Written Answers Nos. 30-34
30. Deputy Brendan Griffin asked the Minister for Health if he will address the problem of the empty and unused ward in the new West Kerry Community Hospital in Dingle, where a number of beds could be opened and thus alleviate the serious shortage of residential beds on the Dingle Peninsula; if he will make this a priority for Kerry health services in 2014; and if he will make a statement on the matter. [47994/13]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
31. Deputy Billy Kelleher asked the Minister for Health his response to the claim by four hospital chief executives that there are unacceptable delays in treatment access for certain cancer patients; and if he will make a statement on the matter. [48052/13]
View answerThe issues raised by the hospitals will be considered in the context of the HSE Service Plan for 2014. I wrote to the HSE on Thursday 31 October to confirm that the Executive has until 15 November to submit its Service Plan. In that letter, I also conveyed to the Executive that my overriding priority is patient safety, with the next priority being to treat patients in as timely a fashion as possible.
Clearly, the diagnosis and treatment of patients with cancer is a high priority for the HSE. I welcome the huge improvements that have been made in recent years, led by the HSE National Cancer Control Programme. It is very encouraging to note that five year relative survival for all cancers is rising and is now 56.4% for people diagnosed between 2003-2007, as compared with 49.6% for people diagnosed in 1998-2002. The Mater Hospital and St. James's Hospital are the two adult designated cancer centres among the hospitals referred to by the Deputy and according to the latest figures available (August 2013), both are in compliance with the HSE Service Plan access targets, which relate to access to breast, prostate and lung cancer clinics. With regard to paediatric cancer care, I am advised that children are treated according to international protocols and standards of care, that all care is clinically prioritised and that there are no extraordinary delays for children accessing cancer services.
Clearly 2014 will be a very challenging year for the health services. In meeting this challenge, the goal, wherever possible, is to cut the cost of services rather than the level or quality of the services delivered, and to accelerate the pace of reform. The reform programme for hospitals, as set out in Future Health,aims to deliver more responsive and equitable access to services for all patients; to organise public hospitals into more efficient and accountable hospital groups, which can deliver better patient care for less cost; and to ensure that smaller hospitals continue to play a key role.
32. Deputy Bernard J. Durkan asked the Minister for Health the extent to which it has been found possible to identify areas within the health services wherein savings can be made to ensure that the health service in general remains within budget without undermining the viability of specific areas; and if he will make a statement on the matter. [48043/13]
View answerAs a result of the economic and financial crisis, the Irish public service is experiencing unprecedented reductions in spending, including the area of health. Current expenditure on healthcare fell by 10% between 2009 and 2013 and will reduce by a further €361m or 3% in 2014. Reductions in the health budget are compounded by underlying cost pressures, including substantial population growth and rising incidence of chronic disease.
In addressing the significant financial challenges faced by the health system, the focus is on actions that enhance efficiency, secure sustainability and do not compromise the overall goals of the health system. My objective is to protect frontline services by cutting the cost of services rather than cutting the services themselves. Various cost saving measures include reducing the public sector pay bill, the fees paid to professionals and payments to pharmaceutical companies.
A total of €666 million of health savings measures have been identified to meet the overall health expenditure ceiling reduction of €361 million for 2014, Programme for Government Commitments of €57 million and health service pressures of €248 million. Clearly the Health Sector will be facing serious challenges in 2014 to keep within its budgetary limits. The level of health services to be delivered within the available funding will be set out in the Health Service Executive’s 2014 National Service Plan. Given the budgetary constraints on the health services in recent years, it remains a priority to focus on improving the way services are organised and delivered, and to reduce costs so as to minimise any negative effect on service provision.
The saving measures agreed by Government to be taken by my Department in order to adhere to the 2014 Expenditure Ceiling post adjustments, are set out in the Expenditure report 2014.
33. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he is satisfied regarding the availability of medical cards of a discretionary nature with particular reference to children and-or adults with special needs; and if he will make a statement on the matter. [48044/13]
View answerUnder Section 45 of the Health Act 1970, as amended, persons who are unable, without due hardship, to arrange a general practitioner service for themselves or their family qualify for a medical card. There is no automatic entitlement to a medical card for persons with a specific illness or disability.
Under this legislation, the determination of eligibility for a medical card is the responsibility of the Health Service Executive. Section 45 requires the HSE to have regard to a person's, and their spouse or partner's overall financial situation in view of their reasonable expenditure. The HSE gives effect to this legislation and Government policy through its Medical Card National Assessment Guidelines.
Where a person's income is in excess of the income thresholds set out in the National Assessment Guidelines, the HSE uses its discretion to grant a medical card to a person who is unable, due to undue hardship, to arrange a GP service. In doing so, the HSE is obliged to have regard to the financial situation and expenditure of the individual and his or her dependents.
The HSE has an effective system in place for the provision of emergency medical cards for patients who are terminally ill in palliative care, or who are seriously ill and in urgent need of medical care that they cannot afford. They are issued within twenty-four hours of receipt of the required patient details and the letter of confirmation of the condition from a doctor or a medical consultant. With the exception of terminally ill patients in palliative care, the HSE issues all emergency cards on the basis that the patient is eligible for a medical card on the basis of means or undue hardship, and that the applicant will follow up with a full application within a number of weeks of receiving the emergency card. As a result, emergency medical cards are issued to a named individual, with a limited eligibility period of six months.
For persons with a terminal illness in palliative care, no means test applies. Once the terminal illness is verified, patients are given an emergency medical card for six months. 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.
I am satisfied that the HSE responds pro-actively to the variety of circumstances and complexities faced by individuals in these circumstances.
The Government is committed to introducing, on a phased basis, a universal GP service without fees within its term of office, as set out in the Programme for Government and the Future Health strategy framework. As announced in the Budget, it has been decided to commence the roll-out of a universal GP service by providing all children aged 5 and under with access to a GP service without fees. This will mean that almost half of the population will have access to GP services without fees. The Government is providing new, additional funding of €37 million to meet the cost of this measure.
The implementation of this measure will require primary legislation. The necessary administrative arrangements will be made during the course of 2014, when the specifics of the legislation are known.
The introduction of a universal GP service constitutes a fundamental element in the Government's health reform programme. The current Government is the first in the history of the State to have committed itself to implementing a universal GP service for the entire population. A well functioning health system should provide equal access to healthcare for its patients on the basis of health needs, rather than ability to pay. The principles of universality and equity of access mean that all residents in Ireland should be entitled to access GP services that are free at the point of use.
34. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the way the budget 2014 figure of €113 million, under the heading of probity savings for medical cards, was reached; the way he expects this cut to be made; if he has estimated the number of full, general practitioner only and discretionary medical cards that will come under this heading; and if he will make a statement on the matter. [48064/13]
View answerThe figure for probity savings for medical cards was determined by the Government in the context of the overall framing of Budget 2014. The savings will be achieved through identifying any medical card or GP visit card holder who is not entitled to such eligibility in line with the legislation governing the schemes. Under the relevant legislation, a medical card is approved either on foot of a means assessment, which meets the current financial guidelines, or where the applicant does not meet the income guidelines but there is undue hardship in the arranging of medical services as a result of the medical or social circumstances. The HSE's National Service Plan for 2014 will outline the activity levels for 2014.
