Tuesday, 2 Jul 2013

Written Answers Nos. 645-664

Medical Card Applications

Questions (645)

Dessie Ellis

Question:

645. Deputy Dessie Ellis asked the Minister for Health the reason a person (details supplied) was refused a medical card. [31548/13]

Written answers

Minister of State at the Department of 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.

Departmental Staff Rehiring

Questions (646)

Thomas Pringle

Question:

646. Deputy Thomas Pringle asked the Minister for Health the number of temporary clerical officers who have been employed by his Department over each of the past three years; the number of those who have been retired public-civil servants; his views on whether his Department should employ retired staff in these positions in view of the level of youth unemployment here; and if he will make a statement on the matter. [31575/13]

Written answers

Minister for Health

My Department has not employed any temporary Clerical Officers in the last three years.

General Medical Services Scheme Administration

Questions (647)

Billy Kelleher

Question:

647. Deputy Billy Kelleher asked the Minister for Health the reason an arbitrary decision was made in 2007 by the Health Service Executive to stop all new medical stoma appliances supplied through the GMS, the reason this embargo continues to date; if there was a review process in the interim and if patient representative associations have been consulted in keeping with the HSE partnership approach; and if he will make a statement on the matter. [31583/13]

Written answers

Minister of State at the Department of Health

A range of stoma products is on the List of Reimbursable Items under the GMS Scheme. Furthermore, where a product that is not on the List is required, application can be made by a medical card holder for the product to be made available through discretionary hardship arrangements.

The HSE is reviewing on a sequential basis, all non drug items on the List. Clinical nutritional products have been completed, significant work on dressings has been conducted and the HSE hopes to proceed to the Ostomy/Colostomy area later this year, as resources allow.

Generic Drugs Substitution

Questions (648)

Billy Kelleher

Question:

648. Deputy Billy Kelleher asked the Minister for Health if he will list the twenty priority drugs, in order of priority, that the Irish Medicines Board will be reviewing with regard to generic substitution of medication; when this process will be taking place; and if he will make a statement on the matter. [31584/13]

Written answers

Minister of State at the Department of Health

The Health (Pricing and Supply of Medical Goods) Act 2013 was commenced on Monday, 24 June 2013. This Act provides for the introduction of a system of generic substitution and reference pricing. It also sets out statutory procedures governing the supply, reimbursement and pricing of medicines and other items to patients under the GMS and community drug schemes.

The key aim of the legislation is to ensure value for money in the supply of medicines; therefore, the medicines that will be reviewed first by the Irish Medicines Board are most costly to patients and the Exchequer. The IMB will review an initial 20 active substances, which equates to approximately 1,500 individual medicines. They include statins, proton pump inhibitors, angiotensin-converting-enzyme (ACE) inhibitors and angiotensin II receptor blockers. The drugs involved are:-

Atorvastatin

Anastrozole

Candesartan

Clopidogrel

Esomeprazole

Lansoprazole

Lercanidipine

Losartan

Olanzapine

Omeprazole

Pantoprazole

Perindopril

Pravastatin

Quetiapine

Rabeprazole

Ramipril

Risperidone

Rosuvastatin

Simvastatin

Valsartan

It is expected that the first List of Interchangeable Medicines, containing groups of atorvastatin products, will be published in mid-August. The IMB will publish subsequent lists for other groups of medicines on an ongoing basis. From the end of the year onwards, hundreds of thousands of prescriptions will be subject to generic substitution, which will offer choice and reduced prices to patients.

Ambulance Service Provision

Questions (649)

Tom Fleming

Question:

649. Deputy Tom Fleming asked the Minister for Health if he will review the new centralisation of ambulance control centres following a series of incidents in response to calls for patients with serious medical conditions; if mistaken addresses and communication difficulties from the new centralised control system in Tallaght will need to be immediately reviewed to eliminate these failures; if he will re-introduce the local control systems and staff at least on a temporary basis to back up the centralised control centre to ensure that all emergency ambulance responses are effective, efficient and timely; and if he will make a statement on the matter. [31590/13]

Written answers

Minister for Health

A tragic event occurred in Kerry last week which was widely reported. Firstly, I wish to extend my deepest sympathies to the family of the child involved. The loss of a loved one is hard for family and friends at any time, but the sudden and unexpected death of a young child is particularly difficult.

In relation to this incident, the facts are that, at 1.16 am on 18 June 2013, an emergency call was received for a baby who was reported as not breathing. The National Ambulance Service (NAS) was initially unable to obtain sufficient details of where help was needed, which led to a delay in reaching the incident. The first emergency resource arrived at the scene 30 minutes after the initial 999 call. The patient was subsequently pronounced dead.

The incident has been the subject of a systems analysis, as is routine in cases where a death occurs, to ascertain whether call-taking protocols were followed. Following an examination of the facts, the HSE is satisfied that systems and processes operated correctly and there are no plans to carry out any further review. However, interrogation has been strengthened to try and mitigate the impact of a call where the incident location cannot be identified. In addition, HSE Communications has been requested to run a publicity campaign to improve public awareness of the need to communicate precisely the locations of incidents. In the interest of respecting the dignity and grief of the family, I wish to make no further comment on the specific incident.

A significant reform programme has been underway to totally reconfigure the way the HSE manages and delivers pre-hospital care services, to ensure a clinically driven, nationally co-ordinated system, supported by improved technology. The National Control Centre Reconfiguration Project, which is endorsed by HIQA and which represents international best practice, will reduce the number of ambulance control centres to a single national control system, with significant investment in new voice, data and mapping technologies. The project is also a key element of Future Health: A Strategic Framework for Health Reform in Ireland 2012-2015.

Both HIQA and the NAS have had concerns over control and dispatch structures at some control centres leading up to the development of the national control system. Accordingly, the NAS moved the Cork and Tralee centres to its Townsend Street centre on an interim basis in May, to mitigate such concerns pending completion of the national centre. Detailed preparations took place to ensure the safety of services during the move of the Cork and Kerry operations. The NAS provided additional staff, training, technology and equipment to assist this process. 112/999 calls from those areas are now answered in Dublin using improved technology. The NAS is satisfied that Townsend St, while not appropriate to the needs of the overall reconfiguration project, is nevertheless suitable and infrastructurally sound for the interim accommodation of these centres.

Services for People with Disabilities

Questions (650)

Finian McGrath

Question:

650. Deputy Finian McGrath asked the Minister for Health the position regarding a placement in a training centre in respect of a person (details supplied) in Dublin 5. [31594/13]

Written answers

Minister of State at the Department of Health

Although the 2013 allocation for disability services has been reduced by 1.2%, the Health Service Executive (HSE) National Service Plan includes an additional €4m to provide training places and day services for school-leavers and Rehabilitative / Lifeskills Training (RT) graduates in 2013. This funding is being allocated to each HSE Region based on its percentage of population. Both the voluntary sector and the HSE are committed to the best use of the funding in a creative and flexible manner so as to secure as many places as possible for this cohort.

The demand for services for school-leavers continues to grow. Information on the final numbers of young people who require training places or day supports is being collated and plans to meet their requirements finalised. Final figures are expected from the HSE shortly, but are likely to exceed last year’s total of 700. Providing the level of services required within the additional funding provided will continue to be a challenge. Work in this area will be progressed largely in line with the HSE guidance document developed in 2012, which led to the successful placement of 99% of RT graduates and 96% of school leavers last year.

In respect of the specific question asked by the Deputy, as it relates to service matters I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.

Housing Grant Applications

Questions (651)

Finian McGrath

Question:

651. Deputy Finian McGrath asked the Minister for Health if there is any funding or Health Service Executive scheme for a couple in their 90s who need a bath to shower conversion in view of the fact that the local council has no funds; if he will advise the couple on their options in receiving support in adapting their home to their current needs; and if he will make a statement on the matter. [31598/13]

Written answers

Minister of State at the Department of Health

The scheme referred to by the Deputy is a matter for the Department of the Environment,Community and Local Government and as such the Minister for Health Dr. James Reilly has no function in this matter.

Special Educational Needs Services Provision

Questions (652)

Pearse Doherty

Question:

652. Deputy Pearse Doherty asked the Minister for Health if detailed consideration has been given to the 2010 Framework for Action for the Inclusion of Children with Special Needs in Early Childhood Education Settings in determining the future of specialist preschools in County Donegal; if he is satisfied that the decision to close St. Agnes' preschool and his lack of commitment to retain the specialist preschool in Ballaghderg is consistent with the policy recommendations; and if he will make a statement on the matter. [31627/13]

Written answers

Minister of State at the Department of Health

The Government is fully committed to protecting frontline services, including services for children with disabilities, to the greatest extent possible. The inclusion of young children with disabilities in mainstream pre-school settings is an integral part of the Government’s policy on mainstreaming which advocates that mainstream public services should serve people with disabilities alongside other citizens. It is with this in mind that the HSE’s Intellectual Disability Services in Co. Donegal have embarked on a project to facilitate the inclusion, where appropriate, of children with an intellectual disability in mainstream pre-schools.

A Project Team has been established to determine the supports that will be required in mainstream pre-schools to accommodate these children. The overall aim of the Project is to ensure that these children can be educated in their own communities and with their own peers, rather than being segregated in specialist disability services, unless a child is assessed as requiring specialist care. I am advised no more than 5% of cases of children with a disability should require specialised pre-school provision to the extent that integration in a mainstream pre-school setting is not feasible.

There are currently two specialised pre-schools in Co. Donegal: St. Agnes pre-school in Donegal town and Ballaghderg pre-school in Letterkenny. The HSE has assured me that it has no immediate plans to close Ballaghderg pre-school and this pre-school will continue to deliver services until 2015. The position in respect of St. Agnes pre-school in Donegal town is that it will close at the end of 2014. The HSE arrived at this decision very recently and it was made following consultation with the parents concerned. There are currently four children at the pre-school. One of these children is due to commence school in September 2013 and the remaining three children will continue to avail of specialist pre-school services at St. Agnes until they are due to commence school in September 2014.

The HSE has given assurances that it will continue to engage with parents as this Project develops with a view to ensuring the children in question receive the best possible support in the most appropriate setting. The Framework for Action for the Inclusion of Children with Special Needs in Early Childhood Education Settings was developed as a research project by Mary Immaculate College in Limerick, having been commissioned by the Department of Education and Skills. In that context, I have been advised that the framework is used primarily as a teaching tool by those delivering courses on the inclusion of children with special needs.

National Lottery Funding Disbursement

Questions (653)

Michelle Mulherin

Question:

653. Deputy Michelle Mulherin asked the Minister for Health the criteria used to assess an application to the Department of Health national lottery fund during 2012 by an organisation (details supplied) in County Mayo; the grounds for failure; and if he will make a statement on the matter. [31634/13]

Written answers

Minister for Health

National Lottery applications are received by my Department from a range of community and voluntary organisations involved in various health related activities. The relevant Unit in my Department liaises with the appropriate personnel in the Health Service Executive to assess each individual application and consider whether the application should be recommended for funding. When the assessment has been completed and a recommendation has been made, I review each application and prioritise them according to their merits before awarding National Lottery funding.

My Department receives a large number of applications for National Lottery Funding each year and it is not possible to fund each one. If the organisation wishes to make an application for National Lottery Funding for 2013 they should send in a formal application. The closing date for completed applications is 12 noon on Friday 30th August 2013. Detailed procedures, along with the application form are set out on my Department's website - www.doh.ie

Medical Card Appeals

Questions (654)

Brian Walsh

Question:

654. Deputy Brian Walsh asked the Minister for Health if he will provide an explanation for the refusal of a medical card appeal in respect of a person (details supplied) in County Galway in view of the fact that the applicant has a long-term medical need; and if he will make a statement on the matter. [31652/13]

Written answers

Minister of State at the Department of 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.

Primary Care Centres Provision

Questions (655)

Pearse Doherty

Question:

655. Deputy Pearse Doherty asked the Minister for Health further to Parliamentary Question Nos. 541 of 30 April 2013 and 531 of 12 February 2013, if he will now consider allocating the proposed grant for primary health care centre in Dungloe under the PPP programme to the capital programme; and if he will make a statement on the matter. [31674/13]

Written answers

Minister of State at the Department of Health

PPPs are arrangements between the public and private sectors for the delivery of public infrastructure and/or public services by the private sector that would otherwise have been provided through traditional public sector procurement. The procurement of infrastructure projects via PPP involves a tendering process, whereby consortia are invited to Design, Build, Finance, Maintain and Operate a particular piece of public infrastructure. The consortium, which must be in a position to secure private debt financing and private equity to support its bid, is also subject to an extensive financial due diligence process by the private funding providers prior to loan approval.

As a consequence of this financial structure, the impact of the infrastructure investment on the General Government Balance is gradual rather than up-front, thereby allowing the Government cost of financing infrastructure to be spread over the lifetime of the asset. The Public Private Partnership (PPP) process involves a large element of up-front funding by the private sector. The €115m referred to in the July 2012 Stimulus Package announcement is the public sector's best estimate of what it could cost the private sector to deliver the PPP bundles. This indented €115m is not public funding which can be allocated to the direct-build capital programme.

The delivery of primary care infrastructure is a dynamic process and must take account of changing circumstances including the feasibility of implementing the delivery of the centres by means of lease, direct- build or PPP. GP engagement and agreement to deliver primary care services from primary care centres is central to delivery of the necessary infrastructure. Regardless of the method of delivery or deprivation ranking, locations cannot be progressed unless there is committed GP engagement.

Medical Card Applications

Questions (656)

Michelle Mulherin

Question:

656. Deputy Michelle Mulherin asked the Minister for Health the position regarding an application for a medical card in respect of a person (details supplied) in County Mayo; if same will be expedited; and if he will make a statement on the matter. [31681/13]

Written answers

Minister of State at the Department of 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 (657)

Michelle Mulherin

Question:

657. Deputy Michelle Mulherin asked the Minister for Health the position regarding a medical card application in respect of a person (details supplied) in County Mayo; if he will expedite same; and if he will make a statement on the matter. [31682/13]

Written answers

Minister of State at the Department of 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.

Primary Medical Certificates Applications

Questions (658)

Brendan Griffin

Question:

658. Deputy Brendan Griffin asked the Minister for Health if a primary medical certificate will be provided to a person (details supplied) in County Kerry; and if he will make a statement on the matter. [31683/13]

Written answers

Minister of State at the Department of 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.

Medical Card Eligibility

Questions (659)

Tom Fleming

Question:

659. Deputy Tom Fleming asked the Minister for Health if he will review the recent decision to downgrade the full medical cards of persons (details supplied) in County Kerry; and if he will make a statement on the matter. [31704/13]

Written answers

Minister of State at the Department of 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.

Hospital Services

Questions (660)

Joe Higgins

Question:

660. Deputy Joe Higgins asked the Minister for Health when the psychiatric unit of Beaumont Hospital will open; and if he will make a statement on the matter. [31705/13]

Written answers

Minister of State at the Department of Health

The particular issue raised by the Deputy is a service matter for the Health Service Executive. Accordingly, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.

Health Services Expenditure

Questions (661)

Michael Healy-Rae

Question:

661. Deputy Michael Healy-Rae asked the Minister for Health if he will provide in tabular form a breakdown of the expenditure on Autism; the total amount of money available; the amount that has been spent on a county basis for the period since the latest round of funding for Autism was announced to date; and if he will make a statement on the matter. [31706/13]

Written answers

Minister for Health

As the Deputy will be aware, accountability for the management of services is a matter for the HSE to address within the ambit of its Vote (Vote 39). The level of health services to be delivered within the available funding for 2013 has been set out in the HSE National Service Plan for 2013, which I approved in January. I have made enquires of the HSE in relation to the Deputy’s specific queries regarding the current expenditure on autism across the country. However, the HSE has advised it is not in a position to provide a breakdown of the funding currently being spent on autism services in Ireland. This is due to the manner in which funding is allocated between broad categories such as services for older people, primary care and disabilities in general. Disability services are provided based on the needs of the individual, rather than by the actual type of disability. The Executive also explained that people with autism may attend autism-specific services, or may obtain services from a service provider who provides services for a wide range of intellectual disabilities, including autism. The HSE will provide in the order of €1.5 billion in 2013 to fund health services for children and adults with disabilities, including autism. This represents approximately 11.5% of the €13.3billion health budget for 2013. It should also be noted that while the HSE provides a range of services to adults and children with disabilities, the majority of this funding is distributed through non-statutory agencies who deliver over 80% of all disability services.

The HSE National Review of Autism Services: Past, Present and Way Forward Report (2012) and the Progressing Disabilities Services for Children and Young People (0-18s) Programme set out the policy context for the provision of autism services to children and young people. The objective of the Progressing Disabilities Programme is to achieve a national, unified approach to delivering disability health services so that there is a clear pathway to the services for all children, regardless of where they live, what school they go to or the nature of their disability. This Programme aims to remedy the variations in service provision that currently persist around the country.

To assist in addressing some of these variations, I announced the allocation of €1m in funding for autism and early intervention services in 2012. Based on a report prepared by the HSE, I approved €300,000 of this funding, which equates to five therapists posts, for Beechpark services in Dublin, north of the Liffey, to address the pressing needs of its catchment area, with a particular emphasis on reducing waiting times. The report also proposed an allocation for Beechpark in the Dublin Mid-Leinster region which was to be rolled out in year two (i.e. Dublin south of the Liffey, Kildare and Wicklow).

I also established an Independent Review Group in 2012, to look at the Beechpark model of services and how resources could be used in the best and most effective way, in light of the HSE Review of Autism Services and the re-organisation of services underway in line with the 0-18's Programme. Further funding in relation to Beechpark and other regions of the country, was put on hold, pending the outcome of this Review. I understand that this Review is expected to be concluded shortly.

Following ongoing discussions on the best way forward in relation to Beechpark Autism Services, the HSE has confirmed that the funding approved will be allocated to HSE Dublin North East in 2013 for Beechpark in order to address the waiting list for services in Dublin North East. This will provide, in the first instance, for the recruitment of the necessary five therapy staff. I am very aware, however, that addressing the significant pressures in Dublin North East is only a starting point. The balance of funding for autism and early intervention services nationally will be made available. The issue of the allocation of these further resources will be required to be looked at, in light of the findings of the Independent Review.

Graduate Nursing Scheme Issues

Questions (662)

Seán Ó Fearghaíl

Question:

662. Deputy Seán Ó Fearghaíl asked the Minister for Health if he will address the concerns raised in correspondence (details supplied) regarding a public health nursing course; and if he will make a statement on the matter. [31713/13]

Written answers

Minister for Health

The 2012 sponsored Student Public Health Nurse Graduate/Postgraduate Diploma recruitment campaign, which was advertised by the HSE with a closing date of 1st June 2012, advised candidates that, on successful completion of the training programme, they would be required to accept an initial assignment as a full-time Public Health Nurse, for a period of not less than two years, in the sponsoring Local Health Office/Integrated Service Area.

Candidates were subsequently advised that the terms and conditions of the Sponsorship Programme had changed and this change meant that there would be no guarantee of immediate PHN positions for candidates on successful completion of the programme. The programme commenced on 8th October 2012. Discussions involving HSE management and the INMO on the change to the terms and conditions have recently been held in the Labour Relations Commission. These discussions are continuing.

Medical Card Eligibility

Questions (663)

Brendan Griffin

Question:

663. Deputy Brendan Griffin asked the Minister for Health if he will consider the introduction of a minium period of one year without further review for medical card holders who have had successful medical card appeals; and if he will make a statement on the matter. [31728/13]

Written answers

Minister of State at the Department of Health

The Health Service Executive operates under the legislative framework of the Health Act of 1970, as subsequently amended. In the interest of probity, the HSE is obliged to ensure that a person’s eligibility is correctly recorded in line with the eligibility legislation and the national guidelines. The HSE aims to ensure that every person who is entitled to the medical card schemes is given the opportunity to avail of their entitlement.

The standard procedure for the review of medical cards, including those granted following appeal, for persons aged 66 years or older is that their medical card will be reviewed every 4 years. For persons under the age of 66 years, the length of validity of a medical card is 3 years. Depending on the individual's circumstances, it may be issued for a shorter period. Medical cards awarded on a discretionary basis are valid for two to three years, in line with general medical cards/GP Visit Cards.

If an individual's circumstances change, he/she must inform the HSE, as he/she may no longer be eligible. In addition to the standard assessment and review processes, random audits of eligibility will also be undertaken by the HSE on an on-going basis. If selected for review under this process, the Medical Card holder will be informed and requested to submit up to date income details.

Hospital Waiting Lists

Questions (664)

John McGuinness

Question:

664. Deputy John McGuinness asked the Minister for Health further to Parliamentary Question No. 727 of 29 January 2013, when a person (details supplied) in County Kerry will receive a scan for a disc assessment at the physio led musculoskeletal clinic in Waterford Regional Hospital; and if he will make a statement on the matter. [31734/13]

Written answers

Minister for 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.