Vol. 833 No. 1
481. Deputy Dara Calleary asked the Minister for Health his views on whether it is fair that over 70s applying for a medical card have their income assessed at gross while under 70s have their income assessed at net; and if he will make a statement on the matter. [10864/14]
Under the arrangements effected by the Health Act 2008, a revised system of assessment for eligibility was introduced for those 70 years of age and over, based on the significantly higher gross income limits rather than the standard net income thresholds. This advantageous arrangement for persons aged over 70 years has facilitated a much greater share of this cohort qualifying for a medical card compared to the general population as a whole.
In the main, persons in the over 70 age cohort do not have the same outlays and expenses as those under 70 years of age who are assessed on a means basis. Under the standard means tested medical card scheme, allowance may be made for rent/mortgage, travel to work and child care costs. Generally, for those over 70, mortgages have been cleared, children have been catered for and they would not have travel-to-work related costs.
However, persons aged 70 or older who are assessed as ineligible under the gross income thresholds may also have their eligibility assessed under the means tested medical card scheme where they face particularly high expenses, e.g., nursing home or medication costs. As I have outlined, this assessment is based on net income and assessable outgoing expenses and the qualifying income thresholds under this scheme are lower than over 70 gross income thresholds.
Furthermore, persons aged over 70 years may still be eligible for a medical card on a discretionary basis where they face undue hardship in arranging medical services as a result of medical or social circumstances.
482. Deputy Brendan Griffin asked the Minister for Health the position regarding the introduction of minimum unit pricing for alcohol; and if he will make a statement on the matter. [10867/14]
The Government has approved an extensive package of measures to deal with alcohol misuse to be incorporated in a Public Health (Alcohol) Bill. These measures are based on the recommendations contained in the Steering Group Report on a National Substance Misuse Strategy, 2012 and include provisions for the introduction of minimum unit pricing for alcohol products. Work on developing a framework for the necessary Department of Health legislation is continuing.
A health impact assessment, in conjunction with Northern Ireland, has been commissioned as part of the process of developing a legislative basis for minimum unit pricing. The assessment will study the impact of different minimum prices on a range of areas such as health, crime and likely economic impact. The study should be finalised by the end of Quarter 2 this year.
483. Deputy Brendan Griffin asked the Minister for Health the position regarding the introduction of a code to ban price based advertising of alcohol; and if he will make a statement on the matter. [10869/14]
Last October, the Government approved an extensive package of measures to deal with alcohol misuse to be incorporated in a Public Health (Alcohol) Bill. These measures are based on the recommendations contained in the Steering Group Report on a National Substance Misuse Strategy.
The package of measures to be implemented will include the regulation of the marketing and advertising of alcohol, provision for minimum unit pricing, regulation of sports sponsorship, structural separation of alcohol from other products in mixed trading outlets and labelling of alcohol products.
In relation to the regulation of marketing and advertising of alcohol, the Bill will specifically include the following provisions:
- limit advertising of alcohol on television and radio from 2016 to evening hours;
- limit advertising of alcohol in cinemas to films classified as over 18s;
- restrict advertising of alcohol in outdoor media from 2018 with a statutory code of practice to govern such advertising in the interim;
- advertising of alcohol in print media will be regulated by way of a statutory code; and
- set limits on how alcohol is portrayed in advertisements (e.g. prowess or sexual content).
In relation to minimum unit pricing, this is a mechanism of imposing a statutory floor in price levels per gram of alcohol that must be legally observed by retailers in both the on and off trade sector. This is a targeted measure, designed to prevent the sale of alcohol at very cheap prices. It is mainly aimed at those who are higher risk, such as adolescents and people who have a harmful and hazardous alcohol consumption pattern.
Work is continuing in my Department on the development of a framework for the implementation of these measures. A health impact assessment, in conjunction with Northern Ireland, was commissioned in 2013, as part of the process of developing a legislative basis for minimum unit pricing. The health impact assessment will study the impact of different minimum prices on a range of areas such as health, crime and likely economic impact. The study should be finalised by mid-2014.
484. Deputy Jim Daly asked the Minister for Health the number of medical scientists' microbiology panels currently in existence; when such a panel was last advertised; when the Health Service Executive experts will be advertising for a future panel; and if he will make a statement on the matter. [10876/14]
As this is a service matter it has been referred to the Health Service Executive for direct reply.
485. Deputy Terence Flanagan asked the Minister for Health the date on which he will introduce free GP care for children aged five and under; the projected budget for this proposal; and if he will make a statement on the matter. [10879/14]
The Government is committed to introducing, on a phased basis, a universal GP service without fees within its term of office, as set out in the Programme for Government and the Future Health strategy framework. As announced in the Budget, it has been decided to commence the roll-out of a universal GP service by providing all children aged 5 and under with access to a GP service without fees. This will mean that almost half of the population will have access to GP services without fees. The Government is providing new, additional funding of €37 million to meet the cost of this measure.
The implementation of this new service requires primary legislation and work on preparing this is ongoing. Preparations are also proceeding in relation to the necessary administrative arrangements. Details of application procedures and the start date for the new service will be announced in due course.
486. Deputy Sean Fleming asked the Minister for Health if persons over 70 years of age who are over 20 years in long-term residential care provided by the Health Service Executive in regional or community hospitals are entitled to a medical card where they are only in receipt of the State pension; if the income of their spouses, with whom they have not lived with for over 30 years since entering long-term residential care under the HSE, is taken into account; and if he will make a statement on the matter. [10884/14]
Under the Health Act 1970, as amended, married persons automatically have the couple's gross income limit applied during the assessment process for eligibility for a medical card, regardless of where either spouse is living.
487. Deputy Patrick O'Donovan asked the Minister for Health when a person in (details supplied) in County Mayo can expect to be called for an outpatient appointment, in view of the fact the person has been waiting since May 2013 to be called and this delay is causing undue stress. [10887/14]
A maximum waiting time target of 12 months has been set for a first time consultant-led outpatient appointment and this is reflected in the HSE Service Plan. The SDU and the NTPF are working closely with hospitals towards achievement of the maximum waiting time.
Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she would be in the best position to take the matter up with the consultant and hospital involved. In relation to the specific hospital appointment query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.
488. Deputy Bernard J. Durkan asked the Minister for Health the progress to date in determination of a medical card review in the case of a person (details supplied) in County Meath; and if he will make a statement on the matter. [10889/14]
The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has issued to Oireachtas members.
489. Deputy Barry Cowen asked the Minister for Health if he will confirm that funding will be provided to ensure a premises (details supplied) in County Offaly will be operated to its full capacity. [10903/14]
As this is a service matter it has been referred to the Health Service Executive for direct reply.
490. Deputy Joan Collins asked the Minister for Health the number of neck and face post-cancer patients who are awaiting dental care for three months, six months and 12 months (details supplied); and if he will make a statement on the matter. [10905/14]
The information sought by the Deputy is not readily available. It is being collated by the HSE and I will forward it to the Deputy as soon as possible.
491. Deputy Sean Fleming asked the Minister for Health the implications for agencies funded by his Department that fail to comply with consolidated public sector pay scales by continuing to make top-up payments to staff; when he expects this issue to be definitively resolved; and if he will make a statement on the matter. [10917/14]
At my request, the HSE has taken urgent action to ensure Section 38 agencies which have been found to be in breach of health sector pay policy are brought into compliance.
Each Section 38 agency was asked to confirm by 31 January this year that they would sign up to the HSE’s new Compliance Statement process. The Compliance Statement includes confirmation that all staff are paid in accordance with the Department of Health’s consolidated salary scales.
The HSE has determined that 10 agencies are now fully compliant with Government pay policy.
A further 31 agencies have indicated that they will cooperate with the new Compliance Statement process and have submitted a total of 126 business cases to the HSE. The HSE has established a Review Panel to assess the merits of these cases by 31 March 2014.
St Vincent’s has committed to achieving full compliance with public pay policy by 31 March 2014 and I envisage that they will submit business cases to the HSE in due course.
The Central Remedial Clinic is engaged in a separate process.
Where the HSE is satisfied that there are legitimate reasons for the continuation of an allowance, these will be submitted to the Department of Health for sanction. The Department of Health will liaise as appropriate with the Department of Public Expenditure and Reform.
I am not in a position to say when this process will be concluded however I can assure the Deputy that I am determined that the payment of unapproved allowances to senior executives will be eliminated in an expeditious manner.
492. Deputy Clare Daly asked the Minister for Health if he will provide details of the ambulance emergency response times for north Kildare from July 2013 to date in 2014. [10931/14]
As this is a service matter, I have asked the HSE to respond directly to the Deputy.
493. Deputy Colm Keaveney asked the Minister for Health his response to the latest Children's Rights Alliance report card, which for a second year running downgrades the Government's performance on mental health and is now awarding an E grade; and if he will make a statement on the matter. [10967/14]
The Government has prioritised reform of all aspects of our mental health services in line with A Vision for Change, including additional and improved quality care for children in both residential and community based settings. Total HSE Mental Health funding in 2014 is significant at around €766m. In this context,additional funding of €90 million, and around 1,100 new posts, has been provided over the last three Budgets. This has been primarily directed to strengthen Community Mental Health Teams for adults and children; specialist community mental health services for older people with a mental illness, improving services for those with an intellectual disability and mental illness, and enhancing Forensic Mental Health services.
Key to developing Child and Adolescent Mental Health Services (CAMHS), as per A Vision for Change, is the establishment of 99 multi-disciplinary CAMHS Teams providing acute secondary mental health care in the community, including hospital liaison and Day Hospital services. In 2008, there were 54 CAMHS Teams. There are now 61 Teams in place. The additional €90m provided for mental health over 2012–14 is being used, in part, to expand and enhance the skill mix of CAMHS Teams. Around 230 new posts were allocated to CAMHS Teams over 2012-13, and recruitment of these is well advanced. More CAMHS posts are planned for later this year. Just over 14,000 referrals were received by the Child & Adolescent Mental Health Teams in 2013. This represents nearly 1,000, or 8% more, than projected in the HSE National Service Plan 2013, while the target of 70% of referrals being seen within 3 months was maintained.
A Vision for Change recommends the provision of 80 Child and Adolescent psychiatric in-patient beds nationally. In 2008, there were 16 such beds and at present there are 51 beds operational country-wide, with more planned. Capacity will be enhanced also, with the completion of the CAMHS Forensic Unit as part of capital developments now underway for the National Forensic Mental Health Service, and the National Children’s Hospital. In addition, improved community based services, coupled with increasing bed capacity, are all aimed at discontinuing the practice of placing children and adolescents in adult acute in-patient units, except in exceptional circumstances. Admissions of children to adult units have decreased by almost 60% from 2008, when there were 247 reported, to a provisional figure of 106 in 2012.
The review of the Mental Health Act 2001, already well progressed, is a key step in providing a revised and more modern mental health legislation in this country. The Programme for Government contains a commitment to review the Act, informed by human rights standards and consultation with service users, carers and other stakeholders.
The review has been delayed due to a number of factors, including the wishes of members of the Expert Group to first see details of the Assisted Decision Making (Capacity) legislation, which was published in June 2013. Due to the high level of inter-connectivity between both sets of legislation, members of the Expert Group reviewing the Mental Health Act felt it would be necessary that the Capacity Bill should be finalised before they completed their own review.
Work is continuing on the completion of the report of the Expert Group, and members are carefully deliberating, re-examining and refining their recommendations on key central issues such as consent to treatment, capacity, criteria for detention, and treatment of children under the Act. It is expected that the final report will be completed in the near future, after which its recommendations will be considered at Ministerial level.
I have noted the contents of the recent report by the Children's Rights Alliance on Mental Health services. As I have indicated on several occasions in the past, despite the real and significant improvements that have taken place on implementing A Vision for Change and modernising mental health services across the country over the last three years, historic deficiencies remain to be addressed. The aim is to strive for equity in providing high quality services, while balancing residential and community-based provision. This approach has already been proven in many areas at local level. The Government will retain its commitment to mental health, and focus on up-grading all aspects of mental health care, in line with evolving service demands and resources available overall for the Health sector, for 2014 and beyond.
494. Deputy Colm Keaveney asked the Minister for Health if an investigation has been held into the circumstances leading to the admission of 68 children into adult psychiatric wards in 2013; if those circumstances have been addressed and in what manner; if this practice will finally be discontinued in 2014; and if he will make a statement on the matter. [10970/14]
As this is a service matter this question has been referred to the HSE for direct reply.
495. Deputy Terence Flanagan asked the Minister for Transport, Tourism and Sport the regulations in place regarding traffic management in an area (details supplied); and if he will make a statement on the matter. [10212/14]
Traffic management in its area is a matter for the relevant local authority, in this case Fingal County Council, under the relevant Road Traffic Acts. The enforcement of any traffic restrictions is a matter for An Garda Síochána.
496. Deputy Barry Cowen asked the Minister for Transport, Tourism and Sport if his Department is in receipt of a report from Offaly County Council outlining the damage to regional, county and local roads resulting from recent severe weather; if funding will be provided to address the necessary repairs; his views based on the fact that up to 40% of County Offaly roads are built on peat foundation, that a special programme with adequate funding should be put in place to alleviate such damage in the future, considering the vulnerability of County Offaly roads. [10726/14]
In the aftermath of the series of severe storms that hit the country this winter, local authorities have been assessing the damage caused, making estimates for repairs, and restoring what needs to be done immediately. Offaly County Council has copied my Department with details of costs of remedial / repair works up to that date which it submitted in mid-February to the Department of Environment, Community and Local Government.
The submission covers clean-up costs, the removal of fallen trees, the provision of sandbags, providing relief drainage and the restoration of road surfaces. I understand that the Minister for Environment, Community and Local Government is in the process of quantifying in detail the likely costs arising for repairs of local authority infrastructure from the more recent storms, in addition to the €70m estimated cost from the storms up to 6 January 2014, and intends to make a full report to Government on the costs and funding in the coming weeks.
The remedial works for County Offaly are similar to those required throughout the country following the severe weather over the winter and are not unique to roads which overlie peat subgrades. Roads over peat have their own set of very particular problems in that they are susceptible to differential settlement and there are no easy or inexpensive ways of dealing with them. A technical guidance document entitled Guidelines on the Rehabilitation of Roads over Peat is available to local authorities to assist them in making decisions on roads with peat subgrades.
497. Deputy Brendan Ryan asked the Minister for Transport, Tourism and Sport the measures his Department are taking regarding the IASS superannuation pension scheme deficit issue; if his Department are working on measures to ensure deferred members can be included in the ongoing negotiations; and if he will make a statement on the matter. [10800/14]
As Minister for Transport Tourism and Sport I have no function in relation to the administration of the IASS. The resolution of the funding difficulties in the scheme, which has a substantial and unsustainable deficit of over €700 million, is primarily a matter for the trustees, the members of the scheme, the companies participating in the scheme and the regulator of such pensions schemes - the Pensions Board.
The trustees have recently announced that they have decided in principle on a number of changes to address the funding difficulties. In their letter to the Employers and the Unions the Trustees formally requested the Employers and the Unions to give appropriate consideration to the position of the deferred members in further discussions. The trustees, who are central to any solution to the funding difficulties, are required by law to act in the best interests of all members. On that basis the trustees have to take account of the interests of deferred members in any proposals that it makes.
The Department of Jobs, Enterprise and Innovation has recently stated that it is actively considering issues in relation to the provision of access to former employees, including retired workers, to the industrial relations machinery of the State under the Industrial Relations Acts.
As the Deputy will be aware, an Expert Panel has been established to carry out a detailed investigation of how a final resolution of the industrial relations issues relating to the IASS can be secured. That investigation will include discussions with relevant stakeholders and the Panel has been asked to make a preliminary report by the end of March.
