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Wednesday, 20 Mar 2013

Written Answers Nos. 127-144

Universal Health Insurance Provision

Questions (130)

David Stanton

Question:

130. Deputy David Stanton asked the Minister for Health the progress that has been made regarding the provision of universal health insurance; and if he will make a statement on the matter. [13701/13]

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Written answers

The Government is embarking on a major reform programme for the health system, the aim of which is to deliver a single-tier health service, supported by universal health insurance (UHI), where access is based on need, not on income.

Last month (15 February), I published The Path to Universal Healthcare, a preliminary document on UHI which provides a comprehensive update on progress achieved to date and sets out the main actions for the road ahead. As outlined in that document, many of the key building blocks for UHI have been progressed including:

- the drafting of legislation to extend access to GP services without fees to persons with prescribed illnesses;

- the work of the Strategic Board on the Establishment of Hospital Groups, and the significant progress made by the Special Delivery Unit to reduce waiting times for scheduled and unscheduled care;

- the development of a 'Money Follows the Patient' policy which was published on the 15th February, and which heralds a fairer, more transparent means of funding healthcare;

- the approval of national healthcare standards and ongoing work in relation to supporting licensing legislation, and

- the enactment of the Health Insurance (Amendment) Act 2012 providing for a new scheme of risk equalisation for the private health insurance market from 1st January 2013.

The Department is currently undertaking detailed work in relation to the preparation of a White Paper on Universal Health Insurance. The White Paper will provide further detail on the UHI model for Ireland in addition to the estimated costs and financing mechanisms associated with its introduction. The work involved is both complex and technical and demands a wide-range of specialised legal and financial expertise. My Department has recently engaged specialised legal expertise to support deliberations in relation to the design of the UHI model and work in this area is underway. In addition, my officials are currently establishing a UHI Design Team which will oversee progress on the preparation of the White Paper.

The reform programme is a major undertaking that requires careful planning and sequencing over a number of years and full implementation of UHI will take some time to achieve. I anticipate that by 2016 the necessary groundwork will be in place to enable us to phase in implementation of UHI, as promised in the Programme for Government. I should add that it is my intention to consult widely as part of the reform implementation process.

Question No. 131 answered with Question No. 37.
Question No. 132 answered with Question No. 17.

Croke Park Agreement Issues

Questions (133, 448)

Dara Calleary

Question:

133. Deputy Dara Calleary asked the Minister for Health the impact of the recent Croke Park Agreement on the health budget in 2013; and if he will make a statement on the matter. [13854/13]

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Billy Kelleher

Question:

448. Deputy Billy Kelleher asked the Minister for Health the impact of the recent Croke Park agreement on the health budget in 2013; and if he will make a statement on the matter. [13935/13]

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Written answers

I propose to take Questions Nos. 133 and 448 together.

Extremely difficult and complex discussions took place between public service management and public service staff representatives, seeking agreement on a series of measures that will secure an additional €1 billion annual saving from the public service pay and pensions bill by 2015. These discussions concluded on Monday February 25th, with proposals being put forward by the Labour Relations Commission (LRC) on a draft Agreement. A key requirement for the health service during the process was to protect front-line care while at the same time significantly reducing costs.

Subject to the ratification of the proposals, significant savings will be made on the health pay bill. Savings will be achieved through the reduction in the overtime rates payable, the elimination of twilight payments and a reduction in Sunday Premium pay. Savings will also be achieved through the progressive reduction in salaries over €65,000 per annum, measures to delay or freeze increments, and balancing measures for those already at the maximum of their scales. In addition, the draft agreement provides for an increase in working hours for most staff and this will deliver a long-term, sustainable and unprecedented increase in productivity. The increased working hours will, it is anticipated, enable the reliance of the health service on overtime and agency working to be substantially reduced, and at the same time, facilitate the achievement of the further staffing reductions required for 2013 and 2014.

The HSE's National Service Plan 2013 includes unallocated pay savings of €150m. As the Plan contains no specific allocations in relation to this €150m, these are not, as yet, reflected in either the programme or regional budgets. These budgets will however be adjusted downwards, later in 2013, when the breakdown of the pay savings under the proposed Agreement has been definitively quantified.

The Revised Estimates Volume for 2013, which will be published shortly by the Minister for Public Expenditure and Reform, will set out the revised allocations for Votes arising from the proposals made by the LRC.

Mental Health Services Provision

Questions (134)

Michael Moynihan

Question:

134. Deputy Michael Moynihan asked the Minister for Health the way recently published Health Service Executive regional plans will help those in need of mental health services; and if he will make a statement on the matter. [13865/13]

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Written answers

Government policy on mental health is guided by A Vision for Change the 2006 Report of the Expert Group on Mental Health Policy. The implementation of this Strategy is a priority for the Government and in this regard a special allocation of €35m was provided in 2012 primarily to further strengthen Community Mental Health Teams in both adult and children's mental health services, to advance activities in the area of suicide prevention, to initiate the provision of psychological and counselling services in primary care, specifically for people with mental health problems and to facilitate the re-location of mental health service users from institutional care to more independent living arrangements in their communities, in line with A Vision for Change. 414 posts were approved to implement the €35m package of special measures.

A further additional €35m was allocated to mental health in Budget 2013 and the HSE National Service Plan, which was approved by the Minister for Health, commits to the further development of suicide prevention initiatives, forensics and community mental health teams for adults, children, older persons and mental health intellectual disability and to the recruitment of over 470 additional staff to implement these measures.

In order to ensure that the additional resources will be used to best effect, discussions are ongoing within the HSE, and in consultation with the Department of Health, to finalise the allocation of these resources. Each HSE Region is being asked to submit a business case against each of the identified objectives detailing how the funding is to be spent and the type and number of WTE to be recruited. It is expected that this process will be concluded in the very near future. I have been assured by the HSE that the recruitment process for the new posts being funded in 2013 and any outstanding posts from the 414 approved in 2012 is being given priority within the HSE.

In relation to the specific question on the HSE Regional Service Plans, as this is a service matter, the question has been referred to the HSE for direct reply.

Question No. 135 answered with Question No. 17.
Question No. 136 answered with Question No. 104.
Question No. 137 answered with Question No. 7.
Question No. 138 answered with Question No. 17.
Question No. 139 answered with Question No. 87.

Maternity Services

Questions (140)

Clare Daly

Question:

140. Deputy Clare Daly asked the Minister for Health the circumstances in which a hospital went to the High Court to seek an order for a woman to have a Caesarean section on 10 March 2013; the nationality of the woman involved; the basis of that decision; and if he will make a statement on the matter. [13741/13]

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Written answers

Following a request for information by officials from my Department, the HSE has confirmed that on Friday 8 March 2013 Patient A attended the ante-natal Clinic in Waterford Regional Hospital. The patient was 13 days overdue. Serious concerns arose following a clinical review at the clinic. The patient was advised that an immediate admission to the hospital for a caesarean section was needed. It was deemed that there was a substantial risk to the health and wellbeing of both the baby and the mother. I am advised that, at this point, the mother refused to be admitted to hospital.

As the risks were deemed unacceptably high, an application was made by the HSE to the High Court seeking an order – Notice of Motion - to allow the hospital (or its doctors or staff) to administer all appropriate medical treatment for the mother to safeguard her health and that of her unborn child. The court order included a request that the patient be compelled to undergo a caesarean section if necessary. As per the patient's entitlement legal representation was organised for the patient by the hospital. The patient's legal representation costs will be covered by the hospital.

An initial Notice of Motion was issued on Friday night requesting the patient to return to the hospital for further review. The mother consented to stay in the hospital. A second consultant obstetrician spoke to the mother and outlined the serious concerns and the risks for both the baby and the mother. The mother again refused to undergo a caesarean section

On Saturday 9 March the patient consented to a caesarean section which was carried out immediately. Therefore a further Court ruling was no longer required. I wish the patient a speedy recovery.

I am unable to advise the Deputy of the nationality of the woman involved on the grounds that this could potentially lead to the identification of the patient.

Question No. 141 answered with Question No. 37.
Question No. 142 answered with Question No. 17.

Hospital Waiting Lists

Questions (143)

Tom Hayes

Question:

143. Deputy Tom Hayes asked the Minister for Health the measures that have been taken to tackle inpatient and day case waiting lists in South Tipperary General Hospital; the impact of these measures; and if he will make a statement on the matter. [14307/13]

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Written answers

In 2011, I established the Special Delivery Unit in my Department as set out in the Programme for Government. The aim of the SDU is to unblock access to acute services by improving the flow of patients through the system. The SDU's Scheduled Care Team focused initially on waiting times for in-patient and daycase elective surgery. For 2012, a target was set that no adult should wait longer than 9 months for inpatient or daycase treatment. By the end of December 2012, the number of adults having to wait more than 9 months for inpatient and day case surgery nationally had fallen to 86. This was down from 3,706 in December 2011, representing a 98% decrease

I am determined that the progress made in 2012 be maintained and improved upon. For 2013, the target is that no adult should be waiting longer than 8 months for inpatient or daycase treatment. It is important to recognise that the progress made in 2012 does not mean the problem is solved, and 2013 will of course be extremely challenging. For example, winter pressures in Emergency Departments have impacted on scheduled care waiting times. However, in the coming months, as winter pressures ease, the SDU will work towards re-balancing scheduled care to maintain the improvements seen in 2012 and to achieve the new 2013 target.

I have asked the HSE to respond directly to the Deputy in regard to the specific hospital referred to.

Services for People with Disabilities

Questions (144)

Gerry Adams

Question:

144. Deputy Gerry Adams asked the Minister for Health if he has considered the proposal to mark 2 April 2013 the start of autism awareness month, by lighting landmark buildings in blue; and if he will make a statement on the matter. [13769/13]

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Written answers

Last year my Department made efforts to mark Autism Awareness 2012 by lighting up Hawkins House in blue. Due to the old lighting system in operation in Hawkins House this proved to be ineffective. My Department had an electrician recently install a test lamp on the roof of the building to see if it were possible to improve the lighting. Unfortunately the cost of carrying out this project effectively is prohibitive.

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