Tuesday, 5 Nov 2013

Written Answers Nos. 1073 - 1093

Medicinal Products Expenditure

Questions (1073, 1074)

Jerry Buttimer

Question:

1073. Deputy Jerry Buttimer asked the Minister for Health the amount of the drug spend by the State through pharmacies in each of the past ten years; and if he will make a statement on the matter. [46026/13]

Jerry Buttimer

Question:

1074. Deputy Jerry Buttimer asked the Minister for Health the amount spent by the State through the drug repayment scheme in each of the past ten years; and if he will make a statement on the matter. [46027/13]

Written answers

Minister of State at the Department of Health (Deputy Alex White)

I propose to take Questions Nos. 1073 and 1074 together.

The data requested by the Deputy is set out in the following table.

-	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012
Total Drug Spend (€m)	943.21	1092.70	1198.14	1365.17	1508.47	1628.53	1694.73	1564.87	1501.24	1565.32
Total Drug Payment Scheme Spend (€m)	204.42	226.83	246.68	285.79	310.11	315.03	263.47	173.44	142.14	125.69

Question No. 1075 answered with Question No. 1072.

Hospital Trusts

Questions (1076)

Jerry Buttimer

Question:

1076. Deputy Jerry Buttimer asked the Minister for Health if he will provide an update on the establishment of hospital trusts; and if he will make a statement on the matter. [46029/13]

Written answers

Minister for Health

The Report on the Establishment of Hospital Groups, which I launched on 14 May, is the most fundamental reform of the Irish acute hospital system in decades. The introduction of Hospital Groups will provide for organisational change in the first instance, giving more autonomy and better enabling the reorganisation of services in a well-planned manner. Over time, this will help to improve services and deliver better outcomes for patients.

In July, expressions of interest were invited through the Public Appointments Service for appointment as Chairpersons and members of Hospital Group Boards. I have now appointed Dr. Tom Lynch as Chair of the Dublin East Hospital Group, Dr. Frank Dolphin as Chair of the Dublin Midlands Hospital Group, Ms Anne Maher as Chair of the Dublin North East Groups and Prof. Geraldine McCarthy as Chair of the South-South West Hospital Group. These appointments are in addition to the existing Chairs of the West/North West Hospital Group, the MidWest Hospital Group and the Children's Hospital Group, Prof. Niall O'Higgins, Mr. Noel Daly and Dr. Jim Browne. CEOs and Boards are already in place for these three hospital groups.

The process of recruiting CEOs for the Dublin East, Dublin Midlands, Dublin North East and South-South West Hospital Groups will now commence, in consultation with the newly appointed Chairpersons, through the Public Appointments Service. My Department will also enter into discussion with the Chairs with a view to appointing the other Board members as soon as possible.

A Strategic Advisory Group is now being established, chaired by Mr. Leo Kearns, which will oversee the establishment of Hospital Groups and the subsequent reorganisation of acute hospital services. Hospital Groups will be required, within one year, to develop a strategic plan which will outline their plans for future services within the group area. These strategic plans will determine the way services are provided within each group, and their successful implementation will be required before Groups can advance to become Hospital Trusts when the necessary legislation is put in place.

Hospitals Policy

Questions (1077)

Jerry Buttimer

Question:

1077. Deputy Jerry Buttimer asked the Minister for Health if he will provide an update on the progress of establishing centres of excellence and the role of lead hospitals in such settings; and if he will make a statement on the matter. [46030/13]

Written answers

Minister for Health

I understand that the Deputy is referring to the role of hospitals within Hospital Groups. The introduction of Hospital Groups will provide for organisational change in the first instance, giving more autonomy and better enabling the reorganisation of services in a well-planned manner. Over time, this will help to improve services and deliver better outcomes for patients.

Chairs have now been appointed to all seven Hospital Groups. CEOs are in place for three of the Groups, and the process of recruiting CEOs for the remaining four Groups will shortly commence, in consultation with Chairpersons, through the Public Appointments Service. My Department will also enter into discussion with the Chairs with a view to appointing the remaining Board members as soon as possible.

A Strategic Advisory Group is now being established, chaired by Mr. Leo Kearns, which will oversee the establishment of Hospital Groups and the subsequent reorganisation of acute hospital services. Each group of hospitals will work together as single cohesive entities managed as one, to provide acute care for patients in their area, integrating with community and primary care. This will maximise the amount of care delivered locally, whilst ensuring complex care is safely provided in larger hospitals. Hospital Groups will be required, within one year, to develop a strategic plan which will outline their plans for future services within the group area and the role of hospitals within each group will be considered in detail in the context of this strategic plan.

Obesity Strategy

Questions (1078, 1079)

Jerry Buttimer

Question:

1078. Deputy Jerry Buttimer asked the Minister for Health the progress being made by the special action group on obesity; when a final report from the group is expected; if consultations will be held on any recommendations from the group; and if he will make a statement on the matter. [46032/13]

Jerry Buttimer

Question:

1079. Deputy Jerry Buttimer asked the Minister for Health following the Irish Society for Rheumatology 2013 annual meeting, which was told by a leading expert that Europe is facing an epidemic of osteoarthritis due to obesity and aging; the measures being taken to counteract this problem here; and if he will make a statement on the matter. [46033/13]

Written answers

Minister for Health

I propose to take Questions Nos. 1078 and 1079 together.

I set up a Special Action Group on Obesity, comprising representatives from the Department of Health, the Department of Children and Youth Affairs, the Department of Education and Skills, the Health Service Executive, the Food Safety Authority of Ireland and Safefood to examine and progress a number of issues to address the problem of obesity.

The Group is concentrating on a range of measures including actions such as: calorie on menus in restaurants, how best to support healthy eating choices, the supply of healthy food products in vending machines, the detection and treatment of obesity, healthy eating guidelines and the promotion of physical activity. Recently I launched a three year Childhood Obesity Campaign. The Group will liaise with other Departments and organisations in a cross-sectoral approach to help halt the rise in overweight and obesity.

Progress has been made on the Healthy Eating guidelines, Calories on Menus initiative and I was presented with a Report last week on recommendations to reduce consumption of high fat, salt and sugar foods and drinks from the Top Shelf of the Food Pyramid. Arising out of the Irish Presidency of the EU and the Informal Meeting of Health Minister's, the EU Commissioner supported the call for an EU Action Plan on Childhood Obesity to be developed by the EU High Level Group On Nutrition and Physical Activity. This Plan has been drafted and will be finalised before the end of the year.

Consultancy Contracts Expenditure

Questions (1080)

Jerry Buttimer

Question:

1080. Deputy Jerry Buttimer asked the Minister for Health if he will furnish details of the money spent by his Department, the Health Service Executive and its predecessors on reports and management consultancy, including costs spent on editing, printing and publishing reports, each year from 1997 to date in 2013; and if he will make a statement on the matter. [46034/13]

Written answers

Minister for Health

The details requested are not readily available within my Department. The information is currently being compiled and will be forwarded to the Deputy as soon as possible. The element of the question relating to HSE expenditure on reports and management consultancy has been referred to that organisation for direct reply to the Deputy.

Medical Card Applications

Questions (1081)

Seán Ó Fearghaíl

Question:

1081. Deputy Seán Ó Fearghaíl asked the Minister for Health the actions he will take to ensure that patients who successfully apply for a medical card receive reimbursement for any costs incurred while awaiting the approval of their application; and if he will make a statement on the matter. [46036/13]

Written answers

Minister of State at the Department of Health (Deputy Alex White)

I am advised by the HSE that refund claims from clients are processed on a case by case basis. Applicants who feel they have incurred medical costs as a result of undue delay on the part of PCRS in processing their medical card application may submit a request for a refund enclosing the relevant receipts for consideration.

Health Services Staff Remuneration

Questions (1082)

Michael Creed

Question:

1082. Deputy Michael Creed asked the Minister for Health with regards to the funding for the Health Service Executive staff and Department of Health staff, the level of savings he has budgeted for under the Haddington Road Agreement for 2014; and if he will make a statement on the matter. [46040/13]

Written answers

Minister for Health

The additional payroll savings required in the health service in 2014 under the Haddington Road Agreement amount to €248 million. These savings targets will be the subject of a verification exercise, overseen by the Secretaries General of my Department, the Department of Public Expenditure and Reform, and the Department of the Taoiseach. The exercise will conclude before the finalisation of the Revised Estimates Volume.

Departmental Staff Data

Questions (1083)

Michael Creed

Question:

1083. Deputy Michael Creed asked the Minister for Health the number of staff employed in his Department in 2012 excluding Health Service Executive staff; the role and function of these staff; and if he will make a statement on the matter. [46054/13]

Written answers

Minister for Health

The role of the Department of Health is to provide strategic leadership for the health service and to ensure that Government policies for the sector are translated into actions and implemented effectively. The civil servants in my office support me and the Ministers of State in their implementation of Government policy, and in discharging their Government, Parliamentary and Departmental duties.

In line with my Department's Statement of Strategy 2011 - 2014 their role involves engaging with service users and other stakeholders, monitoring and evaluating the health service, and steering changes and improvements in the service. In fulfilling this role over the lifetime of the Strategy they have particular regard to key strategic goals in respect of the following areas:

Fair Access and Sustainability;

Patient Safety and Quality;

Health and Wellbeing;

Primary Care;

Acute Hospitals;

Specialised Care Services.

The total number of staff employed in the Department in performing these functions at end December 2012 was 355 Whole Time Equivalents. This includes a small number of staff seconded from the HSE and other Health Agencies who are engaged in Departmental duties for the duration of those secondments.

Health Services Reform

Questions (1084)

Billy Kelleher

Question:

1084. Deputy Billy Kelleher asked the Minister for Health if the money follows the patient system of funding will commence on 1 January 2014; and if he will make a statement on the matter. [46058/13]

Written answers

Minister for Health

I am happy to report that all necessary steps are being taken to ensure that implementation of the new Money Follows the Patient (MFTP) funding system will commence in line with the target date of 1 January 2014. Key developments in this regard are set out as follows.

My Department has been working with the HSE on a MFTP shadow funding exercise which will commence in the coming days. This exercise will take place in a selection of hospitals from across the hospital groups and will involve hospitals continuing to receive their existing base budget under a vote cashing system. 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 impacting on budgets.

The HSE is also working closely with the Department to begin full phased implementation of MFTP in January. Money will effectively be following the patient at this point because hospitals will be funded on the basis of activity completed and the achievement of predetermined activity targets. Budgetary discipline will be delivered under the new system through the use of fixed budgets for MFTP activity. Appropriate governance arrangements to oversee implementation are being progressed and a communications campaign with the hospitals concerned will be rolled out between now and the end of the year.

Work to establish a National Pricing Office (NPO) is also underway. The NPO will be formed through the merging of the HSE Casemix Unit and the ESRI Health Research and Information Division. The Office will initially be established on an administrative basis in January 2014, prior to becoming a statutory body. The key functions of the Office will be to (i) set the national Diagnosis Related Group (DRG) prices on which the MFTP system will be based; and (ii) manage the HIPE data set.

These recent developments have built on the progress made earlier in the year. This included completion of a consultation process which showed that stakeholders were generally welcoming of the move to MFTP. An independent international expert engaged by the HSE also completed a “state of readiness” review for roll-out of MFTP. The key message from this readiness assessment was that the Irish health system is in a strong position to begin phased implementation of MFTP in hospitals in line with the target date of 2014. 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.

Health Services Issues

Questions (1085)

David Stanton

Question:

1085. Deputy David Stanton asked the Minister for Health the incidence rate of Prader-Willi syndrome here; the services and treatments available to sufferers of this genetic disorder; and if he will make a statement on the matter. [46064/13]

Written answers

Minister of State at the Department of Health

As 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.

Health Services Access

Questions (1086)

Denis Naughten

Question:

1086. Deputy Denis Naughten asked the Minister for Health the assistance in place to assist persons to attend outpatient appointments when they are unable to use public transport; the assistance in place to assist persons to attend outpatient appointments when there is no public transport in their area; and if he will make a statement on the matter. [46066/13]

Written answers

Minister for Health

People attending outpatient and hospital appointments are, in general, expected to make their own travel arrangements. There are, however, exceptions for certain clinical conditions, or where, in the clinician's view, the patient would be unable to make the journey without clinical assistance or where the patient must be transported on a stretcher. Local health offices are responsible for the arrangement and provision of non-ambulance transport. Patients or their clinicians should contact their local health office directly in relation to transport requests.

The Department of Social Protection administers the supplementary welfare allowance scheme, which may help meet essential, once-off, exceptional expenditure that a person could not reasonably be expected to meet out of their weekly income. These payments are known as exceptional needs payments. Enquiries relating to this scheme should be addressed to the Department of Social Protection. In relation to the specific queries raised by the Deputy, as these are service matters they have been referred to the HSE for direct reply.

Health Services Provision

Questions (1087)

Dara Calleary

Question:

1087. Deputy Dara Calleary asked the Minister for Health the specific details in tabular form of the health services available on each inhabited Island; if these services include 24-hour medical cover on each island; where no 24-hour medical cover is available if he will consider providing such a service in view of the geographic isolated nature of islands; and if he will make a statement on the matter. [46069/13]

Written answers

Minister of State at the Department of Health (Deputy Alex White)

As this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.

Medical Aids and Appliances Provision

Questions (1088)

Michael Healy-Rae

Question:

1088. Deputy Michael Healy-Rae asked the Minister for Health when a person (details supplied) in County Kerry will receive a hearing aid; and if he will make a statement on the matter. [46074/13]

Written answers

Minister of State at the Department of Health (Deputy Alex White)

The Health Service Executive Community Audiology service administers and monitors hearing tests for adults who are at risk for hearing loss. Appointments for the audiology service are sent in a strict chronology according to clinical priorities and date of receipt of referral. The HSE has been asked to examine this matter and to reply to the Deputy as soon as possible.

Medical Card Data

Questions (1089)

Michael Healy-Rae

Question:

1089. Deputy Michael Healy-Rae asked the Minister for Health if an agreement was made last January 2013 to clamp down on medical cards; if the health service spending plan for 2013 stated that policy changes would result in a reduction of 40,000 cards; and if he will make a statement on the matter. [46077/13]

Written answers

Minister of State at the Department of Health (Deputy Alex White)

The HSE National Service Plan 2013 provides for up to an additional 100,000 medical cards in 2013. At the same time, policy changes are expected to lead to a reduction of approximately 40,000 medical cards. These changes reflect measures agreed by Government under Budget 2013 relating to the changes to income thresholds for the over-70's medical card and changes to income calculations for the standard means assessment medical card.

Medical Card Applications

Questions (1090)

Michael Healy-Rae

Question:

1090. Deputy Michael Healy-Rae asked the Minister for Health if the statement by a consultant neurologist (details supplied) at Beaumont Hospital that half of motor neurone disease patients in need of discretionary medical cards are seeing their applications turned down by the Health Service Executive; and if he will make a statement on the matter. [46079/13]

Written answers

Minister of State at the Department of Health (Deputy Alex White)

Under the relevant legislation, there is no automatic entitlement to a medical card for persons with specific illnesses. The HSE has, however, discretion to award a medical card to avoid undue hardship, even where the person exceeds the income guidelines. 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 processing of medical cards at a national level, rather than at a local level as before mid-2011, ensures that all people are assessed in a similar and fair manner when applying for a medical card. The consideration of discretion is now standardised and operates in an equitable manner. The medical card scheme is now underpinned with a stronger foundation which enables better governance, more transparency and efficient modern processes. Under these processes, nobody who is entitled to a medical card will lose it or be refused one.

Ministerial Appointments

Questions (1091)

Róisín Shortall

Question:

1091. Deputy Róisín Shortall asked the Minister for Health the name, qualifications and current salary of each political staff member appointed by him. [46089/13]

Written answers

Minister for Health

The name and current salary of each political staff member appointed to me is as follows:

Mark Costigan, Press Advisor - €87,258;

Camille Loftus, Special Advisor - €75,647

Colm Fahey, Personal Assistant - €43,713

Dianne Sexton, Personal Secretary - €25,265

All are suitably qualified for their roles.

Question No. 1092 answered with Question No. 1060.

Tobacco Control Measures

Questions (1093)

Olivia Mitchell

Question:

1093. Deputy Olivia Mitchell asked the Minister for Health his views on the proposed restriction of e-cigarettes as medical products which could result in them being more costly and less accessible than traditional tobacco cigarettes; and if he will make a statement on the matter. [46107/13]

Written answers

Minister for Health

The report of the Tobacco Policy Review Group 'Tobacco Free Ireland' was launched on the 3rd October 2013. The report recommends the establishment of a regulatory framework for nicotine products in the context of discussions at European Union level. Last December, the Commission published a proposal for a new EU Tobacco Products Directive, the ultimate purpose of which is to reduce the numbers of people smoking. The proposal is being discussed in the European Parliament and Council of Ministers and the Commission hope that it will be adopted in 2014. Nicotine containing products such as e-cigarettes are being considered in the context of this proposed tobacco products directive. In relation to e-cigarettes the World Health Organisation has noted that the safety has not been established and that not enough scientific evidence exists currently to validate the claim that these products are effective smoking cessation aids.