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Tuesday, 3 Dec 2013

Written Answers Nos. 434 - 448

National Treatment Purchase Fund

Questions (434, 448)

Billy Kelleher

Question:

434. Deputy Billy Kelleher asked the Minister for Health the reason the National Treatment Purchase Fund will no longer publish waiting lists at a time separate from the publication of Health Service Executive monthly reports; if this will result in significant delays in publication of timely and up-to-date information in view of the fact that publication of National Treatment Purchase Fund figures for September were a month behind compared to August; and if he will amend his answer to Parliamentary Question No. 631 of 20 November 2013, which could give the impression that the NTPF has published comprehensive July waiting list data when only national figures were published and no hospital trend analysis of waiting times or child adult waiting list analysis, outpatient data or outpatient data by speciality was published. [51710/13]

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Seán Ó Fearghaíl

Question:

448. Deputy Seán Ó Fearghaíl asked the Minister for Health the purpose and the public interest that is served by delaying publication of national treatment purchase fund waiting list data so as to coincide with the publication of Health Service Executive monthly performance reports; and if he will make a statement on the matter. [51775/13]

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Written answers

I propose to take Questions Nos. 434 and 448 together.

Performance data relating to July 2013 was not available in time to publish an individual July 2013 report. Data relating to July 2013 has, however, been incorporated into the National Trend Analysis of Waiting Times Report, as is standard practice. The National Trend Analysis of Waiting Times is a report which demonstrates cumulative monthly reviews of all patient categories.

With regard to the simultaneous publication of HSE Monthly Management Assurance reports and NTPF monthly reports, this is intended to enable comprehensive consideration of available data relating to both activity and resultant outcomes.

Freedom of Information Requests

Questions (435)

Lucinda Creighton

Question:

435. Deputy Lucinda Creighton asked the Minister for Health further to Parliamentary Question No. 593 of 26 November 2013, if as part of the report request to the Health Service Executive, in part recognition of his expressed sympathies, he will release all of the files in his Department to the mother of the child in question; and if he will make a statement on the matter. [51719/13]

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Written answers

A request under the Freedom of Information Acts 1997 and 2003 for the release of the documents in question is currently under consideration in my Department; a decision will be made in accordance with the provisions of that legislation.

Hospital Waiting Lists

Questions (436)

Niall Collins

Question:

436. Deputy Niall Collins asked the Minister for Health if his attention has been drawn to the fact that an admission date for surgery in respect of a person (details supplied) in County Cork has been deferred to 2014; and if he will assist in having the original date of surgery reinstated [51720/13]

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Written answers

The 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 Health Service Executive, 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 HSE to respond directly to the Deputy in this matter.

Health Insurance Prices

Questions (437)

Jim Daly

Question:

437. Deputy Jim Daly asked the Minister for Health if his attention has been drawn to the additional cost burden being placed on St. Paul's Garda Medical Aid Society as a result of the recent changes to the tax relief at source; if he anticipates further pressures on its health insurance premia as a result of the provisions in the Health (Amendment) Act 2013; if he is in a position to provide any additional safeguards to this society noting the benefit it confers on retired and serving members of An Garda Síochána and their families; and if he will make a statement on the matter. [51722/13]

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Written answers

In Budget 2014, the Minister for Finance announced a cap on tax relief on premia for private health insurance, whereby tax relief for medical insurance premiums will be restricted to the first €1,000 per adult and the first €500 per child insured. Any portion of premium paid in excess of these ceilings will no longer qualify for tax relief. The Minister for Finance has allowed 20% tax relief on policies up to €1000 gross for adults and €500 for children.

It is important to note that the measure is projected to save the Exchequer €94m in 2014 and €127m in a full year. Pricing of insurance premiums is a matter for insurers. In terms of potential increases in premia that might arise from this measure, it is up to each insurer to contain its own costs and to compete actively on the basis of price.

The Health (Amendment) Act 2013 provided for new charges for all private in-patients in public hospitals, which will take effect on 1 January 2014. It is estimated that the rates included in the legislation will raise €560 million in hospital income in 2014 from private patients, which is additional hospital income of approximately €39 million over revenue in 2012.

My Department will continue to oversee the maintenance of a competitive and sustainable private health insurance market, under the provisions of the Health Insurance Acts 1994 to 2012, and to monitor developments on an ongoing basis, to ensure that the market is regulated appropriately in the transition to a market-based Universal Health Insurance system.

Medical Card Appeals

Questions (438)

Michelle Mulherin

Question:

438. Deputy Michelle Mulherin asked the Minister for Health the position regarding an appeal in respect of a person (details supplied); if he will expedite same; and if he will make a statement on the matter. [51725/13]

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Written answers

The 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.

Medical Card Data

Questions (439)

Billy Kelleher

Question:

439. Deputy Billy Kelleher asked the Minister for Health the number of new discretionary medical cards that have issued to date in 2013; the number of new discretionary GP cards that have issued to date in 2013; and if he will make a statement on the matter. [51727/13]

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Written answers

The information sought by the Deputy is not readily available. However, I have asked the Health Service Executive to supply this information to me and I will forward it to the Deputy as soon as possible.

Health Services Provision

Questions (440)

Noel Coonan

Question:

440. Deputy Noel Coonan asked the Minister for Health if he will consider including bowel preparation on the general medical services scheme; his views on whether this will help persons on low incomes afford the potentially life saving preparation ahead of a colonoscopy; and if he will make a statement on the matter. [51728/13]

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Written answers

The HSE is responsible for the administration of the primary care schemes, therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

HSE Investigations

Questions (441)

Clare Daly

Question:

441. Deputy Clare Daly asked the Minister for Health where the responsibility lies for Dáil Éireann being misled by his response to parliamentary questions tabled by me on seven occasions, between 19 May 2011 and 19 November 2013, in which he stated he had been advised that the circumstances surrounding a patient's death were investigated by the Health Service Executive under the national incident protocol, yet at the resumed inquest into the death of a person (details supplied), it emerged that the only investigation was an internal one, which was carried out by the staff of the Rotunda Hospital, appointed by the master of that hospital who approved the report between two and four weeks before the members of the review team signed off on it; and the action he proposes to take regarding same. [51734/13]

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Written answers

I wish to categorically confirm for the Deputy that there is no question of the Dáil being misled in responses to previous Parliamentary Questions regarding this case. May I clarify the HSE's Risk and Incident Investigation procedure and its application in this case.

The investigation of the circumstances surrounding this person's death was conducted in line with the HSE's Risk and Incident Investigation Procedure. A cornerstone of the HSE's incident management procedure, which is in accordance with recognised practice internationally, is that identifying and managing risks and incidents is most appropriately and effectively carried out at local level. It would not be appropriate for all incident investigations to be dealt with at a national level. As local investigation is an integral part of the overall Risk and Incident Investigation Procedure local managers investigate risks and incidents, as appropriate, that occur within their own service.

I have been advised that the circumstances surrounding this patient's death were investigated by the Rotunda Hospital in accordance with the HSE Procedure and that the 11 recommendations made have all been implemented.

Medical Card Eligibility

Questions (442)

Mattie McGrath

Question:

442. Deputy Mattie McGrath asked the Minister for Health the reason for the decision, by the Health Service Executive, not to assess the over 70s medical card applications on medical grounds; the way a person over 70 can be expected to submit an application form as a person aged under 70 and be assessed as such; where is it published that over 70s, with medical circumstances, must submit a MC1 application form; when this change in policy was taken; and his views on whether this significant change in policy will mean those over 70 with medical issues are not being granted discretionary medical cards. [51735/13]

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Written answers

Medical card and GP Visit card eligibility for persons aged 70 or older is based on assessment on a gross income basis and takes account of all income.

Persons aged 70 or older, who are assessed as ineligible under the gross income thresholds that apply, may also have their eligibility assessed under the general means tested medical card scheme. This assessment is based on net income and assessable outgoing expenses and the qualifying income thresholds under this scheme are lower than over-70s gross income thresholds.

The general scheme is not age dependant and is open to persons of all ages ordinarily resident in the state. Should an over-70s person wish to have assessable out-going expenses or medical circumstances considered, he/she can complete an MC1 medical card/GP visit card application form (available from the local health office) and submit the completed form for assessment under the general scheme of assessment.

If a person is means assessed ineligible for a medical card under the general scheme, and that person has other social, medical or financial circumstances relevant to an assessment of their ability to provide for their medical needs or the medical needs of any dependants they may have, these factors will be considered to decide if a medical card or GP visit card should be approved on discretionary grounds under the ‘undue hardship’ or ‘undue burden’ provision of the medical card scheme.

I would like to advise the Deputy that the information above does not reflect any policy or, indeed, operational change in how the medical scheme is administered. These provisions are provided for in the Health Act 1970 (as amended) and are detailed in the HSE’s “Medical Card/GP Visit Card National Assessment Guidelines for People aged 70 years and over ”, available on the HSE’s website.

Health Services Provision

Questions (443)

Terence Flanagan

Question:

443. Deputy Terence Flanagan asked the Minister for Health his views on correspondence (details supplied) regarding acquired brain injury; and if he will make a statement on the matter. [51746/13]

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Written answers

Current services available to persons with Acquired Brain Injury (ABI) include: Acute Hospital services; the National Rehabilitation Hospital; multi-disciplinary community services; long term assisted living supports; and Rehabilitative training services. These services are provided directly by the Health Service Executive (HSE) and a number of non-statutory organisations. Within Disability Services, Headway Ireland and Acquired Brain Injury Ireland are the two main organisations funded to meet the needs of such persons. In 2012, Headway Ireland received €2.4 million from the HSE to provide a range of services to persons with ABI, including Day Services.

As the particular case mentioned by the Deputy relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.

Tobacco Control Measures

Questions (444)

Seán Crowe

Question:

444. Deputy Seán Crowe asked the Minister for Health if there are any health issues and concerns with electronic cigarettes; and the regulations currently in place to deal with this product. [51748/13]

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Written answers

As e-cigarettes are not presented as medicinal products for smoking cessation or as medical devices with a therapeutic purpose they do not fall under the medicinal products or medical devices legislation. As electronic cigarettes do not contain tobacco they are currently not regulated under tobacco legislation.

Products which do not fall under any other regulatory framework come under the European Communities (General Product Safety) Regulations 2004 which specify the duties of producers and distributors placing products on the market. The body with responsibility for this legislation is the National Consumer Agency.

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 Organization 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. A WHO Study Group on Tobacco Product Regulation, concluded that, as no rigorous, peer-reviewed studies have been conducted to show that electronic cigarettes are a safe, effective nicotine replacement therapy (NRT), there is no evidence to support marketing of these products for tobacco cessation.

Health Insurance Regulation

Questions (445)

Lucinda Creighton

Question:

445. Deputy Lucinda Creighton asked the Minister for Health if he will publish the report conducted by Matheson and Goodbody stockbrokers into recommendations regarding splitting up VHI; and if he will make a statement on the matter. [51769/13]

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Written answers

Following a competitive EU tendering process, Goodbody Stockbrokers and Matheson Ormsby Prentice Solicitors were appointed in 2011 as financial and legal advisors to make recommendations on options to address the imbalance in the private health insurance market. The report examined the structure of the market, the position of existing insurers in the market and the question of rebalancing the market so that there would be a more even spread of higher and lower risks between private health insurers.

The report was not confined to the question of dividing up the VHI, it examined a range of options for the purposes of rebalancing the market. I have taken careful account of the report to assist in the development of policy on the sustainability of the PHI market. It has also been of assistance in the development of policy on UHI, and in the forthcoming White Paper on UHI.

The report contains extensive commercially sensitive information, particularly in relation to VHI, which would put the company at a disadvantage in relation to its competitors if this information were released. In the circumstances, I do not propose to publish the report at this time.

Health Services

Questions (446)

Lucinda Creighton

Question:

446. Deputy Lucinda Creighton asked the Minister for Health further to Parliamentary Questions Nos. 466 and 477 of 12 November 2013, when a response will issue; and if he will make a statement on the matter. [51773/13]

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Written answers

In relation to the specific information sought by the Deputy, as this is a service matter it was referred to the HSE for direct reply. I have been informed by the HSE that they are in the process of gathering the detailed information sought by the Deputy and will forward it as soon as possible.

General Practitioner Services

Questions (447)

Eamonn Maloney

Question:

447. Deputy Eamonn Maloney asked the Minister for Health the number of extra GPs that are now practising in the provision of services to medical card and GP visit card patients in the Tallaght, Dublin South West area, as a result of the removal of restrictions following the commencement of the Health (Provision of General Practitioner Services) Act 2012; and if he will make a statement on the matter. [51774/13]

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Written answers

As this is a service issue, I have asked the Health Service Executive to respond directly to the Deputy.

Question No. 448 answered with Question No. 434.
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