr Reilly later met with Ms Aderami privately and apologised.
He said he had made a quip as he left the hall. He said he had been informed that someone had taken offence. He said he had not intended to offend anyone.
Ms Aderemi, who is originally from Nigeria, said the Minister had shaken her hand, tried to give her a hug and said he was sorry and did not mean to embarrass her. She said she accepted his apology.
Dr Reilly had been greeted in silence as he arrived at the conference. However he received applause following an anouncement that nurses would hold senior leadership positions inthe proposed new hospital groups and in the Department of Health.
He said each of the proposed new hospital groups, to be announced formally next week, will have to have a director of nursing as a full executive on the management team.
“I will (also) establish a new chief nursing officer role within the Department of Health, that this role will be at assistant secretary level and a full member of the management advisory committee and will have executive authority to lead the nursing profession in Ireland and represent its perspective both to Government and internationally.”
Dr Reilly told delegates that pay savings of €150 million had to achieved in the HSE this yearin addition to the many reforms and efficiencies designed to improve servies and to live within its budget.
“Frankly, we are between a rock and a hard place.”
The Minister said that management and unions were meeting at the Labour Relations Comission to explore all the avenues open to try to reach a resolution to reducing the paybill.
“If we can find such anagreement it would be so much better than an imposed solution.
However he said the country was borrowing €1 billion per month and that this could not continue.
Shock rise in hospital waiting lists
The number of patients waiting more than nine months for hospital treatment has skyrocketed over the past two months after falling substantially in 2012, new figures show.
Latest figures show that of 2,141 adult and child patients were waiting over nine months for a hospital procedure at the end of February, compared to only 109 patients in this category at the end of 2012.
Of these, 396 patients are waiting over 12 months for treatment, compared to only 37 at the end of last year, while 1,745 are waiting between nine and 12 months for treatment, compared to only 72 at the end of December.
The Department of Health told irishhealth.com that winter pressures in hospital emergency departments had led to the increase, but it expected the waiting lists to reduce again as winter pressure on hospitals eased.
The average waiting time for treatment for patients on waiting lists has increased from 2.1 to 2.7 months since December.
The total number on waiting lists in all time categories has increased from 51,708 to 53,400 over the past two months, according to new figures produced by the National Treatment Purchase Fund’s (NTPF) Patient Treatment Register.
The recent major rise in ‘long waiters’ on treatment lists follows a huge reduction in the number of patients waiting over nine months for treatment in 2012 as a result of an initiative by Health Minister James Reilly‘s Special Delivery Unit (SDU).
The NTPF figures show that the number of patients waiting over nine months for treatment dropped from 4,884 in February 2012 down to 109 in December. During that period, the average waiting time for treatment dropped from 3.1 to 2.1 months.
Minister Reilly and the HSE had pledged that no patient would be waiting over nine months for treatment by the end of 2012, and the current target is to reduce the maximum treatment waiting time to eight months this year.
The figures would indicate that Dr Reilly’s waiting list initiative is in danger of coming off the rails following the recent increase in waiting numbers and waiting times.
However, a Department of Health spokesperson said ‘significant bounceback’ in waiting times in the early months of this year was expected, as winter pressures in emergency departments had impacted on scheduled care waiting times.
“In the coming months, as winter pressures ease, the SDU will work towards re-balancing scheduled care both to maintain the improvements seen in 2012 and to achieve the new 2013 target that no adult should be waiting longer than eight months for treatment.”
The Department said the figure of 2,14 people waiting over nine months for treatment was the total number of adults and children waiting and patients waiting for routine endoscopes, each of which had different targets.
The figures show that around 97% of the 2,141 figure comprises adults waiting over nine months for treatment, with the remainder made up of children awaiting treatment and patients awaiting endoscopies.
The Mater currently has 5,011 patients on waiting lists for hospital treatment, of which 521 have been waiting longer than nine months for treatment, or 10% of total patients on waiting lists at the hospital.
The hospital with the next worst record for long waiters is Cork University Hospital, where 236 (just under 9%) of its 2,708 patients on waiting lists have been waiting over nine months for treatment.
The hospital with the largest number of patients on waiting lists is St James’s in Dublin, with 5,529. However, only 3.5% of these patients have been waiting over nine months for treatment.
Nearly 40% of patients on outpatient lists in one of the country’s main orthopaedic hospitals have been waiting over four years to be seen, new figures show.
Figures for the end of January from the Department of Health’s Patient Treatment Register (PTR) show that there are currently 10,347 public patients on outpatient waiting lists at at the Mid-Western Regional Orthopaedic Hospital in Croom, Limerick.
Of these, 4,109 have been waiting four years or more to see a consultant in an outpatient clinic in order to get assessed for treatment.
Croom Hospital has the highest figure in the country for the number waiting four years or more for an outpatient consultation.
The hospital with the second highest four-year plus waiting numbers for outpatients is the Mid-Western Regional Hospital, also in Limerick, which has 1,716 patients waiting over four years to see a consultant.
This is followed by Waterford Regional Hospital, which 1,086 patients with a four year plus outpatient waiting time.
Nationally, there are now 9,784 patients waiting over four years for an outpatient consultation in a public hospital.
A total of 8,989 patients nationally are currently waiting between three and four years for an outpatient consultation.
The total number of people on outpatient lists, according to the PTR figures for the end of January, is 386,643.
A FORENSIC scientist who was fined for making cannabis oil to treat his own pain is to bring a legal challenge in the European courts.
John Anderson (59) is appealing a conviction handed down at Sligo District Court for possession of cannabis.
Sligo District Court heard the former UK government scientist admit he developed liquid cannabis 10 years ago and used it to treat a tooth problem and shoulder injuries. He was fined €200 for cultivating the plant.
“I had an abscess, and while I was given antibiotics and paracetamol it was agony, so I bought some seeds and grew some cannabis,” he said.
“Smoking cannabis made me sick, so it was a simple process for me as a scientist to develop it into liquid form. It was the perfect relief and got me through until I could have surgery. The relief lasted from a week to a fortnight with just one rub to my jaw.”
When he suffered two separate shoulder injuries – one in a fall and one in a traffic accident – he turned again to cannabis.
“My physiotherapist told me the injuries won’t heal, so I got some cannabis seeds and made more stuff,” said Mr Anderson.
“The Government classes cannabis alongside heroin and cocaine and it states in our laws that cannabis has no medicinal benefits. Research going back 5,000 years says otherwise.”
More medical card cuts on the way
However, further as yet unspecified cuts to medical card entitlements for other age groups are also due to take place next year and are to be revealed in the HSE‘s forthcoming 2013 service plan.
The Department of Health old irishhealth.com are to be changes to the medical card means test next year, but so far no precise details of this have emerged. The Government had been under pressure from the Troika to tighten up on medical card eligibility.
Minister, Reilly, having promised on coming to office last year that he would abolish the 50 cent medical card prescription charge, has now trebled it to €1.50 per prescription item, subject to a monthly maximum charge of €19.50 per family. This increase has been ‘due to the current financial climate’.
Under the over 70s medical card changes, the Minister said 92% of over 70s will still have medical cards, while 5% will no longer have a full card but will qualify for a GP visit card, while the wealthiest 3% will have neither card, which is the same percentage as at present.
Dr Reilly said single over 70s earning €600 to €700 per week will lose their entitlement to a full medical card, while those earning over €700 per week already do not qualify for a card, following the last review of eligibility in 2009. The new thresholds are double for elderly couples.
Elderly people who will be downgraded to a GP visit card will now have to pay drug costs up to €144 per month, following a new rise in the drug payment scheme threshold.
GPs and other professionals providing services under the medical card and other State schemes are to have their fees cut further.
Dr Reilly told a press conference on the health measures in the Budget that €781 million will have to extracted from the health service in savings next year.
By the end of 2013, this will bring the amount cut from the health service in the previous four years to around €3.3 billion. The service is to get €13.626 billion for everyday expenditure next year.
According to the Department of Public Expenditure, this will be reduced to €13.420 billion in 2014, when further health cuts will be required.
However, Dr Reilly said the lesson over the past year had been that by reforming services, more had been done with fewer resources, with inpatient waiting lists and trolley numbers reduced. He admitted, however, that next year would pose great difficulties.
Dr Reilly stressed the need to promote a greater level of generic prescribing. He said there were some drugs that were of the same class that were one-third the price of the other drugs in that class.
There would be legislation and initiatives to promote more generic prescribing.
The bulk of the €781 million in savings will come from €323 million in primary care scheme savings – this includes the medical card scheme.
The projected savings of €323 million in primary care schemes will come from:
* A projected €120 million from agreements with the pharmaceutical industry on drug cost cuts.
* A projected €70m from reductions in fees to primary care health professionals.
* €50m from the increase in prescription charges.
* €20m from changes to medical card means test.
* €12m from replacement of medical cards with GP visit cards for persons over 70 in excess of certain income limits.
* €10m from increasing the threshold in the Drugs Payment Scheme.
* €15m from ‘delisting’ certain products from the medical card scheme.
* €20m from promotion of more cost-effective prescribing practices by GPs and consultants.
* €5m from a reduction in reimbursement prices of oral nutritional supplements.
The remainder of the total €781 million in health service savings will come mainly from ‘pay related savings’, as yet unspecified; increased generation of private income from public hospitals – a measure that was promised for 2012; a net saving on the Department’s vote, and savings in procurement.
Dr Reilly declined to be drawn specifically on what pay savings in health might arise from an extension to the Croke Park Agreement. However, areas such as rostering were being looked at.
Asked what level of cuts in their allocation hospitals might face next year, Minister Reilly said there would be details of hospital allocations in the HSE’s service plan when published.
Minister of State at the Department of Health Alex White indicated that the €20 million planned to be spent on primary care staffing this year but which was reallocated to cover the HSE’s deficit would be spent next year. However, there is no specific provision for this expenditure in 2013 in the Book of Estimates.
Funding is to be allocated for the initial phase of the planned free GP care scheme for people with certain long-term conditions, Mr White said.
Minister of State Kathleen Lynch said a further €35 million would be spent on mental health services next year. She said all of the €35 million allocated for development of these services in 2012 was not spent.
[Posted: Wed 05/12/2012]
THE top civil servant in the Department of Health launched a probe into his own minister, Dr James Reilly, in the wake of the controversy over the decision to locate two primary care centres in his constituency.
Ambrose McLoughlin, the department’s secretary general, ordered an investigation after revelations in the Irish Independent that a supporter of Dr Reilly owned the site of a proposed primary care centre in Balbriggan, Co Dublin.
The revelation that Mr McLoughlin moved to investigate his own minister will heap further pressure on Dr Reilly, who has faced criticism over his handling of the Savita Halappanavar tragedy and HSE overspending.
Informed sources said it was Mr McLoughlin’s “sole decision” to launch the probe and Dr Reilly was aware it had been launched.
The move by Mr McLoughlin to initiate an investigation into the matter came as Mr Reilly was facing intense scrutiny over the controversial decision.
Detailed plans for the future of the health service, which will see free GP care for all introduced in 2015 to be followed by the promised universal health insurance scheme, were announced yesterday. The plans set out target times for implementing 48 reforms, culminating in the introduction of universal health insurance in 2016.
While many of the elements of the Future Health document published Miniser Reilly yesterday are in the programme for government, he pointed out concrete timeframes were being provided for the first time.
The plans will see a new patient safety agency next year and a health and wellbeing agency in 2015. BreastCheck cancer screening will be extended to 65-69 year-old women in 2014, while the first round of the colorectal cancer screening programme for men/women of this age group will have been completed by the end of 2015.
The document anticipates the controversial reorganisation of services by hospital groups, although the Minister indicated this would be done on a trial basis at first.
A series of financial reforms will see control of health spending return from the HSE to the Department of Health in 2014 and the introduction of new financial management systems aimed at controlling costs. The HSE is currently €400 million over budget. Dr Reilly said he wanted to see “aggressive” cost control in the health insurance market with payments being made per medical procedure rather than based on the number of nights a patient spends in hospital.
The increase will add about €100 a year to the cost of health insurance for the average family.
The company said yesterday it was putting up its prices because it needed to price policies “in order to ensure that we can continue to cover the healthcare needs of our customers”.
It blamed the latest price rise on the fact that people were living longer with long-term illnesses. This was contributing to increased demand and use of health services, a spokesman said.
The cost of claims for private hospitals has gone down but public hospital costs continue to rise, according to the insurer.
The increase will take effect from November 22nd. With 57 per cent of the market, VHI is the largest health insurer and has 1.3 million customers.
Last March it increased prices by between 6 per cent and 12.5 per cent, on top of a 1.9 per cent rise last November.
Other insurers have also increased their prices this year. Aviva premiums went up by up to 7 per cent for policy renewals from last week, the fifth increase in less than two years. Laya Healthcare, formerly Quinn Healthcare, has had two price rises this year.
The insurance companies met Department of Health officials last Friday over the department’s plans to modify risk equalisation rules to make insurance more expensive for treatment in private hospitals.
The Department said that notwithstanding the reluctance to loosen current controls on cannabis generally, its expert clinical advice is that the cannabis-based drug Sativex, “is a valid treatment option”.
Sativex is used in other countries for treating symptoms associated with multiple sclerosis.
The Irish Medicines Board has received a market authorisation request from GW Pharma, the makers of Sativex and the agency has recommended the approval of the product for the Irish market based on an analysis of its quality, safety and efficacy.
The Department said its officials have been engaging with experts on how best to legally describe cannabis-based medicinal products, while maintaining existing controls on cannabis and cannabis substances.
Sativex is available in Britain, Germany, Denmark and elsewhere for the relief of symptoms of spasticity for patients with MS, where other treatments have failed to provide adequate benefit.
It said that while the legislative amendments required can be made by means of statutory instrument, the legal issues are complex.
Dr David Finn, Lecturer in Pharmacology & Therapeutics at the Centre for Pain Research NUI Galway, said the issue was about developing therapeutic agents targeting the body in a specific way for a specific purpose.
He said it was not about smoking and inhaling cannabis as a drug of abuse.
Mr Kenny has tonight called for Minister Reilly and his two juniors to move on and get the job of reform done.
Mr Kenny said: “You wouldn’t ask the Taoiseach to comment on an authority that is absolute to any Taoiseach and that is the appointment or removal of any ministers.
“There is a very clear programme for Government here; Mr Reilly has the full support and the confidence of the Government. It is a very challenging job, he has got a changed team in Health, and I expect him to move on with his two ministers of state and get on with the job which is his primary responsibility.”
Reading between the lines one begins to suspect that Reilly is in the last chance saloon