Written Answers Nos 262-274
262. Deputy Bernard J. Durkan asked the Minister for Health the extent to which private health insurance costs continue to be affected by the charges in both the public and the private hospitals; the extent if any to which increases in private health insurance have resulted in increased charges for various services/procedures throughout the health system; and if he will make a statement on the matter. [40297/13]
View answerThe data available on the private health insurance market in recent years shows a number of factors which are affecting private health insurance costs. The reduction in the numbers holding private health insurance, the age profile of those holding private health insurance, increases in claims costs, increases in premiums, and the overall state of the economy are all having an impact on the private health insurance market and its sustainability.
I am determined to address rising costs in the sector in the interests of consumers. I want insurers to address the base cost of each element of claims which they pay and have made it clear to private health insurers that I believe significant savings can be made, ultimately reducing the impact of rising health costs on health insurance premiums for the consumer.
While pricing decisions in relation to products are a matter for the private health insurers, I understand that key factors influencing price increases generally include the increasing volume and cost of claims and an ageing membership, in addition to ongoing medical innovations, which while welcome, have an impact on the cost of care. A significant number of the private health insurance claims are for procedures which are performed in private facilities, and the negotiated price for procedures in private hospitals is a "package" price, which may include the cost of surgery, drugs, pathology, and accommodation.
Last year I established the Consultative Forum on Health Insurance, comprising representatives from the private health insurance companies, my Department, and the Health Insurance Authority, to generate ideas to address health insurance costs. I appointed an independent Chairperson Mr. Pat McLoughlin, who will work with my Department and the insurers under the auspices of the Forum on a review process to give effect to real cost reductions in the private health insurance market. I want all insurers to address the base cost of their claims and to see all procedures provided in an appropriate, safe, healthcare setting.
It is imperative that the cost of health insurance is contained to secure the sustainability of the private health insurance market and to prepare for the move to a system of Universal Health Insurance.
263. Deputy Bernard J. Durkan asked the Minister for Health the total number of reports of various infections arising from MRSA or other hospital bugs on a monthly basis in each of the past three years to date; the action taken arising therefrom; and if he will make a statement on the matter. [40298/13]
View answerAs this is a service matter I have referred the Deputy's question to the Health Service Executive for direct response.
264. Deputy Bernard J. Durkan asked the Minister for Health the extent to which an adequate supply of junior hospital doctors is available throughout the health service in 2013; if they are sourced internally or overseas; and if he will make a statement on the matter. [40299/13]
View answerThe overall position regarding the supply of junior hospital doctors has stabilised since the last training rotation took place on 8 July and the majority of vacancies are now filled. While the majority of doctors are sourced internally, a number of posts are filled through recruitment of doctors from overseas.
Some challenges remain, mainly in smaller hospitals and in certain specialties, including Emergency Medicine and General Medicine at Registrar level. Where sites continue to experience challenges in terms of vacancies, hospital management implement contingency plans. If necessary, hospitals make locum arrangements to ensure continued service delivery. System reform, in particular the implementation of the Report on Hospital Groups and the Framework for the Development of Smaller Hospitals will assist in achievement of a more focused and efficient deployment of NCHD staffing. These changes will build on the significant work that has been done through the HSE National Clinical programmes in recent years.
I am committed to improving the working-conditions of NCHDs and to ensuring that they can have a suitable career pathway within the Irish health system. Intensive work is underway in all hospitals to pursue compliance with the EWTD on junior doctors’ working-hours. At the end of July this year, I set up a working group chaired by Professor Brian MacCraith, President of DCU to carry out a strategic review of the medical training and career structure of NCHDs. I see this as a modernising initiative which is needed urgently and which will, in future years, support the retention of sufficient numbers of doctors trained in Ireland within the system.
266. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the number of nurses engaged through the public health service has fluctuated in each of the past four years to date; if he is satisfied regarding the adequacy of nursing levels at present; and if he will make a statement on the matter. [40301/13]
View answerThe number of nurses engaged in the public health service has reduced over the past four years in accordance with Government policy, arising from the requirement that the numbers employed across the public service must be reduced in order to meet fiscal and budgetary targets. The HSE can make essential staff appointments once it remains within its overall employment ceiling and has the financial resources to do so.
The number of nurses employed has reduced as follows:
|
- |
30/6/2010 |
30/6/2011 |
30/6/2012 |
30/6/2013 |
|
Total WTE excl. career breaks |
37,499 |
36,853 |
34,980 |
34,742 |
While I acknowledge the pressures that reducing budgets and staff numbers place on health service staff, including nurses, I am confident that the reforms which are ongoing and the flexibility introduced by the Croke Park and Haddington Road Agreements will allow the HSE to continue to meet service demands with the reduced nursing complement.
267. Deputy Bernard J. Durkan asked the Minister for Health the extent to which staffing at all levels throughout the public health system remains adequate to meet requirements; and if he will make a statement on the matter. [40302/13]
View answerThe Government has decided that the numbers employed across the public service must be reduced in order to meet its fiscal and budgetary targets. This policy requires that by the end of 2013, the health service achieves a workforce of 98,938 whole time equivalents (WTEs). However, the HSE can make staff appointments once it remains within its overall employment ceiling and has the financial resources to do so.
The health service is the most complex sector of the Irish public service and employs approximately one-third of all public service staff. Despite the substantial reductions in financial and staff resources which have been necessary in recent years, the health budget accounts for approximately €13 billion annually. In addition, the health service is the subject of an ongoing major programme of reform in line with the Programme for Government. It is essential that the health service has the optimum number and mix of staff necessary for the safe and effective functioning of the the service in accordance with its business needs and Government policy on public service numbers.
While I acknowledge the pressures that reducing budgets and staff numbers place on the Health Service, I am confident that the reforms which are ongoing and the flexibility introduced by the Croke Park and Haddington Road Agreements will allow the HSE to continue to meet service demands within the approved staff ceiling.
268. Deputy Bernard J. Durkan asked the Minister for Health the extent to which patients seeking hospital appointments have been placed on waiting lists prior to obtaining a position on the actual hospital list; and if he will make a statement on the matter. [40303/13]
View answerThe 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 the particular query raised by the Deputy, I have asked the Health Service Executive to respond directly to him on the matter.
269. Deputy Bernard J. Durkan asked the Minister for Health the extent to which his Department’s primary care building programme has progressed; the number of such centres already completed and in operation; the number proposed; and if he will make a statement on the matter. [40304/13]
View answerConsiderable progress is being made in the delivery of primary care centres. 32 Primary Care Centres have opened since May 2011.
The delivery of primary care infrastructure is a dynamic process and must take account of changing circumstances including the feasibility of implementing the delivery of the centres by means of lease, direct- build or PPP. GP engagement and agreement to deliver services from primary care centres is central to the delivery of the necessary infrastructure. 35 potential locations for primary care centres for development by way of PPP were announced in the July 2012 Infrastructure Stimulus Package. The HSE is currently finalising sites and assessing GP engagement at each location to determine their interest in participating in the primary care centre development. While it is not possible, at this time, to give start and completion dates for any of the individual 20 potential locations, the best estimate is that these primary care centres will be completed by late 2016.
270. Deputy Bernard J. Durkan asked the Minister for Health the full extent of the plans for primary care provision throughout County Kildare; the number of such primary care centres planned or already in existence; the extent to which patients in rural areas will have ready access to such centres where public transport does not exist; and if he will make a statement on the matter. [40305/13]
View answer271. Deputy Bernard J. Durkan asked the Minister for Health his plans for the replacement of a health centre (details supplied) in County Kildare which has been of significant convenience to the local population in a rural area; and if he will make a statement on the matter. [40306/13]
View answer272. Deputy Bernard J. Durkan asked the Minister for Health his plans, to upgrade the health centre at Johnstownbridge, Enfield, County Kildare which caters for a large catchment area and is extremely overcrowded; and if he will make a statement on the matter. [40307/13]
View answerI propose to take Questions Nos. 270 to 272, inclusive, together.
The HSE has responsibility for the provision of Primary Care Centres and the operation and maintenance of existing health centres. Therefore, these matters have been referred to the HSE for attention and direct reply to the Deputy.
273. Deputy Bernard J. Durkan asked the Minister for Health the extent to which ambulance services throughout North Kildare remain adequate to meet the demand having particular regard to reports to the contrary; and if he will make a statement on the matter. [40308/13]
View answerAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
274. Deputy Bernard J. Durkan asked the Minister for Health the total number of medical cards currently in circulation; the extent to which these numbers have fluctuated over the past five years; and if he will make a statement on the matter. [40309/13]
View answerAt 1st September 2013, 1,987,423 people have free access to GP services under the GMS Scheme which equates to over 43% of the national population. Of these, 1,863,062 people hold medical cards, 53,888 of which are discretionary. This equates to 40.5% of the national population.
Medical cards statistics over the previous five years are outlined below.
|
Date |
No. of Medical Cards |
No. of Medical Cards as % of Population |
|
End 2008 |
1,352,120 |
31% |
|
End 2009 |
1,478,560 |
33% |
|
End 2010 |
1,615,809 |
36% |
|
End 2011 |
1,694,063 |
37% |
|
End 2012 |
1,853,877 |
40% |
