Nursing Homes Support Scheme Applications

Questions (686)

Caoimhghín Ó Caoláin

Question:

686. Deputy Caoimhghín Ó Caoláin asked the Minister for Health when a decision will be made on an application for the fair deal scheme in respect of a person (details supplied) in County Monaghan. [31988/13]

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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.

Medical Aids and Appliances Provision

Questions (687)

Luke 'Ming' Flanagan

Question:

687. Deputy Luke 'Ming' Flanagan asked the Minister for Health if he will instruct the Health Service Executive to consider providing through the GMS a newer generation of ileostomy pouches which are longer lasting and hence more cost effective; his views on whether the current ileostomy product range available from the HSE is out-dated and that a better selection should be made available to those who have need to use such due to illnesses such as inflammatory bowel disease and cancer; and if he will make a statement on the matter. [32020/13]

View answer

Written answers (Question to Health)

This is a service matter, therefore, it has been referred to the HSE for attention and direct reply to the Deputy.

Medical Card Applications

Questions (688)

Michael Healy-Rae

Question:

688. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a medical card in respect of persons (details supplied) in County Kerry; and if he will make a statement on the matter. [32035/13]

View answer

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.

Proposed Legislation

Questions (689, 693)

Nicky McFadden

Question:

689. Deputy Nicky McFadden asked the Minister for Health if legislation will be implemented to regulate the use of sunbeds to assist in reducing the number of persons developing skin cancer; and if he will make a statement on the matter. [32065/13]

View answer

Terence Flanagan

Question:

693. Deputy Terence Flanagan asked the Minister for Health his plans to introduce legislation regarding the regulation of sunbeds here; and if he will make a statement on the matter. [32140/13]

View answer

Written answers (Question to Health)

I propose to take Questions Nos. 689 and 693 together.

I can confirm that legislation will be implemented to regulate the use of sunbeds. This Bill has priority drafting and Officials of the Department are working closely with the Office of the Parliamentary Counsel to complete the drafting of this legislation.

This legislation will prohibit the use of sunbeds on a sunbed premises by persons under 18 years of age and will also set out a comprehensive range of measures to promote a greater public awareness across all age groups of the dangers of developing skin cancer, premature ageing and eye damage from exposure to ultraviolet radiation (UVR). Key provisions in the Bill will include:-

(i) a prohibition on anyone under 18 years of age using a sunbed on a sunbed premises;

(ii) a prohibition on the sale to or hire of sunbeds to anyone under 18 years of age;

(iii) a prohibition on the unsupervised use of sunbeds in a sunbed premises;

(iv) an exemption for medical purposes;

(v) control on the remote sale or hire of sunbeds (internet transactions);

(vi) sunbed operators, sellers and hirers will be required to notify the HSE;

(vii) a requirement that sunbed operators provide training for staff;

(viii) an enforcement regime and the imposition of penalties for non-compliance;

(ix) an obligation on all sunbed operators to provide protective eyewear to users;

(x) a requirement that warning signs be displayed in all sunbed premises;

(xi) a prohibition on certain promotional marketing practices;

(xii) a requirement on operators to ensure that sunbed users are made fully aware of the potential dangers of sunbed use; and a related provision whereby sunbed users are required to sign to confirm that they have been made so aware.

It is important to bear in mind that the Bill, when finalised, must be notified to the EU Commission under the EU Transparency Directive prior to the publication and introduction of the Bill in the Oireachtas. This EU notification requirement will necessitate a minimum of three months to complete.

National Treatment Purchase Fund

Questions (690)

Michelle Mulherin

Question:

690. Deputy Michelle Mulherin asked the Minister for Health the arrangements in place to cover travel expenses of patients availing of treatment abroad facilitated by the Health Service Executive and in particular in respect of a person (details supplied) in County Mayo; and if he will make a statement on the matter. [32074/13]

View answer

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.

Hospital Waiting Lists

Questions (691)

Ciaran Lynch

Question:

691. Deputy Ciarán Lynch asked the Minister for Health when a person (details supplied) in County Cork who is on an urgent orthopaedic outpatient waiting list since 6 December 2012 will be treated; and if he will make a statement on the matter. [32077/13]

View answer

Written answers (Question to Health)

Improving access to outpatient services is a key priority for the Government. Collaborating with individual hospitals, the SDU, together with the National Treatment Purchase Fund (NTPF) and the HSE, has developed the outpatient waiting list minimum dataset. This allows data to be submitted to the NTPF from hospitals on a weekly basis and, for the first time, outpatient data is available on www.ntpf.ie. For 2013, a maximum waiting time target has been set of 12 months for a first time consultant-led outpatient appointment and this is reflected in the HSE service plan. The SDU and the NTPF will work closely with hospitals towards achievement of the maximum waiting time.

Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she would be in the best position to take the matter up with the consultant and hospital involved. In relation to the specific hospital appointment query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.

Palliative Care Services

Question No. 693 answered with Question No. 689.

Questions (692)

Nicky McFadden

Question:

692. Deputy Nicky McFadden asked the Minister for Health if he will ensure that patients in all regions of the country will have access to comprehensive hospice inpatient and home care services; if he will acknowledge the significant savings the provision of an adequate number of hospice beds could make by reducing admissions rates and length of stay in expensive acute hospitals; if 450 beds will be made available in the country; and if he will make a statement on the matter. [32084/13]

View answer

Written answers (Question to Health)

Palliative care services are experiencing increasing demands due to the changing demographics of our ageing population and increasing patient and public expectations, particularly for support for chronic non-malignant diseases.

Government policy on Palliative Care is contained in the Report of the National Advisory Committee on Palliative Care (2001) and the HSE Medium Term Framework for Palliative Care Services (2009 – 2013) and (for children) Palliative Care for Children with Life-limiting Conditions in Ireland - A National Policy.

Palliative care is delivered in a variety of settings from specialist palliative units, to acute hospitals, and in the community. Input is sought from multidisciplinary teams of health care professionals at the level that is most appropriate for the needs of the patient at any particular time. The objective always is to respond to the physical, psychological, social and spiritual needs of patients and to achieve the highest possible quality of life for the patient and family

Although funding pressures have intensified across all service areas in recent years, the HSE continues to work with voluntary and local groups to deliver the best possible service for those who need palliative care. In 2012, approx 35,738 people received specialist home care palliative services and 4,274 people received specialist in-patient care.

The HSE National Service Plan 2013 provides funding of €72m for Palliative Care, exclusive of the palliative care that is provided in acute hospitals, on approximately 170 palliative care support beds or on palliative home care packages.

The HSE has committed to the following access targets for 2013:

- 92% of specialist inpatient beds provided within 7 days

- 98% of specialist inpatient beds provided within one month

The most recent HSE Performance Report for 2013 indicates that to March, this target was exceeded with 94% of those seeking specialist palliative inpatient beds receiving this service within 7 days, and 99% receiving the service within one month.

My Department and the HSE will continue to work to ensure that available resources are used in the most effective way possible to give those who need hospice or other palliative care the services that they need and deserve.

Question No. 693 answered with Question No. 689.

General Medical Services Scheme Payments

Questions (694)

Brendan Griffin

Question:

694. Deputy Brendan Griffin asked the Minister for Health the changes that have been made to the fees payable to general practitioners under the Financial Emergency Measures in the Public Interest Act and the percentage reductions involved; if he foresees any changes to the contract, including a reduction of the capitation fee, a fee based on actual work done and a mechanism that includes the non-payment or recoup of fees paid for those who have emigrated or plan to do so; and if he will make a statement on the matter. [32147/13]

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Written answers (Question to Health)

The current General Medical Services (GMS) General Practitioner (GP) Capitation Contract was introduced in 1989 and is based on a diagnosis and treatment model. Under the GMS contract, GPs receive a range of fees and allowances, including an annual capitation payment in respect of each medical card and GP visit card patient on their GMS list.

Under the Financial Emergency Measures in the Public Interest (FEMPI) Act 2009, an 8% reduction in a range of GP fees and allowances was introduced in 2009, which effected full year savings in the region of €34 million. Further reductions to a range of fees and allowances were introduced in 2010, which effected full year savings in the region of €44 million. This equates to an approximate additional reduction of 9%.

Following a further review and having due regard to Section 9 of the FEMPI Act 2009, the Minister for Health has decided to apply further reductions to the fees and allowances payable to GPs which equate to an overall reduction of 7.5%. This will amount to a saving of some €38 million in a full year. Regulations are being prepared to give effect to the Minister's decision.

The Programme for Government provides for the introduction of a new GMS GP contract with an increased emphasis on the management of chronic conditions, such as diabetes and cardiovascular conditions. It is envisaged that the new contract, when finalised, will focus on prevention and will include a requirement for GPs to provide care as part of integrated multidisciplinary Primary Care Teams. The appropriate payment arrangements will be considered as part of the new GMS contract.

Capitation fees are paid to General Practitioners where a person has eligibility for a Medical/GP Visit Card. Fees are not paid where eligibility no longer exists e.g. following an assessment of their means, emigration or death. Under the Health Act 1970, there is an obligation on all card holders to notify the HSE of any change in their circumstances, which would put them above the Medical Card/GP Visit Card income guidelines.

In addition to the normal three-yearly review of eligibility on expiration of a medical card, targeted reviews of eligibility were introduced during 2012, in relation to medical cards which had been inactive for more than 12 months. In such cases, medical card holders were formally contacted to confirm that they were still resident in the State. In cases where no response was received, eligibility was removed and the payment of capitation fees ceased. A person whose eligibility is under review who appeals a decision regarding their eligibility retains their original eligibility until an Appeal decision is reached.

Health Services Issues

Questions (695)

Denis Naughten

Question:

695. Deputy Denis Naughten asked the Minister for Health further to Parliamentary Questions Nos. 276 and 278 of 30 May 2013, if he will outline the number of psychiatric nursing staff officially appointed or allocated to each unit; the number of involuntary patients resident in each unit; the number of long-term involuntary or forensic patients, those deemed suitable for accommodation in a intensive care rehabilitation unit in each unit; and if he will make a statement on the matter. [32168/13]

View answer

Written answers (Question to Health)

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

Mental Health Services

Questions (696)

Denis Naughten

Question:

696. Deputy Denis Naughten asked the Minister for Health the number of long-term involuntary or forensic patients, the number of those deemed suitable for accommodation in a intensive care rehabilitation unit accommodated outside the Central Mental Hospital and appropriate long-term accommodation; the numbers in the Central Mental Hospital due for release this year and in each of the next three years; the timeline for the completion of regional intensive care rehabilitation units and the capacity of same; and if he will make a statement on the matter. [32169/13]

View answer

Written answers (Question to 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.

Generic Drugs Substitution

Questions (697, 698)

Caoimhghín Ó Caoláin

Question:

697. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the measures that are planned to increase the use of generic drugs here; the legislative and regulatory measures to ensure same; the expected savings from same in 2013; and if he will make a statement on the matter. [32182/13]

View answer

Caoimhghín Ó Caoláin

Question:

698. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the measures planned to decrease the cost of generic drugs here; the legislative and regulatory measures to ensure same; the expected savings from same in 2013; and if he will make a statement on the matter. [32183/13]

View answer

Written answers (Question to Health)

I propose to take Questions Nos. 697 and 698 together.

The prices of drugs vary between countries for a number of reasons, including different prices set by manufacturers, different wholesale and pharmacy mark-ups, different dispensing fees and different rates of VAT. 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 have successfully 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 24th of June, provides for the introduction of a system of generic substitution and reference pricing. 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 are most costly to patients and the Exchequer. The consultation process for the first List of Interchangeable Medicines, containing groups of atorvastatin products, started on the 26th of June. It is expected that this list will be published in mid-August at which time generic prices will fall by 20%.

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.

It is not possible, at this juncture, to provide accurate figures regarding potential savings resulting from the introduction of generic substitution and reference pricing, as these depend on various factors including prevailing prices, number of competitors, availability of substitute products, and market dynamics.

The Department is committed to establishing high-level annual targets by the end of September for the share of generic penetration over the medium-term. These targets will be informed by the ESRI report Pharmaceutical Prices, Prescribing Practices and Usage of Generics in a Comparative Context, which was published on the 27th of June.

Hazardous Waste Disposal

Questions (699)

Seán Kyne

Question:

699. Deputy Seán Kyne asked the Minister for Health if he will outline the procedures in place to ensure the safe disposal of hazardous waste, including radioactive material, from public and private hospitals here; and the steps open to citizens should they harbour concerns regarding the safety of such waste disposal. [32195/13]

View answer

Written answers (Question to Health)

I would like to advise the Deputy that I have no function in relation to the matter raised. Matters relating to hazardous waste are the responsibility of the Environmental Protection Agency (EPA). Matters relating to radiological safety come within the ambit of the Radiological Protection Institute of Ireland (RPII). Both of these public authorities come under the auspices of the Minister for the Environment, Community and Local Government.

Services for People with Disabilities

Questions (700)

Seán Kyne

Question:

700. Deputy Seán Kyne asked the Minister for Health if the system for providing support services, educational, vocational or otherwise, can be urgently assessed so that a permanent, more effective framework can be implemented which would provide certainty as well as options for persons with disabilities graduating from second level education. [32198/13]

View answer

Written answers (Question to Health)

The HSE, through its Occupational Guidance Service, works with schools, service providers, service users and families to identify the needs of young people with disabilities who are due to complete their second level education. The aim is to address the needs of individuals in the following ways, through:

- Health-funded rehabilitative or life-skills training;

- Health-funded day services;

- FÁS-funded vocational training, or;

- Extension to education placement for a specified time.

Vocational training which prepares people, including young people with disabilities, for employment in the open labour market is the responsibility of the Department of Education and Skills and FÁS. Rehabilitative training, which has no connection with the open labour market, is the responsibility of the Department of Health and the Health Service Executive (HSE). The purpose of rehabilitative training is to develop the individual’s life skills, social skills and basic work skills. Approximately 3,000 people with disabilities avail of rehabilitative training each year, some of whom then progress to vocational training, other training or employment. Some young people with disabilities, depending on their individual needs and abilities, require continuing supports from the HSE.

The HSE report New Directions: the report of the National Working Group for the Review of HSE-funded Adult Day Services , which was published in 2012, is guiding the reconfiguration and modernization of day services and will underpin the flexible and innovative approach required when addressing the future requirements of school leavers with disabilities who require continuing support. The New Directions report recommends the development of alternative models of day service based on the provision of individualised supports, rather than centre-based set programmes. The new model will enable young people with disabilities to lead self-directed lives through a range of personal supports.

A Working Group was established under the auspices of the National Consultative Forum to ensure the New Directions implementation plan is progressed through a collaborative approach. One of the work-packages currently being progressed by the Working Group is the development of draft standards for day services, in association with National Disability Authority. The draft standards will form part of a consultation process with service providers, service users and parents due to take place in September 2013. A revised Implementation Plan for New Directions will also form part of the consultation. Following the consultation process, the Interim Standards will be made available to service providers along with an audit tool. The Interim Standards are seen as essential in order to ensure a consistent and measurable approach to the reconfiguration and modernization of HSE-funded day services and supports.

The demand for services for young people with disabilities completing their education or life-skills training continues to grow. The HSE are currently finalising their figures for 2013 but expects that over 700 new places will be required. Service providers and the HSE are working closely together to identify how these needs can be met within available resources. This year, despite a 1.2% cut in the disability budget, an additional €4m has been ring-fenced in the HSE’s National Service Plan for new places. 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 available resources in a creative and flexible manner, so as to be as responsive as possible to the needs of this cohort.

I have asked to be kept informed of progress in finding appropriate training places and day services for this year's school-leavers on an ongoing basis and I have recently met with the National Federation of Voluntary Bodies and the HSE on this issue. I have also asked the HSE to ensure that a plan is put in place immediately to communicate with families and give them some certainty as to the placements or supports which will be available to their children in September.

Health Services Staff Recruitment

Questions (701)

Charlie McConalogue

Question:

701. Deputy Charlie McConalogue asked the Minister for Health the reasons the post of the second neurologist in the north west cannot be taken up as soon as possible (details supplied); the impact this appointment is expected to make on waiting lists in the north-west region; and if he will make a statement on the matter. [32239/13]

View answer

Written answers (Question to Health)

In relation to the particular query raised by the Deputy, as this is a service issue, I have asked the Health Service Executive to respond directly to the Deputy in this matter.

Health Services Issues

Questions (702)

Tom Fleming

Question:

702. Deputy Tom Fleming asked the Minister for Health if he will provide the necessary funding and resources for the Cherryfield facility in Killarney, County Kerry, to ensure the required upgrading of the facility can proceed at an early date. [32283/13]

View answer

Written answers (Question to 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.

Drugs Payment Scheme Threshold

Questions (703)

Seán Kyne

Question:

703. Deputy Seán Kyne asked the Minister for Health if the drugs payment scheme threshold will be protected, or preferably reduced, in recognition of the many citizens with long-term but manageable illnesses who are ineligible for medical cards and rely on the drugs payment scheme to help meet the costs associated with health care. [32286/13]

View answer

Written answers (Question to Health)

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.

There are no plans to alter the Drug Payment Scheme threshold.

Ambulance Service Provision

Questions (704)

Regina Doherty

Question:

704. Deputy Regina Doherty asked the Minister for Health the position regarding the provision and availability of ambulance services throughout County Meath; and if he will make a statement on the matter. [32289/13]

View answer

Written answers (Question to Health)

A significant reform programme is underway in the HSE to reconfigure the management and delivery of pre-hospital emergency care services. Under Future Health: A Strategic Framework for Health Reform in Ireland 2012-2015, this will ensure a clinically driven, nationally coordinated system to support all pre-hospital emergency care activity in the State.

The National Ambulance Service (NAS) is taking steps to improve response times where possible, by addressing challenges such as reliance on on-call rostering, geography, resourcing and the use of emergency ambulances for routine patient transport.

The NAS is moving its emergency ambulance services from on-call to on-duty rostering. This means highly trained paramedic crews are in their stations or vehicles to respond immediately to 112/999 dispatches, and they can move to optimal locations at any time during a shift.

The national control centre reconfiguration project will produce one national control and dispatching system. With improved technology, this will allow the NAS to deploy emergency resources more effectively and efficiently, on a regional and national basis rather than within small geographic areas. The project, endorsed by HIQA, is a key element of Future Health.

In relation to the particular query raised by the Deputy regarding provision of ambulance services in County Meath, as this is a service issue, I have asked the Health Service Executive to respond directly to the Deputy in this matter.