Health Services Provision

Questions (238)

Bernard Durkan

Question:

238. Deputy Bernard J. Durkan asked the Minister for Health the level of support and local health services available to persons who suffer with diabetes in County Kildare; if diabetes is considered a long-term illness in terms of the administration of medical cards; if in the context of the integrated care services a diabetes specialist nurse has been appointed to the Kildare area; if not, the length of time it will take to have a nurse appointed; and if he will make a statement on the matter. [29763/13]

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Written answers (Question to Health)

Under the provisions of the Health Act 1970, eligibility for health services in Ireland is based primarily on residency and means and medical cards are not awarded to any particular group of patients on the basis of a specific medical condition. However, the HSE has discretion to grant a medical card in certain circumstances. Medical card applicants who are unsuccessful following the means assessment, but who indicate that they suffer from a medical condition, are then referred to the Medical Officer for consideration on a medical discretionary basis. The conditions covered by the Long Term Illness Scheme include Diabetes Insipidus and Diabetes Mellitus. Persons suffering from a prescribed condition, who are not already medical card holders, can get free drugs, medicines and medical and surgical appliances for the treatment of that condition under the Long Term Illness Scheme. In relation to the issue raised by the Deputy about the appointment of a Diabetes Nurse Specialist in a specific area, I have asked the Health Service Executive to respond directly to the Deputy on this matter.

National Dementia Strategy Implementation

Questions (239)

Róisín Shortall

Question:

239. Deputy Róisín Shortall asked the Minister for Health when the national dementia strategy will be published; if it will include an implementation plan; and if he will make a statement on the matter. [29777/13]

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Written answers (Question to Health)

It is estimated that there are currently 41,000 people with dementia in Ireland and Alzheimer’s Disease accounts for the majority of cases. Given that the number of people with dementia is expected to rise to between 141,000 and 147,000 by 2041, the Programme for Government contains a commitment to develop a National Alzheimer’s and other Dementias' Strategy by 2013 to; increase awareness; ensure early diagnosis and intervention, and ensure development of enhanced community based services. A significant amount of preparatory work has already been completed. A research review funded by the Atlantic Philanthropies to lay the foundations for the Strategy, titled Creating Excellence in Dementia Care, A Research Review for Ireland’s National Dementia Strategy was published in January 2012. A public consultation process to inform the development of the Strategy was conducted in 2012 and a report of same published on the Department’s website in February 2013. A Working Group, representative of key stakeholders from the Department, the HSE, the medical profession and the community and voluntary sector has been established, the first meeting of which took place in May. While the development of the Strategy will have to have due regard to the constraints imposed by the budgetary situation, it is intended that it will be a transformative Strategy. It will have a very practical focus, will be action oriented and will focus on what can be done to make a difference to the lives of people with dementia. It is intended that a draft of the Strategy will be completed by the end of 2013.

Nursing Home Services

Questions (240)

Nicky McFadden

Question:

240. Deputy Nicky McFadden asked the Minister for Health if the private and voluntary nursing home sector will be enabled to meet the care requirements of an increasing ageing population, particularly in view of the large numbers of persons inappropriately placed in acute hospitals; if a strategy that supports private and voluntary nursing homes to meet the significant growth in demand for nursing home care will be implemented; and if he will make a statement on the matter. [29835/13]

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Written answers (Question to Health)

Government policy is to support older people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not feasible, the health service supports access to appropriate quality long-term residential care. Access to appropriate quality long-term residential care is underpinned by both the system of registration and inspection of nursing homes and the financial support available under the Nursing Homes Support Scheme.

Essentially, our aim is to ensure that people are being cared for at the point of lowest complexity. People should only be entering a long-term nursing home when they have passed the point of being able to be cared for at home. This means that only the most highly dependent people should be in long-term nursing home care. One of the key priorities identified in the HSE's National Operational Plan 2013 is the progression of a Single Assessment Tool for older people. This standardised framework will ensure that there is a robust, equitable standardised care needs assessment nationally. It will also allow resources to be targeted towards those with the greatest needs and enable supports and services to be designed in the most appropriate way possible. The Nursing Homes Support Scheme applies to public, private and voluntary nursing homes and includes a principle of resident choice, i.e. the resident chooses their nursing home themselves, subject to the availability of a bed and the ability of the nursing home to meet their care needs. When a person selects a particular nursing home, that nursing home will carry out an assessment to ensure that it can meet the person's care needs. It is a matter for each private nursing home to determine, having regard to its Statement of Purpose etc., whether it can meet the persons care needs. Patients in acute hospitals that have difficulty finding a nursing home that can meet their particular care requirements are generally those that are most highly dependent. In the majority of cases, this category of patients are ultimately accommodated in public nursing homes. The Department is working closely with the HSE to develop an overall plan regarding future public nursing home provision for the Minister’s consideration. The plan will reflect regional need and have regard to the current severe financial constraints, restrictions on public sector staffing and recruitment and the on-going need to meet service and safety standards; all of which pose challenges for community nursing units across the country.

The Deputy will be aware that the Nursing Homes Support Scheme is currently the subject of a review. The terms of reference for this review are as follows: taking account of Government policy, demographic trends and the fiscal situation; to examine the on-going sustainability of the Nursing Homes Support Scheme; to examine the overall cost of long term residential care in public and private nursing homes and the effectiveness of the current methods of negotiating/setting prices; having regard to 1 and 2 above, to consider the balance of funding between long-term residential care and community based services; to consider the extension of the scheme to community based services and to other sectors (Disability and Mental Health), and to make recommendations for the future operation and management of the Scheme. The review will look at possible alternative models of care. Work will continue on the review in the coming months with a view to completion by end 2013-early 2014.

Drugs Payment Scheme Administration

Questions (241)

Dominic Hannigan

Question:

241. Deputy Dominic Hannigan asked the Minister for Health his plans to require pharmaceutical companies to package prescriptions in boxes of 30 or 31 depending on the month of the year to reduce costs for persons who buy monthly medication; and if he will make a statement on the matter. [29838/13]

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Written answers (Question to Health)

There is no legislation or agreement that deals with the quantity of prescription tablets to be included in a monthly pack. This is at the discretion of the marketing authorisation holders. The standard industry practice across Europe is for prescription tablets to be packaged in sizes of 28, as this number has been found to be convenient for patients. Where the quantity of a preparation prescribed does not correspond with an original pack size and it is not feasible to supply the exact amount prescribed, the pharmacist may, in the exercise of his or her professional judgement and bearing in mind the nature of the product and his or her statutory obligations, supply the nearest pack size to the quantity prescribed.

It is a condition of the Drug Payment Scheme that no individual or family grouping will pay more than €144 in a calendar month (i.e.€144 x 12 in a full year). The payment of a second €144 (in the same pharmacy) should only arise when a person is intentionally getting the next month’s supply on the grounds that he/she will be away the following month or for other such reason. To ensure that an individual or family makes no more than 12 payments in a year it is suggested by the HSE that, where appropriate, once in a 12-month period or periodically throughout the year more than a 28-day supply is given. The packaging will influence how this can be achieved.

National Lottery Funding Applications

Questions (242)

Finian McGrath

Question:

242. Deputy Finian McGrath asked the Minister for Health further to Parliamentary Question No. 965 of 11 June 2013, if funding is available to an organisation (details supplied); and if he will make a statement on the matter. [29839/13]

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Written answers (Question to Health)

My Department has received an application for funding from the 2013 National Lottery allocation from the organisation in question. This is one of a large number currently being assessed by my Department, and the Deputy will be informed of the outcome of the application as soon as a decision has been made.

Orthodontic Services Waiting Lists

Questions (243)

Tom Fleming

Question:

243. Deputy Tom Fleming asked the Minister for Health if he will examine and allow for orthodontic treatment in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [29846/13]

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Written answers (Question to Health)

The HSE provides orthodontic treatment to patients based on their level of clinical need. An individual's access to orthodontic treatment is determined against a set of clinical guidelines and priority is given to patients with greatest needs. The HSE has been asked to examine the specific query raised by the Deputy and to reply to him as soon as possible.

Medicinal Products Supply

Questions (244)

Eoghan Murphy

Question:

244. Deputy Eoghan Murphy asked the Minister for Health if he will revise the current dosage criteria for certain prescribed drugs and medicines for medical card recipients, for example Prozac, to ensure that patients who are recipients of a medical card and in need of certain medication are not over-subscribing on their recommended dosage in order to avail of medicine that is covered by the medical card. [29854/13]

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Written answers (Question to Health)

Prozac® is a brand name of a medicine which contains fluoxetine and which belongs to a group of medicines called selective serotonin reuptake inhibitors (SSRI). All medicines containing fluoxetine authorised for the Irish market are Prescription Only Medicines, i.e. may only be supplied on foot of a prescription from a medical practitioner. Fluoxetine products are used to treat major depressive episodes, obsessive-compulsive disorder (OCD) and Bulimia Nervosa. In the prescribing information, the usual starting dose of fluoxetine is 20 mg daily for adults. It may be necessary for the prescriber to increase the dose depending on the response of the patient to a maximum of 60 mg daily for adults. As for all prescribed medicines, patients who have been prescribed fluoxetine medicines should be reviewed periodically by their treating medical practitioner to ensure that both the medicine and the dose continue to be a suitable treatment for the individual patient.

There are no dosage criteria in place for prescribed drugs and medicines reimbursed under the GMS or other community drug schemes operated by the HSE. Prescribers are responsible for prescribing the appropriate dosage level of a medicine in accordance with the patient's clinical needs. The supply of prescription medicines is controlled in law in a number of ways. Under the Medicinal Products (Prescription and Control of Supply) Regulations, it is prohibited for a person to supply a prescription only medicine except in accordance with a prescription, and the supply must be made from a registered pharmacy by or under the personal supervision of a registered pharmacist. A person who contravenes these Regulations is guilty of an offence.

Medical Card Eligibility

Questions (245)

Michael Healy-Rae

Question:

245. Deputy Michael Healy-Rae asked the Minister for Health if he will ensure that the Health Service Executive puts in place a priority emergency system for persons who are terminally ill and applying for and trying to secure a medical card; and if he will make a statement on the matter. [29885/13]

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Written answers (Question to Health)

The HSE has an effective system in place for the provision of emergency medical cards for patients who are terminally ill, or who are seriously ill and in urgent need of medical care that they cannot afford. They are issued within twenty-four hours of receipt of the required patient details and the letter of confirmation of the condition from a doctor or a medical consultant. With the exception of terminally ill patients, the HSE issues all emergency cards on the basis that the patient is eligible for a medical card on the basis of means or undue hardship, and that the applicant will follow up with a full application within a number of weeks of receiving the emergency card. As a result, emergency medical cards are issued to a named individual, with a limited eligibility period of six months. For persons with a terminal illness, no means test applies. Once the terminal illness is verified, patients are given an emergency medical card for six months. Given the nature and urgency of the issue, the HSE has appropriate escalation routes to ensure that the person gets the card as quickly as possible.

Medical Card Eligibility

Questions (246)

Bernard Durkan

Question:

246. Deputy Bernard J. Durkan asked the Minister for Health if and when eligibility for a medical card will be reviewed in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [29937/13]

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Written answers (Question to Health)

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible. The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has recently reissued to Oireachtas members.

Medical Card Applications

Questions (247)

Bernard Durkan

Question:

247. Deputy Bernard J. Durkan asked the Minister for Health the current position regarding a medical card in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [29938/13]

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Written answers (Question to Health)

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible. The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has recently reissued to Oireachtas members.