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Wednesday, 20 Nov 2013

Written Answers Nos. 205 - 211

Primary Care Centre Provision

Questions (205)

Róisín Shortall

Question:

205. Deputy Róisín Shortall asked the Minister for Health his plans for the provision of primary care centres to meet the needs identified in the Health Service Executive needs analysis carried out in 2012; the way he is prioritising the delivery of such centres by way of direct build, lease arrangement, and public/private partnership; and if he will make a statement on the matter. [49718/13]

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Written answers

The development of primary care is central to the Government's objective to deliver a high quality, integrated and cost effective health system. The development of primary care centres, through a combination of public and private investment, will facilitate the delivery of multi-disciplinary primary health care.

In 2012 the HSE embarked on a prioritisation exercise for Primary Care Centres. However the prioritisation exercise is a dynamic exercise, constantly evolving to take account of changing circumstances including the feasibility of implementation.

It is the Government’s intention to develop as many primary care centres as possible using one of the following:

- direct build (by HSE);

- by way of leasing arrangements with the private sector;

- through Public Private Partnership.

Considerable progress has been made in the delivery of primary care centres and 34 centres have opened since May 2011.

Direct Build – In certain locations, the HSE will deliver primary care facilities either through refurbishment/extension of suitable properties or through new build. Since 2012, primary care infrastructure has been approved and is underway at 15 locations.

Operational lease - Significant progress has been achieved under this mechanism. Construction is underway at 5 locations and planning permission has been granted at an additional 23 locations.

PPPs - The Health Service Executive (HSE) is working with the National Development Finance Agency (NDFA) to progress Primary Care Centre Public Private Partnership. The NDFA as a centre of expertise will be responsible for the delivery of the Primary Care PPP programme on behalf of the HSE, including the management of the procurement phase and the provision of financial advice including a Value for Money assessment. It has been reviewing the processes involved in procurement of PPP projects with a view to streamlining the process and delivering projects more quickly.

The HSE and NDFA have completed an indicative Public Sector Benchmark (PSB) for the overall project. Considerable work on the project has been completed by the HSE and its appointed design teams and technical advisors. The HSE is in the process of lodging planning applications, details of which will be available on the relevant planning website.

It is expected that the NDFA will proceed to market with the PPP projects very shortly.

Medical Card Eligibility

Questions (206)

Éamon Ó Cuív

Question:

206. Deputy Éamon Ó Cuív asked the Minister for Health the reason a P21 will not be accepted when assessing income of an applicant for a medical card, in the situation where a person's primary income is realised from PAYE employment and all of the subsidiary income from self-employment is detailed on the P21; if he will accept that in reply to a similar Parliamentary Question - No. 1163 of 5 November 2013 - he was incorrect in stating that a P21 is a tax balancing statement in respect of PAYE income only and that in fact self-employed income is also assessed on a P21 where a person also has a PAYE income as well as a self-employed income; and in view of this fact if he is willing to review the refusal to accept P21s as a statement of income; and if he will make a statement on the matter. [49726/13]

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Written answers

I have sought further clarification on this matter and I will revert to the Deputy as soon as possible.

Health Insurance Cover

Questions (207)

Billy Timmins

Question:

207. Deputy Billy Timmins asked the Minister for Health if all holders of private health insurance have to have maternity benefit as a component of this; the basis for same; and if he will make a statement on the matter. [49734/13]

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Written answers

The inclusion of maternity benefit in all health insurance products is a statutory requirement, as part of a legal obligation on health insurers to provide a specific minimum level of benefit in all health insurance products sold.

Minimum benefit is one of the key principles on which the Irish private health insurance regulatory system is based. Minimum Benefit Regulations, made under the Health Insurance Acts, require insurers to offer a minimum benefit to every insured person. The key purpose of the Regulations is to ensure the continued availability of the type of broad hospital cover traditionally held as a minimum by the insured population and to ensure that individuals do not significantly under-insure. Minimum Benefit Regulations were introduced in 1996, under Section 10 of the Health Insurance Act, 1994 and cover in-patient, out-patient and day-patient services provided by publicly funded hospitals, private hospitals, registered nursing home and hospital consultants.

The Minimum Benefit Regulations ensure that all consumers obtain an appropriate minimum level of health insurance cover regardless of what plan they purchase and that every plan available is inclusive of a minimum suite of benefits/procedures, some of which are available to the market as a whole and some of which will be applicable specifically to either men or women. Importantly, under Community Rating everybody is charged the same premium for a particular health insurance plan which includes this minimum suite of benefits, irrespective of age, gender and the current or likely future state of their health. Thus, the broad base line of procedures provided by minimum benefit should not be looked at in gender specific terms, but rather as a cohort of procedures that are important to the community of the insured population and thus should be protected and provided as a minimum base to all.

Health Insurance Data

Questions (208)

Billy Timmins

Question:

208. Deputy Billy Timmins asked the Minister for Health the total number of persons who have health insurance as of October 2013; the figures for end of year 2007 to 2012, inclusive; the number of these who have a full medical card or a general practitioner only card; and if he will make a statement on the matter. [49735/13]

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Written answers

The latest data available to me from the Health Insurance Authority is that 2,047,020 people, or 44.6% of the population were insured with in-patient health insurance plans at end September 2013.

The following numbers were insured from 2007 to 2012 inclusive:

2007

2,238,395

2008

2,297,113

2009

2,260,109

2010

2,228,460

2011

2,162,671

2012

2,098,942

Information is not collated on the numbers of persons holding both private health insurance and a medical card or general practitioner visit card.

Universal Health Insurance Provision

Questions (209)

Denis Naughten

Question:

209. Deputy Denis Naughten asked the Minister for Health his timeline for the roll-out of universal health insurance; and if he will make a statement on the matter. [49742/13]

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Written answers

The Government is embarking on a major reform programme for the health system, the aim of which is to deliver a single-tier health service, supported by universal health insurance (UHI), where there is fair access to services based on need, not on ability to pay.

Under UHI, everyone will be insured and will have equal access to a standard package of primary and acute hospital services, including acute mental health services. A new Insurance Fund will subsidise or pay insurance premiums for those who qualify for a subsidy.

Intensive work is currently underway on the preparation of a White Paper on Universal Health Insurance which will provide more detail on the UHI model for Ireland. Drafting is at an advanced stage with a view to publishing the White Paper by the end of this year.

The health reform programme is a major undertaking that requires careful planning and sequencing over a number of years and full implementation of UHI will take some time to achieve. I anticipate that by 2016 the necessary groundwork will be in place to enable us to phase in implementation of UHI, as promised in the Programme for Government. I should add that it is my intention to consult widely as part of the reform implementation process.

Long-Term Illness Scheme Coverage

Questions (210, 213)

Denis Naughten

Question:

210. Deputy Denis Naughten asked the Minister for Health if he will review the long-term illness scheme to include additional chronic illnesses; and if he will make a statement on the matter. [49743/13]

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Terence Flanagan

Question:

213. Deputy Terence Flanagan asked the Minister for Health the steps he has taken to ensure that schemes like the long-term illness scheme and drugs payment scheme are understood and made available to persons who might not be entitled to a medical card or GP visit card; and if he will make a statement on the matter. [49752/13]

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Written answers

I propose to take Questions Nos. 210 and 213 together.

Persons suffering from prescribed conditions, who are not already medical card holders, can get free drugs, medicines and medical and surgical appliances for the treatment of that condition under the Long Term Illness Scheme. There are no plans to extend the list of conditions covered by the Long Term Illness Scheme.

Under the Drug Payment Scheme, no individual or family pays more than €144 per calendar month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals incurring ongoing expenditure on medicines.

In addition, people who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. In the assessment process, the Health Service Executive can take into account medical costs incurred by an individual or a family. Those who are not eligible for a medical card may still be able to avail of a GP visit card, which covers the cost of GP consultations.

Information on the Drug Payment Scheme and the Long Term Illness Scheme is available on the HSE website at the following link: http://www.hse.ie/eng/services/list/1/schemes.

Medical Card Reviews

Questions (211)

Terence Flanagan

Question:

211. Deputy Terence Flanagan asked the Minister for Health the steps he has taken to ensure that policy guidelines introduced in budget 2014 on changes in medical cards are being relayed empathetically to applicants by the Health Service Executive primary care reimbursement service; and if he will make a statement on the matter. [49750/13]

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Written answers

The Deputy may be aware of the recently launched HSE communications campaign designed to raise awareness of the rules governing eligibility for medical cards. Communications on the issue of medical cards will be enhanced to ensure the public has all the information it needs.

The HSE continues to offer ongoing assistance to individuals with regard to their medical card eligibility and this is further bolstered by staff in local health offices who provide information, support and assistance to individuals.

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