Finian McGrath
Question:1317. Deputy Finian McGrath asked the Minister for Health if he will support general practitioners who are under a lot of pressure and who are being forced to lay off staff. [37215/13]
View answerGeneral Practitioner Services
Questions (1317, 1360)
Ciara Conway
Question:1360. Deputy Ciara Conway asked the Minister for Health if he will reconsider reductions in payments to general practitioners under the Financial Emergency Measures in the Public Interest Act; if he has considered that this will result in patients waiting to see general practitioners as well as possible redundancies; if he will further consider alternative saving measures; and if he will make a statement on the matter. [37535/13]
View answerWritten answers
I propose to take Questions Nos. 1317 and 1360 together.
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.
As a result of the economic downturn, significant restrictions on Health spending have had to be implemented since mid-2008 as part of the Government’s efforts to address the major deficit in the public finances. The health service budget has had to be reduced by approximately €2.5 billion, and is expected to make further substantial reductions in order to help bring the national finances under control.
A review was carried out earlier this year under the Financial Emergency Measures in the Public Interest (FEMPI) Act 2009 in relation to the operation, effectiveness and impact of the amounts and rates payable to general practitioners under the relevant Regulations.
Having carefully considered the submissions made during the consultation process, the Minister for Health decided to reduce certain fees and allowances payable to general practitioners under the GMS Scheme, Immunisation Schemes, HeartWatch and the Maternity & Infant Care Scheme. I am satisfied that the proposed reductions are fair and reasonable. It is estimated that the effect of these cuts will result in an overall reduction of 7.5% in fees and allowances payable to GPs under the schemes in question.
During the consultation process, the Irish Medical Organisation and others expressed the opinion that any fee cuts could result in patients no longer being able to avail of a "same day" GP service and could also cause GPs to reduce staff hours. These issues were considered along with the other points raised during the consultation process.
The following Regulations have been prepared to give effect to the Minister's decisions and these came into effect on 24 July 2013:
- S.I. 277/2013 - Health Professionals (Reduction of Payments to General Practitioners) Regulations 2013
- S.I. 278/2013 - Health Professionals (Reduction of Payments to General Practitioners) (National Immunisation Programmes) Regulations 2013
Pharmacists, Consultant Psychiatrists and Consultant Ophthalmologists have also been subjected to fee reductions under FEMPI and public sector workers have taken significant further pay reductions under the “Haddington Road” Agreement. It is appropriate that GPs should share the burden on the country’s road to economic recovery.
Under the FEMPI legislation, the Minister for Health is required to carry out a review of the operation, effectiveness and impact of the amounts and rates fixed under the regulations each year. This will involve a full consultation with stakeholders in 2014. A decision will be taken at that time regarding maintaining, restoring or further reducing fees.
Hospital Services
Questions (1318)
Finian McGrath
Question:1318. Deputy Finian McGrath asked the Minister for Health if he will deal with the lack of a real paediatric rheumatology service in our children's hospitals and if his attention has been drawn to the fact that consultants are overstretched. [37217/13]
View answerWritten answers
Children’s University Hospital, Temple Street has a general paediatrician with a special interest in rheumatology, who is on maternity leave at present. The two rheumatologists at Our Lady’s Children’s Hospital, Crumlin are covering the hospital’s outpatient department clinics in the spirit of cross hospital support. A patient visit includes review with the multidisciplinary team i.e. consultant, physiotherapist and clinical nurse specialist. Links are also made with the dietetic and social work service as required. If a child needs joint injections, they will be done in Our Lady’s Children’s Hospital, Crumlin.
With regard to Our Lady’s Children’s Hospital, Crumlin, both rheumatology consultant posts at Crumlin are general paediatricians with a special interest in rheumatology. The Clinical Director, Director of Operations, Chair of Medical Board and the two consultants have recently met with a view to reducing waiting times for rheumatology patients through a number of potential initiatives including, for example, a pilot project to utilise additional specialised physiotherapy resources. In addition two new consultant appointments taking up positions at the end of the year will also help with this service.
Hospital Acquired Infections
Questions (1319)
Finian McGrath
Question:1319. Deputy Finian McGrath asked the Minister for Health the safeguards that are now in place following the CJD incident at Beaumont Hospital. [37219/13]
View answerWritten answers
The Health Service Executive has advised me that Beaumont Hospital issued a comprehensive report to HIQA and the HSE on 9 August 2013 on this matter, outlining an action plan for measures to prevent risk of transmission from such an occurrence. These actions include a comprehensive process mapping of neurosurgical patients, led by Beaumont’s Chair of Clinical Governance, a review of decontamination processes, led by the Director of Operations/Deputy CEO and a review of the tracking of instruments in theatres, led by the Critical Care Directorate Nurse Manager. Regular meetings, chaired by the CEO, form part of the monitoring programme. The HSE has informed me that all of this work is in progress.
In relation to the specific incident, as soon as a possible CJD diagnosis was made for a patient being treated in Beaumont, the hospital quarantined the equipment used on the patient in question and commenced a review to determine what, if any, risk might exist for other patients. As part of this process, advice was provided by the Irish Panel on TSE (CJD) and from world experts in the UK, who have dealt with similar cases in the UK and worldwide.
The review has identified a small number of patients who may have a slightly higher risk of contracting CJD than people in the general population. The exact number involved has not been made public in order to protect patient confidentiality. The relevant experts consider that the risk to these patients is minimal as transmission of CJD via surgical instrument is very rare, with no recorded cases in the past 30 years. The patients have been contacted and appropriate clinical responses are in place.
Disability Support Services
Questions (1320)
Finian McGrath
Question:1320. Deputy Finian McGrath asked the Minister for Health the supports and services available to a physically disabled person in Dublin 13 and where the person can seek advice. [37222/13]
View answerWritten answers
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.
Hospital Waiting Lists
Questions (1321)
Barry Cowen
Question:1321. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) in County Laois may expect to have a date for surgery. [37241/13]
View answerWritten answers
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 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.
Hospital Services
Questions (1322)
Bernard Durkan
Question:1322. Deputy Bernard J. Durkan asked the Minister for Health if physiotherapy will be offered to a person (details supplied) in County Kildare; and if he will make a statement on the matter. [37242/13]
View answerWritten answers
Patients should contact their referring practitioner in the first instance to discuss their request for an appointment date. The referring practitioner, should he or she consider that their condition warrants an earlier appointment, would be in the best position to take the matter up with the hospital involved.
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.
Health Services
Questions (1323)
Bernard Durkan
Question:1323. Deputy Bernard J. Durkan asked the Minister for Health if a wheelchair could be obtained to aid the parent of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [37249/13]
View answerWritten answers
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.
Health Services
Questions (1324)
Finian McGrath
Question:1324. Deputy Finian McGrath asked the Minister for Health if he will provide adequate facilities in the Crannog Day Hospital, St Vincent’s Hospital, Dublin 3 in order for service users to have full dinners and showers which will support their road to rehabilitation. [37251/13]
View answerWritten answers
As this is a service matter this question has been referred to the HSE for direct reply.
Question No. 1325 answered with Question No. 1306.
Hospital Waiting Lists
Questions (1326)
Sandra McLellan
Question:1326. Deputy Sandra McLellan asked the Minister for Health if he will prioritise an operation in respect of a child (details supplied) in County Cork; and if he will make a statement on the matter. [37256/13]
View answerWritten answers
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 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.
Health Services
Questions (1327)
Finian McGrath
Question:1327. Deputy Finian McGrath asked the Minister for Health if he has a health and safety plan to deal with the rat crisis in Dublin; and if he will make a statement on the matter. [37261/13]
View answerWritten answers
The Deputy's question relates to the management and delivery of health and personal services which are the responsibility of the Health Service Executive under the Health Act, 2004. Accordingly, my Department has requested the HSE to have the matter investigated and to reply directly to the Deputy.
Health Screening Programmes
Questions (1328)
Bernard Durkan
Question:1328. Deputy Bernard J. Durkan asked the Minister for Health the extent to which adequate funding has been made available for vision care; the extent to which funding has been made available to fulfill the commitment to the World Health Organisation objectives of Vision 2020 to eradicate preventable blindness by 2020; and if he will make a statement on the matter. [37263/13]
View answerWritten answers
Vision 2020 is the global initiative for the elimination of avoidable blindness. It is a joint programme of the World Health Organisation (WHO) and the International Agency for the Prevention of Blindness. Vision 2020 has targeted a number of diseases that contribute to blindness, many of which are related to infections commonly found in tropical regions.
The WHO monitoring committee for the elimination of avoidable blindness stated in 2006 that, generally speaking, the prevention of blindness is, for the most part, not a public health issue in a large percentage of countries in the Americas and Europe. It went on to state that many of the countries in these two regions have long solved their infrastructure problems and their health care delivery systems function efficiently.
A number of eye conditions are part of Vision 2020, including cataract, refractive error, glaucoma, diabetic retinopathy and age-related macular degeneration. Detection and treatment services are available throughout the country, in community and acute hospital settings, for many conditions which can lead to vision impairment and blindness. For example, diabetic retinopathy is the most common diabetic eye disease and the leading cause of blindness among working age Irish adults. Approximately 10 per cent of the Irish diabetic population has sight-threatening diabetic detinopathy and around 90 per cent of this group will develop some form of retinopathy.
The HSE commenced the national diabetic retinopathy screening programme (Diabetic RetinaScreen) in February 2013.
Diabetic RetinaScreen offers free, annual diabetic retinopathy screening to people with diabetes aged 12 and older. Eye screening uses specialised digital photography to detect, at an early stage, when it is effective at reducing or preventing damage to sight. The aim of the programme is to reduce the risk of sight loss amongst people with diabetes.
A quality assurance framework and a central database of the eligible diabetic population has been developed for the programme. The first round of screening is being introduced on a phased basis, in line with the roll-out of the first round of screening across other international programmes. Approximately 30 per cent of the eligible diabetic population is expected to be invited in 2013. It is expected that by the end of this year, 5,000 screenings will take place each month. The remaining 70 per cent will be screened in 2014. From 2015 full screening is to be in place.
Two companies have been contracted to provide photography and grading services for the programme. Seven treatment centres have been identified and by the end of October 2013, it is expected that all centres will be online. Treatment is tailored on a case-by-case basis. For 2013, it is estimated that the cost of screening will be €3.1 million and treatment will be €1.8 million.
Screening tests for glaucoma are available and treatment involves anti-glaucoma medication, which is also widely available. Treatment options for certain types of age-related macular degeneration are available, although it is generally agreed that further research is required and this in ongoing on a global basis. Cataract is amenable to surgical intervention and is provided in acute hospitals.
Section 67 of the Health Act 1970 requires that ophthalmic treatment and optical appliances be made available to medical card holders. Services are provided to adult medical card holders and their adult dependants by contracted practitioners. An adult medical card holder may avail of treatment and/or appliances once every two years.
A community ophthalmic treatment scheme, providing both medical and surgical services, is available in some parts of the country.
All children of primary school age are provided with an optical screening service by the HSE as provided for in the Health Act 1970. Any refractive errors are treated and spectacles or other appropriate care is provided where necessary. Children between 12 and 16 years whose parents are in receipt of a medical card are eligible for HSE eye-care services when they are named on their parents' cards. Other children between 12 and 16 years are eligible to be seen by an HSE eye doctor when there is a medical reason for the eye condition, rather than a refractive error. Such patients may be referred for treatment after being examined by an optometrist.
The Government has continued to provide financial supports to those agencies involved in research, support and service provision for people with visual impairments in Ireland. The Government remains committed to provide and develop vision services and supports through health prevention, screening and intervention policies and programmes, all of which contribute as we work to address the priority goal of Vision 2020, namely to eliminate avoidable blindness in Ireland.
Hospital Waiting Lists
Questions (1329)
Barry Cowen
Question:1329. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) in County Offaly will receive a hospital appointment. [37265/13]
View answerWritten answers
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.
Medical Card Applications
Questions (1330)
Finian McGrath
Question:1330. Deputy Finian McGrath asked the Minister for Health the position regarding a medical card in respect of a person (details supplied) in Dublin 5. [37266/13]
View answerWritten 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.
Cross-Border Health Initiatives
Questions (1331)
Sandra McLellan
Question:1331. Deputy Sandra McLellan asked the Minister for Health if there are any implications for persons who travel to the Six Counties to have six different prescriptions filled; and if he will make a statement on the matter. [37267/13]
View answerWritten answers
Since 2003 Irish medicines legislation has allowed for the cross-border recognition of prescriptions. The Medicinal Products (Prescription & Control of Supply) Regulations 2003 as amended (S.I. 540 of 2003) (the Prescription Regulations) set out the requirements relating to the sale and supply of medicines, including medicines supplied on foot of prescriptions.
The legislation permits a pharmacist to dispense a prescription written by a practitioner practising in another EU MS, who is of equivalent status to a registered medical practitioner or registered dentist in Ireland, if the pharmacist is satisfied that he or she can verify the authenticity of the prescription and that he or she can determine the appropriate medicine and dosage instructions of the medicine to be supplied to the patient.
The prescription must not have been issued to facilitate mail order of prescription medicines (which is prohibited in Ireland). Further, a pharmacist may not dispense a cross-border prescription for a controlled drug (e.g. narcotics or psychotropics such as morphine, methadone etc.) because of the potential for abuse.
I understand that a similar provision exists in the legislation in Northern Ireland which allows a pharmacist in Northern Ireland to dispense a prescription written in this State, subject to the prescription meeting the requirements of Northern Irish medicines legislation.
In December 2012, the European Commission adopted Implementing Directive 2012/52/EU which lays down measures to facilitate the recognition of medical prescriptions between EU Member States. The intention of this Directive is to harmonise the rules and facilitate the recognition of prescriptions written in one Member State and dispensed in another Member State. Work is currently under way to transpose this Commission Implementing Directive 2012/52/EU into Irish law. The Directive will apply to prescriptions which are issued on foot of a patient’s request for an EU cross-border prescription.
Health Services
Questions (1332)
Finian McGrath
Question:1332. Deputy Finian McGrath asked the Minister for Health further to Parliamentary Question No. 98 of 26 May 2011, if he will provide an update on an investigation. [37274/13]
View answerWritten answers
As this is a service matter this question has been referred to the HSE for direct reply.
Health Promotion
Questions (1333)
Jerry Buttimer
Question:1333. Deputy Jerry Buttimer asked the Minister for Health the supports in place to support breastfeeding and if he will consider a marketing campaign to promote breastfeeding and the associated benefits; and if he will make a statement on the matter. [37277/13]
View answerWritten answers
The promotion of breast-feeding is one of my Department's public health priorities. Breast-feeding rates in Ireland have increases gradually over recent years and our goal is to increase this rate further. In 2011 47% of babies were exclusively breast-fed on discharge from Irish maternity units, with a total of 55.2% receiving any breast-milk (ESRI, 2012). There is a vast body of evidence to support the importance of breast-feeding for the short and longer term health of the child and mother.
In 2005, the Department of Health and Children published Breastfeeding in Ireland: A five year strategic action plan . A National Breastfeeding Strategy Implementation Committee was appointed in 2007. In 2011, 41.76% of births occurred in the 8 Baby Friendly designated hospitals in the Republic of Ireland. In 2012 the HSE adopted an Infant Feeding Policy for Maternity and Neo-natal Units based on the 10 Steps of the Baby Friendly Hospital Initiative. The Strategic Action Plan is currently being reviewed to inform the development of a new national breast-feeding strategy.
There are nearly 200 support groups throughout the county and contact details are available on www.breastfeeding.ie Support is also available from Public Health Nurses, Midwifes, Lactation Consultants and GPs.
Cancer Incidence
Questions (1334)
Finian McGrath
Question:1334. Deputy Finian McGrath asked the Minister for Health if there is any assessment or report by the Health Service Executive in an area (details supplied) in Dublin 3 regarding the high rate of cancer locally. [37278/13]
View answerWritten answers
The National Cancer Registry (NCR) is the statutory body with responsibility for the collection and analysis of information relating to the incidence of cancer and related tumours in Ireland. I understand that the NCR previously wrote to the Deputy in 2007 concerning cancer incidence in the area in question.
The NCR report of that time found that the number of cancers for the wider area in question was 'slightly fewer than would have been expected based on the rates for Dublin as a whole and slightly more than would have been expected from the national rates. These differences were small and almost certainly due to chance'. As pointed out at that time, analysis at street level is not available.
No further analysis was required or carried out in the interim. Meanwhile, the 'All Ireland Cancer Atlas 1995-2007' provides cancer incidence data at a geographical level for the Republic of Ireland and Northern Ireland and is available on the National Cancer Registry website (www.ncri.ie).