Child Detention Centres

Questions (625)

Caoimhghín Ó Caoláin

Question:

625. Deputy Caoimhghín Ó Caoláin asked the Minister for Children and Youth Affairs in view of the recent annual report from the Ombudsman for Children, the current capacity, work and accommodation conditions at Trinity House, Oberstown boys and Oberstown girls schools; the implementation of the new working roster and the implications of same for staff and for children; the date on which the investigation (details supplied) will be published; and if she will make a statement on the matter. [32181/13]

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Written answers (Question to Children)

I note that the Ombudsman for Children’s Annual Report 2012 refers to two main areas in relation to the detention of children. First of all, the Ombudsman outlines issues experienced by her office in dealing with complaints relating to St Patrick’s Institution. The points made in relation to the procedure for handling complaints from children in St Patrick's Institution are a matter for the Irish Prison Service in the first instance.

The second issue mentioned by the Ombudsman’s annual report relates to her concern that progress is made with the Oberstown capital project, which is to expand the detention places and facilities on the Oberstown campus. This project is required in order to give effect to the Programme for Government commitment to end the practice of detaining children in adult prison facilities. I have outlined my commitment to this project on many different occasions and it remains at the top of my agenda.

To date, I have put in place the required funding package for the project and my officials have, in conjunction with the Office of Public Works, completed the design process and secured planning permission for the proposed development. The tender process is ongoing at present and this is being overseen by a steering group of officials from my Department and the Office of Public Works. A further announcement on the outcome of the tendering process will be made shortly.

There is legal provision under the Children Act 2001 for 24 male bed spaces in Trinity House School, 8 female bed spaces in Oberstown Girls School, and 20 male bed spaces in Oberstown Boys School. However, only 16 of the certified 24 male bed spaces in Trinity House School are currently available for use due to staffing shortages. The Irish Youth Justice Service, which is based in my Department, is currently in discussions with management and staff on the Oberstown campus on an initiative to reorganise the detention capacity for males and female bed places, in order to meet the increased demand for male bed places from the courts. This is being progressed at present.

Work and accommodation conditions on the Oberstown campus are governed by a range of criteria, legislation and operational policies. The campus is subject to inspection by the Health Information and Quality Authority. The campus is also under the remit of the Ombudsman for Children and is periodically reviewed by international organisations such as the Council of Europe. The campus is subject to a range of care policies which are communicated to staff and management and published on the website of the Irish Youth Justice Service.

The new campus staffing roster was implemented on 25 February 2013 following protracted negotiation and agreement between staff and management at the Labour Relations Commission. The operation of the campus roster is currently the subject of discussions between management and staff representatives, in line with the provisions of the LRC agreement. An independent review of the operation of the roster is to commence shortly. This is the first time all care staff on the campus are operating under a set of harmonised conditions for hours worked, taking of breaks and flexibility of staff deployment between each of the three children detention schools. I wish to acknowledge the cooperation of staff with the implementation of the LRC agreement to date.

A number of issues have been the subject of consideration in conjunction with implementation of the campus wide roster, such as the need to ensure that all certified bed capacity is available for use, training needs, harmonisation of care procedures, clarification of procedures for the taking of breaks and the interpretation of the agreement provisions on flexibility of deployment. These are being addressed as part of the ongoing industrial relations process on the campus. Further discussions are also likely on the issue of how the Haddington Road Agreement provisions for working hours will be incorporated into the campus roster.

Preschool Services

Questions (626)

Robert Troy

Question:

626. Deputy Robert Troy asked the Minister for Children and Youth Affairs the number of children availing of the preschool year in 2010-11, 2011-12 and 2012-13 who availed of the special needs arrangement to split the allocation over two years on a pro rata basis; the number who applied for same in each of those years; and if she will make a statement on the matter. [32232/13]

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Written answers (Question to Children)

The free Preschool Year in Early Childhood Care and Education (ECCE) programme provides a free preschool year to all eligible children in the year before commencing primary school. In line with the Programme for Government, my Department has made a significant commitment to maintaining this universal programme.

The programme includes a number of additional provisions to take account of children with special needs. These include an exemption from the upper age limit for qualification under the programme where a child is developmentally delayed and would benefit from starting primary school at a later age. In addition, children with special needs can apply to have the preschool year split over two years on a pro-rata basis, for example availing of the programme for 2 days a week in the first year and for 3 days a week in the second year. Application for these exemptions must be made prior to the child commencing the programme.

The free preschool provision was introduced in January 2010 and in the 18-month period to June 2011 a total of 98 children were approved to avail of the programme on a pro-rata basis. In the periods September 2011 to June 2012, and September 2012 to June 2013, 191 and 264 children respectively were approved for the special provision.

All qualifying children that applied to my Department to avail of the free preschool year on a pro-rata basis and who provided the required medical evidence to support their application were approved for the provision.

Preschool Services

Questions (627)

Robert Troy

Question:

627. Deputy Robert Troy asked the Minister for Children and Youth Affairs the number of children availing of the preschool year in 2010-11, 2011-12 and 2012-13 who availed of grants from the Health Service Executive to support the employment of special needs assistants; the number who applied for same in each of those years; and if she will make a statement on the matter. [32233/13]

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Written answers (Question to Children)

As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy with the most up-to-date information.

Child Care Services Provision

Questions (628)

Robert Troy

Question:

628. Deputy Robert Troy asked the Minister for Children and Youth Affairs if she will provide in tabular form the number of children under six availing of registered child care facilities; the number of children in each different age group in same; and if she will make a statement on the matter. [32236/13]

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Written answers (Question to Children)

Pobal, which administers the childcare support programmes on behalf of my Department, compiles an Annual Survey of the Early Years Sector. For the 2012 Annual Survey, approximately 3,137 of these services responded and provided information on the enrolment levels in the different age categories in these services.

The survey shows that the total enrolment in the 3,137 childcare services was 99,220. This figure includes 3,144 children age 0-1, 14,135 aged 1-3 and 65,854 aged 3-5. The remaining 16,087 were availing of after-school care.

My Department currently provides funding to support three childcare programmes - the Early Childhood Care and Education (ECCE) programme, the Community Childcare Subvention (CCS) programme and the Childcare Education and Training Support (CETS) programme - which provide a range of supports to parents of preschool children and also after-school care for children older than 6 years.

The ECCE programme provides for a free preschool year to all eligible children in the year before they commence primary school. Almost every preschool service (more than 4,300) in the State is participating with over 68,000 children, which is estimated to be almost 95% of the eligible age cohort, availing of free preschool this year.

The CCS programme provides funding to community-based childcare services to enable them to provide childcare at reduced rates to parents in receipt of social welfare payments or on low or relatively modest incomes. These supports are available to both preschool and after school children and it is estimated that in the region of 25,000 children are supported under the CCS each year.

The CETS programme provides €145 towards the weekly cost of full time childcare places to participating childcare services in both the community and commercial sectors for qualifying FÁS and VEC trainees and students with students on part-time courses funded on a pro rata basis. It is estimated that the number of children supported under the CETS programme is in the region of 5,500 annually.

A new After-school Childcare Programme was announced in Budget 2013 and will be fully rolled out in September 2013. This programme represents a full year investment of €14 million, and will provide important support to parents in low income families wishing to take up employment, by ensuring that some 6,000 quality after-school care places are provided to support children's development. It is anticipated that a small number of the places available will be utilised by children in the age cohort referred to by the Deputy.

Child Care Qualifications

Questions (629)

Robert Troy

Question:

629. Deputy Robert Troy asked the Minister for Children and Youth Affairs if she will provide, in tabular form, the total number of personnel employed in registered child care facilities; the detail of the formal accredited qualifications of personnel, that is, FETAC and HETAC level in same; the numbers without formal accredited qualifications in same; and if she will make a statement on the matter. [32237/13]

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Written answers (Question to Children)

Pobal, which administers the childcare support programmes on behalf of my Department, compiles an Annual Survey of the Early Years Sector. For 2012 approximately 3,137 of these services responded and provided information on the level of training/qualifications of 12,838 staff working directly with children.

The survey established that the level of staff qualifications for those services who responded can be categorised as follows: Level 4 - 2.1%, Level 5 - 39.4%, Level 6 - 34.8%, Level 7 - 4.9%, Level 8 - 6.3%, Level 9/10 - 0.7%, Primary Teaching Qualification - 0.5%.

Up to 86.6% of staff working directly with children have qualifications equal to or higher than FETAC Level 5 on the National Framework of Qualification (NFQ). This shows an increase on a similar survey in 2011 and represents substantial progress in the further upskilling of child care workers in recent years.

Public Sector Staff Career Breaks

Questions (630, 634, 637)

Paschal Donohoe

Question:

630. Deputy Paschal Donohoe asked the Minister for Health the numbers of persons who have been accepted for the Health Service Executive's incentivised career break; and if he will make a statement on the matter. [31486/13]

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Paschal Donohoe

Question:

634. Deputy Paschal Donohoe asked the Minister for Health the number of persons within the Health Service Executive who have applied for the incentivised career break; and if he will make a statement on the matter. [31485/13]

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Robert Dowds

Question:

637. Deputy Robert Dowds asked the Minister for Health if it is the case that staff who have worked for the Health Service Executive for at least two years may apply for paid leave of absence for a period of up to three years at a rate of €12,000 per year, and, if this is the case, the reason for same. [31501/13]

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Written answers (Question to Health)

I propose to take Questions Nos. 630, 634 and 637 together.

On 1 May last my Department issued a Circular letter to the HSE, authorising the introduction of an incentivised career break scheme in the HSE and in organisations funded by the HSE under Section 38 of the Health Act 2004. The scheme was intended as a tool to assist managers to achieve the numbers reduction required under the 2013 Employment Control Framework, as well as the corresponding reduction in expenditure, while delivering the agreed level of service.

Under the terms of the scheme, staff who had completed their probationary period, were offered a 3 year career break with an incentive payment of one third of gross basic pay to a maximum of €12,000; this amount is subject to tax and other statutory deductions. Any vacancy which arises under the scheme will not as a general rule be filled; a vacancy may only be filled by redeployment.

A total of 2,732 applications were received by the closing date 31 May, of which 2,521 were deemed to be valid applications. These applications have been considered and to date 366 have been approved while 82 applications have yet to be determined.

Health Services Provision

Questions (631)

Caoimhghín Ó Caoláin

Question:

631. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will review the case of a person (details supplied) in County Westmeath. [31857/13]

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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.

Mobility Allowance Applications

Questions (632)

Ciaran Lynch

Question:

632. Deputy Ciarán Lynch asked the Minister for Health if he will review the refusal of a mobility aid to a person (details supplied) in County Cork; and if he will make a statement on the matter. [31481/13]

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Written answers (Question to Health)

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.

Regulatory and Poverty Impact Assessments

Question No. 634 answered with Question No. 630.

Questions (633)

Stephen Donnelly

Question:

633. Deputy Stephen S. Donnelly asked the Minister for Health if he will provide the regulatory impact analysis for the Health (Amendment) Bill 2013, and, if no such regulatory impact analysis has been conducted, the reason for same; and if he will make a statement on the matter. [31484/13]

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Written answers (Question to Health)

Under Cabinet Procedures, Departments are not required to conduct a Regulatory Impact Analysis (RIA) in respect of a Bill which gives effect to decisions taken by the Government as part of the Budget. Some of the provisions in the Health (Amendment) Bill 2013 fall into this category while others do not. As the Health (Amendment) Bill is a combination of budgetary, charging and general policy matters, the position regarding RIAs is different, depending on the issue concerned.

Of the three main areas covered by the Bill the position in relation to RIAs is as follows: Amendment of the Nursing Homes Support Scheme Act 2009 - RIA undertaken. Arrangements are being made to have this RIA placed on my Department's website; Charges for public in-patient and long-term residential care services - Summary explanatory RIA undertaken for sole purpose of Government Memorandum; Charges for private in-patient services - No RIA undertaken.

With regard to private in-patient charges, the Government decided as part of Budget 2013 that all private patients using public hospital facilities and resources would be charged the economic cost of providing those services. The Government believes that the charge for private care in public hospitals should cover the hospitals' costs of providing the service, including the non-consultant hospital doctors, nursing staff, medical and surgical supplies, diagnostics, operating theatres, administration and support staff. Given that a private patient is using resources that cost, on average, in excess of €1,000 per day, it is clear that the current situation represents a significant loss of income to the public hospital system and an indirect subsidy of about €200 million to private insurance companies. This is equivalent to the cost of running a medium-sized public hospital. Budget 2013 provided for an additional €120 million to be raised in a full year in 2014 from applying charges to all private patients in public hospitals. The charges set out in the schedules to the Bill have been calculated with a view to raising this amount in a full year.

Question No. 634 answered with Question No. 630.

Hospital Waiting Lists

Questions (635)

Seán Fleming

Question:

635. Deputy Sean Fleming asked the Minister for Health when an appointment for cataract surgery will be approved in respect of a person (details supplied) in Dublin 22; and if he will make a statement on the matter. [31494/13]

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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.

Medical Card Eligibility

Question No. 637 answered with Question No. 630.

Questions (636)

John McGuinness

Question:

636. Deputy John McGuinness asked the Minister for Health if a medical card issued to a person (details supplied) in County Kilkenny is still listed as valid up to March 2014. [31496/13]

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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.

Question No. 637 answered with Question No. 630.

Medicinal Products Availability

Questions (638)

Nicky McFadden

Question:

638. Deputy Nicky McFadden asked the Minister for Health the steps taken by his Department in conjunction with the pharmaceutical health care sector to allow for new and innovative medicines to be funded and for timely access to new medicines; if he acknowledges the strong link between innovation and better health outcomes; and if he will make a statement on the matter. [31509/13]

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Written answers (Question to Health)

A focus on innovation in health care is key to the development of new medicines to meet the needs of patients. From a policy perspective it is important to have a regulatory framework in place to support the development of new medicines. Clinical trials are essential for the development of new medicines and the Clinical Trials Proposal currently being negotiated at EU level, which was a key priority for my Department during the Irish Presidency of the EU Council, is designed to make Europe a more attractive place to carry out clinical trials on new and innovative therapies.

The first step for a medicine to be placed on the Irish market involves the manufacturer seeking an authorisation from the Irish Medicines Board (IMB) or in the case of certain medicinal products, the European Medicines Agency (EMA). A determination on the application for authorisation is based on a rigorous scientific assessment of the application against legal and regulatory requirements.

Once authorised, applications for the inclusion of new medicines in the GMS and community drugs schemes are considered in line with procedures and timescales agreed in 2012 between the Department of Health, the HSE and the Irish Pharmaceutical Healthcare Association (IPHA). In accordance with these procedures, the National Centre for Pharmacoeconomics (NCPE) conducts a Health Technology Assessment (HTA) which provides detailed information on the potential budget impact of the medicine. It also assesses whether the medicine is cost effective at the price quoted by the company in question.

In October 2012 a new deal on drug costs was agreed between the IPHA, the HSE and my Department resulting in major savings on the cost of drugs. The gross savings arising from this deal will be in excess of €400 million over 3 years. €210 million from the gross savings will be used to fund new drugs to patients over this period.

Tobacco Control Measures

Questions (639)

Nicky McFadden

Question:

639. Deputy Nicky McFadden asked the Minister for Health the steps he is taking to ensure that the illicit tobacco trade does not benefit from any measures introduced to support a decrease in tobacco consumption; and if he will make a statement on the matter. [31511/13]

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Written answers (Question to Health)

All tobacco products, whether legally produced or illicit are injurious to health and are therefore a threat to public health. I am concerned about the level of smoking in Ireland and it remains my objective that Ireland moves towards being a tobacco free society. The tobacco control measures which have already been introduced and future planned measures will, in my view, make a significant contribution to the reduction in the numbers of people smoking in Ireland, in particular the numbers of children and young people who start to smoke.

In parallel with these tobacco control measures the Revenue Commissioners are responsible for tackling the illicit trade in cigarettes and tobacco products. They attach a high priority to tackling this trade because of the threat that it poses to society. Revenue’s “Strategy on Combating the Illicit Tobacco Trade (2011-2013)” includes a range of measures designed to complement each other in targeting the supply and demand sides of the market for illicit cigarettes and other tobacco products. My Department and the HSE strongly support this Strategy. I understand from the Revenue Commissioners that the intention is to put a further strategy in place, when the current one comes to an end, to act as the strategic focus for the ongoing extensive work against the smuggling and sale of illicit products.

Health Insurance Cover

Questions (640)

Dara Murphy

Question:

640. Deputy Dara Murphy asked the Minister for Health with regard to existing Government inpatient levy on private health insurers, if the new charge on private health insurance for the full cost of a public hospital bed is a double tax on private health insurance; and if he will make a statement on the matter. [31517/13]

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Written answers (Question to Health)

At present, private in-patients in public hospitals are subject to maintenance charges that generally range from €586 to €1,046 per day when they are accommodated in a private designated bed. However, in an emergency admission if a private designated bed is not available and a private in-patient is accommodated in a public bed, the maintenance charge is currently not levied, although the private in-patient continues to pay the fees of his/her hospital consultant.

The Comptroller and Auditor General has reported that 45% of in-patients treated privately by their consultants were not charged for their maintenance costs because they were not occupying private-designated beds. This situation represents a significant loss of income to the public hospital system and an indirect subsidy to private insurance companies, who cover most private patients. I believe that this situation cannot continue and that the new charge makes sense. Up to now insurers have enjoyed a significant subsidy, where these private patients have only paid a standard €75 charge per day to the hospital even though they have seen and paid their consultant privately.

The gap between the cost of providing this service to private in-patients and the amount that public hospitals are currently allowed to raise from those private patients is estimated to be about €200m per year. The subsidy is equivalent to the cost of treating over 30,000 public patients every year or operating a medium size public hospital. While everyone is entitled to use a public hospital, some people choose to be treated privately, in which case they have chosen to pay the consultant and the hospital. The Government believes that users of private services should pay for the costs of providing these services even when they are provided by a public hospital.

As part of Budget 2013, the Government announced that it would raise €60m in 2013 under this heading, and €115m in a full year. This represents a modest phasing in of the charge – as called for by the insurers themselves - and is a relatively modest extra cost on an industry that pays out some €2 billion in claims costs every year.

The Health (Amendment) Bill 2013 is presently before the Dáil and provides for charges to be levied on all in-patients who are treated privately by their consultant, irrespective of where the patient is accommodated in the hospital and regardless of whether they are admitted directly or through emergency departments.

Medicinal Products Prices

Questions (641)

Nicky McFadden

Question:

641. Deputy Nicky McFadden asked the Minister for Health the measures he has taken to address the cost of medication here; if pharmacists are obliged to publish dispensing details and other fees; if greater price transparency could be achieved; and if he will make a statement on the matter. [31518/13]

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Written answers (Question to Health)

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 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 November 2012 and further price reductions were implemented on 1 January 2013 in accordance with the agreement.

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 and the HSE also 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. Under this Agreement, from 1 November 2012, the HSE will only reimburse generic products which have been priced at 50% or less of the initial price of an originator medicine. In the event that an originator medicine is priced at less than 50% of its initial price the HSE will require a generic price to be priced below the originator price. This represents a significant structural change in generic drug pricing and should lead to an increase in the generic prescribing rate.

It is estimated that the combined gross savings from the IPHA and APMI deals will be in excess of €120 million in 2013.

The Health (Pricing and Supply of Medical Goods) Act 2013, which was commenced on the 24 of June, provides for the introduction of a system of generic substitution and reference pricing. The Act 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 Act aims to achieve value for money while avoiding disruption in the availability of medicines on the Irish market. This legislation will promote price competition among suppliers and ensure that lower prices are paid for these medicines resulting in further savings for both taxpayers and patients.

At present, pharmacists are not required to publish their dispensing and other fees. However, under the Pharmaceutical Society of Ireland’s (PSI) Code of Conduct, pharmacists are required to provide honest, relevant, accurate, current and appropriate information to patients regarding the nature, cost, value and benefit of medicines provided by them. Every pharmacist has an obligation to comply in full with the statutory Code of Conduct.

The PSI advises patients that their pharmacist should be in a position to provide them with whatever information or clarification they require about prescribed medicines, including information about the pricing of those medicines. The Department of Health has asked the PSI to examine how greater price transparency can be achieved. It should also be noted that the Health (Pricing and Supply of Medical Goods) Act 2013 provides patients with an incentive to seek products priced at or below the reference price.

It is the view of the HSE and the Department of Health that there should be total transparency provided when any pharmaceutical service is accessed by a member of the public.

Medical Card Applications

Questions (642)

Bernard Durkan

Question:

642. Deputy Bernard J. Durkan asked the Minister for Health if he will review the recent refusal of a medical card in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [31532/13]

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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 Appeals

Questions (643)

John McGuinness

Question:

643. Deputy John McGuinness asked the Minister for Health if an application for a medical card can now under appeal will be expedited and approved in respect of a person (details supplied) in County Carlow. [31538/13]

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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 Appeals

Questions (644)

Brendan Griffin

Question:

644. Deputy Brendan Griffin asked the Minister for Health if a decision has been made on a medical card appeal in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [31545/13]

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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.