Written Answers Nos. 345-359
345. Deputy Kevin Humphreys asked the Minister for Health the EU states with whom Ireland has a bilateral or waiver agreements with under EU Regulation 883/04; if he will provide in a list form, detailing for each EU country the arrangements that are in place for the reimbursement of health care costs under this regulation; the agreements were terminated in recent years; and if he will make a statement on the matter. [54820/13]
View answerThe coordination of health and social security arrangements among EU/EEA states and Switzerland is governed by Regulation (EC) 883/2004 and its Implementing Regulation 987/2009 (formerly Regulation (EC) 1408/71 and its Implementing Regulation 574/72). Under their provisions people who are insured with the healthcare system of one state but residing or staying in another state can access the public healthcare system of that member state in certain circumstances, at the cost of the state in which they are insured. The Regulations provide for the reimbursement of such costs between states. The Regulations also allows for two or more states to agree alternative arrangements for reimbursement other than those laid down in the Regulations, or to mutually waive reimbursement altogether.
The following is the list of the states with which Ireland has or has had waiver/bilateral agreements in recent years, with an indication of their present status.
|
States |
Agreements |
Present Status |
|
Austria |
Waiver Agreement |
Terminated 1 May 2010 |
|
Belgium |
Waiver Agreement |
Terminated 1 April 2012 |
|
Denmark |
Waiver Agreement |
Active |
|
France |
Partial Waiver Agreement |
Terminated 1 January 2013 |
|
Germany |
Waiver Agreement |
Terminated 1 May 2010 |
|
Luxembourg |
Waiver Agreement |
Active |
|
Netherlands |
Waiver Agreement |
Terminated 1 January 2007 |
|
Sweden |
Waiver Agreement |
Active |
|
United Kingdom |
Bilateral (Lump Sum) Agreement |
Active |
|
- |
- |
- |
347. Deputy Kevin Humphreys asked the Minister for Health if the Health Service Executive intend to pursue the recouping of costs associated with the issuance of non-means tested medical cards to EU citizens under EU Regulation 883/04 in 2013 or 2014; and if he will make a statement on the matter. [54822/13]
View answer348. Deputy Kevin Humphreys asked the Minister for Health if the Health Service Executive or the PCRS have an estimate on the cost of issuance of non-means tested medical cards to EU citizens under EU Regulation 883/04 for countries with which from which we do not get reimbursed; and if he will make a statement on the matter. [54823/13]
View answer350. Deputy Kevin Humphreys asked the Minister for Health if he is satisfied with the current situation with respect to the reimbursement of health care costs under EU regulation 883/04, the collation of information by the PCRS with regard to who has been given these entitlements and the failure to have reimbursement agreements with 26 out of 27 EU countries; and if he will make a statement on the matter. [54825/13]
View answerI propose to take Questions Nos. 347, 348 and 350 together.
Regulation (EC) 883/2004 and Implementing Regulation 987/2009 provide for the coordination of social security systems, including healthcare, within the EU/EAA and Switzerland. Under its provisions, persons residing in Ireland who are attached to the social security system of another member state are entitled to receive health care services in Ireland at the cost of that member state, provided they are not subject to Irish social security legislation. Persons in this category are entitled to full eligibility and receive a medical card as evidence of their entitlement. An estimate on the cost of the issuance of such medical cards under EU Regulation 883/04 is not available.
The EU Regulations provide for the costs to be reimbursed between member states. The Regulations also allow for two or more states to agree alternative arrangements for reimbursement other than those laid down in the Regulations, or to mutually waive reimbursement altogether. Ireland has had waiver agreements with a number of member states whereby costs arising under the application of the Regulations were mutually waived. Many of these agreements have been terminated in recent years. In view of this and of the increased numbers availing of services since the EU was expanded, the Health Service Executive intends pursuing the recoupment of costs from other member states. The Executive is currently in the process of preparing claims for recoupment of costs associated with medical cards issued under EU Regulations with a view to issuing these claims in 2014. The Health Service Executive is also currently working on systems to capture costs associated with the provision of healthcare under the European Health Insurance Card (EHIC) so as to enable it to commence the issuing of claims for reimbursement of costs to the relevant competent member states in the near future.
It must be noted that Ireland's primary interaction has been and continues to be with the United Kingdom with whom it operates a bilateral healthcare reimbursement agreement, covering such persons as temporary visitors between the two countries, pensioners of one country and their dependants residing in the other country, and the dependant families of persons employed in the other country. Under the terms of the agreement net liability between the two countries is calculated on a lump sum basis rather than an individual basis. The payment made in any one year is based on an estimate of the number of persons falling within categories eligible for reimbursement and for whom each country is liable and an estimate of the the average cost of providing healthcare treatment. The amount received by Ireland from the United Kingdom in respect of reimbursement of healthcare costs provided under the relevant EU Regulations was €220 million in 2012. A similar amount has been received this year.
351. Deputy Thomas P. Broughan asked the Minister for Health if the required number of staff will be employed at the new day care building at St. Joseph’s Raheny, Dublin 5; and if he will provide the timeline for these potential employments. [54844/13]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
352. Deputy Thomas P. Broughan asked the Minister for Health the number of approved additional posts in mental health services which have been filled to date this year; and when it is expected that any outstanding vacant posts will be filled. [54845/13]
View answerFollowing on from the special allocation of €35 million for mental health in Budget 2012, a further €35 million was provided in Budget 2013 for the continued development of our mental health services. Some 900 new posts have been provided 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. Budgetary pressures within the HSE delayed the full utilisation of the €35 million allocated in Budget 2012 with the recruitment of the new posts only commencing towards the very end of 2012.
Recruitment of the posts approved for both 2012 and 2013 is continuing. As at the end of November, the recruitment process is complete or in the final stages for 395 or 95% of the 414 posts approved in 2012. Of the posts approved in 2013, the recruitment process is complete for 134 or 28% of the posts, 172 or 36% of the posts were in the final stages of the recruitment process and a further 106 or 22% were at earlier stages, indicating that 412 or 86% of the 2013 allocation have been completed or are in the recruitment process. The posts related to the €35 million allocated in 2013 will continue to come on stream and are targeted to be completed in Quarter 2 of 2014.
There are a number of posts, however, for which there are difficulties in identifying suitable candidates due to factors including availability of qualified candidates and geographic location. The HSE's National Recruitment Service is currently working to ensure that the remaining posts will be filled as soon as possible, from existing panels or through competition in the absence of panels, at the earliest opportunity. Options to enable more local recruitment are also being considered where this will assist in filling specific posts.
353. Deputy Eoghan Murphy asked the Minister for Health the reason for the delay in processing and arranging Health Service Executive physiotherapy appointments in the Pembroke-South Dock area. [54856/13]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
354. Deputy Denis Naughten asked the Minister for Health further to Parliamentary Question No. 495 of 12 November 2013, if the national ambulance service has received a report regarding serious incidents in the region during the period in question; the response by the service to such a report; the steps which have been taken to address these concerns; the corresponding figures for dropped shifts in the month of November; and if he will make a statement on the matter. [54862/13]
View answerAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
355. Deputy Denis Naughten asked the Minister for Health the number of ambulance-AP shifts that have been dropped at each ambulance base nationwide in each of the past four months; the implications of these dropped shifts on response times and patient outcomes; and if he will make a statement on the matter. [54863/13]
View answerAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
356. Deputy Billy Timmins asked the Minister for Health the reason the Protection of Life in Pregnancy Act has not been implemented to date; the number of members of the medical profession that were contacted with a view to participating in the review panel and what the response has been; the measures that have been taken to date to implement the legislation and the difficulties that have been experienced; and if he will make a statement on the matter. [54864/13]
View answerAs the Deputy might be aware there are operational issues which needed to be addressed before the Protection of Life During Pregnancy Act 2013 could be commenced and my Department has been liasing with the HSE in this regard. These include the establishment of a panel of medical practitioners for the purpose of the formal medical review provisions and administrative facilities to enable the review committee, drawn from the panel, to perform its functions.
I understand that this process is progressing in a satisfactory manner and that the HSE has received considerable support from the relevant professional colleges in this regard. Therefore it is my intention to commence the Act shortly.
357. Deputy Thomas P. Broughan asked the Minister for Health the reason a significant number of nursing posts in hospitals across Ireland have recently been advertised by the Health Service Executive to be filled by foreign nationals when thousands of nurses are graduating from colleges and universities in this State each year; the reason an extended period of training in theatre and critical care is not made available to recent Irish graduates rather than sourcing staff from overseas for these specialties. [54865/13]
View answerThe Health Service Executive has recently advertised internationally to fill 54 theatre nursing posts and 34 critical care posts. This reflects a significant level of ongoing vacancies and difficulties in attracting candidates for these posts following recruitment campaigns in Ireland.
While a considerable number of nurses graduate each year, approximately 1,500, it is not possible to offer the vacant posts to such graduates. Candidates for these posts would be required to have considerable experience and to have undertaken a higher diploma programme. Recent graduates, therefore, would not be eligible.
One of the main considerations in developing the Nurse Graduate Scheme was the need to retain recently qualified nurses at a time when job opportunities in the public service are very limited. The Scheme supports the retention of recently qualified graduate nurses and midwives within the Irish health system and enables them to gain valuable work experience and development opportunities post-graduation. In time they could pursue careers as theatre and critical care specialists.
358. Deputy Catherine Murphy asked the Minister for Health in situations where a hospital discharges a patient that requires full time nursing home care and where that need is accepted under the fair deal scheme but where the funding is not yet in place in the event of their family not having the funds, the options available to them; if changes to the scheme are being considered in that context; and if he will make a statement on the matter. [54889/13]
View answerThe HSE makes every effort to ensure that individuals who qualify for financial support under the Nursing Homes Support Scheme are provided with such support as expediently as possible. However, there is a set budget for the Scheme each year and the HSE must operate within it. The budget for the Scheme in 2013 is €974m.
The HSE operates a national placement list to enable it to remain within budget and to ensure equity of access to finding nationally. In addition, it tries to match the funding available for the Scheme to the level of demand by releasing funding on a weekly basis. At 3rd December there were a total of 123 applicants awaiting funding approval which represents a waiting period of less than one week.
Individuals who are awaiting funding approval can contact their local Area Manager's Office to discuss their circumstances and the options that may be available to them pending Nursing Homes Support Scheme funding becoming available. The provision of services must, however, be managed with due regard to available resources.
Finally, the Nursing Homes Support Scheme is currently being reviewed. This review, which is expected to be completed in early 2014, will make recommendations for the future operation and management of the Scheme.
359. Deputy Catherine Murphy asked the Minister for Health where a private nursing home charges additional fees which are mandatory such as for occupational and leisure services, the reason that is not included in the evaluation of the cost; the account that is taken for additional charges such as the cost of hospital visits in situations where family members do not have the ability to fund these; where that is positioned in the fair deal scheme; and if he will make a statement on the matter. [54890/13]
View answerThe Nursing Homes Support Scheme provides financial support towards the cost of long-term residential care services in nursing homes. Under the Scheme, services and supports which are common to the vast majority of nursing home residents are included in the cost of care. These are: nursing and personal care appropriate to the level of care needs of the person; bed and board; basic aids and appliances necessary to assist a person with the activities of daily living; and laundry service. Goods and services that are already available to individuals under an existing scheme are not included in the goods and services covered by the Nursing Homes Support Scheme.
A person's eligibility for other schemes, such as the Medical Card Scheme or the Drugs Payment Scheme, is unaffected by the Nursing Homes Support Scheme.
Incontinence wear, where required, is provided free of charge by the HSE to all Nursing Homes Support Scheme residents that possess a Medical Card.
Part 8 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009 stipulates that the registered provider of the nursing home must agree a contract with each resident within one month of their admission. This contract must include details of the services to be provided to that resident and the fees to be charged. Residents should not be charged fees which are not set out in the contract.
