Nursing Homes Support Scheme Applications

Questions (271)

Robert Troy

Question:

271. Deputy Robert Troy asked the Minister for Health the reason funding for the fair deal scheme is suspended; when it will reopen and the timeframe that he envisages approved applicants will have to wait for necessary funding. [26305/13]

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Written answers (Question to Health)

Firstly, I would like to clarify that the HSE did not suspend accepting applications for the Nursing Homes Support Scheme. On 15 April 2013, the HSE temporarily suspended the chronological operation of the placement list for the Nursing Homes Support Scheme. Instead, funding under the Scheme was targeted at hospitals with the highest number of delayed discharges in an effort to alleviate pressure in Emergency Departments. The hospitals targeted were the Dublin Academic Teaching Hospitals (DATHs) and Cork University Hospital.

It is understood that the HSE re-commenced the chronological operation of the placement list with effect from 9 May 2013. This ensures that funding is available to people in the community, people in nursing homes and people in all acute hospitals. The latest information provided to the Department shows that there are 873 people awaiting funding and that the average time spent awaiting funding is 49 days.

Mobility Allowance Decision

Questions (272, 282)

Robert Dowds

Question:

272. Deputy Robert Dowds asked the Minister for Health if he will provide an update on plans for a replacement for the motorised transport and mobility grants for disabled persons, following the recent decision to close the existing schemes because they were operating unlawfully. [26309/13]

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Michael Healy-Rae

Question:

282. Deputy Michael Healy-Rae asked the Minister for Health further to the abolition of the mobility allowance and the motorised transport grant, if he will ensure that there is an immediate way of supporting the persons who are affected by this basic right, which is to be mobile and which at present is being jeopardised; and if he will make a statement on the matter. [26410/13]

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Written answers (Question to Health)

I propose to take Questions Nos. 272 and 282 together.

Following detailed consideration arising from the position of the Ombudsman regarding the legality of the mobility allowance and motorised transport grant schemes, the Government decided in February that the schemes could no longer continue and that an alternative must be devised. An independently chaired Review Group is seeking solutions which will not run counter to the Equal Status Acts. The Review Group's interim report regarding the immediate issue of the closure of the schemes is now under consideration by Government. A final report looking at the wider issue of general transport for people with disabilities will be submitted by the Review Group in June.

At this stage, I am not in a position to pre-empt any decision Government may make. However, I can assure the Deputies that the Government is aware of the needs of those relying on these supports and will take all of this into consideration when making a decision on future arrangements.

Long-Term Illness Scheme Coverage

Questions (273)

Patrick O'Donovan

Question:

273. Deputy Patrick O'Donovan asked the Minister for Health his plans to include Addison's disease as one of the qualifying medical conditions under the long-term illness scheme; and if he will make a statement on the matter. [26315/13]

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Written answers (Question to Health)

There are no plans to extend the list of conditions covered by the Long Term Illness scheme. 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. 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 GP consultations.

Mental Health Services Provision

Questions (274)

Peter Mathews

Question:

274. Deputy Peter Mathews asked the Minister for Health the facilities in place, for those diagnosed with mental health problems including Asperger's syndrome, for those between 16 and 18 years; and if he will make a statement on the matter. [26329/13]

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Written answers (Question to Health)

The Health Service Executive provides a range of community based and in-patient mental health services to children and adolescents, informed by A Vision for Change and funding prioritised by the Government for new service developments now planned or underway. On-going initiatives include increasing child and adolescent in-patient bed provision nationally from 39 to 66 beds by the end of this year, with further expansion due in 2014. Also, 150 additional posts were allocated for Child and Adolescent Mental Health Teams in 2012, and a further 80 posts for this purpose in 2013. A significant number of these posts have been filled, and the HSE is progressing recruitment of the remaining number as a matter of priority.

In general, up to now, children were admitted to child appropriate centres or, in the absence for whatever reason of such facilities, for older children, the latter were admitted to adult units if this was the only viable care option. The provision of additional bed capacity in recent times reflects, for children 16 -18 years reflects an almost 50% decrease in admission of children to adult units since 2008.

Under Mental Health Commission guidelines, admission of 17-18 year olds to adult units is permitted in circumstances where a child and adolescent bed is not available, and where admission to such a bed is determined to be in the best interest of the young person. Where admission to an adult unit is required, liaison between the relevant community team, the adult team and the in-patient unit is maintained to ensure the best possible outcomes for the young person concerned. It should be noted also that, in 2012, the HSE finalised "Access Protocols for 16 and 17 year olds to Mental Health Services", which came into effect from 1 January this year. In an effort to ensure that children are treated in an age appropriate manner, the new protocols provide that from 1 January, 2013, CAMHS accept referrals of all new cases of children up to their 17th birthday, and from 1 January 2014 referrals will be accepted for all new cases up to age 18.

I have asked the HSE to provide a detailed reply to the Deputy in relation to mental health facilities, as raised in this question, and also to reply in respect of services provided by the Executive concerning Asperger’s Syndrome.

Home Help Service Provision

Questions (275)

Finian McGrath

Question:

275. Deputy Finian McGrath asked the Minister for Health if he will advise on the rights of home help care companies that do not want to amalgamate and are being forced to do so by the Health Service Executive; the impact on service level agreements; and if they can be compelled to do so by the HSE. [26338/13]

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Written answers (Question to Health)

As this is a service matter it has been referred to the Health Service Executive for direct reply.

Health Services Staff

Questions (276)

Denis Naughten

Question:

276. Deputy Denis Naughten asked the Minister for Health the number of staff required to be on duty at any one time in each acute psychiatric facility in the Health Service Executive west region; the grades of those staff; the acceptable staff to patient ratio for each of those facilities; if there are staff shortages in any facility; if he is satisfied that the staffing levels currently available in each facility are sufficient; and if he will make a statement on the matter. [26341/13]

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Written answers (Question to Health)

As this is a service matter this question has been referred to the HSE for direct reply.

Nursing Staff Provision

Questions (277)

Denis Naughten

Question:

277. Deputy Denis Naughten asked the Minister for Health his views on whether there are adequate nursing staff employed within acute psychiatric facilities across the country; the vacancies which currently exist; the steps he is taking, if any, to ensure the safety of staff employed in such facilities where there may be staff shortages; and if he will make a statement on the matter. [26342/13]

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Written answers (Question to Health)

The HSE National Service Plan sets out the quantum and type of health services to be provided in 2013 within the overall level of funding provided. Subject to overall parameters set by Government, the HSE has the responsibility for determining the composition of its staffing complement, including nursing. 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).

The Croke Park Agreement has been crucial to the health service’s ability to manage through the very difficult circumstances of recent years. The flexibility and adaptability shown by staff has meant that even with reducing staff numbers, service levels have largely been maintained. Where critical service needs are concerned, limited recruitment of key staff has taken place.

The Deputy will be aware that there has been significant investment in mental health services in both 2012 and 2013 with an additional €35 million provided in each of these years. While this funding was provided primarily to enhance community mental health services in line with A Vision for Change, the HSE, in 2012, converted 31 of the posts originally intended for community mental health teams in the Dublin Mid-Leinster region to nursing posts in acute in-patient mental health services in the same region. Some of the funding provided in 2013 will be used to fund nursing posts in Emergency Departments to implement the Clinical Programme in Self Harm.

Issues relating to quality and safety of all services, including mental health services are kept under regular review by the Department of Health and the HSE and as an employer the HSE is committed to ensuring that appropriate systems, processes and resources are in place to ensure the safety, health and welfare of staff, particularly those staff affected by their activities at work.

The specific details asked by the Deputy in the question are operational matters for the HSE. Accordingly, I have asked the HSE to reply directly to the Deputy.

Hospital Accommodation Provision

Questions (278)

Denis Naughten

Question:

278. Deputy Denis Naughten asked the Minister for Health the bed capacity of each psychiatric facility in the Health Service Executive west region; and if he will make a statement on the matter. [26343/13]

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Written answers (Question to Health)

As this is a service matter this question has been referred to the HSE for direct reply.

General Practitioner Services

Questions (279)

Dara Calleary

Question:

279. Deputy Dara Calleary asked the Minister for Health when free general practitioner care as outlined in the programme for Government will be introduced; the timeframe for same; the illnesses or disabilities to be covered under the new provision; and if he will make a statement on the matter. [26347/13]

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Written answers (Question to Health)

The Government is committed to introducing, on a phased basis, a universal GP service without fees within its first term of office, as set out in the Programme for Government and the Future Health strategy framework. This policy constitutes a fundamental element in the Government’s health reform programme. There has been no change to the Government’s over-arching commitment to this goal. This Government is the first in the history of this State to have committed itself to implementing a universal GP service for the entire population.

On examining the progress made in the universal GP care plan, it has became clear that the legal and administrative framework required to provide a robust basis for eligibility for a GP service based on having a particular medical condition is likely to be overly complex and bureaucratic for a short-term arrangement. Relatively complex primary legislation would be required in order to provide a GP service to a person on the basis of their having a particular illness. The assessment system for such an approach would have to be robust, objective and auditable in order to have the confidence of this House as well as the general public. This legislation would have to address how a person could be certified as having such an illness, and who could do this, and how to select the diagnostic basis for medical conditions. As well as primary legislation, there would be a need for secondary legislation to give full effect to this approach for each condition. While it would not be impossible to achieve this, it would take several months more to finalise the primary legislation, followed then by the preparation of statutory instruments. In my view, this would entail putting in place a cumbersome legal and administrative infrastructure to deal with what is only a temporary first phase on the way to universal GP service to the entire population.

The Cabinet Committee on Health has discussed the issues relating to the delay in the initial step of the roll-out of the universal GP service. In doing so, it has considered the importance of weighing the balance between, on the one hand, resolving the legal issues but with a further delay and, on the other hand, with the need to bring forward an important Programme for Government commitment with the minimum of further delay.

No decision has been taken by the Cabinet Committee or by Government on changing the first step of the plan to extend GP care without fees to persons with chronic illnesses. Instead, it has been agreed that we should prepare and set out a number of alternative options with regard to the phased implementation of a universal GP service without fees. Minister Reilly and I expect to report back to the Cabinet Committee in the near future. As part of this work, consideration will be given to the approaches, timing and financial implications of the phased implementation this universal health service.

The Government has already made clear its commitment to delivering on the implementation of a GP service for the entire population by providing additional financial resources in the two most recent Budgets. The HSE Vote now contains funding of €30 million for this year for an initial phase of the provision of GP services as part of this Programme for Government commitment.

To conclude, far from abandoning its commitment to universal GP care, this Government is determined to expedite the implementation of a national GP service for the entire population, something to which no previous Government has ever aspired.

Hospital Waiting Lists

Questions (280)

Heather Humphreys

Question:

280. Deputy Heather Humphreys asked the Minister for Health when a person (details supplied) in County Kilkenny will receive an appointment for hip replacement surgery; and if he will make a statement on the matter. [26392/13]

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Written answers (Question to Health)

The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2013, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has recently been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.

In relation to this particular query raised by the Deputy, I have asked the Health Service Executive to investigate the situation and respond directly to the Deputy in this matter.

Counselling Services

Questions (281)

Robert Troy

Question:

281. Deputy Robert Troy asked the Minister for Health if a person (details supplied) in County Westmeath is entitled to free counselling and support services. [26399/13]

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Written answers (Question to Health)

As this is a service matter this question has been referred to the HSE for direct reply.