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Wednesday, 16 Jan 2013

Written Answers Nos. 934-955

Services for People with Disabilities

Questions (934)

Seán Ó Fearghaíl

Question:

934. Deputy Seán Ó Fearghaíl asked the Minister for Health the rationale and criteria used in determining a 3.7% budget cutback figure as the disability sector’s contribution to the health sector budget rationalisation plans; and if he will make a statement on the matter. [1235/13]

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Written answers

The amount allocated for Disability Services this year is €1,535m, which is a reduction of 1.2% on the allocation for 2012. €6m of the reduction relates to savings and efficiencies in the disability sector and is based on the implementation of the recommendations in the Report of the Value for Money and Policy Review of Disability Services Programme (2012). This report points the way towards the achievement of optimal effectiveness and efficiency within the existing substantial resources expended on health and personal services for people with a disability. During 2013 the HSE will commence an early examination of the VFM findings in regard to rosters, skills mix, the unit cost base and average costs across the HSE-funded agencies in the sector. A commissioning and procurement framework will also be developed during the course of the year. The balance of the reduction relates to the disability sector share of staff numbers reductions, such as the Employment Control Framework (ECF) and the incentivised career break scheme.

The Government is committed to protecting frontline services for people with disabilities to the greatest possible extent and I am working to ensure that protection is afforded to the disability sector, and the Social Care area as a whole.

In 2013 the HSE is seeking to maximise the provision of services within available resources and to maintaining a consistent level to that provided in 2012, by providing the following specialist disability services:

- residential services to over 9,000 people with a disability;

- day services to over 22,000 people with intellectual and physical disabilities;

- respite residential support for over 7,500 people with intellectual and physical disabilities;

- 1.68m hours of Personal Assistant / Home Support Hours

The HSE's National Service Plan includes €150m in unallocated pay savings which are not, as yet, reflected in the programme or regional budgets. These pay savings targets will be allocated later in 2013, when the terms of the expected agreement with public sector unions on an extension of the Public Service Agreement becomes known.

Services for People with Disabilities

Questions (935)

Seán Ó Fearghaíl

Question:

935. Deputy Seán Ó Fearghaíl asked the Minister for Health the way the social and economic implications of the policy of budget cutbacks for those school leavers with disabilities, who are no longer guaranteed rehabilitative training or day service funding, are to be addressed; and if he will make a statement on the matter. [1236/13]

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Written answers

I recognise the importance of life-skills training and day care services to people with disabilities who are leaving the education system in 2013. Day services for adults with disabilities provide a network of support for 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 HSE, through its Occupational Guidance Service, works with schools, service providers, service users and families to identify the needs of young people with disabilities who are due to complete their second level education. The aim is to address the needs of individuals in the following ways:

- Health-funded rehabilitative (life skills) training (RT);

- Health-funded day services;

- FÁS-funded vocational training;

- Approval to extend education placement for a specified time.

The demand for services for school-leavers continues to grow. In 2012, almost 700 school-leavers required RT places or day services and the position in 2013 is expected to be similar. While the HSE makes every effort to provide day services or RT places to school-leavers with special needs, this has always been dependant on the availability and location of appropriate places coupled with the needs of the individual school-leaver. The HSE is currently reviewing the outcomes for 2012 school-leavers in terms of placements achieved and scoping out the likely requirements for 2013. I wish to acknowledge the work of the HSE and the voluntary service providers in meeting the considerable challenges placed on them last year by finding places for the vast majority of school-leavers without additional funding. I am pleased to confirm however that, although the 2013 allocation for disability services has been reduced by 1.2%, the HSE National Service Plan includes an additional €4m to provide training places and day services for school-leavers in 2013. Both the voluntary sector and the HSE are committed to the best use of this funding in a creative and flexible manner so as to secure as many places as possible within the available resources although this will continue to be a challenge in the current environment.

Services for People with Disabilities

Questions (936)

Seán Ó Fearghaíl

Question:

936. Deputy Seán Ó Fearghaíl asked the Minister for Health the way the recommendations of the Congregate Settings and the New Directions Reports are to be implemented in a sector that is already decimated by unprecedented budgetary restriction and the implications for those persons at the heart of the reports; and if he will make a statement on the matter. [1237/13]

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Written answers

In recent years disability service provision has been moving towards a community based and inclusive model rather one which is institutional and segregated. The key lessons from the Report of the Working Group on Congregated Settings (2011) and New Directions, the Report of the National Working Group for the Review of HSE-funded Adult Day Services (2012), together with the Value for Money and Policy Review of Disability Services in Ireland (2012), will provide a catalyst for achieving a more effective, person centered disability service, in line with international best practice. The implementation of these reports will be progressed though the HSE’s National Disability Governance Group and through the National Consultative Forum in 2013. It should be borne in mind that the radical change recommended in the reports is not the sole responsibility of the Health Sector but rather, a collaborative responsibility shared between the person, their families and carers, a multiplicity of agencies, Government and society as a whole.

The Report of the Working Group on Congregated Settings (July 2011), sets out a framework to guide the transfer of identified individuals from congregated settings to live in the community. A HSE-led National implementation Group is developing a national plan and change programme to progress the recommendations of the Congregated Settings Report and transfer the 3,600 people with disabilities who live in these settings into the community over the next 7 years. In July 2012 the Department of Health and the Department of the Environment, Community and Local Affairs jointly published the National Implementation Framework to support the Government's National Housing Strategy for People with Disability 2011 to 2016 . As part of this process €1m has been transferred from the Health Vote to the Housing Vote to provide for the social housing costs of up to 150 people leaving institutions in 2013.

A National Implementation Working Group has also been established by the HSE to oversee the implementation of the recommendations in New Directions. The report proposes that day services in the future take the form of a menu of 12 individualised, outcome-focused supports which will provide adults with disabilities with the support necessary to live a life of their choosing in accordance with their own wishes, aspirations and needs. The guiding principle for the future is that supports will be tailored to individual need and will be flexible, responsive and person-centred. During 2013 the HSE will manage and direct the migration towards a person-centred model of services and supports, through demonstration projects initiated by service providers as proof of concept, which will run in parallel with current services. Their suitability for wider application will then be evaluated.

Water Fluoridation

Questions (937)

Brendan Griffin

Question:

937. Deputy Brendan Griffin asked the Minister for Health if he has considered the arguments to discontinue the practice of water fluoridation here (details supplied); the reason the State continues the fluoridation policy; if he will initiate a fresh review of the policy; and if he will make a statement on the matter. [1545/13]

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Written answers

Water fluoridation and the use of appropriate fluorides is a major plank of public health policy in Ireland in the prevention and management of tooth decay. In 2002 the Forum on Fluoridation, which was established to review this policy, concluded that the fluoridation of public piped water supplies should continue as a public health measure. The Irish Expert Body on Fluorides and Health, established in 2004, monitors new and emerging issues on fluoride and its effects on health and related matters. It advises that the balance of scientific evidence worldwide confirms that water fluoridation, at the optimal level, does not cause any ill effects and is the safest and most cost effective method of protecting the oral health of the population.

The information provided by the Deputy has been forwarded to the Expert Body for consideration by its New and Emerging Issues Sub-Committee.

Animal Experimentation

Questions (938, 1072)

Clare Daly

Question:

938. Deputy Clare Daly asked the Minister for Health the permitted humane methods of killing for different species of animals bred for or used in laboratory experiments at different stages of their development and or different body weights, under SI 566/2002, operable until 1 January 2013 [2072/13]

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Maureen O'Sullivan

Question:

1072. Deputy Maureen O'Sullivan asked the Minister for Health the permitted humane methods of killing for different species of animals bred for or used in laboratory experiments at different stages of their development and or different body weights, under SI 566/2002, operative until 1 January 2013. [1510/13]

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Written answers

I propose to take Questions Nos. 938 and 1072 together.

I would like to advise the Deputy that EU Directive 2010/63/EU on the protection of animals used for scientific purposes has been transposed into Irish law by European Union (Protection of Animals Used for Scientific Purposes) Regulations 2012. These Regulations, which came into operation on 1 January 2013, considerably strengthen the protection of animals still needed for research and safety testing. They also play a significant role in terms of minimising the number of animals used and require that alternatives to animal testing be utilised where possible.

The Deputy's question relates to the European Communities (Amendment of Cruelty to Animals Act 1876) Regulations 2002 which were revoked by the aforementioned 2012 Regulations. While the 2002 Regulation did not specify specific methods of killing, it did require that killing of animals be done by a humane method (defined as "the killing of the animal with the minimum of physical and mental suffering, depending on the species"). In this context, account was to be taken of Commission Recommendation (2007/526/EU) on guidelines for the accommodation and care of animals used for experimental and other scientific purposes. This Recommendation set out requirements in relation to humane killing. General requirements were outlined in relation to all species and where appropriate, more specific requirements were outlined in relation to certain species.

The new legislation, now in force, sets out a comprehensive range of measures that must be complied with in relation to methods of killing. It requires that where an animal (used or intended to be used in a procedure, or bred specifically so that their organs or tissues may be used for scientific purposes) is killed, the person responsible for the killing shall ensure that the method of killing with the minimum pain, suffering and distress is used, and the animal is killed by a competent person in the establishment of the breeder, supplier or user, as appropriate. Additionally it requires that in the case of the killing of an animal covered by Annex IV to the Directive, the breeder, supplier or user, or other person responsible, shall ensure that the appropriate method of killing as set out in that Annex is used.

Regulatory Impact Assessment Numbers

Questions (939)

Niall Collins

Question:

939. Deputy Niall Collins asked the Minister for Health the number of regulatory impact assessments that have been carried out by his Department in the past twelve months; and the list of regulatory impact assessments carried out within his Department in the past twelve months [57762/12]

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Written answers

During the 12 month period, 1 January 2012 to 31 December 2012, a Regulatory Impact Assessment (RIA) was completed by my Department in relation to the Health (Pricing and Supply of Medical Goods) Bill 2012. This Bill will introduce a system of generic substitution and reference pricing for prescribed drugs and medicines and is currently before the Houses of the Oireachtas.

Medical Card Applications

Questions (940)

Sandra McLellan

Question:

940. Deputy Sandra McLellan asked the Minister for Health if he will review a medical card application in respect of a person (details supplied) in County Cork [57772/12]

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Written answers

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Medical Card Delays

Questions (941)

Michael Healy-Rae

Question:

941. Deputy Michael Healy-Rae asked the Minister for Health the reason for the delay in dealing with the medical card application in respect of a person (details supplied); and if he will make a statement on the matter. [57778/12]

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Written answers

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Medical Card Applications

Questions (942)

Barry Cowen

Question:

942. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) in County Offaly may expect a decision on an application for medical card [57783/12]

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Written answers

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Hospital Waiting Lists

Questions (943)

Billy Timmins

Question:

943. Deputy Billy Timmins asked the Minister for Health the position regarding an appointment for a hip replacement consultation in respect of a person (details supplied) in County Carlow; and if he will make a statement on the matter. [57785/12]

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Written answers

The management of inpatient and daycase 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.

Health Services Provision

Questions (944)

Terence Flanagan

Question:

944. Deputy Terence Flanagan asked the Minister for Health the position regarding funding in respect of a person (details supplied); and if he will make a statement on the matter. [57786/12]

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Written answers

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Underage Drinking

Questions (945)

Terence Flanagan

Question:

945. Deputy Terence Flanagan asked the Minister for Health the steps he is taking to address the problem of underage drinking; and if he will make a statement on the matter. [57795/12]

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Written answers

The National Substance Misuse Strategy Steering Group reported in February, 2012. The report contains a range of recommendations to, among other things, reduce the consumption of alcohol in general. These recommendations are grouped under five pillars of Supply Reduction (availability), Prevention, Treatment, Rehabilitation and Research. The Report contains a range of recommendations that impact directly and indirectly on the problem of excessive youth alcohol consumption.

Real and tangible proposals are currently being finalised on foot of the recommendations in the National Substance Misuse Strategy report. These proposals cover all of the areas mentioned in the report, including: the areas of advertising of alcohol and sponsorship of various public events by the drinks industry. I intend to submit these proposals to the Government for consideration and approval as soon as possible.

Speech and Language Therapy

Questions (946)

Ciaran Lynch

Question:

946. Deputy Ciarán Lynch asked the Minister for Health if a decision has been taken to withdraw occupational and speech and language therapy provision from a special needs school (details supplied) in County Cork; the alternative arrangements that have been made; if individual family circumstances were considered before changes were made; and if he will make a statement on the matter. [57806/12]

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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.

Drugs Payment Scheme Threshold

Questions (947)

Michael McGrath

Question:

947. Deputy Michael McGrath asked the Minister for Health his plans to make allowances under the drugs payment scheme for persons who have undergone an organ transplant and who will be on medication for life requiring them to pay the full €144 each month; and if he will make a statement on the matter. [57807/12]

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Written answers

Under the Drug Payment Scheme, no individual or family pays more than €144 per calendar month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals incurring ongoing expenditure on medicines.

There are no plans to make changes to the scheme. In addition, people who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. In the assessment process, the Health Service Executive can take into account medical costs incurred by an individual or a family. Those who are not eligible for a medical card may still be able to avail of a GP visit card, which covers the cost of general practice consultation.

Nursing Homes Support Scheme Oversight

Questions (948)

Billy Kelleher

Question:

948. Deputy Billy Kelleher asked the Minister for Health the projected savings as a result of the increase in fair deal charges as announced in Budget 2013; and if he will make a statement on the matter. [57815/12]

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Written answers

The asset contribution under the Nursing Homes Support Scheme will be increasing from 5% to 7.5% per annum, as announced in Budget 2013. This will be capped at three years, or 22.5%, in the case of the principal private residence. The change will apply to both new and existing nursing home residents. However, for existing residents, it should be noted that, in the case of the principal private residence, the higher percentage will only apply for the time remaining of the three year cap. In the case of all other assets, it will apply for as long as the person remains in receipt of financial support under the Scheme.

It is important to note that the legislation underpinning the Scheme must be amended before these measures can be implemented. Therefore, an effective date will be announced in 2013. The projected savings for a half year are €3m.

Medicinal Products Expenditure

Questions (949)

Tom Fleming

Question:

949. Deputy Tom Fleming asked the Minister for Health if he will investigate the outcome of the Trinity College Dublin researchers' findings in which savings of more than 50% can be made on the five most common medicines by prescribing similar but cheaper versions of the drugs and where their findings also state that the ten most prescribed medicines were on average 2.7 times more expensive here than in the UK; and if he will make a statement on the matter. [57821/12]

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Written answers

The prices of drugs vary between countries for a number of reasons, including different prices set by manufacturers, different wholesale and pharmacy mark-ups, different dispensing fees and different rates of VAT. In recent years, a number of changes to the pricing and reimbursement system have been successfully introduced in Ireland. These have resulted in reductions in the prices of thousands of medicines.

Following intensive negotiations involving the Irish Pharmaceutical Healthcare Association (IPHA), the HSE and the Department of Health, a major new deal on the cost of drugs in the State was concluded in October last. It will deliver a number of important benefits, including

- significant reductions for patients in the cost of drugs,

- a lowering of the drugs bill to the State,

- timely access for patients to new cutting-edge drugs for certain conditions, and

- reducing the cost base of the health system into the future.

The gross savings arising from this deal will be in excess of €400m over 3 years. €210 million from the gross savings will make available new drugs to patients over 3 years. Thus, the deal will result in a net reduction in the HSE expenditure on drugs of about €190m.

The Department of Health and the HSE have also successfully finalised discussions with the Association of Pharmaceutical Manufacturers in Ireland (APMI), which represent the generic industry, on a new agreement to deliver further savings in the cost of generic drugs. It is estimated that the combined gross savings from the IPHA and APMI deals will be in excess of €120 million in 2013.

The IPHA agreement provides that prices are referenced to the currency adjusted average price to wholesaler in the nominated EU member states in which the medicine is then available. The prices of a range of medicines were reduced on 1 January 2013 in accordance with the agreement.

The Health (Pricing and Supply of Medical Goods) Bill 2012, which is currently before the House, provides for the introduction of a system of generic substitution and reference pricing. The Bill provides that when the HSE is setting a reference price for, or reviewing a reference price set for, a relevant group of interchangeable medicinal products it shall take into account the following criteria:

- the ability of suppliers to meet patient demand for the relevant item;

- the value for money afforded by the relevant item;

- the equivalent prices of the relevant item in all other Member States where the product is marketed;

- the prices of therapeutically similar items; and

- the resources available to the HSE.

It is important to balance achieving best value for money for the taxpayer with assuring continuity of supply for critical medical products, particularly in a small market like Ireland. Consequently, the Bill aims to achieve value for money while avoiding disruption in the availability of medicines on the Irish market.

Hospital Charges

Questions (950, 951)

Michael Healy-Rae

Question:

950. Deputy Michael Healy-Rae asked the Minister for Health if it is true that sick and dying cancer patients are being pursued by debt collectors acting on behalf of our public hospitals for €75 per day for chemotherapy treatment; the policy in these hospitals regarding engaging debt collectors; and if he will make a statement on the matter. [57838/12]

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Michael Healy-Rae

Question:

951. Deputy Michael Healy-Rae asked the Minister for Health with regard to the €75 per day charge for persons suffering from cancer who have to receive different types of daily treatments, if it is time for him to issue a new directive excluding some categories of patients from this charge; and if he will make a statement on the matter. [57839/12]

View answer

Written answers

I propose to take Questions Nos. 950 and 951 together.

The public in-patient charge (€75 per day subject to a maximum of €750 in any period of 12 consecutive months) is provided for by the Health (In-Patient Charges) Regulations 1987 (as amended), made under Section 53 of the Health Act 1970 (as amended). These regulations underpin charges for any person admitted to hospital as a day case.

Under the regulations, medical card holders are exempted from this charge.

In 2011 the Health Service Executive instructed all collection agencies involved in the collection of hospital charges that charges in excess of the prescribed amounts may not be levied on patients.

Environmental Regulations

Questions (952)

Clare Daly

Question:

952. Deputy Clare Daly asked the Minister for Health if he will investigate the cost involved to his Department and the health system in general following the European Environmental Agency findings against the ESB and a multi national alumina industry [57848/12]

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Written answers

My Department has been advised by the Department of Environment, Community and Local Government, the Department with primary responsibility for matters relating to air quality, that all power plants in Ireland are subject to the licensing, monitoring and enforcement requirements of the Integrated Pollution Prevention and Control (IPPC) regime. Plants operating with an IPPC licence are monitored by the Environmental Protection Agency (EPA) to ensure that the terms of their licences are respected, including emission levels. My Department has also been informed that there has been no breach of IPPC licensing conditions by the ESB or other power plants and that monitoring undertaken by the EPA confirms that total emissions from such plants are consistently below the levels prescribed to ensure adequate protection of human health and the environment. In view of this I do not consider that an investigation along the lines suggested by the Deputy is necessary.

Medical Card Applications

Questions (953)

Michael Healy-Rae

Question:

953. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a medical card application in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [57860/12]

View answer

Written answers

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Medical Card Applications

Questions (954)

Michael Healy-Rae

Question:

954. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a medical card application in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [57861/12]

View answer

Written answers

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Health Services Provision

Questions (955)

Caoimhghín Ó Caoláin

Question:

955. Deputy Caoimhghín Ó Caoláin asked the Minister for Health his views on the current absence of occupational therapy services in the Ballinasloe area of County Galway; if an occupational therapist has been selected for the area; the time frame for such an appointment and provision of said services; and if he will make a statement on the matter. [57863/12]

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.

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