Written Answers Nos. 583 - 603
583. Deputy Alan Farrell asked the Minister for Health his views on the establishment of independent hospital trusts under the universal health insurance system particularly in relation to the agreement of funding and staffing levels; and if he will make a statement on the matter. [50996/12]
View answerThe Government is embarking on a major reform programme for the health service, the aim of which is to deliver a single-tier health system, supported by universal health insurance (UHI), where access is based on need, not on income. Under UHI, everyone will have equal access to a comprehensive package of curative services. The key changes required to support the reform programme which will pave the way for the introduction of universal health insurance are outlined in the provisions of "Future Health: A Strategic Framework for Reform of the Health Service 2012 - 2015" which was published by the Minister for Health on 15 November 2012. Earlier this year I appointed Professor John Higgins to chair a Strategic Board on the Establishment of Hospital Groups. Work is continuing on finalising a Draft Report on the recommendations for submission to the Strategic Board. The Report will be submitted to me when the Board have signed off on it and in turn, I will then bring it to Cabinet.
Another key building block for UHI is the development of a 'Money Follows the Patient' funding model to replace the current block grant allocation system. Under 'Money follows the Patient', providers will be paid for the needs they address, the quantity and quality of the services they provide and the outcomes they deliver. They will be liberated, subject to overall budgetary ceilings, to pursue the most cost-effective means of achieving this standard of performance. Once the key building blocks have been put in place, it will be possible to proceed with implementation of UHI. Hospitals will then become independent, not-for-profit trusts with managers accountable to their boards. As a precursor to this, it is intended to integrate hospitals into groups on a collaborative administrative basis.
The rationale behind the establishment of hospital groups and trusts is to support increased operational autonomy and accountability for hospital services in a way that will drive service reforms and provide the maximum possible benefit to patients. As part of the drive to ensure real accountability, an annual budget and employment ceiling will be developed for each group. Groups will also have the authority to deploy and re-deploy staff across hospitals within the group; this will help to alleviate problems that have arisen in the past in relation to the equitable distribution of health care staff across all hospital sites. Before Hospital Trusts are finally established, the make-up and functioning of the Groups will be reviewed and if changes prove necessary then they will be made with Government approval when the hospital trusts are being formed.
584. Deputy Alan Farrell asked the Minister for Health if the Health Service Executive tendering process for payroll services will be offered only to Irish service providers; and if he will make a statement on the matter. [50997/12]
View answerOne of the key commitments in the Public Service Reform Plan is to identify and evaluate new business models and opportunities to support the delivery of non-core processes and services. External Service Delivery is an area that can potentially deliver a range of benefits for the provision of health services. These include both cost and efficiency savings stemming from better work and management practices. The Health Sector, along with Education, Justice and Local Government Sectors, are required to prepare and implement detailed benefits-driven external service delivery plans. This plan is currently being prepared by my Department in conjunction with the HSE. The option of external delivery of the HSE payroll is currently being explored. In the event of a tendering process, the process will be in line with EU Public Procurement Directives.
585. Deputy Finian McGrath asked the Minister for Health the position regarding the case of a person (details supplied) in Dublin 5 who is on a waiting list for Cappagh Hospital. [51009/12]
View answerThe management of waiting lists for patients awaiting public health care is based on the principle that after urgent and cancer patients are treated, then clinically assessed routine patients should be seen in chronological order (i.e. longest waiter first). Should the patient's general practitioner consider that the patient's condition warrants an earlier appointment, he/she would be in the best position to take the matter up with the consultant and hospital involved. In relation to the specific query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.
586. Deputy Gerald Nash asked the Minister for Health when the review of the decision not to award a medical card in respect of a person (details supplied) in County Louth will be completed; and if he will make a statement on the matter. [51057/12]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
587. Deputy Jim Daly asked the Minister for Health if a medical card holder can purchase a branded drug over a generic drug and pay the difference in the cost of the branded drug to the pharmacy, for example, pay the €2 difference of the cost of the drug to the pharmacy; and if he will make a statement on the matter. [51058/12]
View answerThere is no cost to medical card holders for prescribed drugs which are on the list of reimbursable items, other than the prescription charge of 50 cent per item. The Health (Pricing and Supply of Medical Goods) Bill 2012 provides for the introduction of a system of generic substitution and reference pricing. Generic substitution allows pharmacists to substitute a cheaper generic equivalent, at the patient’s request, when a more expensive product has been prescribed. Reference pricing involves setting a common reimbursement amount for selected groups of medicines, which will be done by the HSE. Only the reference price is reimbursed by the State. When this Bill is enacted and commenced eligible patients will not be required to pay any additional costs for medicines priced at or below the reference price. However, if a patient chooses a particular brand that is more expensive than the reference price they will have to pay the difference between the brand price and the reference price to the pharmacy. Reference pricing coupled with generic substitution provides patients with an incentive to opt for the cheapest available product, but does not impose any unavoidable additional costs on patients.
588. Deputy Billy Kelleher asked the Minister for Health if he will provide, in tabular form, the number of bed days lost through delayed discharges in each hospital to date in 2012; and if he will make a statement on the matter. [51059/12]
View answerThis information is collected and collated by the Business Intelligence Unit within the Health Service Executive. Therefore, I have asked the Health Service Executive to respond directly to the Deputy.
589. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) in County Offaly may expect a decision on an application for a medical card. [51064/12]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
590. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) in County Offaly may expect a decision on an application for a medical card. [51065/12]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
591. Deputy Michael Healy-Rae asked the Minister for Health if he will ensure that essential funding will be maintained in respect of an organisation (details supplied); and if he will make a statement on the matter. [51076/12]
View answerThe Department of Environment, Community and Local Government and local authorities have statutory responsibility for the provision of homelessness services in Ireland in line with the National Homeless Strategy, 'The Way Home 2008-2013' and 'Pathway to Home' which set out the new configuration of support services to be provided in the Dublin region for those at risk of, or currently experiencing homelessness. Local authorities identify and address the level of need through a range of community based accommodation options and related housing supports, and the HSE and its partner agencies arrange health and personal social care supports appropriate to the individual service user's needs within this structure. The allocation of the HSE's homeless budget comes within the remit of the HSE and is allocated based on identified needs in line with the overall financial constraints that the HSE operates within. In relation to the specific issue raised by the Deputy, as this is a service issue it has been referred to the HSE for direct reply.
592. Deputy Micheál Martin asked the Minister for Health the position regarding plans for the future delivery of children's hospital services in the catchment area of the Tallaght Hospital, Dublin, following his announcement last week regarding the location of the proposed National Children's Hospital at the St. James' Hospital site; if he will appreciate that there is now confusion regarding the future of services at Tallaght; and if he will give assurances to the community on the matter [51088/12]
View answerThe Dolphin report concluded that the existing plan for the Ambulatory and Urgent Care Centre in Tallaght must be revisited in the light of a decision made about the location of the National Children’s Hospital. It is anticipated that most children around the country who require hospital care will receive it closer to their home. It is envisaged that there will be an urgent care centre or urgent care centres based on consideration of the geographical distribution of attendances and acuity of the patient. The location and number of such centres will be given careful consideration and this will be done urgently to reach a decision as soon possible.
593. Deputy Micheál Martin asked the Minister for Health his views on concerns expressed by community drugs projects in the Tallaght, Dublin 24, area regarding recently announced cuts by the Health Service Executive, which have the potential to have a seriously negative effect on the work of those projects, if he will give assurances to these groups; and if he will make a statement on the matter. [51089/12]
View answerI understand that the Deputy is referring to the review and reconfiguration of nursing services in the Addiction Services in the HSE Dublin Mid-Leinster region. I have referred the matter to the HSE for direct reply to the Deputy.
594. Deputy Micheál Martin asked the Minister for Health recognising the important role that assistance dogs can play in the care plan for children with autism and the reluctant decision now being made by the Irish Guide Dogs for the Blind to no longer accept applications for assistance dogs, the funding available for the training and provision of assistance dogs; and if he will make a statement on the matter. [51094/12]
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.
595. Deputy Finian McGrath asked the Minister for Health the position regarding home help in respect of a person (details supplied) in Dublin 3. [51103/12]
View answerGovernment policy is to support older people to live in dignity and independence in their own homes and communities for as long as possible. This is achieved through a range of community based services such as Home Care, Meals-on-Wheels and Respite or Day Care. As this is a service matter it has been referred to the Health Service Executive for direct reply.
596. Deputy Billy Kelleher asked the Minister for Health the number of operations, medical and surgical procedures in public hospitals that were cancelled in 2010, 2011 and to date in 2012; and if he will make a statement on the matter. [51106/12]
View answerThis information is collected and collated by the Business Intelligence Unit within the Health Service Executive. Therefore, I have asked the Health Service Executive to reply to the Deputy directly in this matter.
597. Deputy Michael Healy-Rae asked the Minister for Health if he recognises that certain services for persons with significant intellectual disabilities provided by voluntary bodies and partly funded through the Health Service Executive are essential social services and should not and will not be reduced or withdrawn as a consequence of funding reduction by the State; if he will direct the HSE to ensure they are fully provided for the delivery of essential services (details supplied) and will not be subject to any reduction where it is proven that the service is being provided within a cost effective framework; and if he will make a statement on the matter. [51123/12]
View answerExpenditure on health services for people with a disability in 2012 will be around €1.4 billion. In the case of disability services, the HSE National Service Plan 2012 provides for a 3.7% reduction in budgets but makes it clear that there is scope for achieving efficiencies of 2% or more through measures such as consolidation and rationalisation of back office costs. All providers will be expected to achieve some efficiency savings but the level of savings required will vary depending on the profile of the service provider, efficiency savings achieved to date and the scope for further savings. Some reductions in day services, residential and respite services will be unavoidable even with such efficiencies. The aim will be to tailor such reductions to minimise the impact on service users and families as much as possible. Pending completion of the national estimates, budgetary and service planning process for 2013 it is not possible to predict the service levels to be provided next year.
598. Deputy Eoghan Murphy asked the Minister for Health further to Parliamentary Question No. 1000 of 6 November 2012, if he has considered a penalty scheme for persons who do not attend appointments and give no prior notice of non-attendance in view of the high percentage that occur. [51160/12]
View answerI refer the Deputy to my previous reply of the 6th November this year. It remains the position that, while acute hospitals currently have in place a variety of DNA (did not attend) policies, a standardised approach is now being developed as part of a national Outpatient Performance Improvement Programme. This Programme, developed by the Special Delivery Unit (SDU) will be implemented nationally over the period 2012 to 2015 to improve the provision of outpatient services. The Programme will address the management of DNAs as well as a range of other issues. If a patient finds they cannot attend the appointment they have been given I would appeal to all such patients to inform the clinic concerned as soon as they know they cannot attend.
599. Deputy Michael McCarthy asked the Minister for Health the reason a person (details supplied) in County Kerry who was deemed to be within the guidelines for a general practitioner visit card has been refused same; and if he will make a statement on the matter. [51176/12]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
601. Deputy Robert Troy asked the Minister for Health the average number of post-mortems which are carried out annually in the Midland Regional Hospital, Tullamore, County Offaly. [51204/12]
View answerThe information sought by the Deputy is not readily available in my Department. Therefore, I have asked the Health Service Executive to respond directly to the Deputy in relation to this matter.
602. Deputy Róisín Shortall asked the Minister for Health if he will ensure that funding is maintained to a service (details supplied) and that no further cuts are made to this vital service which offers care and necessary supports for persons with special needs. [51206/12]
View answerPending completion of the national estimates, budgetary and service planning process for 2013 it is not possible to predict the service levels to be provided next year. In relation to the specific queries raised by the Deputy, as these are service issues they have been referred to the HSE for direct reply.
603. Deputy Róisín Shortall asked the Minister for Health the reason medical card holders can no longer receive the prescription Osteole 1500mg on their medical card; the reasons this item was removed from the list; and if an alternative is available to patients in need of this medication. [51207/12]
View answerIn the current financial environment the Health Service Executive (HSE) is facing a challenge to deliver services in a way that will minimise any adverse impact on patients and continue to protect, as far as possible, the most vulnerable citizens. Unfortunately, it has become necessary for the HSE to suspend certain products from its list of reimbursable items, including glucosamine. Glucosamine (Osteole) is indicated for the management of symptoms of osteoarthritis. The National Centre for Pharmoeconomics (NCPE) has assessed the cost-effectiveness of glucosamine on two occasions and concluded that it did not offer value for money to the HSE. There are no alternative glucosamine products available under the Community Drugs Scheme. However, these products are available over the counter without prescriptions.
