Written Answers Nos. 206 - 215
206. Deputy Billy Kelleher asked the Minister for Health the number of the 477 community mental positions promised in the past two budgets that have been filled; if he will provide in tabular form the number of these positions filled and the numbers unfilled in each local health area; and if he will make a statement on the matter. [43990/13]
View answerThis Government has prioritised the reform of our mental health services in line with A Vision for Change and is committed in particular to the delivery of more and better quality care in the community. Additional funding totalling €70 million and some 900 new posts have been provided as part of the last two Budgets primarily to strengthen Community Mental Health Teams for both adults and children and to enhance specialist community mental health services for older people with a mental illness, those with an intellectual disability and mental illness and forensic mental health services in line with A Vision for Change.
Of the 414 posts allocated in 2012, as at 30th September 2013, the recruitment process is complete for 378 or 91%, of the posts. A number of the remaining posts are at various stages in the recruitment process. In addition, there are a number of posts for which there are difficulties in identifying suitable candidates due to various factors including the availability of qualified candidates and geographical location. 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. I have received assurances from the HSE that the filling of these posts is being given priority within the HSE. In relation to the specific question on the number of positions filled or unfilled in each local health area, I have asked the HSE to respond to you directly with this information.
207. Deputy Finian McGrath asked the Minister for Health if it is possible for a family to apply for the treatment abroad scheme for their child who needs rehabilitation and the type needed is not available here. [43998/13]
View answerThe HSE operates a Treatment Abroad Scheme (TAS), for persons entitled to treatment in another EU/EEA member state or Switzerland under EU Regulation 1408/71, as per procedures set out in EU Regulation 574/72 and in accordance with Department of Health and Children Guidelines. Within these governing EU Regulations and the Department of Health and Children’s Guidelines, the TAS provides for the cost of approved treatments in another EU/EEA member state or Switzerland through the issue of form E112 (IE).
The TAS allows for an Irish based consultant to refer a patient that is normally resident in Ireland for treatment in another EU member state or Switzerland, where the treatment in question meets the following criteria:
(a) The application to refer a patient abroad has been assessed and a determination given before that patient goes abroad.
(b) Following clinical assessment, the referring consultant certifies the following:
- They recommend the patient be treated in another EU/EEA country or Switzerland;
- The treatment is medically necessary and will meet the patient's needs;
- The treatment is a proven form of medical treatment and is not experimental or test treatment;
- The treatment is in a recognised hospital or other institution and is under the control of a registered medical practitioner;
- The hospital outside the state will accept EU/EEA form E112 (IE).
Patients in conjunction with their Irish based public referring hospital consultant have the ability to apply to the HSE TAS seeking access to public health care outside the state through model form E112. Applications to the TAS are processed and a determination given in accordance with the statutory framework prior to a patient travelling to avail of treatment. Approved applicants/patient's hospital treatment costs are covered through the issue of form E112 (IE) for specific identified episodes of care. The governing Regulations do not provide for the patient's travel or subsistence costs but the HSE in line with its national travel policy provides funding for patient's air or sea fares.
Once a patient is discharged from a specific episode of care abroad, their care immediately reverts to their Irish based consultant.
Further information on the scheme is available on the HSE website http://www.hse.ie/eng/services/list/1/schemes/treatmentabroad/ or by contacting the HSE Treatment Abroad Scheme office on 056 778 4551 or via email on treatmentabroad.scheme@hse.ie. Application forms and information documents can be obtained through that office.
208. Deputy Michael McGrath asked the Minister for Health if he will provide details of any reciprocal arrangements that apply between Ireland and other countries concerning the provision of medical cards or health services to persons from other jurisdictions residing here and vice versa; if these benefits are means tested in any way; and if he will make a statement on the matter. [44000/13]
View answerIn relation to persons on a temporary visit to Ireland, under EU Regulations a person who becomes ill or injured while on a temporary stay in any EU/EEA Member State or Switzerland may available of emergency health care in the public health system of the country under the terms of that countries public health system. The European Health Insurance Card (EHIC) is issued to facilitate this process. In Ireland such a person is treated as if they have full eligibility (i.e. have a medical card) and no charge is levied. Irish citizens are treated in a similar manner when they require such emergency public health care within the EU/EEA and Switzerland (and produce their EHIC), the arrangements are reciprocal and Ireland provides services to citizens of other EU/EAA States and Switzerland while they provide emergency care to our citizens.
A Reciprocal Agreement exists for Treatment for Medical Care for Temporary Visitors between Australia and Ireland and provides that where a resident of Australia is temporarily in Ireland, and needs immediate necessary medical treatment while in Ireland, they shall be provided with such medical treatment as is clinically necessary for the diagnosis, alleviation or care of the condition requiring attention, as a public patient within the public health care system on terms no less favourable than would apply to a resident of Ireland.
In relation to Australia, "resident" means a person who is an Australian resident for the purposes of the Health Insurance Act 1973 and holds either a current Australian passport or any other current passport endorsed to the effect that the holder is entitled to reside indefinitely in Australia.
Where a person is ordinarily resident in Ireland and belongs to one of the following groups, they will qualify for a Medical Card under EU Regulations. They are:
- living in Ireland and receiving a social security payment from another European Union /European Economic Area (EU/EEA) country or Switzerland and are not getting an Irish social welfare payment (apart from Child Benefit or Early Childcare Supplement). The person must not be liable to contribute to the Irish Social Welfare System, (i.e. PRSI)
- living in Ireland and working in another EU/EEA country or Switzerland and are liable to pay Social Insurance Contributions in that country
- living in Ireland and is the dependent spouse or child of someone employed in another EU/EEA country and Switzerland. The person must not be getting an Irish Social Welfare Payment apart from Child Benefit or Early Childcare Supplement and must not be liable to contribute to the Irish social welfare system.
Means testing does not apply to medical cards granted under EU Regulations.
209. Deputy Terence Flanagan asked the Minister for Health if he will provide an update regarding the delay in opening the 24-bed unit in Blanchardstown hospice; and if he will make a statement on the matter. [44010/13]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
210. Deputy Michael McGrath asked the Minister for Health if his attention has been drawn to the serious funding pressures faced by Cork Local Drugs Task Force, that their budget has been reduced significantly since 2008 and if he will protect their budget in 2014; and if he will make a statement on the matter. [44012/13]
View answerNo decisions have been taken yet in relation to the allocations to Drugs Task Forces for 2014. The matter is currently under consideration. It is anticipated that Drugs Task Forces will be informed of their allocations later in the year.
211. Deputy Róisín Shortall asked the Minister for Health if his attention has been drawn to the fact that there has been a 21% reduction in the operational budget of the Daughters of Charity Services for persons with intellectual disabilities since 2009; if his attention has been drawn to the fact that the chief executive officer believes that any further reduction in funding will result in the closure of services; and if he will make a statement on the matter. [44014/13]
View answerAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
212. Deputy Seán Ó Fearghaíl asked the Minister for Health if he will ensure that a medical procedure is carried out in respect of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [44015/13]
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 this particular query raised by the Deputy, I have asked the Health Service Executive to investigate the situation and respond directly to the Deputy in this matter.
213. Deputy Patrick Nulty asked the Minister for Health the level of spending on agency nursing staff by the Health Service Executive to date in 2013; the measures he is taking to reduce this spend; and if he will make a statement on the matter. [44019/13]
View answerAgency staffing arrangements are intended to be used in the health service to address short-term needs, such as periods of staff absence for maternity leave or due to illness. In recent years there has been an increase in usage of such arrangements, which are expensive and not ideal from a continuity-of-care perspective. There are a number of measures in train to address the level of spending on agency nursing staff.
In the first instance, the Public Service Stability Agreement 2013 - 2016 (The Haddington Road Agreement) provides for staff throughout the health service staff to increase their working hours. The value ascribed to this element of the Agreement is in the region of five million hours annually for the health workforce as a whole. In the case of nurses and midwives, the standard working-week has increased from 37.5 to 39 hours. One of the principal ways in which this measure will lead to savings is to enable the service's reliance on agency staffing and overtime working to be reduced. My Department has emphasised to the HSE the need for a clear focus by managers on maximising the benefits in this regard.
The Haddington Road Agreement also provides for the implementation of the Graduate Nurse/Midwife Placement Initiative on an agreed basis with the health unions. Staff are currently being appointed under this scheme and the additional resource which they represent will also contribute to savings on agency and overtime expenditure. In addition, as part of the 2014 Estimates process it has been agreed that the HSE will establish a Nurse Bank. This measure will improve the continuity of nurse-provided care and will also reduce reliance on agency staffing. As the level of spending on agency nursing staff by the Health Service Executive to date in 2013 is an operational matter, it has been referred to the Executive for attention and direct reply to the Deputy.
214. Deputy Patrick Nulty asked the Minister for Health the action he is taking to ensure that the target of spending 8% of the health budget on mental health is reached; and if he will make a statement on the matter. [44020/13]
View answerIn 2013, 5.5% of the Health Service Executive Budget (€733 million) will be spent on specialist mental health services. Since 2012, funding has been at a lower percentage than in previous years as prior to that the figures in the Revised Estimates for Public Services for Health Care Group Areas such as Mental Health included an allocated share in relation to both pension and corporate costs, which are now shown separately. In addition, about 1 in 4 people experience mental health problems in their lifetime, many of whom will be dealt with in primary care. It is estimated that approximately 90% of mental health problems are dealt with in primary care and some 30% of people who attend primary care have a mental health problem and expenditure on these services is not captured in this percentage.
This Government has prioritised the reform of our mental health services in line with A Vision for Change our strategy for the development of our mental health services and is committed in particular to the delivery of more and better quality care in the community. Additional funding totalling €70 million and some 900 new posts have been provided as part of the last two Budgets primarily to strengthen Community Mental Health Teams for both adults and children and to enhance specialist community mental health services for older people with a mental illness, those with an intellectual disability and mental illness and forensic mental health services in line with A Vision for Change.
In Budget 2014, the Government has again re-committed to the continuation of the development of this critical service for a highly vulnerable group in these extremely challenging times, where the options for additional expenditure generally are very constrained. A sum of €20 million is being ring-fenced for the further development of our mental health services in 2014. This €20m means that, despite serious resource pressures overall, funding of €90m has been made available since 2012, up to the end of 2014, that has been specifically ear-marked for mental health and suicide prevention.
215. Deputy Patrick Nulty asked the Minister for Health the action he is taking to ensure that the rate of organ donation here improves substantially; if he will appoint transplant co-ordinators in each hospital as part of this effort; and if he will make a statement on the matter. [44021/13]
View answerMy Department is working with the HSE's National Organ Donation and Transplantation Office to establish the required infrastructure to improve organ donation and transplantation rates. Priority areas for action in 2014 are being identified and the deployment of key donation personnel will be considered in this context.
