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Tuesday, 9 Oct 2012

Written Answers Nos. 597-607

Medical Card Applications

Questions (598)

John O'Mahony

Question:

598. Deputy John O'Mahony asked the Minister for Health when a person (details supplied) in County Mayo will receive a decision on their application for a medical card; and if he will make a statement on the matter. [42800/12]

View answer

Written answers

As this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.

Medical Products

Questions (599)

Billy Kelleher

Question:

599. Deputy Billy Kelleher asked the Minister for Health the efforts he has made to supply Kalydeco to persons with Cystic Fibrosis here; and if he will make a statement on the matter. [42827/12]

View answer

Written answers

The HSE recently received an application for Kalydeco's inclusion under the Community Drugs Scheme. In accordance with normal procedures, the National Centre for Pharmacoeconomics is conducting a Health Technology Assessment on this product which will consider if the drug is cost-effective at the price offered to the HSE. No reimbursement decision will be made until the assessment has been completed.

Health Services Staff Issues

Questions (600)

Brian Walsh

Question:

600. Deputy Brian Walsh asked the Minister for Health the number of personnel employed by the Health Service Executive in the area of human resources nationally and in each of the HSE regional administrative areas. [42835/12]

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Written answers

As this is a service matter, it has been referred to the Health Service Executive for direct reply.

Hospital Services

Questions (601)

John Lyons

Question:

601. Deputy John Lyons asked the Minister for Health if he will provide clarification on the level of services provided at the menopause clinic in the Rotunda Maternity Hospital, Dublin 1; and if he will make a statement on the matter. [42840/12]

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Written answers

As this is a service matter, it has been referred to the Health Service Executive for direct reply.

Nursing Home Services

Questions (602)

Derek Nolan

Question:

602. Deputy Derek Nolan asked the Minister for Health if he will provide an update in relation to a nursing home (details supplied) in County Galway; the rationale behind the temporary closure of day care services there; if there are any plans to address the empty beds and staffing shortages; and if he will make a statement on the matter. [42841/12]

View answer

Written answers

As this is a service matter, it has been referred to the Health Service Executive for direct reply.

Medical Aids and Appliances Applications

Questions (603)

Tom Fleming

Question:

603. Deputy Tom Fleming asked the Minister for Health the position regarding a hearing aid replacement in respect of a person (details supplied) in County Kerry [42850/12]

View answer

Written answers

As this is a service matter, it has been referred to the HSE for direct reply.

Health Services Provision

Questions (604)

Finian McGrath

Question:

604. Deputy Finian McGrath asked the Minister for Health the support available to a person (details supplied) in Dublin 5. [42851/12]

View answer

Written answers

As 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.

Dental Services Provision

Questions (605)

Anthony Lawlor

Question:

605. Deputy Anthony Lawlor asked the Minister for Health if he will provide an update detailing the progress being made on the proposed new method for categorising need for orthodontic services for school going children; and if he will make a statement on the matter. [42862/12]

View answer

Written answers

Patients who are referred by the HSE's dental service school screening programme to the HSE Orthodontic Service are assessed under the modified Index of Treatment Need, which was introduced in 2007. Patients with the greatest level of need, i.e. Grade 5 or Grade 4, are provided with treatment.  The HSE is commencing an independent review of Orthodontic Services which will consider a number of service provision models. The outcome of this review will give guidance as to what changes will be desirable to provide the best model of care delivery, given current resources and expected future demand for services.

Suicide Prevention

Questions (606, 610)

Michael Healy-Rae

Question:

606. Deputy Michael Healy-Rae asked the Minister for Health if he has considered setting up an independent body to deal with the ever-increasing situation where many persons on a daily basis are taking their own lives; and if he will make a statement on the matter. [42868/12]

View answer

Dominic Hannigan

Question:

610. Deputy Dominic Hannigan asked the Minister for Health his views on the idea of a new independent national authority for suicide prevention here similar to the Road Safety Authority; and if he will make a statement on the matter. [42893/12]

View answer

Written answers

I propose to take Questions Nos. 606 and 610 together.

The HSE's National Office for Suicide Prevention was established in 2005 on foot of a recommendation in Reach Out, our National Strategy for Action on Suicide Prevention. The role of the National Office is to oversee the implementation of Reach Out and to coordinate suicide prevention initiatives around the country. The National Office is advised and guided by an advisory group comprising individuals with considerable knowledge and expertise in the areas of suicide prevention, mental health promotion and bereavement support. Its work is centred around evidence-based interventions and involves the funding of new research or pilot projects. I am happy that the advisory group brings an independent voice to the table. In addition the National Office for Suicide Prevention publishes an Annual Report outlining its activities and work each year so it is fully accountable. I believe that a commitment to evidence-based programmes and partnerships with a common purpose is what is required to address the issue of suicide and this role is being carried out at present by the National Office.

Programme for Government Implementation

Questions (607)

Simon Harris

Question:

607. Deputy Simon Harris asked the Minister for Health if he will outline in tabular form the commitments in the Programme for Government pertaining to his ministerial portfolio; the current status of these commitments in terms of implementation; and if he will make a statement on the matter. [42881/12]

View answer

Written answers

As the Deputy may be aware the first Annual Report of the Programme for Government was published last March. It is the Government's intention to publish the second annual report in March 2013. The table that follows this reply sets out the current position in regard to health-related commitments. If further information is required, the Deputy can write to my Department.

Introduce Universal Health Insurance with equal access to care for all. Under this system there will be no discrimination between patients on the grounds of income or insurance status. The two-tier system of unequal access to hospital care will end. The Universal Health Insurance system will be designed according to the European principle of social solidarity: access will be according to need and payment will be according to ability to pay. The principle of social solidarity will underpin all relevant legislation. As a statutory system of health insurance, guaranteed by the State, the Universal Health Insurance system will not be subject to European or national competition law.

In progress

Act speedily to reduce costs in the delivery of both public and private health care and in the administration of the health care system.

In progress

Introduce a system of risk equalisation for the current insurance market.

In progress

A Special Delivery Unit will be established in the Department of Health to assist the Minister in reducing waiting lists and introducing a major upgrade in the IT capabilities of the health system.

In progress

A Patient Safety Authority, incorporating HIQA, will be established.

In progress

The Minister for Health will be responsible for health policy and for implementing this ambitious programme of reform and cost control.

In progress

The Health Service Executive will cease to exist over time. Its functions will return to the Minister for Health and the Department of Health and Children; or be taken over by the Universal Health Insurance system. Staff will be deployed accordingly.

In progress

Health capital spending will be a priority.

In progress

Within the Health capital budget, the immediate priority areas will be primary care centres, step-down and long-term care facilities, and community care facilities such as day centres for older people.

In progress

The completion and commissioning of the cystic fibrosis unit will be expedited.

Completed

The National Children’s Hospital will be built.

In progress

Our policy on mental health incorporates the recommendations of A Vision for Change. We are committed to reducing the stigma of mental illness, ensuring early and appropriate intervention and vastly improving access to modern mental health services in the community.

In progress

We will endeavour to end the practice of placing children and adolescents in adult psychiatric wards.

In progress

We will review the Mental Health Act 2001 in consultation with service users, carers and other stakeholders, informed by human rights standards, and introduce a Mental Capacity Bill that is in line with the UN Convention on the Rights of Persons with Disabilities.

In progress

A comprehensive range of mental health services will be included as part of the standard insurance package offered under Universal Health Insurance.

In progress

Given the central role of primary care in our reforms, we will ensure that patients can access mental health services such as psychologists and counsellors in the primary care setting.

In progress

We will also strengthen GP education and training in mental health so that they can better diagnose, treat and refer as necessary.

In progress

We will ring fence €35m annually from within the health budget to develop community mental health teams and services as outlined in A Vision for Change to ensure early access to more appropriate services for adults and children and improved integration with primary care services.

In progress

Part of the ring-fenced funding will be used to implement Reach Out, the National Suicide Prevention Strategy, to reduce the high levels of suicide.

In progress

We will close unsuitable psychiatric institutions moving patients to more appropriate community-based facilities.

In progress

We will develop specific strategies for elderly patients and those with intellectual disabilities who remain under the care of mental health services.

In progress

To ensure a joined-up approach to mental health in the community we will establish a cross-departmental group to ensure that good mental health is a policy goal across a range of people’s life experiences including education, employment and housing for example.

In progress

We will develop a national Alzheimer’s and other dementias strategy by 2013 to increase awareness, ensure early diagnosis and intervention, and development of enhanced community based services to be implemented over five years.

In progress

We will introduce a cervical cancer vaccination catch-up programme for all girls in secondary school.

Completed

We will also extend Breastcheck to 65-69 year old women.

In progress

We will develop a National Carers Strategy to support carers and to address issues of concern.

Completed

We will reopen discussions with the Irish Thalidomide Association regarding further compensation for victims of Thalidomide.

In progress

We will seek a mechanism to compensate those women who were excluded on age grounds alone from the Lourdes Hospital Redress Scheme.

In progress

We will legislate to clarify the law surrounding assisted human reproduction including the law relating parental relationships arising from assisted human reproduction.

In progress

We will legislate to regulate stem cell research.

In progress

We acknowledge the recent ruling of the European Court of Human Rights subsequent to the established ruling of the Irish Supreme Court on the X-case. We will establish an expert group to address the recent ruling of the European Court of Human Rights subsequent to the established ruling of the Irish Supreme Court on the X-case, drawing on appropriate medical and legal expertise with a view to making recommendations to Government on how this matter should be properly addressed.

In progress

We will legislate for post-mortem procedures and organ retention practices as recommended by the Madden report.

In progress

We will legislate to change the organ donation to an opt-out system for organ transplantation, rather than an opt-in system so as to improve the availability of organs for patients in desperate need.

In progress

Universal Primary Care will remove fees for GP care and will be introduced within this Government’s term of office.

In progress

Access to care without fees will be extended to all in the final phase.

In progress

GPs will be paid primarily by capitation for the care of their patients and will work in primary care teams with other primary care professionals.

In progress

A new GP contract will provide incentives to GPs to care more intensively for patients with chronic illnesses. This will significantly reduce pressures and demands on the hospital system.

In progress

Registration with a primary care team will be compulsory once the Universal Primary Care system is fully implemented.

In progress

Exchequer funding for primary care will go to a Primary Care Fund on a transitional basis, which will pay providers of primary care.

In progress

The goal under UHI will be to create an integrated system of primary and hospital care.

In progress

Ring-fenced funding will be provided to recruit additional psychologists and counsellors to community mental health teams, working closely with primary care teams to ensure early intervention, reduce the stigma associated with mental illness and detect and treat people who are at risk of suicide.

In progress

The legislative basis for Universal Primary Care will be established under a Universal Primary Care Act.

In progress

Universal Primary Care will be introduced in phases so that additional doctors, nurses and other primary care professionals can be recruited.

In progress

GP training places will be increased.

In progress

GPs will be encouraged to defer retirement and will be recruited from abroad

In progress

The number of practice nurses will be increased so that GPs can delegate care when appropriate to nurses.

In progress

Access to primary care without fees will be extended in the first year to claimants of free drugs under the Long-Term Illness scheme at a cost of €17 million.

In progress

Access to primary care without fees will be extended in the second year to claimants of free drugs under the High-Tech Drugs scheme at a cost of €15 million.

In progress

Access to subsidised care will be extended to all in the next phase.

In progress

A system of Universal Health Insurance (UHI) will be introduced by 2016, with the legislative and organisational groundwork for the system complete within this Government’s term of office.

In progress

Under UHI insurers will be obliged to offer the same package of services to all.

In progress

This guaranteed UHI package will be determined by the Minister for Health in consultation with the Hospital Insurance Fund and medical experts and will be regularly reviewed in a process to be established in legislation, the Universal Health Insurance Act.

In progress

Insurers will not be allowed to sell insurance giving faster access to procedures covered by the UHI package.

In progress

Hospitals and clinics which participate in supplying care under UHI will not be allowed to sell faster access to procedures covered by the UHI package.

In progress

A White Paper on Financing UHI will be published early in the Government’s first term and will review cost-effective pricing and funding mechanisms for care and care to be covered under UHI.

In progress

The legislative basis for UHI will be established by the Universal Health Insurance Act.

In progress

UHI will provide guaranteed access to care for all in public and private hospitals on the same basis as the privately-insured have now.

In progress

Insurance with a public or private insurer will be compulsory with insurance payments related to ability to pay.

In progress

The State will pay insurance premia for people on low incomes and subsidise premia for people on middle incomes.

In progress

Everyone will have a choice between competing insurers.

In progress

The VHI will be kept in public ownership to retain a public option in the UHI system.

In progress

Exchequer funding for hospital care will go into a Hospital Insurance Fund which will subsidise or pay insurance premia for those who qualify for subsidy.

In progress

The Hospital Insurance Fund will oversee a strong and reformed system of community rating and risk equalisation; provide direct payments to hospitals for services that are not covered by insurance such as Emergency Departments and ambulances; and provide matching payment to hospitals for treatments delivered.

In progress

The Hospital Insurance Fund will also control those health care costs for which central control is most effective.

In progress

Enact legislation to prohibit the practice of Female Genital Mutilation for the protection of girls and women.

Completed

Outline key priorities for short-term implementation of the National Addiction Strategy, underpinned by a realistic timeframe and targets.

In progress

Require all local and regional drugs taskforces to build on the success of Education Prevention Units in other taskforces.

In progress

Target resources to increasing the number of needle exchange programmes and rehabilitation places across the country where it is needed most.

In progress

Assist drug users in rehabilitation through participation in suitable local community employment schemes.

In progress

Expand rehabilitation services at local level in line with need and subject to available resources.

In progress

Integrate drug and alcohol abuse strategies at local level

In progress

Develop compulsory as well as voluntary rehabilitation programmes.

In progress

Ensure every Government Department, Agency or task force responsible for implementing elements of the National Addiction Strategy will be required to account to the Minister for their budget annually and to demonstrate progress on achieving targets.

In progress

Work with Local and Regional Drug Task Forces to implement effective programmes aimed at preventing addiction in schools.

In progress

Under UHI public hospitals will no longer be managed by the HSE. They will be independent, not-for-profit trusts with managers accountable to their boards. Boards will include representatives of local communities and staff.

In progress

The existing policy of co-location of private hospitals on public hospital lands will cease.

Completed

Smaller hospitals may combine in a local hospital network with a shared management and board.

In progress

Hospitals will be paid according to the care they deliver and will be incentivised to deliver more care in a “money follows the patient” system.

In progress

Insurers will negotiate directly with hospitals to help control costs and encourage innovation in the delivery of care.

In progress

Insurers will not take over the running of hospitals which will be independent providers of care separate from insurers as purchasers of care.

In progress

The Minister for Health will be responsible for hospitals policy and determining that hospitals which play an important role in an area should not be allowed to close under UHI.

In progress

The Hospital Insurance Fund will assist hospitals in more remote locations that may not have a large throughput of patients to continue to provide important local services.

In progress

To ensure that hospitals compete on an equal footing, public hospitals will be compensated for costs that they bear that private hospitals do not such as Emergency Departments and training health care professionals.

In progress

The Patient Safety Authority will introduce a national licensing system for hospitals, and will oversee the transition of hospitals from the HSE to independent local control.

In progress

Ensure that the quality of life of people with disabilities is enhanced and that resources allocated reach the people who need them. To achieve this, we will reform the delivery of public services to bring about back office savings that will protect front line services.

In progress

A Comprehensive Spending Review will examine all provision for people with disabilities with a view to determining how users can get the best services. We will also ensure that money spent on disability services under the National Disability Strategy is clearly laid out and audited.

In progress

Move a proportion of public spending to a personal budget model so that people with disabilities or their families have the flexibility to make choices that suit their needs best. Personal budgets also introduce greater transparency and efficiency in funding services.

In progress

Put the National Standards for Residential Services for People with Disabilities on a statutory footing and ensure that services are inspected by the Health Information and Quality Authority.

In progress

In the first term of this Government the legislative basis for UHI will be enacted.

In progress

In the first term of this Government public hospitals will be given autonomy from the HSE.

In progress

In the first term of this Government the HSE’s function of purchasing care for uninsured patients will be given to a Hospital Care Purchase Agency which will combine with the National Treatment Purchase Fund to purchase care for the uninsured over this transition period. This separation of purchaser-provider functions will enable the development of a money follows the patient system of purchase of care for people without insurance before the implementation of the UHI system.

In progress

Investment in the supply of more and better care for older people in the community and in residential settings will be a priority of this Government.

In progress

Additional funding will be provided each year for the care of older people to fund more residential places, more home care packages and the delivery of more home help and other professional community care services.

In progress

The Fair Deal system of financing nursing home care will be reviewed with a view to developing a secure and equitable system of financing for community and long-term care which supports older people to stay in their own homes.

In progress

The integration of care in all settings is key to efficient health care delivery, in which the right care is delivered in the right place.

In progress

Integration of care will be the responsibility of an Integrated Care Agency under the aegis of the Minister for Health.

In progress

This agency will oversee the flow of centrally tax-funded resources between the different arms of the system so that there are incentives for care to occur in the best setting.

In progress

Reference pricing and greater use of generics will be introduced to reduce the State’s large drugs bill and the cost to individuals of their medications.

In progress

Under the new GP contract the rate of remuneration of GPs will be reduced.

In progress

Under a new consultant’s contract hospital consultants’ remuneration will be reduced.

In progress

Action will be taken to reduce the cost of procurement for medical equipment and construction of facilities.

In progress

The Minister for Health and the Department of Health will be responsible for policy and spending.

In progress

The HSE will cease to exist as its functions are given to other bodies during this process of reform.

In progress

The HSE hospital purchasing arm will merge with the NTPF to become a new purchaser of public patient care during this period of transition.

In progress

HSE hospitals will become autonomous providers of care.

In progress

We will also develop and implement national standards for home support services which are subject to inspection by the Health Information and Quality Authority.

In progress

We will complete and implement the National Positive Ageing Strategy so that older people are recognised, supported and enabled to live independent full lives.

In progress

We will support older people in living in their own homes and communities for as long as they wish and will facilitate this by ensuring that the eligibility criteria for the home help and the Home Care Package Scheme are applied consistently.

In progress

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