Written Answers Nos. 684 - 707
685. Deputy Dan Neville asked the Minister for Health the position regarding services for a person with special needs at a training centre (details suppled) in County Limerick; if he will provide funding for the options programme in Limerick; and if he will make a statement on the matter. [52788/12]
View answer697. Deputy Willie O'Dea asked the Minister for Health if he will provide funding for the Options Programme in County Limerick which allows persons with special needs, the average age of which currently is 24 years, to remain within the training environment, giving a sense of worth of worth and value; and if he will make a statement on the matter. [52830/12]
View answerI propose to take Questions Nos. 685 and 697 together.
Every effort is made within available resources to provide services to young adults with disabilities who have completed their education or training programmes. Day services for adults with disabilities provide a network of support for over 25,000 people who have a wide spectrum of need, ranging from those with severe and profound disabilities who are likely to need long-term specialist service provision to people with lower support needs and greater potential for community participation and inclusion. The demand for services for those who have left school or training continues to grow and this year almost 700 school-leavers and training graduates required new placements. Disability services have been required to cater for demographic pressures such as this from within their existing budgets in 2012, which have been reduced by 3.7% in the current year. The moratorium on staff recruitment has also given rise to challenges in service provision and in addition the physical capacity to provide further services may not be present in all agencies.
The training centre in Dooradoyle provides a training programme for young adults over l8 years of age with special needs. Each trainee is funded for a maximum of 4 years and receives a training allowance of €31.80. Individuals with a disability in receipt of this allowance are usually eligible for the Disability Allowance also. In recent years, on completion of the 4 year programme many of the young adults had no employment option available to them. As a response to this lack of available employment, efforts were made to maintain the young adults within the training environment and continue to pay them the training allowance, although on completion of the training course the payment of the allowance should have ceased. No additional funding was provided for this initiative. The funded 4 year training programme continues to be provided at the centre but the numbers are now at a point where it is not possible to continue to offer a 5 day placement and pay an allowance to the young people who have completed their training due to funding constraints and lack of physical capacity at the training centre.
The HSE is currently in discussions with the parents of these young adults on how best to meet their needs. Options being explored include reducing their attendance time from 5 days to 3 days per week and the discontinuance of the training allowance.
686. Deputy Caoimhghín Ó Caoláin asked the Minister for Health when he will introduce a vaccination for Meningococcal Disease Type B; if he will outline the process for same; and if he will make a statement on the matter. [52792/12]
View answerMeningococcal B vaccine has received a positive opinion from the Committee for Medicinal Products for Human Use of the European Medicines Agency (EMA) but it is not yet licensed for use.
The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). NIAC is a committee of the Royal College of Physicians of Ireland comprising of experts in a number of specialties including infectious diseases, paediatrics and public health. The committee's recommendations are informed by public health advice, international best practice and by the National Centre for Pharmacoeconomics (NCPE).
Should NIAC advice recommend the inclusion of a new vaccine into the primary childhood immunisation programme in Ireland, my Department, in association with the National Immunisation Office will examine the issue. If it is subsequently decided that a vaccine should be included in the vaccination programme, the Health Service Executive, through the National Immunisation Office, initiates the procurement process.
There is no doubt about the role that vaccines have played in improving the health of children. The development of new vaccines is very welcome. A Health Technology Assessment which includes a cost benefit analysis is carried out prior to any new vaccine being considered. This has a vital role in ensuring that care technologies, including vaccines, are used in a manner appropriate to their ability to maximise health gain and achieve value for money.
687. Deputy Michael Healy-Rae asked the Minister for Health the position regarding medical card patients and non-national doctors (details supplied); and if he will make a statement on the matter. [52794/12]
View answerThe Health (Provision of General Practitioner Services) Act 2012, which was enacted in March 2012, eliminates restrictions on fully qualified and trained GPs wishing to obtain contracts to treat public patients under the General Medical Services (GMS) contract. Under the provisions of this legislation any medical practitioner:
(a) whose name is included in the Specialist Division of the register of medical practitioners established under section 43(2)(b) of the Medical Practitioners Act 2007, and
(b ) who holds a current certificate of registration within the meaning of section 2 of that Act in respect of the medical specialty “General Practice” recognised under section 89(1) of that Act;
is eligible to apply for a GMS contract, irrespective of their nationality.
The GMS Scheme allows medical card patients and GP visit card patients to choose their GP from a choice of locally based doctors who hold a GMS contract.
688. Deputy Regina Doherty asked the Minister for Health the reason the breast check programme currently stops at the age of 64 years; if it will be made available to women over this age; and if he will make a statement on the matter. [52800/12]
View answerThe BreastCheck Programme provides free mammograms to all women aged 50-64. The Programme for Government includes the extension of BreastCheck to women in the 65-69 age group, in keeping with EU Guidelines on effective screening for breast cancer.
The main priority for the HSE's National Cancer Screening Service (NCSS) at present is to maximise national uptake in the 50-64 year age cohort. The extension of the BreastCheck programme has been listed as a priority in the HSE's 3 year Corporate Plan (2012 -2015). The HSE's National Cancer Control Programme is examining how it can extend the programme to 65-69 year olds. A review of the BreastCheck screening process has been submitted to my Department. This review should help to inform how greater efficiencies may be achieved within the Programme.
In the meantime women of any age who have concerns about breast cancer should seek the advice of their GP who will, if appropriate, refer them to the symptomatic breast services in one of the eight designated specialist cancer centres.
689. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the efforts he is making to combat Meningitis; if his attention has been drawn to the work of the Meningitis Research Foundation; if he will outline the efforts he is making to support them in their work; and if he will make a statement on the matter. [52801/12]
View answerThe HSE National Immunisation Office has responsibility for the implementation of the childhood immunisation programme in Ireland. Immunisation protects against many illnesses including meningitis and a number of vaccines in the current schedule protect against certain forms of meningitis e.g. Hib, MMR, MenC and PCV. Through the ongoing endeavours of the HSE, targeted media campaigns and interventions in specific areas, vaccination rates have increased. Since 2011, a 95% uptake rate, the target set by WHO is being achieved for 6 in 1 vaccinations. This means that more Irish children than ever are protected.
The Meningitis Research Foundation, a UK based charity registered in 1989, established an office in Dublin in 1996. It aims to work with families who have been affected by meningitis to promote awareness of the disease and to assist in raising funds for research into its prevention and treatment. My Department administers a National Lottery Discretionary Fund from which grants are paid to community and voluntary organisations providing a range of health related services. The Meningitis Research Foundation previously received lottery funding from my Department and can apply for further such funding again. It must be stressed that lottery funding is once-off discretionary funding and is not intended to provide a source of ongoing revenue funding.
690. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if his attentionn has been drawn to the high cost often associated with getting repeat prescription forms completed by general practitioners; if he will outline the guidance for GPs in this regard and his plans to address this situation; and if he will make a statement on the matter. [52809/12]
View answerA repeat prescription facility was introduced to the General Medical Services (GMS) Scheme in March 1991.
Under this facility, prescriptions for certain drugs and medicines may be renewed on a three monthly, rather than a monthly, basis. Patients who are stabilized on their medication do not need to visit their General Practitioner (GP) every month in order to have their prescriptions renewed. The facility to change prescriptions from monthly to quarterly for suitable patients provides efficiencies for GPs and patients, by reducing unnecessary consultations and journeys to the surgery and pharmacy.
In addition, Regulation 7(5) of the Medicinal Products (Prescription and Control of Supply) Regulations 2003 as amended provides that prescriptions for medicinal products are valid for a period of six months from the date specified on the prescription. Prescriptions for Controlled Drugs, which are listed in Schedule 2 and 3 of the Misuse of Drugs Regulations 1988 as amended, are valid for fourteen days from the date on the prescription.
691. Deputy Seán Ó Fearghaíl asked the Minister for Health the way his new proposed risk equalisation measures differ from those struck down in the Supreme Court in 2008; if he considers them to be more likely to successfully withstand any legal challenge and, if so, the reason; and if he will make a statement on the matter. [52814/12]
View answerThe Risk Equalisation Scheme, which was affirmed by the Oireachtas in 2003 and approved by the European Commission that same year, provided a mechanism for sharing the costs of providing necessary care among the insurers. The Scheme and its supporting regulatory regime were challenged in the courts by BUPA Ireland. These challenges were rejected by the European Court of First Instance and by the High Court in Ireland. However, they ultimately succeeded when, in July 2008, the Supreme Court found that the manner in which the Risk Equalisation Scheme was implemented to be ultra vires.
While the Supreme Court found the Scheme to be ultra vires, it is important to note that the Supreme Court decision did not strike down the principles of community rating, open enrolment and lifetime cover, nor indeed the principle of having a scheme of risk equalisation in place. Following the judgement, there was a need for a prompt response to maintain confidence in the market. It was therefore necessary to introduce measures in order to support community rating and ensure, as far as possible, that market segmentation did not become prevalent due to the introduction of plans aimed at younger, healthier lives. In response the Government introduced a temporary scheme of tax relief/community rating levy in January 2009 which provides a very significant degree of support for the cost of health insurance claims by older people.
The Interim Scheme of Age-Related Tax Credits and Community Rating Levy was introduced initially for the three years from 2009 to 2011 in order to provide direct support to community rating. It achieves this by way of a mechanism which provides for a cost subsidy from the young to the old. The Scheme was extended for a further year in 2012 under the Health Insurance (Miscellaneous Provisions) Act 2011 and improved through the use of tax credits on the basis of 5-year age bands. This provides more precise levels of support for community rating than the 10-year bands which had been in place since 2009.
The Interim Scheme provides that health insurers receive higher premiums in respect of insuring older people, but that older people (in six age bands ranging from 60-64 yrs to 85 yrs +) receive tax credits equal to the amount of the additional premium so that all people continue to pay the same amount for a given health insurance product. The scheme is designed to be Exchequer neutral and ensures that every customer has the benefit of a community rated health insurance premium.
To support the principle of community rating, the Programme for Government contains a commitment to put a permanent scheme of risk equalisation in place. This is a key requirement for the existing private health insurance market and is designed to keep health insurance affordable for older persons and to maintain the stability of the market. The Health Insurance (Amendment) Bill 2012, to provide for this permanent RES, was published on 18 October, 2012. The Second Stage for this Bill has now been completed and Committee Stage is scheduled for later today, 27th November. The main object of the Bill is to ensure that, in the interests of societal and intergenerational solidarity, the burden of costs of health services be shared by insured persons by providing for a cost subsidy between the healthy and the less healthy, including between the young and the old. The key measures in the Bill are
- the provision of risk equalisation credits (payable from a new Risk Equalisation Fund (REF) administered by the Health Insurance Authority) in respect of
- the payment of private health insurance premiums by insured persons aged 50 years and over, based on age, gender and type of insurance cover.
- each hospital stay involving an overnight stay in a hospital bed in private hospital accommodation
- the payments from the REF to be funded by a stamp duty payable by open market insurers in respect of each insured life covered. The stamp duty will be collected by the Revenue Commissioners and transferred to the REF. There will be four rates of stamp duty, depending on whether the policy provides for advanced cover or non advanced cover and whether the insured life is a child or an adult.
The new RES will be operated prospectively by the Health Insurance Authority (HIA), with funds collected via a stamp duty by the Revenue Commissioners. In terms of financial arrangements, the main difference between this and the current Interim Scheme is that risk equalisation payments will be disbursed by the HIA rather than by the Revenue Commissioners. The rates will be set each year by an Act of the Oireachtas. The mechanism for assessing whether over-compensation has occurred will be the same as the mechanism which has operated successfully under the current Interim Scheme since its introduction in 2009. The new RES will allow for a greater number of risk factors than the existing Interim Scheme, including a measure of health status. One criticism of the Interim Scheme, which has been in place since 2009 and which will finish on 31 December 2012, was that younger people taking out products that provided benefits below the standard level were potentially cross-subsidising standard level benefits taken out by older people. The new RES 2013 will provide for differentiated levels of stamp duty and health credits between higher level (advanced) cover and lower level (non-advanced) cover with a view to addressing this point.
The Government is fully satisfied of the requirement to provide for a permanent Risk Equalisation Scheme. I am confident that the introduction of a permanent Scheme, from 1 January next, along the lines proposed in the Health Insurance (Amendment) Bill, 2012, will be one that is robust, fully operational and functioning soundly and will further strengthen and maintain stability in the private health insurance market, as we move to develop a new system of universal health insurance.
692. Deputy Gerry Adams asked the Minister for Health the reason a young person (details supplied) in County Louth was refused their E112 application for assistance towards the cost of medical treatment outside the State on 13 November 2012; and if he will make a statement on the matter. [52825/12]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
693. Deputy Gerry Adams asked the Minister for Health the number of E112 applications that have been received by the Health Service Executive in the current year; and the number of these applications that were refused. [52826/12]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
694. Deputy Gerry Adams asked the Minister for Health if patients making E112 applications are being refused due to a lack of funds to pay for treatment abroad. [52827/12]
View answerThe HSE operates a Treatment Abroad Scheme (TAS), for persons entitled to treatment in another EU/EEA member state or Switzerland under EU Regulation 1408/71, as per the procedures set out in EU Regulation 574/72, and in accordance with Department of Health and Children Guidelines. Within these governing EU Regulations and the Department of Health and Children’s Guidelines, the TAS provides for the cost of approved treatments in another EU/EEA member state or Switzerland through the issue of form E112 (IE).
The TAS allows for an Irish based Consultant to refer a patient that is normally resident in Ireland for treatment in another EU member state or Switzerland, where the treatment in question meets the following criteria:
(a) The application to refer a patient abroad has been assessed and a determination given before that patient goes abroad.
(b) Following clinical assessment, the referring Consultant certifies the following:
- They recommend the patient be treated in another EU/EEA country or Switzerland;
- The treatment is medically necessary and will meet the patient’s needs;
- The treatment is a proven form of medical treatment and is not experimental or test treatment;
- The treatment is in a recognised hospital or other institution and is under the control of a registered medical practitioner;
The hospital outside the state will accept EU/EEA form E112 (IE).
Applications to the scheme are made prior to a patient travelling abroad, are processed in line with the above criteria, are medically assessed and a decision issued to the applicant.
In summary, decisions are made based on the criteria of the scheme and the medical assessors’ recommendation and not treatment costs or HSE TAS funding. However, like all government bodies, the HSE TAS is aware of its fiduciary duties with regard to public expenditure and always strives to ensure that same is used in the most appropriate, efficient and effective manner.
695. Deputy Gerry Adams asked the Minister for Health if he will instruct the Health Service Executive treatment abroad scheme office to accept statements from consultants in hospitals here that state clearly that an applicants required treatment is not available here. [52828/12]
View answerThe HSE operates a Treatment Abroad Scheme (TAS), for persons entitled to treatment in another EU/EEA member state or Switzerland under EU Regulation 1408/71, as per the procedures set out in EU Regulation 574/72, and in accordance with Department of Health and Children Guidelines. Within these governing EU Regulations and the Department of Health and Children’s Guidelines, the TAS provides for the cost of approved treatments in another EU/EEA member state or Switzerland through the issue of form E112 (IE).
The TAS allows for an Irish based Consultant to refer a patient that is normally resident in Ireland for treatment in another EU member state or Switzerland, where the treatment in question meets the following criteria:
(a) The application to refer a patient abroad has been assessed and a determination given before that patient goes abroad.
(b) Following clinical assessment, the referring Consultant certifies the following:
- They recommend the patient be treated in another EU/EEA country or Switzerland;
- The treatment is medically necessary and will meet the patient’s needs;
- The treatment is a proven form of medical treatment and is not experimental or test treatment;
- The treatment is in a recognised hospital or other institution and is under the control of a registered medical practitioner;
- The hospital outside the state will accept EU/EEA form E112 (IE).
Applications to the scheme are only accepted on the basis of referral from an Irish based consultant and not self referrals, referral from a G.P. or by way of a consultant/hospital outside the state requesting the return of a patient. Patients must be clinically assessed prior to referral and application to the HSE TAS for treatment abroad.
This system also ensures that the patients have continuity of care here in Ireland and as a result any future referrals needed can be made in line with the requirements of the Scheme.
696. Deputy Gerry Adams asked the Minister for Health if Our Lady of Lourdes Hospital, Drogheda, County Louth, has the necessary resources to carry out a specific type of blood test, anti NMDA, voltage gated, potassium channel antibiotics and GAD antibodies; and if he will make a statement on the matter. [52829/12]
View answerAs this relates to a particular hospital, I have asked the Health Service Executive to respond directly to the Deputy in this matter.
698. Deputy Bernard J. Durkan asked the Minister for Health if consideration has or will be given by way of award of National Lottery grant toward the operational running costs of a centre (details supplied) in County Kildare; if his attention has been drawn to the volume and scale of services provided at the centre; if consideration has been given to facilitating a move to a larger premises in a more central location; and if he will make a statement on the matter. [52833/12]
View answerMy Department has received an application for funding from the 2012 National Lottery allocation from the organisation in question. This is one of a large number currently being assessed by my Department, and the Deputy will be informed of the outcome of the application as soon as a decision has been made.
700. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 217 of 15 November 2012, if all public consultation has now been completed; if he has communicated the intended alterations to regulations under the Misuse of Drugs Act that are EU-relevant to the EU and if so, the date of same. [52928/12]
View answerAs a result of consultations with key stakeholders, draft Misuse of Drugs (Amendment) Regulations are currently being prepared. These will be published on the Department’s website in the next few weeks and comments will be invited to be made in the subsequent two-week period.
Following this, it will be necessary to seek Government approval to notify the proposed regulations to the EU Commission and other Member States under the Technical Standards Directives because of the implications of the proposed regulatory changes on trade in pharmaceutical products.
Subject to successful completion of the EU notification period, which may take up to 3 months, it is anticipated that the new regulations will be introduced in early 2013.
701. Deputy Róisín Shortall asked the Minister for Health the outcome of the Primary Care Reimbursement Service project to monitor the prescribing patterns of benzodiazepines; and if the prescribing patterns of psychiatric services and other institutions can now be included in this project. [52929/12]
View answerI have asked the HSE to supply this information and it will be forwarded to the Deputy as soon as it is available.
702. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will ascertain from the Health Service Executive if he considered the option of extending the existing HSE health centre (details supplied) in Dublin 5 to develop a primary care centre rather than entering the proposed public private partnership for the development of a primary care centre on nearby Tonglegee Road; and if he will make a statement on the matter. [52940/12]
View answerThe delivery of the healthcare infrastructure programme is a service issue. Therefore your question has been referred to the HSE for direct reply.
703. Deputy Arthur Spring asked the Minister for Health if there is an overall policy for car parking charges in public hospitals here [52944/12]
View answer704. Deputy Arthur Spring asked the Minister for Health if he will provide a list in tabular form of hourly and weekly car parking charges, in descending order, in public hospitals here [52945/12]
View answerI propose to take Questions Nos. 703 and 704 together.
In relation to these particular queries raised by the Deputy, as they are service matters, I have asked the Health Service Executive to respond to the Deputy directly in these matters.
705. Deputy Joe O'Reilly asked the Minister for Health if he will consider lifting the recent embargo on a promised podiatry post at Cavan Hospital, sanctioned in April 2012 in view of teh fact that the post was planned as part of the National Footcare Programme and is critical to tackling diabetes foot disease in the community and keeping persons with this complication out of hospital and promised podiatry posts have been filled in Counties Dublin, Galway and Limerick but not in Cavan; and if he will make a statement on the matter. [52951/12]
View answerThe HSE National Clinical Programme for Diabetes - which includes the care of children and adolescents with diabetes - was established within the Clinical Strategy and Programmes Directorate. The purpose of the Programme is to define the way diabetic Clinical Services should be delivered, resourced and measured; and a clinician has been appointed to lead on the development of the programme. In relation to the specific query raised by the Deputy, as this is a local service issue, it has been referred to the HSE for direct reply.
