Written Answers Nos. 1583-1600
1584. Deputy Billy Kelleher asked the Minister for Health the amount of demographic funding to provide emergency placements and services for school leavers with intellectual disabilities; the same figure last year; the number of children who benefitted from the funding last year; the projected number this year; and if he will make a statement on the matter. [37124/12]
View answerIn 2011, €10 million was allocated to address demography pressures in the following areas: day services, including services for young people leaving school and graduating from rehabilitative (Life Skills) training (RT); residential places; respite services; and personal assistance hours. The funding was allocated across the 4 Health Service Executive (HSE) regions based on their percentage of population.
|
HSE Region |
Allocation 2011 |
No. of Day Places |
No. of Residential Places |
No. of Residential Enhanced Places |
Personal Assistance Hours |
No. of Respite Service places |
No. of Respite Centre Places |
|
DML |
€2,838,000 |
158.00 |
6 |
0 |
7,339 |
0 |
0 |
|
DNE |
€2,272,000 |
141.37 |
2 |
3 |
0 |
0 |
3 |
|
South |
€2,559,000 |
82.92 |
9.26 |
3.357 |
8,276.86 |
3.3429 |
3.357 |
|
West |
€2,331,000 |
132.00 |
6.27 |
0 |
0 |
0 |
0 |
|
Total |
€10,000,000 |
514.29 |
23.53 |
6.357 |
15,616 |
3.3429 |
6.357 |
In 2012, disability services are required to cater for demographic pressures, such as new services for school leavers and emergency residential placements, from within their existing budgets.
Service providers and the HSE have come together under the auspices of National Consultative Forum to identify how the needs of young people leaving school or exiting RT this year can be responded to within available resources. Significant progress has been made and there are many excellent examples of collaborative working between providers, and between providers and the HSE, in responding innovatively to the needs of individuals. The HSE has received requests for 695 places for school leavers and 392 places in respect of RT graduates in 2012. To date 641 school leavers (92%) and 377 RT graduates (96%) have been accommodated with an appropriate service.
The health service as a whole has to operate within the parameters of funding available to it and given the current economic environment, this has become a major challenge for all stakeholders, including the HSE, voluntary service providers, services users and their families. HSE Managers and disability agencies continue to work collaboratively in identifying solutions for the remaining 54 school leavers and the 15 individuals progressing from RT who still require a suitable service.
1585. Deputy Billy Kelleher asked the Minister for Health the amount of funding provided to voluntary service providers for those with intellectual and other disabilities; the same figure last year; and if he will make a statement on the matter. [37125/12]
View answerAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
1586. Deputy Billy Kelleher asked the Minister for Health of the €55 million in additional funding allocated to the fair deal scheme, the revised extra amount which is expected to allocated; and if he will make a statement on the matter. [37126/12]
View answer1599. Deputy Billy Kelleher asked the Minister for Health the level of new funding available for the fair deal scheme; the number of patients waiting to be accepted onto the scheme; the mean average length of time patients are waiting to be accepted to the scheme; the level of funding in 2011; the level of funding in 2012 provided for in budget 2012; the amount drawn down; and if he will make a statement on the matter. [37139/12]
View answerI propose to take Questions Nos. 1586 and 1599 together.
In 2011, the gross budget for long-term residential care was €963m. The total gross budget for this year is €994.7m. This is effectively the budget for the Nursing Homes Support Scheme, however, pre-Nursing Homes Support Scheme arrangements must also be facilitated from within the subhead, i.e. people in contract beds, people who choose to remain on subvention and people who were in public nursing homes prior to the commencement of the Scheme.
Additional funding of €55 million was originally allocated to the Nursing Homes Support Scheme for 2012. However, the Minister subsequently decided to transfer €13 million of the €55 million for an initiative being developed by the Special Delivery Unit in 2012 to improve access to care and quality of care for the frail elderly, achieve better patient outcomes and experience as well as better value for money.
A further €5 million was transferred to Primary Care services to underpin overall government policy of shifting focus to primary and community services. Returns against the Vote and from HSE indicate spending within budget. On average, applications for the Scheme take between 4 to 6 weeks to process, from receipt of completed application to date of determination. Depending on the level of complexity of the individual case, processing of the application may take longer. For example, in cases where ancillary State support is sought, additional factors may impact on the timeframe, e.g. the HSE must establish title of a property before a decision can be made and establishing title can be a lengthy process in some cases.
At end-June there were 21,901 people in receipt of financial support for long-term nursing home care (an increase of 353 on the figure at end-2011). A further 914 people had been allocated funding, but were not yet in payment. There is nobody on the placement list waiting for funding to be allocated.
1587. Deputy Billy Kelleher asked the Minister for Health the number of hospital consultants earning more than €200,000 including allowances from the public health system; the number earning more than €300,000; the number earning more than €400,000; the average salary of hospital consultants; the average hours of consultants in January 2011 and in January 2012; and if he will make a statement on the matter. [37127/12]
View answerAs this is a service matter, it has been referred to the HSE for attention and direct reply to the Deputy.
1588. Deputy Billy Kelleher asked the Minister for Health in the context of his plans for universal health insurance, his plans for the VHI; if it will be broken up; and if he will make a statement on the matter. [37128/12]
View answerThe European Court of Justice (ECJ) ruled in September 2011 that the VHI can no longer enjoy a derogation from the requirement to be authorised by the Central Bank. Having given consideration to this judgement, the Government decided on 6 December 2011 that the Minister should proceed with all necessary steps to bring the VHI to the point of authorisation, including proceeding with a formal application for this purpose.
My Department and the VHI continue to meet regularly to progress issues relating to VHI's authorisation application and my Department has also met with the Central Bank, to review requirements for authorisation pending final Government decisions in this area.
When all necessary elements for authorisation are in place, the Government will consider whether to provide the necessary capital to the VHI to bring its reserves to the solvency levels required for authorisation. The Government also agreed that alternatives to authorising VHI should also be explored during the preparation of an application for authorisation. where access is based on need, not income. The Programme for Government commits to retain the VHI in public ownership to offer a public option under that system. The structure of the private health insurance market, including the VHI, will be fully considered in the context of the introduction of UHI.
1589. Deputy Billy Kelleher asked the Minister for Health if any small hospitals will be closed either as part of reconfiguration or due to budgetary measures; and if he will make a statement on the matter. [37129/12]
View answerThe organisation of hospital services locally, regionally and nationally will be informed by the ongoing development of the HSE Clinical Programmes, the work of the Strategic Board on the formation of Hospital Groups and the publication of the Small Hospitals Framework, in order to improve patient access, quality clinical outcomes and the provision of patient care in a setting which is most appropriate to patient needs. In this context, I want to ensure that as many services as possible can be provided safely and appropriately in smaller, local hospitals. The Small Hospitals Framework will demonstrate clearly that the future of smaller hospitals is secure. It will set out what services can and should be delivered safely by these hospitals in the interest of better outcomes for patients.
As Minister for Health I am eager to initiate improvements to our hospital system. I am currently examining the Framework in the context of the overall reorganisation of the health services. Such consideration will ensure that when implemented, it will optimise the significant resources that smaller hospitals have to offer. It is my intention to publish the Framework when this process has been completed. Consideration of the establishment of Hospital Groups is also progressing. The changes that will and must take place will have a considerable impact on how our hospital services are aligned, including greater opportunities for inter-site co-operation.
1590. Deputy Billy Kelleher asked the Minister for Health the number of hospital consultants in breach of the working time directive; if he is concerned that this may impact on the safe delivery of services; and if he will make a statement on the matter. [37130/12]
View answerThe Working Time Directive provides for a maximum average working week of 48 hours. The Directive and related case law from the European Court of Justice define working time as time spent at a place determined by the employer while performing duties on behalf of the employer. This can be summarised as time spent working or on-call on-site. Time spent on-call off-site does not count as working time.
Consultants working in the public health service are employed under a number of contracts. Consultants employed under the 1991 and 1997 Consultant Contracts are contracted to work 33 hours a week, while those employed under the 2008 Consultant Contract are contracted to work 37 hours a week. Irrespective of contract, many consultants are liable to provide on-call services and attend on-site outside of contracted hours. Consultants employed on the 2008 Contract may be required formally to provide up to 5 additional hours on Saturdays, Sundays or bank holidays – albeit, to date, this provision has not been activated in other than exceptional circumstances.
While consultants have work schedules documenting contracted hours, they do not formally ‘clock-in’ or participate in other means of recording time spent on-call on-site. The HSE does not therefore hold information regarding average working hours in excess of the 33 or 37 weekly contracted hours. Taking the above into account, the HSE does not have information indicating that any hospital consultant is working an average of more than 48 hours a week calculated over the 6-month reference period.
1594. Deputy Billy Kelleher asked the Minister for Health the total amount of funding made available to the voluntary redundancy scheme in 2012; the estimated cost of the scheme in 2012; and if he will make a statement on the matter. [37134/12]
View answer1698. Deputy John Lyons asked the Minister for Health his plans to introduce a targeted redundancy programme in the Health Service Executive; and if he will make a statement on the matter. [38089/12]
View answerI propose to take Questions Nos. 1594 and 1698 together.
The Government is committed, in line with the Programme for Government, to reducing numbers in the Public Service in the period to 2015, while protecting front-line services as far as possible. It will continue to examine all areas where savings and numbers reductions might be achieved. While the option of offering voluntary redundancy on a targeted basis may be considered in the course of achieving the required reductions, there are no specific proposals or plans in this regard for the health services at present.
1597. Deputy Billy Kelleher asked the Minister for Health the meetings he has held with members of the health insurance industry in relation to changes in charges announced in budget 2012, the number of such meetings he has held; and if he will make a statement on the matter. [37137/12]
View answerFollowing Budget 2012, I met with representatives of the country's main health insurance companies. At this meeting we discussed a range of issues including addressing the issue of driving down costs related to health insurance. The outcome of the meeting was the agreement to establish a Health Insurance Consultative Forum to engage on issues of mutual concern.
In February of this year I established the Health Insurance Consultative Forum which comprises representatives from the country's main health insurance companies, the Health Insurance Authority and the Department of Health. The core focus of the Forum is on identifying ways of addressing costs throughout the industry, whilst always respecting the requirements of competition law. Bilateral meetings have taken place with each insurer where they have brought forward their own ideas for cost savings in the market. These ideas are the subject of ongoing deliberation and policy analysis within the Department.
The Forum also facilitates participating parties to consider certain issues related to the implementation of Universal Health Insurance (UHI). The future delivery of health services under UHI will require competing insurance companies driving efficient, cost effective delivery of high quality health care.
1598. Deputy Billy Kelleher asked the Minister for Health the basis on which the figure of €143 million was arrived at in regard to savings to be achieved on the generation and collection of private income in budget 2012; if he expects to achieve this figure; the contacts he has held with insurance companies before arriving at the figure; and if he will make a statement on the matter. [37138/12]
View answerAs part of Budget 2012, I outlined savings of €143m to be generated through a combination of increased charges for private patients, improved collection of income and changes to bed designation legislation. This figure was determined as part of the normal budgetary process and, therefore, was not subject to discussions with insurance companies.
From 1 January 2012, the charges for patients who choose to be treated on a private basis in public hospitals increased by between 3% and 5% depending on the category of hospital. The increase in charges is in keeping with the long-standing policy of moving towards recovering the full economic cost of providing treatment to private patients in public hospitals. It is anticipated that the increased charges will yield additional revenue in the region of €18 million in 2012. With regard to the introduction of new legislation to allow charges to be raised in respect of all private patients in public hospitals, work on this matter is proceeding in preparation for 2013. In the meantime, in order to raise the resources required for 2012, the Department has agreed a system of improved cash-flow and accelerated payment in principle with private health insurance providers which will provide a once-off cash flow benefit in 2012. The details of the accelerated payment system are being finalised with the health insurers at present.
1600. Deputy Billy Kelleher asked the Minister for Health the total cuts to the budget of service providers to persons with a disability in 2012; and if he will make a statement on the matter. [37140/12]
View answerAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
