Written Answers Nos. 69-76
69. Deputy Brian Stanley asked the Minister for Health if he will address the need for greater support for persons with Huntington's Disease, including the provision of a HD neurology clinic, the promotion of increased awareness, the provision of medical cards for persons with the condition and all-Ireland cooperation in services; and if he will make a statement on the matter. [41008/12]
View answerHuntington's Disease (HD) is a genetic, neurological disorder and is classified as a rare disease. The supports provided by the Health Service Executive (HSE) to people with HD involve a multi-disciplinary team approach to the provision of health and personal supports and incorporates assisted living services, including Personal Assistant Services, Aids & Appliances and hospital, primary care and community services.
The Huntington's Disease Association of Ireland (HDAI), provides consultation, information and individualised support to those diagnosed with Huntington's Disease, their families and their health care team. The HSE is committed to working in partnership with voluntary disability service providers including HDAI, to ensure that all of the resources available for people with disabilities are used in the most effective manner possible. The HSE recognises the valuable contribution of the HDAI and approved a grant of just over €68,000 for 2012 to support the work of the organisation. The HDAI is a member of the Neurological Alliance of Ireland and the Disability Federation of Ireland. Both umbrella organisations provide support to the HDAI and are supported by the State through funding from the Health Service Executive.
The Report - "The National Policy & Strategy for the Provision of Neuro-Rehabilitation Services 2011 - 2015" published in December 2011 and jointly commissioned by the Department of Health and the Health Service Executive (HSE), is the over-arching policy on Neuro-rehabilitation services. In conjunction with the development of the Rehabilitation Medicine Programme of the HSE Clinical Strategy Programmes Directorate, there is now a clear policy with a recommended service framework, which when implemented, will ensure that neuro-rehabilitation services are developed for those we serve in the most appropriate, effective and efficient way. The HSE National Service Plan 2012, specifically supports the work of the Rehabilitation Medicine Programme in committing to the development of regional networks, local rehabilitation teams and the development of associated protocols, pathways and bundles. The appointment of Regional Rehabilitation Medicine Consultants will, together with a multi-disciplinary team, ensure that national best practice is implemented in each Region, crossing the boundaries between acute and community services.
Medical cards are provided to persons who, under the provision of the Health Act 1970, are in the opinion of the HSE unable without undue hardship to arrange GP services and other health services for themselves and their dependants. The assessment for a medical card is therefore determined primarily by reference to the means, including the income and expenditure, of the applicant and his or her partner and dependants. Under this legislation, there is no automatic entitlement to a medical card for persons with specific illness such as Huntington's Disease. There is however, a provision for discretion by the HSE to grant a card in cases of "undue hardship", where the income guidelines are exceeded. The HSE has recently set up a clinical panel to assist in the processing of applications for discretionary medical cards where there are difficult personal circumstances.
Ireland has been supportive of EU proposals on rare diseases, which concluded with a council recommendation in June 2009 that countries are recommended to develop plans or strategies preferably by the end of 2013. We are now well advanced in developing this work. I established a National Steering Group to develop a policy framework for the prevention, detection and treatment of rare diseases. The Steering Group consulted extensively with patients and key stakeholders in June and July of this year and it is expected that the Steering Group will submit a plan to me towards the end of this year.
70. Deputy Bernard J. Durkan asked the Minister for Health if the extent to which generic prescribing will lead to cost reductions throughout the health services in a single year and or for the remainder of the current year; the procurement policies within the health services that are structured in a manner to maintain best practice in respect of patients needs while at the same time availing of competitively priced prescriptions; and if he will make a statement on the matter. [40922/12]
View answerThe Health (Pricing and Supply of Medical Goods) Bill 2012 was published on the 13th of July 2012. This legislation will introduce a system of reference pricing and generic substitution for prescribed drugs and medicines. These reforms will promote price competition among suppliers and ensure that lower prices are paid for these medicines resulting in savings for taxpayers and patients. The Health (Pricing and Supply of Medical Goods) Bill, 2012 is a Government priority for this Oireachtas session. The Bill completed its passage through the Seanad on Wednesday, the 19th of September, and will now go to the Dáil. It is not possible, at this juncture, to provide accurate figures regarding potential savings resulting from generic substitution, as these depend on various factors. Section 24(3)(a) of the Bill provides that when the HSE sets a reference price, or reviews a reference price for a group of interchangeable medicinal products, it has to take into account the ability of suppliers to meet patient demand. Therefore, reference prices will be set at levels which will facilitate rather than jeopardise supply.
71. Deputy John McGuinness asked the Minister for Health the progress made to date in collecting moneys owed by insurance companies; and if he will make a statement on the matter. [40979/12]
View answerThe HSE and Voluntary hospitals recoup a considerable amount of income from private insurance companies in return for private and semi-private treatment services provided to patients with private health insurance cover. Lengthy delays can occur between the discharge of patients and the receipt of payment from the health insurance companies. I have emphasised to the HSE the importance of addressing this problem, in conjunction with the insurers, so that the maximum resources possible are available to the health system.
The HSE has introduced a number of initiatives to improve the claims collection process and facilitate faster submission of claims which will accelerate income collection within the public hospital system. In particular:
- The HSE has instructed hospitals to bring down the value of claims awaiting Consultant action and hospitals will also target the highest-value claims. This issue was addressed in the proposals recently agreed with the IHCA and IMO at the Labour Relations Commission which includes an explicit requirement that consultants complete private insurance claims documentation within 14 days of receipt.
- The HSE has also awarded the contract for the roll-out of an electronic claims management system in eleven HSE sites to replace the current paper based system. Work has already commenced and the system will be operational in four sites by the end of October.
Other issues in relation to private patient income have also been advanced in 2012. 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.
The Department has also been working with the main health insurers to agree in principle a system of improved cash-flow and accelerated payment which will provide a once-off cash flow benefit in 2012 in the region of €125m. The details of the accelerated payment arrangements are at an advanced stage and are being finalised with the health insurers at present.
72. Deputy Thomas P. Broughan asked the Minister for Finance the amount of cigarettes, tobacco products, illegal tablets, and alcohol seized by Customs and Excise at Dublin Airport for the years 2010, 2011 and to date in 2012; and if he will make a statement on the matter. [41063/12]
View answerI am informed by the Revenue Commissioners that the information sought by the Deputy is set out in the following table:
|
Year |
Cigarettes (number) |
Tobacco (kgs) |
Alcohol (Litres) |
Tablets (number) |
|
2010 |
24,463,902 |
1168.98 |
107 |
182,902 |
|
2011 |
19,306,084 |
1212.35 |
337 |
187,420 |
|
2012* |
10,749,942 |
1320.86 |
206 |
612 |
The figures in respect of tablets include prohibited drugs and unlicensed medicines.
*2012 figure is to 26/09/12
73. Deputy Terence Flanagan asked the Minister for Finance further to Parliamentary Question No. 64 of 18 July 2012, if he will respond to correspondence (details supplied); and if he will make a statement on the matter. [41064/12]
View answerThe issue of access to credit for small businesses is a priority for the Government and in that regard a number of initiatives have been introduced. The restructuring plan for the banking system creates capacity for the two pillar banks, Bank of Ireland and AIB, to provide lending in excess of €30 billion in the next three years. The Government has imposed targets on the two domestic pillar banks for lending to SMEs over the three calendar years 2011 to 2013. Both banks were required to sanction lending, including lending for working capital purposes, of at least €3 billion in 2011, €3.5 billion this year and €4 billion in 2013 for new or increased credit facilities to SMEs. Both banks achieved their 2011 targets.
The Credit Review Office (CRO) reviews decisions by the pillar banks to refuse, reduce or withdraw credit facilities (including applications for restructured credit facilities) from €1,000 up to €500,000. The Credit Review Office has to date overturned 60% of the decisions referred to them, supplying €6.9 million of credit, supporting 683 jobs in the SME sector. The Action Plan for Jobs 2012 contains a commitment, to be completed this year, to “assess the Credit Review Office to ensure SMEs are getting the support on bank lending they require.” I understand that work is underway on this process and that my Department expects to receive a report in early November.
The Temporary Partial Credit Guarantee Scheme, a key commitment under the Action Plan for Jobs 2012, will facilitate up to €150 million of additional lending to eligible SMEs per annum. Take-up of the Scheme will be closely monitored. The purpose of the scheme is to encourage additional lending to SMEs, not to substitute for conventional lending that would otherwise have taken place.
The Microenterprise Loan Fund Bill was published on 22 June and my colleague the Minister for Jobs, Enterprise and Innovation is taking the legislation through the Oireachtas at present. The scheme, which is expected to be operational shortly, will facilitate up to €40 million in additional lending to microenterprises over the next five years (an Exchequer allocation of €10 million has already been approved by Government as seed capital for the fund). Furthermore, the Government is in the process of facilitating up to €150 million per annum of additional credit through the Temporary Partial Credit Guarantee Scheme, designed for SMEs which, because of lack of collateral or because of the specialised sector they operate in, face difficulties in accessing bank credit.
On 4 November 2011, the Central Bank published a revised statutory Code of Conduct for Business Lending to Small and Medium Enterprises (the SME Code) setting out new requirements for lenders when dealing with SMEs in, or facing, financial difficulties which came into effect from 1 January 2012. A full review of the SME Code will be undertaken by the Central Bank in 2012.
In addition to these initiatives, and following the meeting between the President of the EIB, Mr. Werner Hoyer and myself and the Minister for Public Enterprise and Reform, officials from my Department and the National Pensions Reserve Fund (NPRF) have been engaging with the European Investment Bank (EIB) on non-traditional forms of EIB financing for Irish SMEs. This includes the EIB providing financing to SMEs via non-bank channels and there have been detailed discussions with the EIB on financing for an SME Fund being developed by the NPRF. I understand that these discussions are progressing satisfactorily.
I also might mention that the Government announced the establishment of the Strategic Investment Fund (SIF) in September 2011. The SIF will channel commercial investment from the National Pensions Reserve Fund (NPRF) towards productive investment in the Irish economy, following appropriate legislative changes to the investment policy of the NPRF. As well as money from the NPRF, the SIF will seek matching commercial investment from private investors and target investment in areas of strategic significance to the future of the Irish economy.
74. Deputy Jack Wall asked the Minister for Finance the mechanism available to a person (details supplied) in County Kildare to obtain a tax clearance certificate; and if he will make a statement on the matter. [41120/12]
View answerI have been advised by the Revenue Commissioners that an application can be made on-line for a Tax Clearance Certificate on www.revenue.ie. Alternatively, an applicant can submit a TC1 form to the appropriate Revenue Office. A Tax Clearance Certificate can only be issued by Revenue to a person whose tax affairs are in order at the date of issue of that Certificate. In relation to the particular case referred to by the Deputy, Revenue has advised the individual concerned of the reasons why it not possible to issue a Tax Clearance Certificate at present. It will not be possible to issue a certificate until outstanding compliance issues arising from very substantial tax debts involving the taxpayer and related companies are resolved.
75. Deputy Denis Naughten asked the Minister for Finance if he will outline the way the market selling price of a motor home is calculated for the purpose of assessing the liability for vehicle registration tax; and if he will make a statement on the matter. [41127/12]
View answerI am advised by the Revenue Commissioners that the typical way that the market selling price of a motor home is calculated is by reference to market indicators such as sales advertisements for similar vehicles in the State. In addition due allowance is made for factors such as the possibility of a negotiated reduction in price and whether the appropriate VRT has already been paid. A recent photograph of a particular vehicle may also be used in the valuation process. Exceptionally, where it is considered that reliance on advertisements alone do not provide an adequate basis for valuation, or where there are no advertisements for similar vehicles, then motor caravan dealers and others involved in this trade may be consulted for an opinion. Where, as may arise in the case of newer factory-manufactured motor caravans, either advertisements or consultations are deemed to provide an insufficient basis, the valuation will be made by reference to published retail prices for similar vehicles in the UK market. In such cases a deduction will be made for UK VAT with the addition of Irish VAT and VRT.
76. Deputy Brendan Griffin asked the Minister for Finance if he will permit tour operators to claim back VAT on fuel costs to allow them to be as competitive as tour operators from Northern Ireland operating here; and if he will make a statement on the matter. [41198/12]
View answerThe transport of passengers and their accompanying baggage is exempt from VAT under paragraph 14(3) of Schedule 1 to the Value-Added Tax Consolidation Act 2010. A person who provides a bus tour service does not register for VAT and cannot recover VAT incurred on goods and services used for the purposes of that tour service, including fuel costs. In the UK, passenger transport is zero rated for VAT purposes, which means passenger transport providers do not charge VAT on the services they supply but, unlike in Ireland, can recover VAT incurred on the goods and services used as part of that service, including the fuel. Irish, and UK, VAT law must comply with the EU VAT Directive. As passenger transport was exempt in Ireland on 1 January 1978, it is possible under the VAT Directive to continue to apply that exemption. For the same historic reasons the UK are entitled to continue to apply a zero rate to passenger transport services. It is not possible under EU law for Ireland to apply a zero rate to such services.
However, UK passenger transport operators who establish their businesses in Ireland are subject to the same VAT rules as Irish operators. They are exempt from VAT and not zero-rated, and as such not entitled to deductibility in respect of VAT incurred on items such as fuel. In addition, UK passenger transport operators who are not established in the State are not entitled to any refund of VAT incurred in this State for the purposes of carrying out passenger transport activities.
