Written Answers Nos. 360-74
360. Deputy Kevin Humphreys asked the Minister for Health if a person who turns 18, has a severe intellectual disability, and has a medical card will still be able to include his or her monthly prescription charges within the gross family total at their pharmacy; and if he will make a statement on the matter. [54896/13]
View answerMedical card holders are required to pay a €2.50 charge per item for medicines and other prescription items supplied to them by community pharmacists, subject to a cap of €25 per month for each person or family. These new rates are effective from 1 December 2013. Prescription charges do not apply to children in the care of the HSE or to methadone supplied to patients participating in the Methadone Treatment Scheme.
For the purposes of the cap of €25 per month, a family is defined as an adult, their spouse/partner, any children under 16 years of age and any children between 16 and 21 years of age who are in full time education.
361. Deputy Charles Flanagan asked the Minister for Health in the context of recent High Court decisions where the Health Service Executive has resisted until the commencement of the hearing of the case the acceptance of responsibility and liability in respect of the injury of an individual which may have occurred some years before the hearing of the action, if a duty of candour might be placed on HSE to facilitate earlier and more timely settlements; and if he will make a statement on the matter. [54900/13]
View answerThe management of clinical negligence cases taken against the HSE is delegated to the State Claims Agency (SCA) which has a statutory mandate to investigate and manage these cases to completion. I am advised that the SCA, wherever it is proper to do so, based on expert medical and legal advice, admits breach of duty at the earliest possible opportunity to avoid distress to patients and their families. Many of these cases however, particularly those involving catastrophic injuries, are very complex in nature and require time to investigate the liability and causation issues. This inevitably involves some delay before a formal admission of liability, if appropriate, can be made.
In relation to medical malpractice generally, on Tuesday 12 November this year, the HSE launched National Open Disclosure Policy, Guidelines and supporting documents following on from a joint HSE State Claims Agency national pilot project in relation to Open Disclosure. Open Disclosure is defined as “ an open consistent approach to communicating with patients and their families when things go wrong in healthcare. This includes expressing regret for what has happened, keeping the patient informed, providing feedback on investigations and the steps taken to prevent a recurrence of the adverse event".
362. Deputy Terence Flanagan asked the Minister for Health further to Parliamentary Question No. 189 of 20 November 2013, regarding an investigation, if he will respond to the following (details supplied). [54904/13]
View answerAs advised previously, this is a matter for the HSE. I have now asked the HSE to investigate as a matter of urgency.
363. Deputy Tom Fleming asked the Minister for Health if he will as a matter of priority, make the necessary funding and resources available in the 2014 Health Service Executive service plan in respect of a recreational service (details supplied) in County Kerry; and if he will make a statement on the matter. [54909/13]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services, including disability services.
In relation to the specific queries raised by the Deputy, as these are service issues they have been referred to the HSE for direct reply.
364. Deputy Sean Fleming asked the Minister for Health the position regarding a knee replacement appointment in respect of a person (details supplied) in County Laois; and if he will make a statement on the matter. [54917/13]
View answerThe 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.
365. Deputy Sean Fleming asked the Minister for Health when a person (details supplied) in County Laois will receive an appointment with a view to a medical procedure being carried out; and if he will make a statement on the matter. [54918/13]
View answerThe 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.
366. Deputy Denis Naughten asked the Minister for Health further to Parliamentary Question No. 164 of 28 November 2013, if he has received a response from the Health Service Executive; if he will now have an independent investigation into all of the circumstances surrounding this case and its handling by HSE management; and if he will make a statement on the matter. [54924/13]
View answerI wish to assure the Deputy that there is no ongoing risk to the public in relation to this case. This matter is receiving urgent attention in the HSE and I expect a report early in the New Year.
367. Deputy Catherine Murphy asked the Minister for Health the reason Cork University Hospital has diverted funding earmarked to open the as yet unused epilepsy monitoring unit to other areas of the hospital; if he considers this a retrograde move to the overall delivery of epilepsy services here considering there is only one other such unit in the State, and €500,000 has already been invested in establishing the Cork unit; if he is satisfied that the move will not put at unnecessary risk the 100 or so epilepsy patients in the CUH catchment area; and if he will make a statement on the matter. [54925/13]
View answer376. Deputy Dominic Hannigan asked the Minister for Health the position regarding the recruitment of staff for the epilepsy monitoring unit in Cork University Hospital; when he expects the unit to open; if the funding for the unit is ring-fenced within the CUH budget; and if he will make a statement on the matter. [54984/13]
View answerI propose to take Questions Nos. 367 and 376 together.
The National Epilepsy Programme, under the auspices of the National Clinical Care Programmes provides for the commissioning of a Regional Epilepsy Monitoring Unit to be based in Cork University Hospital. The Unit aims to provide accessible, comprehensive care for patients in the HSE-South area with Epilepsy, particularly those with acutely unstable Epilepsy and disabling chronic Epilepsy. It further aims to:
- reduce wait times for video-EEG monitoring and the early identification of Epilepsy-related comorbidities, particularly mental illness and cognitive impairment;
- provide rapid access (<1 month) to out-patient clinics for patients referred by ED, AMU, or GP;
- provide access to safe inpatient facility (EMU) for patients with acutely unstable Epilepsy admitted from ED or AMU or transferred from other hospitals in the region, and
- enable the early identification of patients with refractory Epilepsy that might benefit from Epilepsy surgery.
The unit will include the establishment of 24/7 video-EEG monitoring service with 3 main purposes:
- establish definitive diagnosis in patients with seizure-like episodes;
- characterise and classify type of Epilepsy in patients with poorly understood Epilepsy e.g. persons with intellectual disability; and
- pre-surgical assessment of patients with disabling refractory Epilepsy.
Critical to the commissioning and opening of the unit is the requirement to recruit appropriately skilled staff. The HSE has advised that the recruitment process has now been completed and contracts have been offered to the selected persons. It is anticipated that the Epilepsy Monitoring Unit will open on the 31 March 2014.
368. Deputy Catherine Murphy asked the Minister for Health if he will provide the number of extra occupational therapists, speech and language therapists and psychological services to address the shortfall which exists in all three services which have been recruited in 2013; if he has fully committed the moneys promised earlier this year towards this recruitment; and if he will make a statement on the matter. [54934/13]
View answerAll staffing arrangements have to be considered in the light of the current budgetary pressures in the health service and the need to reduce the numbers employed throughout the public sector. This has been combined with a firm focus on improving public service efficiency and effectiveness. The Haddington Road Agreement provides for health service staff to increase their working hours. The value ascribed to this element of the Agreement is in the region of five million hours annually for the health workforce as a whole. The HSE can also make staff appointments once it remains within its overall employment ceiling and has the financial resources to do so.
As the recruitment of therapists is a matter for the HSE in the first instance, the Deputy's enquiry has been referred to the Executive for direct reply.
369. Deputy Terence Flanagan asked the Minister for Health if he will provide a breakdown of moneys paid to persons (details supplied) over the past five years; and if he will make a statement on the matter. [54947/13]
View answerFunding for the provision of all health services has been provided to the Health Service Executive as part of its overall vote. I have therefore, asked the Executive to arrange to have the matter investigated and to have a reply issued directly to the Deputy.
370. Deputy Terence Flanagan asked the Minister for Health the role the Health Service Executive played in the appointment of the CRC directors who recently resigned and in the appointment of directors to other charities; and if he will make a statement on the matter. [54962/13]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
371. Deputy Terence Flanagan asked the Minister for Health the measures he is taking to increase the transparency and accountability of State-funded agencies; and if he will make a statement on the matter. [54965/13]
View answerI would like to emphasise the high priority that I and the Ministers of State at the Department of Health are according to improving governance within all organisations in the health sector.
One of the fundamental reasons for the major Health Reform Programme now being delivered on is to enhance accountability across the whole health system, improve its governance and to deliver more cost effective quality safe services that deliver best outcomes for the patients and the public we serve.
I have recently established a Governance Forum for the Health Sector to support and help Chairs, Board members and CEOs to fulfil their accountability and governance roles. My Department will be insisting on structured induction programmes for all new Board members and a system of independent regular governance audits.
As part of these new induction programmes it will be made clear to new Board members of Section 38 agencies that they have no discretion to make extra payments to staff which are not encompassed by and in line with the Department’s consolidated salary scales. All health sector agencies will be encouraged to publish details of payments, whether salary or otherwise, to all senior managers and senior clinicians in their annual reports and to make details easily accessible on websites.
All State agencies under the aegis of, or funded by, the Department of Health are also subject to the Code of Practice for the Governance of State Bodies issued by the Department of Finance and the Framework for Corporate and Financial Governance issued by the Department of Health. Line Units within the Department with governance responsibility for individual agencies meet regularly throughout the year with the agencies concerned to monitor compliance in this regard.
The Health Service Executive (HSE) funds a range of service providers under section 38 or section 39 of the Health Act 2004. The staff in bodies funded under Section 38 of the Health Act, 2004 are classified as public servants and are subject to the standard salary scales for the health sector as well as having public service pension schemes and being counted in public service employment numbers. Employees of agencies that receive grants from the HSE under Section 39 are not public servants and are not specifically subject to the salary scales approved for public servants.
The HSE itself is also committed to the development of effective working relationships in line with the provisions of the Health Act 2004 and significant progress has been made in improving the governance and management framework between the HSE and voluntary service providers. A Register of Non-Statutory Agencies covering Service Arrangements and Grant Aid Agreements is in operation. This provides information on Agencies and facilitates the maintenance of key data on funding arrangements including compliance with requirements under the HSE's formalised national governance framework to manage the funding provided to voluntary organisations. These Governance Documents provide a national standard consistent with the application of good governance and are subject to regular review.
In 2013 an additional information return was also added to all Service Arrangements, both Section 38 and 39, requiring agencies to separately report on all individual staff paid at Grade 8 level equivalent or above, detailing their salary including allowances and any other benefits paid. The HSE’s internal audit service also provides audit reviews of Agencies either on an individual Agency basis, a sample basis, or across a range of agencies on a specific topic such as the recent Section 38 Agencies Remuneration Audit. The results of these audits have influenced the documentation reviews and also recommendations relating to management structures and corporate processes.
372. Deputy Terence Flanagan asked the Minister for Health the cost to the health service of providing a European health insurance card to Irish citizens; and if he will make a statement on the matter. [54968/13]
View answerThe European Health Insurance Card (EHIC) was introduced in 2004 across the European Union. Under EU Regulation (EC) 883/04 persons who are linked to another EU/EEA State for Social Security purposes and who are visiting or on temporary stay in another State are entitled to necessary health care if they become ill or injured while on a temporary stay. States are entitled to seek reimbursement of the cost of the provision of these services to individuals from the State which is "competent" for the client concerned, i.e. the State which issued the EHIC. The cost of the provision of such care to persons holding EHICs issued by Ireland is currently in the region of €5.0 million per annum.
373. Deputy Terence Flanagan asked the Minister for Health his views regarding top-ups (details supplied); and if he will make a statement on the matter. [54974/13]
View answerThe Health Service Executive (HSE) grant aids a wide range of organisations, including the Rehab Group, under Section 39 of the Health Act 2004. Employees of these agencies, including the Rehab Group, are not public servants or bound by the Department of Health consolidated salary scales.
However, both my colleague Minister Reilly and myself, are concerned to ensure that the State receives value for all monies invested in public services on behalf of the taxpayer. Having regard to the findings of the recent audit of agencies funded under Section 38 of the Health Act 2004, the Department has recently written to the HSE asking that it write to all agencies funded under Section 39, including Rehab Group, asking them to have due regard to Government pay policy, in particular for senior managers, in light of the current difficulties and the severe challenges faced by the health services.
374. Deputy Terence Flanagan asked the Minister for Health if there is a conflict of interest regarding a person (details supplied); and if he will make a statement on the matter. [54981/13]
View answerThe issue raised by the Deputy is a matter for the HSE. I have therefore, referred the matter to the Executive and that they respond directly to him.
