Written Answers Nos. 272-288
272. Deputy Sean Fleming asked the Minister for Children and Youth Affairs if she will reverse the cuts to a programme (details supplied) in view of the work carried out by them and the minimum cost involved in this organisation; and if she will make a statement on the matter. [57469/12]
View answerThe School Completion Programme (SCP) aims to retain young people in the formal education system to completion of senior cycle and to improve children’s participation and attendance in school.
In 2013, funding of €26.456m has been made available by my Department to support the programme, which involves 124 projects and initiatives throughout the country.
The Comprehensive Review of Expenditure (CRE) identified the requirement for savings of 6.5% per annum over the period 2012-2014. Projects and initiatives were required to reduce their budget by 6.5% for the 12/13 school year to achieve the necessary savings in 2012.
Projects were requested to revise their plans for 2012/13 in order to achieve efficiencies and reduce costs whilst prioritising evidence based services to support children’s educational outcomes. The National Educational Welfare Board (NEWB), under the remit of my Department, has provided assistance to projects through this process in accordance with its management responsibilities for the programme.
In the present challenging financial circumstances it is not feasible to alter the notified allocations to individual projects.
My Department intends to complete a review of the SCP over the course 2013. The Department will consult with individual projects and initiatives within the SCP as part of this process. This review provides the opportunity to identify best practice, to clarify roles and responsibilities and to build upon the learning and experience to date.
It is anticipated that the review will assist to identify operational efficiencies and other reforms necessary to consolidate the programme on a sustainable footing as a key component of an integrated school support service under the NEWB.
My Department and the NEWB continue to work closely with management committees, schools and local SCP coordinators to ensure available resources are targeted to deliver tailored support to meet the needs of students.
273. Deputy Róisín Shortall asked the Minister for Children and Youth Affairs if she will provide clarity on the situation regarding the level of funding from the Health Service Executive that is provided in respect of a group (details supplied); if this funding is being withdrawn is it a national or local decision; if her attention has been drawn to only local support to non-regulated childminders is provided through the Health Service Executive funded Childminders' Advisory Worker Post; if she will clarify the bodies that will support this sector if HSE funding is discontinued. [57505/12]
View answerI understand that there has been a reduction in funding by the Health Service Executive (HSE) to the City and County Childcare Committees in some areas. The HSE has, however, confirmed that it will endeavour to support the CCCs wherever possible. I have asked my Department to engage further with the Committees and the HSE and to provide a report to me on this matter.
My Department provides annual funding to each CCC to enable it to support and advise all childcare providers at local level. In 2012, the total amount allocated to the CCCs was €11.3m. My Department also provides annual funding, totalling €2.85m in 2012, to the seven National Voluntary Childcare Organisations, including Childminding Ireland, who provide support at a local level to their members.
In relation to the specific funding provided by the HSE to the service referred to, I have asked the HSE to examine this matter and to respond directly to the Deputy with the most up-to-date information.
274. Deputy Róisín Shortall asked the Minister for Children and Youth Affairs further to Parliamentary Question No. 961 of 6 November 2012, if she will detail the funding allocation for 2013 in respect of this front line youth service; the steps she is taking to safeguard the valuable work of this service; and if she will make a statement on the matter. [57681/12]
View answerThe Youth Affairs Unit of my Department supports the delivery of a range of youth work programmes and services for all young people, including those from disadvantaged communities, by the voluntary youth sector. Targeted supports for disadvantaged, marginalised and at risk young people are provided through the Special Projects for Youth Scheme, the Young Peoples Facilities and Services Fund Rounds 1 and 2 and Local Drugs Task Force Projects.
My Department is working on the funding allocation for youth services in 2013. Having regard to the savings requirements identified in the Comprehensive Review of Expenditure my Department is seeking to ensure that, in the determination process for the allocations, the front line youth services, particularly those for the most vulnerable young people are protected as far as is possible from the impact of any necessary reductions in funding.
In this context, full consideration is being given to the project in question as part of the range of youth work services in its locality. No decisions have been made by my Department neither in relation to the 2013 funding for youth services throughout the country, nor in relation to the funding allocations to be provided for individual projects, including the project referred to by the Deputy. Youth organisations and projects will be advised of their 2013 allocations as soon as possible.
275. Deputy Róisín Shortall asked the Minister for Children and Youth Affairs if her attention has been drawn to the concerns of psychologists regarding her proposals to move all child psychology services to the child and family support agency; if her attention has been drawn to the fact that most referrals to child psychology services come through primary care staff; if an impact analysis has been carried out to assess the consequences for children who require multi-disciplinary support such as is currently provided through the multi-disciplinary primary care team model [57698/12]
View answerThe Government has given approval to the drafting of a Bill to establish the Child and Family Support Agency. Work on the preparation of the legislation is proceeding as a priority and the intention is that the Agency will be established in early 2013. In order to inform the content of the legislation the Government has decided that upon establishment the Child and Family Support Agency will have responsibility for a range of services. This includes the full range of child welfare and protection services currently operated by the HSE including family support and alternative care services. Due to its particular relevance, it has also been decided to include domestic, sexual and gender-based violence services within the Agency's responsibilities. The Government has further decided that the new Agency will assume responsibility for the functions of both the Family Support Agency and the National Educational Welfare Board. These two organisations currently operate under the aegis of the Department of Children and Youth Affairs. The draft legislation will also provide for the provision of community-based psychology services to children and families by the Agency. It is envisaged that this will involve the transfer of certain psychology staff currently employed by the HSE who are operating within a community setting.
The Government's consideration of these matters was informed, inter alia, by the content and recommendations of the Report of the Task Force on the Child and Family Support Agency which I published in July of this year. The Task Force considered that the Agency needs to be as broadly based as possible and should include those services that might, in the first instance, help prevent problems arising for a family, that would identify problems and provide supports at an early stage and that would assist children and families in managing serious problems requiring specialised interventions beyond their own resources. Therefore, in addition to child welfare and protection services the Task Force considered that the core services of the new Agency must include a broad based range of universal and targeted services with an emphasis on prevention, early intervention, family support and therapeutic care interventions.
Arising from the Government's consideration and decision with regard to the functions of the new Agency it has been agreed by the Department of Children and Youth Affairs and the Department of Health that an impact analysis will be jointly developed of the proposed future arrangements for the provision of the community psychology service as it relates to children and family services covered by the Child and Family Support Agency and to services provided by the HSE. This work will be undertaken as a priority.
I recently met with representatives from the Heads of the Psychology Services Ireland and with a delegation from the IMPACT trade union to discuss issues relating to the future governance and organisational arrangements for the provision of community based psychology services. Our shared objective is to ensure that the optimal national governance and service delivery framework is in place to ensure the best possible outcomes for children and families and other clients who need to avail of this key service. The views of the profession and its representatives will receive appropriate consideration as part of the impact analysis.
276. Deputy Pearse Doherty asked the Minister for Health if he will provide an analysis of the €308 million of pay related savings in his Department's budget in 2013; and if he will set out the way such savings estimates were validated by his Department. [57390/12]
View answerA total of €308m in pay-related savings has been targeted for the health services in 2013. These savings will be achieved under three separate headings: firstly, by intensifying the implementation of the Public Service Agreement within the health services, secondly, through the negotiation of an agreement on further workplace change and savings with public sector unions, as has been proposed by Government, and thirdly, through further reductions in staffing in 2013.
Required measures under the PSA and included in the recently-revised sectorial plan for Health include new rosters in hospitals, changes in skill mix in nursing homes, the implementation of the recent agreement reached with Hospital Consultants, a significant reduction in overtime and agency spending and a reduction in management grades.
The Government has initiated discussions with the Trade Unions on a new agenda for improvements in the productivity of public servants and reductions in the cost of delivery of public services. Detailed engagement is expected to commence early in 2013, under the leadership of the Department of Public Expenditure and Reform.
Implementation of the PSA is overseen by the national-level Implementation Body. Each sector is required to provide periodic reports to the Implementation Body and this arrangement will continue in respect of measures to be implemented in 2013.
277. Deputy Pearse Doherty asked the Minister for Health if he will provide the underlying workings in support of the €60 million savings on Department vote in his Department's 2013 budget; and if he will set out the way such savings estimates were validated by his Department. [57391/12]
View answerThe adjustments to the Department of Health Vote, Vote 38, are set out in the Budget book published recently and available on the website of the Department of Public Expenditure and Reform.
The Department of Health Vote is being reduced by €90m. This arises from a range of measures. Even allowing for additional expenditure related to the EU Presidency, there will be a reduction in the Department’s Administrative Budget. There will be savings on the National Treatment Purchase Fund and €25m of its budget will be transferred to the HSE for use in an Intervention Fund. There will also be a range of further reductions, including a reduction in funding to health agencies.
278. Deputy Pearse Doherty asked the Minister for Health if he will provide the underlying workings in support of the €160 million reduction in cost of drugs and other prescribed items in his Department budget for 2013; and if he will set out the way such savings estimates were validated by his Department. [57392/12]
View answerDue to the very difficult and challenging economic environment, the Government has committed to achieving additional savings of €160 in expenditure on drugs and medicines in 2013 as set out in the following table:
|
Primary Care Scheme |
Savings and Target |
|
IPHA/APMI Agreement on Drug Price Reductions |
€120 million |
|
Quality Prescribing Initiative |
€20 million |
|
Reduce price of oral nutritional supplements |
€5 million |
|
Delisting products from GMS scheme |
€15 million |
279. Deputy Micheál Martin asked the Minister for Health his views on whether the optimal situation for children in special schools is the provision of multi-disciplinary teams involving teachers, allied health professionals such as physios, occupational therapists and speech and language therapists, in the school setting ensuring correct synergies across all disciplines, consistency over time in attending the needs of the child and ensuring a truly holistic approach to the child's development; and if he will make a statement on the matter. [57500/12]
View answer297. Deputy Micheál Martin asked the Minister for Health if he will suspend the implementation of the Health Service Executive's programme for progressing disability services for children and young people in view of the fact that it is causing undue anxiety to parents of children with special needs particularly in Cork; and if he will make a statement on the matter. [57497/12]
View answer298. Deputy Micheál Martin asked the Minister for Health if he will ensure that the Health Service Executive's Programme for progressing disability services for children and young persons will not lead to a reduction of allied health professional staff in special schools and that the existing complement will be retained and enhanced; and if he will make a statement on the matter. [57499/12]
View answerI propose to take Questions Nos. 279, 297 and 298 together.
The HSE has recognised the need to increase the level of consistency and standardisation in the way both early intervention services and services for school-aged children with disabilities are delivered. It is currently engaged in a reconfiguration of existing therapy resources to geographic based teams for children (0-18 years) as part of the National Programme on Progressing Disability Services for Children and Young People (0-18 years).
The Programme is organised at national, regional and local level and includes representatives from the health and education sectors, service providers (both statutory and non-statutory) and parents. These stakeholders are working together to see how current services can be reorganised in line with agreed policy. The HSE has stated that it is very cognisant of stakeholder's views particularly of parents within this context. It has also worked to ensure that information about the Programme is made widely available.
The Executive is working very closely with the education sector, which is fully involved in the development of the Programme, to ensure that, from the children’s and parents’ perspective, the services provided by each sector in so far as possible are integrated. Detailed Local Area action plans are being implemented with the following objectives: one clear pathway to services for all children with disabilities according to need; resources used to the greatest benefit for all children and families, and health and education working together to support children to achieve their potential.
The purpose of the reconfiguration of existing therapy resources is to ensure that the resources available are used to best effect, in order to provide health supports and ongoing therapy to all children (0-18 years) in line with their prioritised needs. In particular, it will mean that all children, regardless of where they receive their education services will have equitable access to services based on their needs.
While the HSE supports the principle of providing access to mainstream education where appropriate, the Programme recognises the important continuing role of special schools. In this context, the HSE envisages that children attending special needs primary schools will have access to health supports and therapy services based on their needs. The Department of Education and Skills is a partner in this programme and an Education and Health working group comprised of representatives from both sectors is developing a framework for closer working relationships.
Decisions in relation to the local reorganisation of services will be made by Local Implementation Groups, which include representatives of all the service providers in the local area, parents and the education sector. They have a complex task which includes agreeing the principles which should underpin all disability services, mapping of existing services and gaps, consideration of the changes needed in structures and a detailed plan of how to advance. This plan will include issues of timing and the phasing of proposed changes.
My Department has asked the HSE to provide the Deputy with detailed information on the implementation of the Programme in Cork which he has referred to in his question.
280. Deputy Peadar Tóibín asked the Minister for Health his views regarding charges by certain doctors for medical examinations and subsequent reports (details supplied); and if he will make a statement on the matter. [57539/12]
View answerUnder the General Medical Services (GMS) contract, a general practitioner (GP) is expected to provide his/her patients who hold medical cards or GP visit cards with all proper and necessary treatment of a kind generally undertaken by a GP.
The contract between the HSE and GPs under the GMS Scheme stipulates that fees are not paid to GPs by the HSE in respect of certain medical certificates which may be required, for example, "under the Social Welfare Acts or for the purposes of insurance or assurance policies or for the issue of driving licences".
Consultation fees charged by general practitioners to private patients and to GMS patients outside the terms of the GMS contract are a matter of private contract between the clinicians and the patients. While I have no role in relation to such fees, I would expect clinicians to have regard to the overall economic situation in setting their fees. I should add that General Practitioners who hold GMS contracts with the HSE must not seek or accept money from medical card or GP visit card holders in respect of routine treatment.
281. Deputy Billy Kelleher asked the Minister for Health the reason the assesment of needs in respect of a person (details supplied) in County Cork as laid down in the Disability Act of 2005 has not been met eight months after the application; and if he will make a statement on the matter. [57381/12]
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.
282. Deputy Billy Kelleher asked the Minister for Health if he will provide in tabular form a breakdown of the waiting lists for assessment of needs under the Disability Act 2005 by county.; and if he will make a statement on the matter. [57382/12]
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.
283. Deputy Robert Troy asked the Minister for Health if the Health Service Executive plan to appoint an ophthalmologist for the Longford-Westmeath area. [57399/12]
View answerThe HSE has therefore been asked to examine this matter and to reply to the Deputy as soon as possible.
284. Deputy Ciarán Lynch asked the Minister for Health the basis on which a registration fee of €295 was deemed appropriate for social workers; if he has given consideration to charging a registration fee on a par with that paid by other professional groups such as nurses and teachers; and if he will make a statement on the matter. [57401/12]
View answerUnder the provisions of the Health and Social Care Professionals Act 2005, there is a two-year transitional period from the date on which the register of the members of that profession is established, during which existing practitioners may apply for registration.
The Health and Social care Professionals Council (the Council) is an independent statutory body and is responsible for setting the level of fees.
The Council has set the following fee structure: a registration fee of €100 for new graduates, who have obtained recognised professional qualifications within two years of applying for registration; an annual retention fee of €295 for registrants, including those who paid the lower rate on graduation, is payable on the annual renewal date.
All health regulators are self funding by way of annual fee income with operational costs being determined by the complexity and breadth of statutory functions specified in its legislation. The greater the registrant base the lower the annual fee charged. Given the enormous registrant base in teaching and nursing, for example, the annual fee charged amounts to less than €100 per annum. Health regulators are single profession regulators whereas the Council is charged with regulating twelve disparate professions, which can add significantly to operating costs. The twelve designated professions to be registered by the Council range in number from under 50 Clinical Biochemists to 5,550 Social Care Workers, which amounts to about 20,000 registrants in total across all professions. This is an extremely low registrant base when compared to a registrant base of well in excess of 60,000 for nurses.
The Council has extensive statutory functions under the 2005 Act, and considers the annual fee of €295 the minimum required to enable it to operate. The fee charged by the Council, which takes account of the requirement to become self funding by end 2015, is on a par with that charged by other health regulators and less than some in certain cases. The State is currently funding the Council in its establishment phase (€1.937 million in 2012) to offset the current shortfall in income from registration fees and will continue to do so on a reducing basis for the next 3 years.
In response to concerns about the level of fee, the Council has reviewed the regulatory structure to establish what scope exists for controlling registration fees and operational costs and has adopted the following measures: where an existing practitioner with the necessary experience and recognised professional qualifications, or equivalent, pays the registration fee of €295 and is granted registration during the transitional period, also known as grandparenting, the application fee will cover them for the remainder of the grandparenting period and one full year of retention of registration after expiration of grandparenting. This concession will only apply to existing practitioners availing of the transitional provisions set out in the Act; the Council has entered into discussions with the HSE in regard to the feasibility of arrangements for the deduction of the registration fee from monthly salary thereby spreading the cost throughout the year; finally, the Council has proposed significant restructuring of the way in which the designated professions will be registered and regulated to provide a more cost effective operating system and keep costs to a minimum. This will require the enactment of primary legislation in due course.
285. Deputy Joe Carey asked the Minister for Health the supports his Department provides in relation to fertility treatment; his plans for the future regarding same; and if he will make a statement on the matter. [57404/12]
View answerAssisted Human Reproduction treatment (AHR) is not provided or funded by the public health system; such treatment is available from clinics that operate privately. Patients who access these services privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme.
In addition, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Scheme administered by the Health Service Executive. Medicines covered by the High Tech Scheme must be prescribed by a consultant/specialist and authorised by the 'High Tech Liaison Officers'. The cost of the medicines are reflected in the PCRS Statistical Analysis of Claims and Payments under the High Tech Drugs. The patient uses their valid established eligibility of GMS or DPS as appropriate to access the medicines.
I am conscious of the financial burden that fertility services can place on the couples concerned; however, this matter has to be considered in the context of the difficult economic situation that prevails and the other compelling funding demands across a full range of health issues.
286. Deputy Pádraig Mac Lochlainn asked the Minister for Health if he will put in place the necessary resources to carry out surgery in respect of a person (details supplied). [57406/12]
View answerAs previously advised to the Deputy, in relation to the specific issue raised by him, as this is a service issue it has been referred to the HSE for direct reply.
287. Deputy Terence Flanagan asked the Minister for Health if he will ensure that there are no cuts to the budget for a hospice (details supplied) in Dublin 5; and if he will make a statement on the matter. [57420/12]
View answerThe level of funding available for the health budget, and the extent of savings required in the health sector, is being considered as part of finalising the HSE Service Plan 2013. The allocation of funding across care groups, including Palliative Care, will therefore be agreed in this context.
As was the case in previous years, the Health Service Executive has engaged with voluntary providers, including individual Hospices, to discuss service levels in 2013 in line with resources available. Nonetheless, despite the severe financial challenges facing the Exchequer, every effort will be made to protect front-line services, including Hospice care.
288. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if it is the case that the Health Service Executive intends to recruit 35 leadership/motivational coaches for HSE managers (details supplied); if he will outline the purpose, role and terms of contract of same; if he will detail the cost of same; and if he will make a statement on the matter. [57427/12]
View answerThe HSE will be undergoing radical reform in the coming years. Strong leadership and management in the health service will be of crucial importance in order to deliver on reforms and changes of this scale. As a result, the HSE is implementing a Succession Management Programme in order to strengthen management capacity.
It is anticipated that most executive coaching requirements will be delivered by qualified HSE staff. However, some additional coaching capacity is required and the HSE has tendered for such services on a regional basis. As this tendering process a matter for the HSE in the first instance, I have referred the Deputy's question to the HSE for a more detailed response.
