Written Answers Nos. 1464-1483
1465. Deputy John O'Mahony asked the Minister for Health if there is a charge payable from the holder of a medical card direct to a general practitioner for medical card holders who receive a 'flu jab; and if he will make a statement on the matter. [37999/13]
View answer1466. Deputy John O'Mahony asked the Minister for Health if a medical card holder has to pay a general practitioner for having blood taken to diagnose a condition or to monitor an ongoing condition; and if he will make a statement on the matter. [38000/13]
View answerI propose to take Questions Nos. 1465 and 1466 together.
The Health Professionals (Reduction of Payments to General Practitioners) (National Immunisation Programmes) Regulations 2013 – S.I. No. 278 of 2013 specify that the amount payable to a general practitioner for administering to an individual in an "at-risk" category an influenza vaccine under the General Medical Services Scheme provided that the influenza vaccine is not administered by the general practitioner (or by another general practitioner in the same practice) on the same day as a PPV is €15.
The vaccine and its administration are free of charge to persons in the “at-risk” category who have a Medical Card or GP Visit Card. In such cases, the €15 fee is reimbursed to the GP by the Primary Care Reimbursement Service.
The following are deemed to be in the "at risk" category and are recommended for Influenza Vaccination:
- persons aged 65 and over;
- those with a long term medical condition such as diabetes, heart or lung disease;
- people whose immune system is impaired due to disease or treatment;
- residents of nursing homes or other long-stay institutions;
- persons with a body mass index (BMI) over 40;
- pregnant women (vaccine can be given at any stage of pregnancy);
- healthcare workers;
- carers;
- people in regular close contact with poultry, water fowl or pigs.
Where a Medical Card or GP Visit Card holder is not in the “at-risk” category, the vaccine and its administration are a matter of private contract between the patient and their GP.
Under the GMS contract, a GP is expected to provide his/her patients who hold a Medical Card or GP Visit Card with all proper and necessary treatment of a kind generally undertaken by a GP. Where blood tests form part of the investigation and necessary treatment of patients' symptoms or conditions, these should be provided free of charge to Medical Card and GP Visit Card holders. The HSE also points out that, in many GP surgeries, it is the practice nurse who takes blood samples. The HSE significantly subsidises the cost of employing practice nurses.
The HSE is continuing to advise eligible patients who believe they have been inappropriately charged by a GP for routine phlebotomy services, to seek a refund from the GPs in question. It is appreciated that because of the nature of the GP/patient relationship, it may be difficult for patients to make such complaints. Where public representatives are made aware of GPs charging GMS patients in error, they may wish to notify the HSE directly.
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.
Officials in my Department are in consultation with the HSE with a view to drawing up a new contract. The appropriate arrangements in relation to phlebotomy services will be considered as part of the new contract.
1467. Deputy Brian Walsh asked the Minister for Health his plans to introduce measures to regulate the sale of electronic cigarettes here; and if he will make a statement on the matter. [38002/13]
View answerOn the 19th December 2012, the European Commission published a proposal for a new EU Tobacco Products Directive, the ultimate purpose of which is to reduce the numbers of people smoking. The proposal, which is currently being considered by Member States recommends that Nicotine Containing Products (e.g. electronic cigarettes) below a certain nicotine threshold are allowed on the market, but must feature health warnings. Products above a specified threshold of nicotine are only allowed on the market if authorised as medicinal products, like nicotine replacement therapies (NRT) and would therefore have to comply with the legislative framework put in place by medicinal legislation similar to current NRT products.
The proposal is being discussed in the European Parliament and Council of Ministers and the Commission hope to have it adopted in 2014. Good progress has been made to date in the negotiations .The main objective of this proposal is to reduce the attractiveness of tobacco products, particularly to children and young people. This Directive will have a very positive impact on the health of Europeans. I have been very supportive of this proposal throughout Ireland's Presidency of the European Union and will continue to advance it at every opportunity .
1468. Deputy Bernard J. Durkan asked the Minister for Health the procedure to be followed to obtain an appointment to see a child psychologist in respect of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [38003/13]
View answerAs this is a service matter this question has been referred to the HSE for direct reply.
1469. Deputy Michael Healy-Rae asked the Minister for Health when the decision was taken to try to reduce the amount of nappies that are being used by persons who have no other choice but to use them, such as disabled children, elderly people and so on (details supplied); and if he will make a statement on the matter. [38004/13]
View answerAll persons with continence problems receive a baseline continence assessment from the HSE. The purpose of this assessment is to develop a continence management plan tailored for each person. The assessment includes an examination of diet and waist and hip measurements to ensure the continence products prescribed are appropriate to the individual needs of the person. Ongoing reassessment is required where the person's clinical and physical needs change over time.
1470. Deputy Damien English asked the Minister for Health the number of Health Service Executive beds in the Louth/Meath region that are allocated for respite care services; the number of such beds that are not used seven nights per week; and if he will make a statement on the matter. [38010/13]
View answerThe information requested by the Deputy is not available in my Department. However, I have asked the HSE to provide the information it has available directly to you in relation these matters.
1471. Deputy Denis Naughten asked the Minister for Health where the currently unused Teledoc machines to be used as part of the TRASNA programme are being stored; the cost of such storage; the catalogue price for the purchase of such machines; and if he will make a statement on the matter. [38011/13]
View answerAs this is a service matter this has been referred to the HSE for direct reply to the Deputy.
1472. Deputy Finian McGrath asked the Minister for Health the reason for the refusal of a medical card in respect of a person (details supplied) in County Cork. [38013/13]
View answerThe 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.
1473. Deputy Róisín Shortall asked the Minister for Health if his attention has been drawn to the fact that the cut-backs in funding for disability services have led to a situation where the residential care offered at St. Michael's House residential unit in Warrenhouse, Baldoyle may not be able to operate on a full-time basis meaning that residents will have to move out of their homes and back to their families every weekend; the discussions, if any, he has had with St. Michael's House on this matter; his views on the appropriateness of such a move in view of Government policy in relation to promoting independence for persons with disabilities; and the way he proposes to resolve the matter. [38015/13]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services, including disability services. The HSE either directly provides or contracts disability agencies such as St Michael House to provide a range of disability services through service level arrangements.
St Michael's House received over €70 million in 2012 in funding from the HSE to provide a range of services to approximately 1,660 children and adults with an intellectual disability in over 170 centres in the Greater Dublin Area and Navan Co. Meath.
The HSE and St Michael's House work in close collaboration with regard to the funding and delivery of services to people with an intellectual disability. As a voluntary agency, St Michael’s house are obliged to work within the resources available to them and in that regard have introduced significant efficiencies over recent years to remain within budget. The HSE has advised that these changes to date have not resulted in service contraction.
The Haddington Road Agreement (HRA) sets out measures relating to productivity, cost extraction and reform which together intends to achieve a required pay bill reduction of €150m identified in the HSE Service Plan 2013. The agreement provides a framework and opportunities for managers within the health services, including agencies such as St Michael's House, to reduce their costs associated with agency and overtime and a wide range of other pay costs, particularly through measures such as additional working hours and revised rates in respect of overtime.
The HSE has advised the Department of Health that the recent application of additional budget cuts under the HRA has presented a significant challenge to St Michael’s House. A process is now underway between the HSE and St Michael’s House to identify the impact of these budget reductions on services. The Department of Health has received assurances from the HSE that both organisations are committed to working within the terms of the HRA to ensure that services are impacted upon only as a measure of last resort.
1474. Deputy Finian McGrath asked the Minister for Health his views on correspondence (details supplied) regarding cuts to services. [38023/13]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services, including disability services. The HSE either directly provides or contracts disability agencies such as St Michael House to provide a range of disability services through service level arrangements.
St Michael's House received over €70 million in 2012 in funding from the HSE to provide a range of services to approximately 1,660 children and adults with an intellectual disability in over 170 centres in the Greater Dublin Area and Navan Co. Meath.
The HSE and St Michael's House work in close collaboration with regard to the funding and delivery of services to people with an intellectual disability. As a voluntary agency, St Michael’s house are obliged to work within the resources available to them and in that regard have introduced significant efficiencies over recent years to remain within budget. The HSE has advised that these changes to date have not resulted in service contraction.
The Haddington Road Agreement (HRA) sets out measures relating to productivity, cost extraction and reform which together intends to achieve a required pay bill reduction of €150m identified in the HSE Service Plan 2013. The agreement provides a framework and opportunities for managers within the health services, including agencies such as St Michael's House, to reduce their costs associated with agency and overtime and a wide range of other pay costs, particularly through measures such as additional working hours and revised rates in respect of overtime.
The HSE has advised the Department of Health that the recent application of additional budget cuts under the HRA has presented a significant challenge to St Michael’s House. A process is now underway between the HSE and St Michael’s House to identify the impact of these budget reductions on services. The Department of Health has received assurances from the HSE that both organisations are committed to working within the terms of the HRA to ensure that services are impacted upon only as a measure of last resort.
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.
1475. Deputy Michael Healy-Rae asked the Minister for Health the number of hospital consultant posts that have been advertised in the 12 months since the salaries for new entrant consultants were cut that have actually been filled; and if he will make a statement on the matter. [38040/13]
View answerAs this is a service matter, I have asked the Health Service Executive to reply directly to the Deputy with the information sought.
1476. Deputy Simon Harris asked the Minister for Health his plans to regulate sunbed use here; his views on the use of sunbeds by under 18 year olds; and if he will make a statement on the matter. [38052/13]
View answer1477. Deputy Simon Harris asked the Minister for Health the date on which he intends to publish and progress the Public Health (Sunbeds) Bill; and if he will make a statement on the matter. [38053/13]
View answer1559. Deputy Thomas Pringle asked the Minister for Health when he plans to introduce legislation to regulate the use of sunbeds [38519/13]
View answerI propose to take Questions Nos. 1476, 1477 and 1559 together.
The Public Health (Sunbeds) Bill has now been drafted. Under the Draft Bill, I propose to make it an offence to sell or hire a sunbed to a person under 18 years of age or allow such a person to use a sunbed on a sunbed premises. Breaches of this core provision will result in prosecution and very significant penalties will be available to the courts in cases of non-compliance.
The Draft Bill provides for a prohibition on sunbed businesses from permitting persons under 18 years of age from purchasing or hiring a sunbed or using a sunbed on a sunbed premises. Other key provisions included in the Bill:-
(i) a prohibition on the unsupervised use of sunbeds in a sunbed premises;
(ii) an exemption for medical purposes;
(iii) control on the remote sale or hire of sunbeds (internet transactions);
(iv) sunbed operators, sellers and hirers will be required to notify the HSE;
(v) a requirement that sunbed operators provide training for staff;
(vi) an enforcement regime and the imposition of penalties for non-compliance;
(vii) an obligation on all sunbed operators to provide protective eyewear to users;
(viii) a requirement that warning signs be displayed in all sunbed premises;
(ix) a prohibition on certain promotional marketing practices;
(x) 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.
I am delighted to be in a position to confirm that the drafting of the Bill has been completed and that the Bill has been notified to the EU Commission under the EU Transparency Directive - a process that will take a minimum of 3 months to complete. Following completion of the Commission's process, the Bill will be published and initiated in the Oireachtas.
1478. Deputy Patrick O'Donovan asked the Minister for Health if he will provide a breakdown in tabular form by county, year and by care company of the amount of money spent by the Health Service Executive in the delivery of private home care for elderly persons and vulnerable adults in their own homes from 2007 to date; and if he will make a statement on the matter. [38074/13]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
1479. Deputy Patrick O'Donovan asked the Minister for Health his plans to introduce legislation to cover minimum standards, complaints procedures, reporting mechanisms, inspection procedures and other issues as he sees fit, for the protection of elderly persons and vulnerable adults who are cared for in their own homes by public and or private organisations; and if he will make a statement on the matter. [38075/13]
View answerThe Programme for Government (Government for National Recovery, 2011-2016) commits to developing and implementing national standards for home support services, which will be subject to inspection by the Health and Information Quality Authority (HIQA).
Primary legislation and resources will be required to implement a statutory regulation system for home care services. Officials in the Department are examining this matter in the overall context of the licensing of Health Care providers. Various options are being considered but given the legislative priorities that apply across the wider Social Care area, including residential services for children and people with disabilities, it is not expected that relevant legislation will be prepared until later in the period covered by the Programme for Government.
I would like to emphasise, however, that statutory regulation or licensing is only one way of improving the safety and quality of services and that other measures have or are being taken to improve the standards of community service for older people delivered by, or on behalf of, the HSE. These include the Procurement Framework for Home Care services (with quality and screening requirements) introduced in mid 2012. New National Quality Guidelines for Home Care Support Services, and new National Home Help Guidelines, which have been prepared and are currently the subject of negotiations between the HSE and SIPTU under the auspices of the Labour Court.
1480. Deputy Michael Healy-Rae asked the Minister for Health the reason the pilot project providing a GP service for persons with no medical cards is only being provided to the Roma community at Tallaght Hospital, Dublin 24; the amount this service is costing per week; the amount it cost initially to set up; the justification of providing a service to one ethnic community, for instance the reason persons from Bangladesh are not being provided with the same service; the reason persons from Poland are not being provided with the same service; the reason members of our own travelling community not being provided with the same service; his views on whether this not active discrimination of the worst type to pick out one group of persons above everybody else and provide them with a service that absolutely no one else is entitled to, that is, people with no medical cards, being able to walk in and avail of every health service at absolutely no charge; and if he will make a statement on the matter. [38108/13]
View answerThe Deputy may be aware that the Roma have been recognised as the most disadvantaged group in Europe. SafetyNet is funded by the HSE to provide a basic GP service for the most vulnerable Roma, including Roma children, who would otherwise not have access to GP services. Following a successful pilot phase of the SafetyNet Roma GP mobile clinic between September and December 2012, which welcomed more than 100 members of the Roma community, funding has been provided by the HSE Social Inclusion Department to implement the primary healthcare initiative for another year on the grounds of Tallaght hospital.
This service is viewed as a first step in a process of supporting vulnerable service users to access health care and alleviating some of the health inequalities experienced by the Roma population in Ireland. This initiative is viewed as a short term measure whilst a longer term solution to this matter is found nationally. The establishment of the service is also in response to the Council of the European Union requesting that all EU countries address the care of the Roma medical needs for those residents in their respective EU countries. It also ties in with recommendations under the National Intercultural Health Strategy 2007-2012.
The annual service costs approximately €23,000 for medical care and a further €11,000.00 towards costs of interpreting, translations and supporting links to community services for Roma who need assistance to apply for social welfare etc.
In relation to the other cultural group mentioned by the Deputy, i.e. Irish Travellers, the provision of a GP mobile clinic is not required because most Travellers can avail of GP services through the medical card scheme. All other groups mentioned by the Deputy are nationalities and all individuals can avail of medical services in Ireland in line with agreed eligibility requirements regardless of nationality.
1481. Deputy Colm Keaveney asked the Minister for Health the funding being provided in 2013 to the National Service User Executive, established under Recommendation 3.5 of A Vision for Change; the funding provided in 2012; and if he will make a statement on the matter. [38112/13]
View answer1482. Deputy Colm Keaveney asked the Minister for Health if he is committed to the role of the National Service User Executive, established under Recommendation 3.5 of A Vision for Change, in informing the National Mental Health Service Directorate and the Mental Health Commission on issues relating to user involvement and participation in planning delivering, evaluating and monitoring services including models of best practice; and if he will make a statement on the matter. [38113/13]
View answer1483. Deputy Colm Keaveney asked the Minister for Health in view of information set out on page 28 of the 2006 document A Vision for Change, in which services users, in the context of user involvement, should at a minimum be reimbursed for out-of-pocket expenses at the same rates as health professional, if he will confirm if this is current practice and, if not, the rate at which services users and professionals are reimbursed and if he can account for the differential; and if he will make a statement on the matter. [38114/13]
View answerI propose to take Questions Nos. 1481 to 1483, inclusive, together.
A Vision for Change recommended that a National Service User Executive be established to inform mental health policy makers and service providers on issues relating to user involvement and participation in planning, delivering, evaluating and monitoring services. Both the HSE and I fully recognise the importance of ensuring service user involvement in the on-going development of our mental health services, have supported the establishment and development of the NSUE and collaborated closely with the NSUE in the delivery of its remit.
As the issues of funding for the National Service Users Executive and the reimbursement of expenses to service users is a service matter for the HSE, I have asked the HSE to reply to you directly on these issues.
