Haddington Road Agreement Issues

Questions (241)

Clare Daly

Question:

241. Deputy Clare Daly asked the Minister for Health the reason sections 38 and 39 funded voluntary organisations were included in the savings required by the Haddington Road agreement and the impact this will have on the provision of services. [41249/13]

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Written answers (Question to Health)

The Haddington Road Agreement (HRA) is a critical enabler for employers and organisations, across the full spectrum of the public health sector, to make their contribution to the cost reductions required by Government and to support the public service reform agenda. All agencies funded by the HSE, including Section 39 agencies, are required to make an appropriate and proportionate contribution to the implementation of payroll and related cost reduction measures, in line with other publicly funded bodies. The costs reductions applied across the health service are designed to protect existing levels of services and to provide a more sustainable payroll cost base into the future.

Employees of bodies funded under Section 38 of the Health Act 2004, as public servants, are party to the HRA. While employees in bodies funded under Section 39 of the Health Act 2004 are not public servants, and therefore not party to the HRA, the HSE is in communication with the Section 39 bodies to ensure that the savings and flexibility measures which derive from the Agreement, are pursued across the Section 39 sector.

Special Educational Needs Staffing

Questions (242)

Michael Healy-Rae

Question:

242. Deputy Michael Healy-Rae asked the Minister for Health his views on correspondence on behalf of Early Childhood Ireland (details supplied) seeking that special needs assistants be provided to pre-schools to ensure that every child can access a free preschool place in the year before entering primary school; and if he will make a statement on the matter. [41408/13]

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Written answers (Question to Health)

The Government is fully committed to protecting frontline services, including services for children with disabilities, to the greatest extent possible, notwithstanding the financial constraints which the health sector must operate within. Significant resources have been invested by the health sector in recent years in services for children with disabilities. In particular, there is now an increased awareness of the importance of early intervention for these children in terms of ensuring they get the best start in life and are supported as much as possible to reach their full potential.

As the Deputy will be aware, the Health Service Executive has operational responsibility for the provision of health and personal social services, including disability services for children. Within this context and subject to the financial resources available, it has a responsibility to ensure that the health-related needs of children with disabilities are addressed and that these children are appropriately supported in pre-school and school settings. This is done in a number of ways such as by providing grant-aid to support pre-school provision in community pre-schools and by funding special pre-schools that cater specifically for children with disabilities. It has also facilitated children with disabilities to attend mainstream pre-schools by providing assistant supports where these supports may be necessary. The HSE’s role in supporting children with disabilities involves it working in close co-operation with the disability service providers that it funds, with the education sector, with the Department of Children and Youth Affairs and with the parents and families of the children in question. The HSE's reorganisation of existing therapy resources to geographic based teams for children and young people with disabilities under the Progressing Disabilities Programme for Children and Young People (0-18) is also significant in this context. This aims to increase the level of consistency and standardisation in the way both early intervention services and services for school-aged children with disabilities are delivered and to have one clear pathway for all children with disabilities according to need.

While the health, children and youth affairs and education sectors co-operate on a regular basis with a view to integrating their services for children with a disability as much as possible there is a need to strengthen these arrangements. The Children, Adolescents and Young People with Complex Disabilities Unit led by a Principal Officer has been established in my Department. This important development aims to foster greater collaboration between my Department, the Department of Education and Skills and the Department of Children and Youth Affairs on children’s disability issues and to build on the cross-sectoral working arrangements that are already in place. A dedicated Cross-Sectoral Team, comprising representatives of my Department, the HSE, the Department of Education and Skills and the Department of Children and Youth Affairs plays a key role in this regard.

A sub group of this Cross-Sectoral Team has been set up to examine the issues around the integration of children with disabilities into mainstream Pre-School Settings, building on previous analysis in this area. Representatives of the Departments of Health, Children and Youth Affairs, Education and Skills, the Health Service Executive and of the City and County Childcare Committees are members of this group and it is chaired by the Department of Health. It is envisaged that the work of this Sub-Group will be completed later this year, at which point it will report to the Cross Sectoral Team.

Nursing Home Services

Questions (243)

Joe Higgins

Question:

243. Deputy Joe Higgins asked the Minister for Health the practical and financial assistance that will be given to residents of a home (details supplied) in County Dublin in finding alternative accommodation following announcement that the home will close in the next three to five years following budget cuts [41234/13]

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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 attention and direct reply to the Deputy.

Medical Card Applications

Questions (244)

Pat Deering

Question:

244. Deputy Pat Deering asked the Minister for Health when a medical card will issue to a person (details supplied) in County Carlow; and if he will make a statement on the matter. [41237/13]

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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 issued to Oireachtas members.

Medical Card Eligibility

Questions (245)

Sandra McLellan

Question:

245. Deputy Sandra McLellan asked the Minister for Health the reasons persons who have life threatening serious illnesses are not granted a medical card for life (details supplied). [41239/13]

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Written answers (Question to Health)

Under the provisions of the Health Act 1970, the assessment for a medical card is determined primarily by reference to the means, including the income and expenditure, of the applicant and his or her partner and dependants. While people with specific illnesses are not automatically entitled to medical cards, the legislation provides for discretion by the HSE to grant a medical card where a person's income exceeds the income guidelines. In these cases, social and medical issues are considered when determining whether or not undue hardship exists for the individual in accessing GP or other medical services. Discretion will be applied automatically during the processing of an application where additional information has been provided which can be considered with discretion by staff or a medical officer, where appropriate. At Minister Reilly's request, the HSE set up a clinical panel to assist in the processing of applications for discretionary medical cards, where a person exceeds the income guidelines but there are difficult personal circumstances, such as an illness.

The HSE also has a system in place in relation to the provision of emergency medical cards for patients who are terminally ill, or who are seriously ill and in urgent need of medical care that they cannot afford. Emergency medical cards are issued within 24 hours of receipt of the required patient details and letter of confirmation of condition from a doctor or consultant and are generally requested by a manager in a Local Health Office or a Social Worker.

With the exception of terminally ill patients in palliative care, all emergency cards are issued for six months on the basis that the patient is eligible for a medical card on the basis of means or undue hardship, and will follow up with a full application within a number of weeks of receiving the emergency card. Where a patient is terminally ill in palliative care, the nature of the terminal illness is not a deciding factor in the issue of an emergency medical card in these circumstances and no means test applies.

Given the nature and urgency of the issue, the HSE has appropriate escalation routes to ensure that the person gets the card as quickly as possible and the HSE ensures that the system responds to the variety of circumstances and complexities faced by individuals in these circumstances. The HSE has been asked to examine this individual matter raised by the Deputy and to respond as soon as possible.

Health Services Reform

Questions (246)

Billy Kelleher

Question:

246. Deputy Billy Kelleher asked the Minister for Health if a full assessment has been carried out on the possible impact on the health services as a result of the FEMPI measures being implemented, if he will detail same and the actions being taken to counteract increased pressure on services; and if he will make a statement on the matter. [41240/13]

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Written answers (Question to Health)

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 certain health professionals under the relevant Regulations. The professionals concerned were General Practitioners, Pharmacists, Dentists, Ophthalmologists, Optometrists and Dispensing Opticians who hold contracts with the HSE, Smeartakers contracted under the CervicalCheck programme and Consultant Psychiatrists who hold contracts with the Mental Health Commission.

Having carefully considered the submissions made during the consultation process, the Minister for Health decided to make the following reductions: an overall reduction of 7.5% in fees and allowances payable to GPs under the GMS Scheme, Immunisation Schemes, HeartWatch and the Maternity & Infant Care Scheme; the elimination of the 20% retail mark-up to Community Pharmacists in respect of items dispensed under the Drug Payment Scheme, the Long Term Illness Scheme, the European Economic Area Scheme and the Health (Amendment) Act 1996 Scheme; a 3% reduction in fees paid to Consultant Ophthalmologists; a 3% reduction in fees paid to Consultant Psychiatrists who hold contracts with the Mental Health Commission.

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; S.I. 279/2013 - Health Professionals (Reduction of Payments to Community Pharmacy Contractors) Regulations 2013; S.I. 274/2013 - Health Professionals (Reduction in payments to Ophthalmologists, Optometrists and Dispensing Opticians) Regulations 2013; S.I. 276/2013 - Health Professionals (Reduction of Payments to Consultant Psychiatrists) Regulations 2013.

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.

General Medical Services Scheme Payments

Questions (247)

Brendan Griffin

Question:

247. Deputy Brendan Griffin asked the Minister for Health if health expenses will be reimbursed to a person (details supplied) in County Kerry; and if he will make a statement on the matter. [41263/13]

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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 issued to Oireachtas members.

National Treatment Purchase Fund Waiting Times

Questions (248)

Ciara Conway

Question:

248. Deputy Ciara Conway asked the Minister for Health the position regarding orthopaedic surgery cancellations (details supplied); the reason that the budget for the National Treatment Purchase Fund running low was not foreseen and pre-op procedures avoided; if he will indicate when these patients will have their operations rescheduled; and if he will make a statement on the matter. [41268/13]

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Written answers (Question to Health)

In July 2011 I announced changes to the remit of the National Treatment Purchase Fund (NTPF), namely that its role would be changed to support the mission of the Special Delivery Unit (SDU). The NTPF/SDU are working closely with hospitals towards achievement of maximum waiting time targets.

I am advised that, as part of this work in 2012, funding was set aside from the 2012 NTPF allocation to support Waterford Regional Hospital in arranging initial consultations for a limited number of orthopaedic outpatients with the cooperation of Cappagh Hospital in Dublin. In doing so, it is never possible to predict with certainty, in advance of consultations taking place, whether all those outpatients will require further medical help, or to predict the cohort of patients who will require follow-on inpatient surgical intervention. In 2013, unlike previous years, any funding for such performance improvement initiatives is held within the HSE Vote. Hence, the hospitals involved agreed to an orderly transition of the initiative (that had already been commenced) in a manner that minimised any disruption to the patients involved and made best use of the patient appointments already held, while working within a budget now provided directly to public hospitals.

Hence, of the 1,871 patient referrals from Waterford Regional Hospital to Cappagh Hospital, 1,623 patients had their treatment completed at Cappagh while the remaining 248 will now have their treatment provided by Waterford Regional Hospital. I am advised that those patients who had been scheduled for either an outpatient appointment or a procedure at Cappagh Hospital, all are being rescheduled for appointments and treatment at Waterford Regional Hospital and the hospital is currently writing to these patients advising them that their care needs will be seen to as expeditiously as possible.

Ambulance Service Provision

Questions (249)

Peadar Tóibín

Question:

249. Deputy Peadar Tóibín asked the Minister for Health in view of the fact that the Health Information and Quality Authority does not receive or publish key performance indicators on a regional basis regarding the delivery of the ambulance service, and this means that the management of the service cannot see or respond to regional variances in service provision, if he will instruct HIQA to collect and publish these KPIs. [41272/13]

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Written answers (Question to Health)

The Health Information and Quality Authority (HIQA) published the Pre-hospital Emergency Care Key Performance Indicators for Emergency Response Time in October 2012. They developed a set of key performance indicators (KPIs), which classify 112/999 emergency calls by clinical status. Clinical Status 1 ECHO calls involve life-threatening emergencies of cardiac or respiratory origin. Clinical Status 1 DELTA calls involve life-threatening emergencies of other than cardiac or respiratory origin. The HIQA target for patient-carrying vehicles is to meet the Clinical Status 1 ECHO and DELTA incident response time of 18 minutes 59 seconds in 85% of cases.

It is acknowledged that response-time indicators should not be used in isolation as a means of evaluating of pre-hospital emergency service delivery. Following a review of the validity of time-based KPIs for clinical status data, and in line with international views, it is considered that clinical outcome indicators would be more appropriate. For example, there may be significant regional variations in response times because of the influence of differing geographic and demographic factors in different areas, while outcomes may be similar. Work is now in progress on the development of clinical outcome indicators for pre-hospital emergency responses.

In relation to the Deputy's query, the HSE publishes monthly performance data, including performance information for pre-hospital emergency response times at national level. This information is collected from data reported at regional level within the National Ambulance Service and is available to management for information and decision-making in relation to local service provision.