Written Answers Nos. 197-205
197. Deputy Billy Kelleher asked the Minister for Health the reason no paediatrics urologist has been appointed to Temple Street University Hospital despite the Spina Bifida and Hydrocephalous Ireland organisation being told in February 2012 that the post was ready to be filled; and if he will make a statement on the matter. [43921/13]
View answer198. Deputy Billy Kelleher asked the Minister for Health his views that the appointment of a paediatric urologist at Temple Street University Hospital will in view of the ongoing debate on organ donation prove to be a proactive measure in trying to prevent the need for future kidney transplants amongst patients such as spina bifida sufferers [43927/13]
View answer223. Deputy Maureen O'Sullivan asked the Minister for Health in view of the fact that renal failure is one of the top causes of death for children with spina bifida, the reason since 2009, when spina bifida care was transferred to Temple Street University Hospital, there has not been a paediatric urologist established in the hospital to carry out routine monitoring tests such as blood test for kidneys, renal ultrasound, DMSA scan, bladder function assessment, video urodynamic study and spinal MRI which may prevent fatal kidney failure; the reason the recent vacancy for a paediatric urologist by the HSE has not been filled yet and when the appointment will be made; and if he will make a statement on the matter. [44041/13]
View answer231. Deputy Clare Daly asked the Minister for Health if he will justify the fact that there has been no paediatric urologist at Temple Street Hospital despite the absolute requirement for such a position to be available for treating children with spina bifida who could die from kidney failure and that they will commit to the provision of a urology monitoring system at the hospital [44081/13]
View answerI propose to take Questions Nos. 197, 198, 223 and 231 together.
The Children's University Hospital, Temple Street is the national tertiary care centre for spina bifida and hydrocephalus. All infants born in Ireland with Spina Bifida are transferred to Temple Street after birth for ongoing neonatal management. Children with spina bifida are seen by a multidisciplinary team at Temple Street which includes a Consultant Paediatrician with a special interest in Spina Bifida, a Spina Bifida Nurse Specialist and Neurosurgery input. It is intended to recruit a consultant urologist in order to ensure dedicated urology input. A recruitment process took place in 2009/2010 and again in 2012/2013. As neither was successful, a new recruitment process is now in train and I am advised that the HSE is hopeful that this new recruitment process will result in a suitable candidate taking up the post.
In the interim, spina bifida patients are being reviewed by a consultant surgeon who has been granted honorary status at the hospital. The hospital has also completed negotiations to establish a regular clinic with a UK paediatric urologist. Dates have now been scheduled in October and December for visits from this urologist and an appropriate Service Level Agreement is in place. As an interim arrangement, those children requiring urgent urological input are prioritised clinically and seen in the UK under the Treatment Abroad Scheme. All patients are being kept under regular review and are referred on a case by case basis to the UK for treatment, pending the appointment of a permanent urologist.
199. Deputy Billy Kelleher asked the Minister for Health the number of persons availing of private health insurance for each of the years 2008, 2009, 2010, 2011, 2012, and to date in 2013 in each of the following age groups, 17 years and under, 18 to 29 years, 30 to 39 years, 40 to 49 years, 50 to 59 years, 60 to 69 years, 70 to 79 years, 80 years and over; and if he will make a statement on the matter. [43935/13]
View answerThe latest data available to me from the Health Insurance Authority on the numbers insured with open membership private health insurers is as follows:
|
MEMBERSHIP |
- |
|
End 2008 |
- |
|
Age Group |
Market |
|
17 & under |
518189 |
|
18 - 29 |
334372 |
|
30 - 39 |
370084 |
|
40 - 49 |
322627 |
|
50 - 59 |
268526 |
|
60 - 69 |
188676 |
|
70 - 79 |
96071 |
|
80 & over |
37014 |
|
Total |
2135559 |
|
End 2009 |
- |
|
Age Group |
Market |
|
17 & under |
518236 |
|
18 - 29 |
309892 |
|
30 - 39 |
364506 |
|
40 - 49 |
320916 |
|
50 - 59 |
272324 |
|
60 - 69 |
197341 |
|
70 - 79 |
100839 |
|
80 & over |
38695 |
|
Total |
2122749 |
|
End 2010 |
- |
|
Age Group |
Market |
|
17 & under |
506156 |
|
18 - 29 |
284479 |
|
30 - 39 |
351248 |
|
40 - 49 |
315640 |
|
50 - 59 |
272164 |
|
60 - 69 |
203808 |
|
70 - 79 |
106035 |
|
80 & over |
41502 |
|
Total |
2081032 |
|
End 2011 |
- |
|
Age Group |
Market |
|
17 & under |
492165 |
|
18 - 29 |
260971 |
|
30 - 39 |
334317 |
|
40 - 49 |
310086 |
|
50 - 59 |
270048 |
|
60 - 69 |
208366 |
|
70 - 79 |
110354 |
|
80 & over |
44857 |
|
Total |
2031164 |
|
End 2012 |
- |
|
Age Group |
Market |
|
17 & under |
476983 |
|
18 - 29 |
234221 |
|
30 - 39 |
314142 |
|
40 - 49 |
303541 |
|
50 - 59 |
267065 |
|
60 - 69 |
212223 |
|
70 - 79 |
114706 |
|
80 & over |
47410 |
|
Total |
1970291 |
200. Deputy Billy Kelleher asked the Minister for Health if Voluntary Health Insurance Healthcare will seek authorisation from the Central Bank of Ireland before the end of 2013; the estimated financial cost to the State of same; if the company’s reinsurance agreement with Berkshire Hathaway will have any impact on this; and if he will make a statement on the matter. [43939/13]
View answerThe Government agreed in December 2011 to address the European Court of Justice ruling of September 2011 and to work with the VHI in its application process for authorisation by the Central Bank of Ireland (CBI) subject to further Government consideration of any application for authorisation. Officials from my Department, the VHI and the CBI continue to engage regularly to progress the application. My Department is also in regular contact with the EU Commission in relation to the authorisation and related State Aid issues.
Given the recent private health insurance market developments, including changes to taxation and the report of the Health Insurance Authority in relation to Risk Equalisation, further analysis will be required. The VHI's readiness for authorisation and any subsequent capital requirements will be determined by the CBI after their assessment of VHI's application, taking into account their business plan, which may include options such as reinsurance.
Reinsurance, used to reduce the risks associated with underwritten policies by spreading risks across alternative institutions, may provide for the possibility of a reduction in capital requirements for VHI’s authorisation. Future capital requirements will depend on the nature and length of any reinsurance deal that VHI can secure. The CBI will take reinsurance into account when determining VHI's solvency and consequent capitalisation requirements.
201. Deputy Martin Heydon asked the Minister for Health the steps he is taking to stop general practitioners charging medical card holders for blood tests; the way he can address the inconsistencies that exist between different medical practices and the charges they implement for such blood tests; and if he will make a statement on the matter. [43956/13]
View answerUnder paragraph 11 of the General Medical Services (GMS) contract, a general practitioner (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 and not requiring special skill or experience of a degree or kind which GPs cannot reasonably be expected to possess.
Under paragraph 27 of the GMS contract, a medical practitioner shall not demand or accept any payment or consideration whatsoever in reward for services provided by him/her, or for travelling or for other expenses incurred by him/her or for the use of any premises, equipment or instruments in making the services available.
In circumstances where the taking of blood is necessary to either (a) assist in the process of diagnosing a patient or (b) monitor a diagnosed condition, the GP may not charge that patient if they are eligible for free GMS services under the Health Act, 1970, as amended.
The HSE has written to GP contract holders and clarified the position in relation to this matter and has also communicated its position to the Irish Medical Organisation. Any alleged instances of eligible patients being requested to pay for a routine service of this nature from their own limited resources is viewed as a serious matter by the HSE and the Department.
I have been advised by the HSE that its Local Health Offices will fully investigate any reported incidents of eligible patients being charged for phlebotomy services which form part of the investigation and necessary treatment of patients' symptoms or conditions. In such cases, where a medical card holder or a GP visit card holder has been inappropriately charged for the taking of blood, the HSE will make deductions from those GPs' routine GMS payments.
Officials in my Department are in consultation with the HSE with a view to drawing up a new GMS contract. The appropriate arrangements in relation to phlebotomy services will be considered as part of the new contract.
202. Deputy Michael McGrath asked the Minister for Health the position regarding an application for national lottery funding in respect of an organisation (details supplied) in County Cork. [43958/13]
View answerMy Department has received an application for funding from the 2013 National Lottery allocation from the organisation in question. This is one of a large number currently being assessed. The Deputy will be informed of the outcome of the application as soon as a decision has been made.
203. Deputy Seán Ó Fearghaíl asked the Minister for Health the key elements of Vision for Change that have been implemented; the key elements that have yet to be achieved; and if he will make a statement on the matter. [43961/13]
View answer205. Deputy Billy Kelleher asked the Minister for Health the key elements of Vision for Change that have been implemented; the key elements that have yet to be achieved; and if he will make a statement on the matter. [43989/13]
View answerI propose to take Questions Nos. 203 and 205 together.
Implementation of A Vision for Change (AVFC) and the reform of our mental health services is a priority for this Government. Implementation of AVFC has been slower than originally expected. It has been delayed by a number of factors including the changed economic context, constraints in public spending and the moratorium on recruitment.
Nonetheless, a great deal of progress has been made with the accelerated closure of old psychiatric hospitals and their replacement with bespoke new facilities, better suited to modern mental health care. Progress also includes shorter episodes of in-patient care and the involvement of service users in all aspects of mental health policy, service planning and delivery.
A modern mental health service is best delivered in the community and in 2012 a special allocation of €35m was provided primarily to further strengthen Community Mental Health Teams in both adult and children’s mental health services, to advance activities in the area of suicide prevention, to initiate the provision of psychological and counselling services in primary care, specifically for people with mental health problems and to facilitate the re-location of mental health service users from institutional care to more independent living arrangements in their communities, in line with AVFC. 414 posts were approved to implement the €35m package of special measures.
Budgetary pressures within the HSE delayed the full utilisation of this funding, but this sum is now available to mental health services along with an additional €35m allocated in Budget 2013 for the continued development of mental health services across a range of headings, including the further development of forensic services and community mental health teams for adults, children, older persons with a mental illness and those with an intellectual disability and mental illness. 477 posts have been approved to implement these measures.
As at 30 September 2013, the recruitment process is complete for 378 or 91% of the 414 posts approved in 2012. There are a number of posts for which there are difficulties in identifying suitable candidates due to factors including availability of qualified candidates and geographic location, and the remainder are at various stages in the recruitment process.
Of the 477 posts approved in 2013, as at 30th September 2013, 255 or 54% of these posts were in the final stages of the recruitment process and a further 149 were at earlier stages, indicating that 85% of posts are in the recruitment process. The HSE’s National Recruitment Service is currently working to ensure that the remaining posts will be filled as soon as possible, from existing panels or through competition in the absence of panels, at the earliest opportunity. Options to enable more local recruitment are also being considered where this will assist in filling specific posts. I have received assurances from the HSE that the recruitment process for these new posts is being given priority within the HSE.
Budget 2014 provides €20 million ringfenced for mental health services which will enable the HSE to continue to develop and modernise our mental health services in line with the recommendations of AVFC, and will allow for the recruitment of additional staff to further enhance our Adult, Child and Adolescent and Specialist Community Mental Health Teams. This will bring to €90 million the total investment ringfenced by the Government in mental health services since 2012 up to end 2014. This significant investment in mental health in recent years demonstrates the Government’s ongoing commitment to the implementation of A Vision for Change.
204. Deputy Bernard J. Durkan asked the Minister for Health if and when a medical card will issue in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [43983/13]
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.
