David Cullinane (Waterford, Sinn Fein)
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1697. To ask the Minister for Health the exchange visits since 2017 between mesh removal surgeons here and colleagues in other jurisdictions; the itinerary followed; the hosts and participants; the observations of mesh removal operations; the training provided; and if he will make a statement on the matter. [15168/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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This question relates to a clinical matter and is therefore referred to the HSE for direct reply to the Deputy.

David Cullinane (Waterford, Sinn Fein)
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1698. To ask the Minister for Health the legal costs incurred to date in the defence of medical negligence claims relating to mesh implants in circumstances in which the case has been settled and remains open, respectively; and if he will make a statement on the matter. [15169/21]

David Cullinane (Waterford, Sinn Fein)
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1699. To ask the Minister for Health the number of medical negligence claims relating to the implantation of mesh implants in circumstances in which the HSE and-or its employees are named as defendants that have been received; the number of these claims that were settled; the settlement amounts; and if he will make a statement on the matter. [15170/21]

David Cullinane (Waterford, Sinn Fein)
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1700. To ask the Minister for Health if he has investigated whether the use of mesh implants in the healthcare system is underpinned by a form of indemnity insurance provided by the Government to the manufacturer or provided by the manufacturer to the Government; and if he will make a statement on the matter. [15171/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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I propose to take Questions Nos. 1698 to 1700, inclusive, together.

The State Claims Agency (SCA) has a statutory remit to manage personal injury claims on behalf of Delegated State Authorities including the Health Service Executive. The State Claims Agency has provided me with the following information, in respect of the Deputy's questions. 

The below information has been extracted from the National Incident Management System (NIMS).

Criteria Used

- This response shows the number of claims received by the State Claims Agency in relation to Transvaginal Implants as recorded on NIMS.

- Transvaginal Implants claims are classified as Type of Mass Injury equal to ‘Transvaginal Implants’.

- This information is correct as of 16/03/2021.

The State Claims Agency is on notice of 56 active claims in relation to transvaginal implants. These claims involve a number of defendants including HSE hospitals, voluntary hospitals, private hospitals, individual clinicians, manufacturers and suppliers of the product in question.

The litigation concerning these cases is on-going and, as a result, the State Claims Agency regrets that it is not in a position to release to the Deputy further details regarding these claims due to the commercial sensitivity of this information.

Regarding the Deputy’s question on the use of mesh implants and the indemnity arrangements in place, the SCA has informed me that typically, a product manufacturer will purchase product liability insurance to cover its product liability exposures. There are a number of product manufacturers involved in the mesh implant cases and, consequently, a number of product liability insurers. The issues of indemnity between parties will be a matter for discussion between the parties as part of each party’s preparation of its defence in the individual cases or an issue ultimately decided by the courts hearing individual cases.

David Cullinane (Waterford, Sinn Fein)
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1701. To ask the Minister for Health the expenditure on the procurement of mesh implants by year since 2015; and if he will make a statement on the matter. [15172/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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This question relates to a procurement matter and is therefore referred to the HSE for reply to the Deputy

David Cullinane (Waterford, Sinn Fein)
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1702. To ask the Minister for Health the number of women who were injured by mesh implantation and sent to a person (details supplied) to have complications treated. [15173/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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This PQ relates to a clinical decision matter and is therefore referred to the HSE for direct reply to the Deputy.

David Cullinane (Waterford, Sinn Fein)
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1703. To ask the Minister for Health the number of women who had mesh devices implanted and have had organs such as bladders and bowels removed; and if he will make a statement on the matter. [15174/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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This question relates to service delivery matter and is therefore referred to the HSE for direct reply to the Deputy

David Cullinane (Waterford, Sinn Fein)
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1704. To ask the Minister for Health the number of women who have been sent via referral systems to the University College London Hospital, NHS England for the full removal of transobturator mesh implants since 2017, by type; and if he will make a statement on the matter. [15175/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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This question relates to a clinical decision making matter and is therefore referred to the HSE for direct reply to the Deputy

David Cullinane (Waterford, Sinn Fein)
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1705. To ask the Minister for Health the progress regarding the full removal of mesh implants in Ireland; the progress regarding compensation for persons who have suffered as a result of mesh implants or partial and improper removal; and if he will make a statement on the matter. [15176/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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I understand that complications from a mesh implant are very distressing and painful for those women involved. I would like to emphasise that the ongoing priority focus of my Department and the HSE has been to put the necessary structures in place so that women affected by mesh complications can be referred to the new national mesh centres and seen for treatment in a timely fashion, bearing in mind the current impact of the COVID-19 pandemic and requirements of public health guidance.  

The national mesh complications care pathway has been in place since November 2018 providing multidisciplinary specialist services for women suffering from mesh complications across two sites at Cork University Hospital (CUMH) and National Maternity Hospital (NMH) Dublin.  Funding of €500,000 per hospital has been approved for CUMH and the NMH to establish these mesh specialist centres and recruitment is on-going. Both of these centres have been accepting referrals and treat women suffering with post mesh complications.  

Furthermore, under the HSE National Service Plan 2021, funding has been provided to enhance and improve gynaecology services which will include funding for mesh services. This funding will enable the implementation of additional specialist services, which will support ongoing work to implement the recommendations from the CMO’s Report on the Use of Uro-Gynaecological Mesh in Surgical Procedures (November, 2018).  

Women affected by mesh continue to be strongly encouraged to engage with the relevant HSE contact points and the associated care pathways, to ensure that their service needs can be identified and provided for. A dedicated webpage about vaginal mesh implants, including contact information regarding the pathways for women suffering complications has been published on the HSE website.  National mesh administrators have been recruited in each of the two special centres to provide central contact point services.  

Recognising the importance of the health service listening to and learning from patients’ experiences, I am anxious that women affected by mesh complications have the opportunity to have their voices heard and share their experiences to inform learning and women’s health policy.  This will also enable the health services to better understand women’s experiences and respond to the care needs of women and tailor service delivery and supports to meet requirements. My Department is developing a process for an independent, compassionate engagement with the women affected, taking account of the wider context relating to the COVID-19 pandemic.   

Women's health is a Government priority, as outlined in the Programme for Government. Budget 2021 and the HSE National Service Plan 2021 provide significant investment in services that are important to women, including gynaecology services. A Women’s Health Fund is also provided for, which will support proposals arising from the work of the Women’s Health Taskforce to improve women’s health outcomes and experiences of healthcare.

David Cullinane (Waterford, Sinn Fein)
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1707. To ask the Minister for Health the annual cost of i-ports for children with diabetes; if these costs are reimbursed; if not, if there are plans to add them to the long-term illness scheme or otherwise reimburse them; the estimated annual cost of reimbursing such products; and if he will make a statement on the matter. [15180/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.