10. Deputy Clare Daly asked the Taoiseach and Minister for Defence further to the fact that the Attorney General is examining the possibility of settling pending cervical smear claims following the successful legal action of a person (details supplied), if a similar approach is being taken regarding outstanding Lariam cases in view of the successful legal action in the first Lariam case before the courts in 2017. (Question 20410/18 asked on 10 May 2018 - Defence Forces Medicinal Products)

Deputy Clare Daly: The Minister of State is aware that in December last year the State settled the first case for Lariam damage brought by a member of the Defence Forces. No witnesses were called and there was no evidence to defend the case. The man was attacked and it took him four long years before he got the settlement. In light of the decision of the Taoiseach to request the Attorney General to consider withdrawing from the legal actions in the cervical cancer cases, has the Minister of S...

129. Deputy Clare Daly asked the Taoiseach and Minister for Defence the terms of reference provided to the working group on Lariam established in 2011. (Question 9544/18 asked on 27 Feb 2018 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): A Malaria Chemoprophylaxis Working Group was established in January 2011 and reported in April 2013. The Group was re-convened in August 2015 and reported in October 2017. The purpose of the Group was to review, inter alia, issues arising in relation to the use of Lariam, particularly in the context of the current and potential litigation. 
Both reports were produced by the Working Group in the context of current and potential l...

109. Deputy Clare Daly asked the Taoiseach and Minister for Defence the number of recommendations the 2013 report of the working group on Lariam contained. (Question 6584/18 asked on 08 Feb 2018 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 109 to 111, inclusive, together.
As stated previously, the two reports of the Working Group were produced in the context of current and potential litigation and are legally privileged. Therefore, it would be inappropriate to comment in any detail in relation to these reports.  It would also be inappropriate to comment in relation matters such as any papers published by Defence Force Medical Offi...

110. Deputy Clare Daly asked the Taoiseach and Minister for Defence the recommendations of the 2013 Lariam report that are repeated in the latest report of the working group on Lariam. (Question 6585/18 asked on 08 Feb 2018 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 109 to 111, inclusive, together.
As stated previously, the two reports of the Working Group were produced in the context of current and potential litigation and are legally privileged. Therefore, it would be inappropriate to comment in any detail in relation to these reports.  It would also be inappropriate to comment in relation matters such as any papers published by Defence Force Medical Offi...

111. Deputy Clare Daly asked the Taoiseach and Minister for Defence the papers published in peer reviewed journals by each Defence Forces medical officer involved in malaria chemoprophylaxis on same. (Question 6591/18 asked on 08 Feb 2018 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 109 to 111, inclusive, together.
As stated previously, the two reports of the Working Group were produced in the context of current and potential litigation and are legally privileged. Therefore, it would be inappropriate to comment in any detail in relation to these reports.  It would also be inappropriate to comment in relation matters such as any papers published by Defence Force Medical Offi...

112. Deputy Clare Daly asked the Taoiseach and Minister for Defence further to Parliamentary Question No. 113 of 16 January 2018, the qualifications of the medical experts consulted as part of the work of the working group on Lariam; and the medical qualifications of members of the working group, in view of the fact that legal privilege does not attach to information regarding a person’s qualifications. (Question 5325/18 asked on 06 Feb 2018 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): The Working Group’s Report was produced in the context of current and potential litigation and is therefore legally privileged. This includes all the information about the group and information regarding the qualifications of any members of the Group who may appear as expert witnesses in any related litigation where their qualifications as experts would be an issue in the ordinary course of litigation.
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122. Deputy Clare Daly asked the Taoiseach and Minister for Defence if his attention has been drawn to the fact that more than 3,000 serving Army personnel and veterans who were prescribed Lariam have approached one law firm (details supplied) in the UK with a view to taking cases; and if he will make a statement on the matter. (Question 4724/18 asked on 31 Jan 2018 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): It would not be appropriate for me to comment in relation to litigation matters arising in another jurisdiction.
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16. Deputy Clare Daly asked the Taoiseach and Minister for Defence if his Department has reviewed the recent settlement in a Defence Forces lariam damages case and is giving consideration to a redress and compensation scheme for members of the Defence Forces harmed by lariam in view of the outcome of that case. (Question 3350/18 asked on 24 Jan 2018 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 16 and 35 together.
As I have indicated to this House in the past, fundamentally the choice of malaria chemoprophylaxis for use in the Defence Forces is a medical matter that should be decided by qualified medical professionals. In the Defence Forces these are decisions for highly qualified Medical Officers, having regard to the specific circumstances of the mission and the individual member of t...

35. Deputy Clare Daly asked the Taoiseach and Minister for Defence if the Defence Forces prescribing policy in regard to lariam as the first choice anti-malarial will change in view of the recent substantial settlements in cases here and in the United Kingdom for army lariam damage. (Question 3349/18 asked on 24 Jan 2018 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 16 and 35 together.
As I have indicated to this House in the past, fundamentally the choice of malaria chemoprophylaxis for use in the Defence Forces is a medical matter that should be decided by qualified medical professionals. In the Defence Forces these are decisions for highly qualified Medical Officers, having regard to the specific circumstances of the mission and the individual member of t...

113. Deputy Clare Daly asked the Taoiseach and Minister for Defence the qualifications of the medical experts consulted as part of the work of the working group on Lariam; and the medical qualifications of members of the working group. (Question 54747/17 asked on 16 Jan 2018 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): As previously advised the report of the Working Group on Malaria Chemoprophylaxis was convened in the context of current and potential litigation and is legally privileged, as is all the information about the group to include consultations and deliberations.
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75. Deputy Clare Daly asked the Taoiseach and Minister for Defence if his attention has been drawn to the six monthly progress report on the use of Lariam for military personnel issued by the House of Commons Defence Committee (details supplied); and if he will make a statement on the matter. (Question 52734/17 asked on 12 Dec 2017 - Defence Forces Medicinal Products)

Taoiseach and Minister for Defence (Deputy Leo Varadkar): I am aware of the Ministry of Defence’s six-monthly progress report on the use of Lariam for military personnel, published by the House of Commons Defence Committee. The choice of malaria chemoprophylaxis in use by other armed forces is an internal matter for those forces. It would not be appropriate for me to comment on the policy and practices of other States in this regard . 
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543. Deputy Clare Daly asked the Taoiseach and Minister for Defence if he has signed decisions to grant Defence Forces disability pensions in which the applicant has applied on the basis of disability due to Lariam use; and if so, the number of such decisions to grant he has signed. (Question 51834/17 asked on 05 Dec 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 543 and 544 together.
I would refer the Deputy to my reply to Question No. 71 on 11th July 2017. Under the Army Pensions Acts a disability pension or gratuity may, following retirement, be granted to a former member of the Permanent Defence Force (PDF) for permanent disablement due to a wound or injury attributable to military service – whether at home or abroad – or to a disease that is secondar...

544. Deputy Clare Daly asked the Taoiseach and Minister for Defence if he has denied Defence Forces disability pension applications in which the applicant has applied on the basis of disability due to Lariam use; and if so, the number of such denials he has issued. (Question 51835/17 asked on 05 Dec 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 543 and 544 together.
I would refer the Deputy to my reply to Question No. 71 on 11th July 2017. Under the Army Pensions Acts a disability pension or gratuity may, following retirement, be granted to a former member of the Permanent Defence Force (PDF) for permanent disablement due to a wound or injury attributable to military service – whether at home or abroad – or to a disease that is secondar...

1370. Deputy Clare Daly asked the Taoiseach and Minister for Defence further to Parliamentary Questions Nos. 57 and 59 of 18 October 2017 and in view of the fact that 12 Defence Forces personnel have died by suicide subsequent to being prescribed Lariam his views on whether Defence Forces personnel travelling to sub Saharan Africa (details supplied) should have the right to a second medical opinion in regard to the most suitable anti-malarial drug to take while in sub Saharan Africa and have the right to follow that advice; and if he will make a statement on the matter. (Question 45760/17 asked on 07 Nov 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): As this matter pertains to litigation matters currently being heard in the High Court, it would be inappropriate for me to comment at this time.
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1387. Deputy Clare Daly asked the Taoiseach and Minister for Defence further to Parliamentary Question No. 59 of 13 December 2016, when the report of the working group on Lariam will be published in view of the recent publication of the Air Corps toxic chemicals report notwithstanding the fact that litigation has been launched by a number of persons. (Question 46878/17 asked on 07 Nov 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): As I indicated to the Deputy in my reply to your Parliamentary Question on 15 February 2017, the Malaria Chemoprophylaxis Working Group was first established in January 2011 and reported in April 2013. The Group was re-convened in August 2015. The purpose of the Working Group is to review, inter alia, issues arising in relation to the use of Lariam, particularly in the context of the current and potential litigation. Therefor...

57. Deputy Clare Daly asked the Taoiseach and Minister for Defence the position regarding progress toward the discontinuance of the use of Lariam in the Defence Forces following the passage of a motion in the Houses of the Oireachtas calling for same in June 2017; and if he will make a statement on the matter. (Question 43977/17 asked on 18 Oct 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 57 and 59 together.
As I stated in my reply to the Private Members’ Motion, which was before the Dáil on 28 June, fundamentally the use of anti-malarial drugs is a medical matter that should be decided by qualified medical professionals. In the Defence Forces these are decisions for highly qualified Medical Officers having regard to the specific circumstances of the mission and the individual me...

247. Deputy Clare Daly asked the Taoiseach and Minister for Defence further to Parliamentary Question number 2104 of 11 September 2017, the date on which he expects to receive the report of the working group on Lariam. (Question 40040/17 asked on 21 Sep 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I understand that the Report has been finalised by the Working Group. I anticipate that it will be submitted to me in the near future.
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2083. Deputy Clare Daly asked the Taoiseach and Minister for Defence further to Parliamentary Questions Nos 1726 and 1727 of 26 July 2017, his views on whether the stock management in the Defence Forces pharmacy may be inadequate. (Question 36975/17 asked on 11 Sep 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 2083 and 2084 together. 
I am advised by the military authorities that the stock management policy and processes in the Defence Forces are reviewed on an annual basis. I am informed that stock levels are predominately demand-driven and that pharmaceutical requirements are met where possible under a ‘Just in Time’ model which leads to next day delivery directly to the patient site resulting in d...

2084. Deputy Clare Daly asked the Taoiseach and Minister for Defence the reason for the very different figures for the number of doxycycline tablets purchased provided in response to parliamentary questions numbers 622 of 17 July 2012 and 1727 of 26 July 2017; and the reason for the difference of almost 20,000 tablets reported as purchased in the two replies. (Question 37014/17 asked on 11 Sep 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 2083 and 2084 together. 
I am advised by the military authorities that the stock management policy and processes in the Defence Forces are reviewed on an annual basis. I am informed that stock levels are predominately demand-driven and that pharmaceutical requirements are met where possible under a ‘Just in Time’ model which leads to next day delivery directly to the patient site resulting in d...

2103. Deputy Clare Daly asked the Taoiseach and Minister for Defence further to Parliamentary Question No. 314 of 28 June 2017, the reason the information could not be obtained by checking the HSPC, Health Protection Surveillance Centre, returns in view of the fact that malaria is a noticeable disease which should be reported to HSPC. (Question 37838/17 asked on 11 Sep 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I have been advised that Defence Force Medical Officers are required to make returns to the Health Protection Surveillance Centre (HPSC) on an individual basis. Therefore, in order to obtain the information that you sought, all available Defence Force Medical Officers were consulted in relation to your question of 28 June. 
As I indicated to you in my reply to Parliamentary Question of 14 June 2016, summary information in resp...

2104. Deputy Clare Daly asked the Taoiseach and Minister for Defence his views on the WHO advice that Lariam, Malarone and doxycycline are all equally effective in preventing malaria in sub-Saharan Africa in view of the fact that in 2015 and 2016 20 to 25% of troops in sub-Saharan Africa were prescribed one of the alternatives to Lariam and there were no cases of malaria during that period. (Question 37839/17 asked on 11 Sep 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): The Deputy will be aware that this matter was the subject of discussion at a Private Member’s Motion in the Dáil on 28th June last. As I indicated to the House at that time, Malaria is a serious disease and is a threat to any military force operating in areas where the disease is prevalent. It must be emphasised that the reason Defence Forces use a malaria chemoprophylaxis in the first instance is to protect personnel. 
In the...

1726. Deputy Clare Daly asked the Taoiseach and Minister for Defence the number of Malarone tablets purchased by the Defence Forces in each of the years 2006 to 2013; and the number of malarone tablets in stock at year end in each of those years. (Question 35110/17 asked on 26 Jul 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 1726 and 1727 together.
I have been advised by the military authorities that the number of Malarone and Doxycycline tablets purchased each year from 2006 to 2013, is as follows: 
Malarone: 
 2006 2007 2008 2009 2010 2011 2012 2013 Total purchased 3,120 11,232 0 1,728 2,304 1,416 1,632 360 

Doxycycline: 
 2006 2007 2008 20...

1727. Deputy Clare Daly asked the Taoiseach and Minister for Defence the number of Doxycycline tablets purchased by the Defence Forces in each of the years 2006 to 2013; and the number of doxycycline tablets in stock at year end in each of those years. (Question 35122/17 asked on 26 Jul 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I propose to take Questions Nos. 1726 and 1727 together.
I have been advised by the military authorities that the number of Malarone and Doxycycline tablets purchased each year from 2006 to 2013, is as follows: 
Malarone: 
 2006 2007 2008 2009 2010 2011 2012 2013 Total purchased 3,120 11,232 0 1,728 2,304 1,416 1,632 360 

Doxycycline: 
 2006 2007 2008 20...

502. Deputy Clare Daly asked the Taoiseach and Minister for Defence the number of persons to whom Doxycycline was prescribed in each of the years 2006 to 2012 respectively. (Question 33239/17 asked on 12 Jul 2017 - Defence Forces Medicinal Products)

Minister of State at the Department of Defence (Deputy Paul Kehoe): I have been advised by the Military Authorities that to collate the figures requested by the Deputy would require a Medical Officer(s) to examine the medical files of all Defence Forces personnel that travelled to malaria prone areas within the period of time specified. 
Due to the scope of the request and the demands it would place on already limited resources, I regret that it is not possible to provide the information request...

47. Deputy Clare Daly asked the Taoiseach and Minister for Defence further to Question No. 262 of 30 March 2017 and the clarification of 13 June 2017 (details supplied), the year in which the Defence Forces was first of the view that the specific reactions of anxiety, restlessness or confusion, if declared by a member of the Defence Forces to be present, would necessitate withdrawal of mefloquine. (Question 32348/17 asked on 11 Jul 2017 - Defence Forces Medicinal Products)

Deputy Clare Daly: This follows a previous question that was answered thanks to the good offices of the Ceann Comhairle, about listed side effects of Lariam. We asked the Minister of State to say whether they were deemed minor, tolerable or intolerable. This is important because that is the basis upon which the Defence Forces define whether someone can serve or not, and whether Lariam should be withdrawn.
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