Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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825. To ask the Minister for Health his views on whether the Choosing Wisely policy that is in use in the United States of America, Australia, Germany and other countries has been examined in an Irish context, a policy that is designed to stop using various interventions that are not supported by evidence and others where risks outweigh harm, but not to withhold necessary care; and if he will make a statement on the matter. [22147/15]

Leo Varadkar (Dublin West, Fine Gael)
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The Choosing Wisely Campaign which began in the United States in 2012 is focused on promoting conversations between clinicians and patients about unnecessary tests, treatments and procedures. Its principles lie in being physician led, patient focused, shared decision making, evidence based and multiprofessional.

As part of the Patient Safety First Initiative I appointed the National Clinical Effectiveness Committee (NCEC) to prioritise and quality assure to the level of international methodological standards a suite of National Clinical Guidelines to direct clinical practice decisions for key areas of clinical practice. Clinical guidelines are internationally recognised methods for defining healthcare interventions, improving the effectiveness of care and treatment and reducing variation in care delivery based on the best available evidence. This is a quality improvement approach which promotes cost-effective healthcare that is evidence-based, with subsequent improved clinical decision making and clinical outcomes. Both the NCEC and guideline development groups involve patients and the public in the guideline process.

NCEC National Clinical Guidelines endorsed by the Minister for Health are mandated for implementation in the Irish health system. Six NCEC National Clinical Guidelines have been published to date: National Early Warning Score (February 2013), Prevention and Control of MRSA (December 2013), Surveillance, Diagnosis and Management of Clostridium Difficile Infection in Ireland (June 2014), Sepsis Management (November 2014), Maternity Early Warning System (November 2014) and Clinical Handover in Maternity Services(November 2014).

The NCEC Sepsis Management Guideline has received international recognition and is accredited by the National Institute for Health and Care Excellence (NICE).

In addition the Health Information and Quality Authority (HIQA) undertakes health technology assessments (HTA) appropriate to decision makers’ needs to inform national policy and service decisions and National Clinical Guidelines. HTAs are a form of research which evaluates the clinical and cost effectiveness of health technologies such as drugs, equipment, diagnostic techniques and health promotion activities. HIQA has published HTA recommendations on treatment thresholds for a number of procedures including gallstone disease and surgeries such as tonsillectomies and cataracts.

Recommendations based on evidence are made for clinical practice both by NCEC, HIQA and the HSE. For example the decision for targeted rather than universal MRSA screening in Irish hospitals was based on a cost-effective analysis published in the National Clinical Guideline on the Prevention and Control of MRSA (December 2013). The national antibiotic campaign was launched to raise awareness on the correct use of antibiotics. The key message of this campaign is that antibiotics are wasted on viral illnesses, such as colds and flu, and are of no benefit to those suffering from them.

I will continue to examine new ways that we can drive forward the agenda for increasing the use of evidence for clinical decision making including participation in international campaigns such as 'Choosing Wisely'.