Written Answers Nos 218-224
218. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the policy changes/new income calculations that will apply for medical card applications in 2013; and if he will make a statement on the matter. [2253/13]
View answerNew eligibility rules for medical cards for persons aged over 70 years were announced in budget 2013. The income thresholds would be reduced and the higher income over-70s will receive a GP visit card instead of a medical card. The new rules will not take effect until later in 2013, after primary legislation has been enacted. The implementation date will be announced and publicised in advance by the Department and HSE. When the changes come into effect, the following rules for medical cards for persons aged over 70 will apply:
- a single person over 70 with a gross income of up to €600 per week will qualify for a medical card and a single person over 70 with a gross income of between €600 and €700 per week will qualify for a GP visit card;
- a couple over 70 with a gross income of up to €1,200 per week will qualify for a medical card and a couple with a gross income of between €1,200 and €1,400 per week will qualify for a GP visit card.
In relation to eligibility for the standard medical card, the rules relating to a person’s spending and earnings that are taken into account when carrying out the means test will be tightened. My Department will first examine this proposal in more detail in consultation with the HSE. Again, the new rules and the implementation date will be announced and publicised in advance by the Department and HSE.
219. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the cuts from which disability funding outlined in the Health Service Executive National Service Plan 2013 will apply; the way this will affect staffing levels; and if he will make a statement on the matter. [2254/13]
View answerThis Government currently provides funding of over €1.5 billion to the Disability Services Programme through the HSE’s National Service Plan for 2013 and is committed to protecting frontline services for people with disabilities to the greatest possible extent. The Minister for Health is 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;
With regards to staffing levels the Government has decided that the numbers employed across the public service must be reduced in order to meet its fiscal and budgetary targets. The health sector must make its contribution to that reduction. This policy requires that by the end of 2013, the health service achieves a workforce of 98,955 whole time equivalents (WTEs). This is a very challenging target given the level of staff reductions that have been achieved in recent years. In order to mitigate the impact on frontline services of the reduction in employment numbers, the priority is to reform how health services are delivered in order to ensure a more productive and cost effective health system. Therefore, the HSE is using the provisions of the Public Service Agreement to bring about greater flexibilities in work practices and rosters, redeployment and other changes to achieve more efficient delivery of services.
Staff reductions will be pursued throughout 2013 through natural turnover (retirements and resignations) and such other targeted measures or initiatives as may be determined by Government in relation to the health sector or the wider public service. The HSE National Service Plan provides for investment of an additional 1,025 WTEs in a number of key prioritised areas, as well as the completion of the 2012 mental health investment programme (400+) posts. Also, a graduate nurse employment programme will be implemented, involving the recruitment of up to 1,000 nurses on two-year contracts. This will provide additional nursing capacity at service level.
220. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the way he will reduce the State's drug bill; the savings that will be made over the next three years; the legislation and agreements that will be necessary to deliver these savings; and if he will make a statement on the matter. [2255/13]
View answer221. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide in tabular form the State's drug bill for 2012, broken down by scheme, Health Service Executive area, drug type, generic, branded on-patent, branded off-patent; and if he will make a statement on the matter. [2256/13]
View answerI propose to take Questions Nos. 220 and 221 together.
Regarding 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 represents 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. In relation to the State's drug bill, I wish to advise that the information is being collated by the HSE and will be forwarded to the Deputy as soon as it is available.
222. Deputy Caoimhghín Ó Caoláin asked the Minister for Health his proposals to transfer clinical psychologist post from the Health Service Executive to the new Child and Family Support Agency; the consultation and engagements with professional bodies and unions that have taken place in advance of this move; and if he will make a statement on the matter. [2257/13]
View answerNo final decision has been made on the proposed transfer of community psychologists from the Health Service Executive to the new Child and Family Support Agency which is due to be established later this year. A sub group of the Oversight Group on the establishment of the new Agency has recently been set up by the Department of Health and the Department of Children and Youth Affairs to consider this important issue. The sub group which is co-chaired by officials from the two Departments will carry out an impact analysis of the proposed future arrangements for community psychologists as they relate to children and family services covered by the Child and Family Support Agency and to services provided by the HSE. The sub group's impact analysis when completed will help to inform consideration of this issue.
223. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the legislation that is needed to give full effect to the Health Service Executive National Service Plan 2013; the timeline for same; and if he will make a statement on the matter. [2258/13]
View answerThe Government has approved and published the Legislation Programme for the Spring 2013 Parliamentary session. This includes a number of Bills that are required to underpin decisions made in the Budget and reflected in the Health Service Executive National Service Plan 2013, as follows: Health (Amendment) Bill; Health (Amendment (No.2) Bill, and Health (Private Patient Charges) Bill.
224. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the areas in which the €15 million in savings in community schemes, as outlined in the Health Service Executive National Service Plan 2013, will be applied; and if he will make a statement on the matter. [2259/13]
View answer225. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the ares in which the €15 million in savings in probity on local schemes, as outlined in the Health Service National Plan 2013, will be applied; and if he will make a statement on the matter. [2260/13]
View answerI propose to take Questions Nos. 224 and 225 together.
The Service Plan for the HSE includes two amounts of €15m to be saved during the course of 2013. Further details of these amounts will be included in regional business plans which are anticipated by the end of January 2013. The €15m related to probity is a savings target related to the purchase and use of goods in local Integrated Service Areas – which are referred to within the HSE as ‘local schemes’. The second target relates to a specific procurement initiative intended to deliver €15m of value to the HSE during the course of 2013. This initiative is still under deliberation and is commercially sensitive and as such it is not possible to provide further details at this time.
