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Wednesday, 18 Sep 2013

Written Answers Nos. 1280-1298

Tobacco Control Measures

Questions (1280)

Billy Kelleher

Question:

1280. Deputy Billy Kelleher asked the Minister for Health if any assessment has been made to date on the impact of the introduction of pictorial health warnings on tobacco packaging with regard to consumption levels especially on the levels of smoking among young persons and children [36839/13]

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Written answers

As the Deputy will be aware, the Public Health (Tobacco) (General and Combined Warnings) Regulations 2011 (SI No. 656), came into effect earlier this year. Since Friday, 1st February 2013, cigarette packaging placed on the Irish market must display graphic photographs with a strong health warning. These images depict the negative health impacts associated with smoking, and were selected by Ireland from the library of images developed by the European Commission. From these images, the most effective combined warnings for the Irish market were identified by research conducted by TNS MRBI commissioned by the Office of Tobacco Control in the Health Service Executive.

Although no formal assessment of the impact of the warnings has taken place in Ireland as yet, it is anticipated that these particular measures will have a positive impact on reducing the numbers of young people starting to smoke. A recent Eurobarometer survey found a high level of public support for various tobacco control measures among Irish citizens, with 90% in support of the introduction of pictorial health warnings on all tobacco products (1). Research and experience in other countries has shown that health warnings combined with coloured photographs can be an effective means of discouraging smoking and informing people about the health risks related to smoking. According to the World Health Organisation, in Canada the introduction of photo images on cigarette packs resulted in a fourfold increase in smoker’s intentions to quit (20% before - 87% after). Also according to the WHO, in Brazil 56% of people changed their opinion about the health consequences of smoking after the introduction of the new packaging. Research has demonstrated clear evidence that health warnings for tobacco packaging increase consumers’ knowledge about the health consequences, contribute to changing consumers’ attitudes towards tobacco use and to changing consumers’ behaviour (2). Combined pictorial and text warnings have been found to be significantly more impactful and memorable than text only warnings (3) and they have therefore been found to be more effective especially in changing consumer behaviour (2). Health warnings on tobacco packaging have been identified as a critical element of tobacco control policy (2).

A new tobacco policy is currently being finalised in the Department of Health. In recognition of the fact that no one element in isolation can be effective in reducing tobacco consumption, Irish tobacco policy is comprised of a suite of measures including education, taxation, regulation and health promotion initiatives such as the inclusion of graphic (or pictorial) warnings on tobacco packaging.

References:

(1) http://ec.europa.eu/health/tobacco/docs/eurobaro_attitudes_towards_tobacco_2012_en.pdf

(2) http://ec.europa.eu/health/tobacco/docs/warnings_report_en.pdf

(3) http://ec.europa.eu/health/tobacco/docs/eurobaro_tobaccowarninglabels_ql_5818_en.pdf

Medical Card Eligibility

Questions (1281)

Michael McGrath

Question:

1281. Deputy Michael McGrath asked the Minister for Health the current national interest rate applied to savings or similar investments for the purposes of calculating eligibility for a medical card for persons aged 70 years and over; if a person may opt to have their income assessed for eligibility based on the actual level of interest earned during the relevant period; and if he will make a statement on the matter. [36842/13]

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Written answers

Under the Health Service Executive’s (HSE) Medical Card/GP Visit Card National Assessment Guidelines, savings or similar investments up to the first €36,000 for a single person and up to the first €72,000 for a couple are disregarded in the assessment process for a medical card and only interest from savings or similar investments above these figures will be considered as income for means testing purposes. The relevant portion of savings and similar investments will be assessed on the income calculated at a notional interest rate, based on the prevailing interest rates at the time of application. The HSE Central Application Unit will review the notional rate on a quarterly basis. The notional rate currently being applied is 3%.

Alternatively, where the applicant wishes to have the actual interest from savings/investments considered, the HSE will apply this approach and will use the most beneficial option in favour of the applicant, subject to submission of the appropriate certificates from the relevant institutions. In the case of “longer term” investment accounts, where the interest is only applied at the end of a fixed period, if the applicant so wishes, the HSE will only take account of the interest earned on the date the investment matures.

Income will not be imputed from property (whether a family home, a holiday home or any other property) for means testing purposes, unless it is rented and only the net rental income will be included as income. The income to be assessed will be the gross income, less any cost necessarily incurred associated with the rental of the property and such cost may include insurance premia, loan/mortgage repayments, maintenance etc.

Assisted Human Reproduction

Questions (1282)

Joe Higgins

Question:

1282. Deputy Joe Higgins asked the Minister for Health the work that has been done to date to bring forward legislation on stem cell research; and if he will make a statement on the matter. [36861/13]

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Written answers

I wish to inform the Deputy that I am currently considering policy proposals to regulate Assisted Human Reproduction and related matters, including stem cells, based on work undertaken by my Department. I will make a decision on these matters in due course.

Mental Health Services Provision

Questions (1283)

Billy Kelleher

Question:

1283. Deputy Billy Kelleher asked the Minister for Health the position regarding the provision of services to persons with borderline personality disorder; if his attention has been drawn to the fact that those with this disorder are high users of accident and emergency departments for self harm and that development of services for them could relieve pressure in emergency departments; and if he will make a statement on the matter. [36863/13]

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Written answers

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

Orthodontic Service Provision

Questions (1284)

Arthur Spring

Question:

1284. Deputy Arthur Spring asked the Minister for Health if treatment will be provided by the Health Service Executive to a person (details supplied) in County Kerry as the person who is not a suitable candidate for other treatments due to illness. [36872/13]

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Written answers

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

Medical Card Eligibility

Questions (1285)

Michelle Mulherin

Question:

1285. Deputy Michelle Mulherin asked the Minister for Health the criteria that applies to an Irish citizen aged over 70 years who is in receipt of a British pension and is seeking a medical card; and if he will make a statement on the matter. [36882/13]

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Written answers

Regulation (EC) 883/04 and Implementing Regulation 987/09 provide for the coordination of social security systems, including healthcare, within the EU/EEA and Switzerland, with the aim of ensuring the free movement of persons. This objective of the Regulation is to ensure that persons exercising their right to move and to stay freely within the EU/EEA and Switzerland do not suffer disadvantage.

Medical Cards may be issued to EU\EEA citizens residing in Ireland under EU Regulation 883/04 if the person is in receipt of a contributory social insurance payment from one, or more, of the Member States, provided they are not receiving a contributory social insurance payment from the Irish State. EU\EEA citizens who are in receipt of a qualifying payment from another member State should make an application for a Medical Card directly to the HSE. The application should be accompanied, as evidence that they are receiving a qualifying payment, by the relevant EU "S" form issued by the Member State making their payment. The position regarding the UK is that, under a reciprocal agreement, the EU "S" form is not required, however, proof of receipt of a qualifying payment from the UK authorities should be provided with the application to the HSE.

Medical Card Applications

Questions (1286)

Michael Healy-Rae

Question:

1286. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a medical card in respect of a person (details supplied); and if he will make a statement on the matter. [36887/13]

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Written answers

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 issued to Oireachtas members.

An Bord Altranais agus Cnáimhseachais na hÉireann

Questions (1287)

Gerry Adams

Question:

1287. Deputy Gerry Adams asked the Minister for Health the reason An Bord Altranais agus Cnáimhseachais na hÉireann is commonly referred to as the Nursing and Midwifery Board of Ireland in the sector; the steps he is taking to ensure it is given its full Irish title by employees, members and those in the sector; and if he will make a statement on the matter. [36896/13]

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Written answers

The Nurses and Midwives Act 2011 is the legislation which provides for the operation of An Bord Altranais agus Cnáimhseachais na hÉireann or, in the English language, the Nursing and Midwifery Board of Ireland. Both titles are legally recognised by that Act.

Hospital Services

Questions (1288)

Joan Collins

Question:

1288. Deputy Joan Collins asked the Minister for Health if he will provide a list of hospitals that have a protocol for the treatment of sepsis in place [36906/13]

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Written answers

In relation to the specific query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.

Medical Card Eligibility

Questions (1289)

Michael Healy-Rae

Question:

1289. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a medical card in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [36920/13]

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Written answers

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 issued to Oireachtas members.

Hospitals Expenditure

Questions (1290)

Colm Keaveney

Question:

1290. Deputy Colm Keaveney asked the Minister for Health if he will provide a financial breakdown of the current budgetary performance of every hospital providing acute services within the Health Service Executive with details of the expected target of each acute hospital and the projected outturn; and if he will make a statement on the matter. [36925/13]

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Written answers

The funding pressures now being experienced in the health services mean that the acute sector must reduce its costs in order to deliver the agreed level of activity within the resources available to it. This means that we must concentrate on maximising efficiency and getting the best possible services for patients from the budgets available to us.

In relation to the specific queries raised by the Deputy, as these are service issues they have been referred to the HSE for direct reply.

Suicide Prevention

Questions (1291)

Colm Keaveney

Question:

1291. Deputy Colm Keaveney asked the Minister for Health the measures he has implemented since coming into office to reduce the numbers of deaths by suicide; the measures he is planning to implement by the end of 2013; the targeted reduction to be achieved by the end of 2013, 2014, 2015; and if he will make a statement on the matter. [36926/13]

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Written answers

Suicide is a tragedy that we are constantly working to prevent and also working to give more support to the families affected. Dealing with the current high levels of suicide and deliberate self-harm is a priority for this Government and in this regard significant additional funding has been provided in recent years to address this issue. Reach Out our National Strategy for Action on Suicide Prevention makes a number of recommendations in relation to fast track referrals to community-based mental health services, effective response to deliberate self-harm, training, reducing stigma and promoting positive mental health, initiatives aimed at helping young men and research.

Since 2011, funding for the NOSP has increased significantly from €4 million in 2011 to €7.9 million in 2013. This increase in funding along with the additional investment in mental health has led to work being progressed on almost every recommendation in Reach Out including the following actions:

- Supporting over 40 individual organisations and programmes both internal and external to the HSE. This increase in funding has focused on resourcing front line services for persons who are in emotional distress, who have engaged in self harm or who have been bereaved through suicide. Many of these services are being delivered by Non-Governmental Organisation sector with direct funding from the NOSP, i.e. Pieta House, Samaritans and Console.

- Working to build the capacity of frontline service providers and communities to respond to suicide through the delivery of a number of suicide prevention training programmes i.e. over 42,000 participants have completed the ASIST and safeTALK programmes. In addition, the NOSP has invested significantly in the development of Dialectical Behaviour Therapy (DBT) services across community mental health teams.

- The NOSP resourced the Irish College of General Practitioners (ICGP) to implement a training programme on suicide prevention for GPs and general practice staff. International evidence highlights GP training in depression and the management of suicidal behaviour as critical to reducing suicide rates.

- The development of the National Clinical Care Programme for Self Harm in Emergency Departments and the SCAN (Suicide Crisis Assessment Nurse) service.

- The delivery of two effective social marketing campaigns on mental health that have changed public attitudes and behaviours related to help seeking and mental health. The NOSP is working to develop a new national communication strategy for suicide prevention.

- The NOSP is currently working with the Irish Association of Suicidology and other partners to develop national standards for service providers that will improve the quality and safety of funded services.

- The NOSP in partnership with the Department of Education and Skills launched national guidelines on Mental Health and Suicide Prevention for the post primary school sector. These guidelines have been distributed to schools and health services on a nationwide basis.

- The HSE is implementing the CIPC (Counselling in Primary Care) programme. This national service was launched in 2013 and is delivering counselling to medical card holders at a primary care level.

The NOSP publishes an Annual Report which outlining its activities which is laid before Both Houses of the Oireacthas. The Annual Report for 2012 was published on 5 September 2013.

The NOSP has been reviewing its current activities to make the most of our available resources, including looking at best practice internationally to inform evidence-based policy decisions. The review will result in a renewed strategic approach which will build on work already undertaken under Reach Out. Its aim will be to support population health approaches and interventions that will assist in reducing the loss of life through suicide. This renewed focus will provide for improved coordination and integration of services to ensure that pathways of care for persons at risk of suicide or in suicidal crisis can be accessible, acceptable and available.

Targets to reduce the rate of suicide for the years 2013 to 2015 have not been set. However, it is proposed that the development of targets related to suicidal behaviour and population well-being will be considered as part of the review.

Ambulance Service Provision

Questions (1292)

Denis Naughten

Question:

1292. Deputy Denis Naughten asked the Minister for Health the number and location of ambulance coverage black spots identified by the national ambulance service; the steps being taken to address the poor response time at each location; the estimated population catchment in each case; and if he will make a statement on the matter. [36932/13]

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Written answers

In relation to the particular queries raised by the Deputy, as these are service issues, I have asked the Health Service Executive to respond directly to the Deputy in these matters.

Mental Health Services Provision

Questions (1293)

Denis Naughten

Question:

1293. Deputy Denis Naughten asked the Minister for Health the number and location of planned acute psychiatric beds; the estimated cost of providing these beds; the number and location of overcapacity of beds within the acute psychiatric service and the plans to reduce such numbers; and if he will make a statement on the matter. [36933/13]

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Written answers

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

Orthodontic Service Waiting Lists

Questions (1294)

Tom Fleming

Question:

1294. Deputy Tom Fleming asked the Minister for Health if he will address the unacceptable long waiting times for routine orthodontic treatment for patients in County Kerry that now stands at three and a half years; the action he will take to rectify the situation; and if he will make a statement on the matter. [36961/13]

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Written answers

The HSE has commissioned an independent review of orthodontic services. The outcome of this review, which is near completion, will give guidance as to what changes will be desirable to provide the best possible model of care delivery, given the current resources available and future demand for services.

Medical Card Eligibility

Questions (1295)

Joan Collins

Question:

1295. Deputy Joan Collins asked the Minister for Health the reason a medical card was withdrawn in respect of a person (details supplied) in County Sligo; if his attention has been drawn to the fact that the person is entitled to a medical card as their income is below the limit; the reason the person is being discriminated against; if he will restore their medical card; if he will compensate them for the medical bills accrued since the medical card was withdrawn; and if he will make a statement on the matter. [36965/13]

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Written answers

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 issued to Oireachtas members.

Hospital Transfers

Questions (1296)

Tony McLoughlin

Question:

1296. Deputy Tony McLoughlin asked the Minister for Health the level of savings that has been achieved by the Health Service Executive in relation to their transport budget by availing of the rural transport scheme in North Leitrim; if based on these figures the HSE will be prepared to roll out this service to the local rural transport scheme within other parts of the North West region; and if he will make a statement on the matter. [36970/13]

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Written answers

In relation to the specific query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.

Hospital Administration

Questions (1297)

Aengus Ó Snodaigh

Question:

1297. Deputy Aengus Ó Snodaigh asked the Minister for Health the reason an automatic answering system and auto attendance system for switch boards is being installed in Our Lady's Children's Hospital in Crumlin, despite the fact that a similar system introduced in St Vincent's Hospital Dublin has been turned off because it is not customer friendly; and the logic behind the introduction of such a system and the cost for each hospital where such a system has been installed. [36979/13]

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Written answers

In relation to the specific queries raised by the Deputy, as these are service matters they have been referred to the HSE for direct reply.

Mental Health Services Funding

Questions (1298, 1346, 1428, 1566, 1567)

Andrew Doyle

Question:

1298. Deputy Andrew Doyle asked the Minister for Health the appointments made for community mental health services in 2012 and to date in 2013; the funding provided for these services over the past two years; if he expects there to be any delay in providing these services; and if he will make a statement on the matter. [36982/13]

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Michael Healy-Rae

Question:

1346. Deputy Michael Healy-Rae asked the Minister for Health his views on whether the Government will honour its commitment to appoint new staff for community mental health services this year; and if he will make a statement on the matter. [37323/13]

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Peter Mathews

Question:

1428. Deputy Peter Mathews asked the Minister for Health his plans to invest in health services based in the community, with a range of multi disciplinary staff offering a choice of treatment options, easy access to mental health support from one's GP; access to talking therapies; helping persons with a mental health difficulty to get into and maintain employment and secure accommodation; and if he will make a statement on the matter. [37789/13]

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Gerry Adams

Question:

1566. Deputy Gerry Adams asked the Minister for Health if he will provide a breakdown of the number of the 414 posts promised for mental health services in 2012 that were actually in place by the end of the 2012; the number that are now in place; whether any of the €35 million promised for mental health services in 2012 was spent to cover overruns in other areas of the health service; and if so, and the amount of same [38560/13]

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Gerry Adams

Question:

1567. Deputy Gerry Adams asked the Minister for Health the number of the 477 posts promised for the mental health services in 2013 that are currently in position; and if he will make a statement on the matter. [38561/13]

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Written answers

I propose to take Questions Nos. 1298, 1346, 1428, 1566 and 1567 together.

This Government has prioritised the reform of our mental health services in line with A Vision for Change and is committed in particular to the delivery of more and better quality care in the community. In 2012, a special allocation of €35 million was provided for mental health to be used primarily to further strengthen Community Mental Health Teams in both adult and children’s mental health services, to advance activities in the area of suicide prevention, to initiate the provision of psychological and counselling services in primary care and to facilitate the transfer of mental health service users from institutional to community based care. 414 posts were approved to implement the €35 million package of special measures.

Budgetary pressures within the HSE delayed the full utilisation of this funding in 2012, however this sum is now available to mental health services along with an additional €35 million allocated in Budget 2013 for the continued development of our mental health services across a range of headings, including the further ongoing development of community services. Of the 414 posts approved in 2012, as at the 26th August 2013, 397 have either been filled or are awaiting clearance.

477 posts have been approved from the 2013 allocation for mental health services. As at 26th August 2013, 220 of these posts have been accepted with a further 24 posts offered to candidates. Of the 233 remaining posts, 162 are at various stages in the recruitment process. The National Recruitment Service (NRS) creates national panels in anticipation of vacancies. On occasion however, it is difficult to fill some posts for various reasons including availability of qualified candidates and geographical location. In addition, specific specialist staff are required to fill 91 of these posts and the NRS and the mental health services are working to further improve the process to allow for more bespoke and specialised panels to meet local service needs and maximise successful recruitment. The NRS is working to ensure that the remaining posts will be filled at the earliest opportunity.

I have received assurances from the HSE that the recruitment process for the new posts being funded in 2013 and any outstanding posts approved in 2012 is being given priority within the HSE.

In relation to the specific issue of mental health services in County Kerry, as this relates to a service matter, I have referred it to the HSE for direct reply.

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