Written Answers Nos. 185-192
185. Deputy Terence Flanagan asked the Minister for Health the reduction of payments to health professionals that has been made by his Department over the past year; his plans to reduce further payments made by his Department; and if he will make a statement on the matter. [42788/13]
View answerA 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 24th 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.
186. Deputy Bernard J. Durkan asked the Minister for Health if a medical card will be awarded in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [42790/13]
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.
187. Deputy Billy Timmins asked the Minister for Health the position regarding children who are on a programme of free dental treatment, that is, orthodontic treatment, braces and so on, who were attending national school last year and are now in first year in secondary school and need to continue on the programme of treatment started in national schools; the position in connection with continuing with this necessary dental treatment; and if he will make a statement on the matter. [42793/13]
View answerThe HSE provides orthodontic treatment to those who have been assessed and referred for treatment before their 16th birthday. Where a course of orthodontic treatment commences while a child is in primary school the necessary treatment will continue after the child enters secondary school.
Orthodontic referrals are generally received via the Public Dental Service primary school screening programme. Those who attend private schools or are home schooled are also included. An individual's access to orthodontic treatment is determined against a set of clinical guidelines called the Modified Index of Treatment Need. Patients with the greatest level of need, i.e. Grade 5 or Grade 4 are provided with treatment by the HSE.
188. Deputy Peadar Tóibín asked the Minister for Health the reason a hospital (details supplied) in the early 1990s took the organs from stillborn babies; the reason they were taken without the knowledge or permission of mothers; where those organs went and what was done with them and the reason for same; and if he will make a statement on the matter. [42809/13]
View answerMy Department published two reports by Dr Deirdre Madden in 2006. The first of these reports "Post Mortem Practice and Procedures" inquired into the policies and practices relating to the removal, retention and disposal of organs from children who had undergone post-mortem examination in the State since 1970. The second report "Working Group on Post Mortem Practice" considered the application of the recommendations of the first Report to (a) babies who died before or during birth, (b) minors and (c) adults.
In line with a recommendation in Dr Madden's reports, an independent audit of all retained organs in the State was carried out by Ms Michaela Willis and her report was published in 2009.
In March 2012, the Health Service Executive published "Standards and Recommended Practices for Post Mortem Examination Services" and these were circulated to all relevant hospital staff. The overall aim of the standards and recommended practices for post-mortem examinations is to drive high quality services based on best professional practice and current legal requirements. Meanwhile, the Heads of a Human Tissue Bill, which will incorporate aspects of the key recommendation of Dr Madden's Reports are at an advanced stage of drafting.
189. Deputy Patrick Nulty asked the Minister for Health the number of delayed discharges there have been in Connolly Hospital, Blanchardstown in 2013; the reasons for these delayed discharges; the actions that has been taken to reduce this figure; and if he will make a statement on the matter. [42831/13]
View answerDelayed Discharges continue to present a significant challenge to the optimal use of acute hospital resources. They impede the operational functioning of a hospital and expose patients concerned, predominantly older persons, to the inappropriate risks of longer acute hospital stays e.g. hospital acquired infections. Higher numbers of delayed discharges can also be associated with extended waits in the Emergency Department.
My Department and the HSE remain seriously concerned regarding the situation in relation to delayed discharges and consider it essential that this issue is successfully addressed. A number of actions have been initiated in this regard. These include the establishment by me of a Ministerial task force to deliver substantial improvements in delayed discharges, including a review of the operational arrangements associated with the ‘Fair Deal’ scheme. Senior personnel have been tasked with improving cross hospital-community process issues, focusing first on the ‘longest waiting’ delayed discharges (>100 days). The aim is to remove all local barriers to discharge and identify those matters which require action at a national level. The management teams have been making good progress with respect to these tasks and it is intended to quickly roll-out this structure to all areas.
The HSE increased allocations of Fair Deal approvals, temporarily prioritised Fair Deal referrals for patients in acute hospitals, including referrals to long stay facilities from acute hospitals for older persons with complex needs and also targeted appropriate homecare packages for older persons in acute hospitals experiencing significant delayed discharges. New reporting systems and processes have also been introduced. A HSE web-based database that allows tracking at patient level (on an anonymous basis) is in the implementation phase in a number of hospital sites. In addition, the categorisation of reasons for delay has been reviewed. The data captured through the web-based system will facilitate revised metrics for each hospital. There will be a greater emphasis on reducing the bed days lost to delayed discharges, with targets established on a site-by-site basis.
As the issues raised regarding the number of delayed discharges and the reasons for these delayed discharges from Connolly Hospital, Blanchardstown are operational matters for the HSE, I have asked the HSE to reply directly to the Deputy in relation to this.
190. Deputy Patrick Nulty asked the Minister for Health the funding and grants available to assist communities established day care centres for the elderly; the other supports his Department and the Health Service Executive offer communities that wish to establish day care centres for the elderly; if he has a strategy for the development of day care centres for the elderly; and if he will make a statement on the matter. [42832/13]
View answerGovernment policy is to support older people to live in dignity and independence in their own homes and communities for as long as possible. Approximately €392 million has been allocated by the Health Service Executive in 2013 to provide for community support services, including the Home Help Service, Home Care Packages, day care and meals-on-wheels. The HSE estimate that approximately 21,460 clients will avail of Day Care services in 2013. In the context of the development of an integrated model of care for older people, the HSE is currently reviewing the provision of day care services to ensure that clients are receiving the most appropriate service to meet their needs. As the Health Service Executive has responsibility for the funding of these services, I have arranged for the question to be referred to the Executive for direct reply to the Deputy.
191. Deputy Patrick Nulty asked the Minister for Health if he is confident that the structures and systems are in place for the introduction of money following the patient in January 2014; and if he will make a statement on the matter. [42833/13]
View answerMy Department is working closely with the HSE to ensure that full phased implementation of Money Follows the Patient (MFTP) will commence from January 2014. I am confident that all necessary steps are being taken to deliver the new funding model in line with this target date.
Progress has been made on a number of areas in this regard including completion of a “State of Readiness” review by an internationally recognised expert in MFTP. The purpose of this review was to assess the health system’s capacity to roll out MFTP in public hospitals. I am happy to report that the assessment concludes that the Irish health system exhibits the key components required for a MFTP funding system and is in a strong position to begin phased implementation of MFTP in line with the target date of 2014.
The Department and HSE have also been working towards the establishment of a National Pricing Office from January 2014. This Office will be comprised of staff working in the HSE Casemix Programme and the ESRI Health Information and Research Division. Its main functions will be to set the national Diagnosis Related Group prices, on which the MFTP system is based, and manage the HIPE dataset.
Preparations are now being made for the commencement, in November, of a shadow funding exercise in a selection of hospitals from across the hospital groups. This exercise will involve hospitals continuing to receive their existing base budgets. However, a process will be put in place to: (i) compare on a systematic basis, actual hospital activity against baseline activity targets; and (ii) inform hospitals of what the financial implications of any variance from the targets would be in a “live” system, without changing budgets during the shadow period. This will be a valuable learning exercise for the hospitals concerned.
I regard MFTP as a key building block in the move to Universal Health Insurance and I am committed to supporting MFTP fully as it develops.
192. Deputy Patrick Nulty asked the Minister for Health in view of the fact that the one million hours that have been cut in recent years from home help services, if he will ring fence resources for home help from any further cuts; and if he will make a statement on the matter. [42834/13]
View answerThe Health Service Executive has committed in its National Service Plan 2013 to maintaining community supports such as home help and home care packages at the levels planned for in 2012. This means that 10.3m hours of home help will be provided with 50,000 people receiving this service, and that 10,870 people will be in receipt of home care packages. On-going regular reviews of home support services by the HSE will help to ensure that service users receive supports that are aligned to their assessed needs and that new applicants can, as far as possible, continue to be processed and allocated appropriate supports within the available resources.
