Written Answers Nos. 179-184
179. Deputy Derek Nolan asked the Minister for Health the Health Service Executive policy regarding the cost of the provision of incontinence wear; if any associated cost is passed on to the service user of the HSE facility; and if he will make a statement on the matter. [5809/14]
View answerAs this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.
180. Deputy Denis Naughten asked the Minister for Health the number of public outpatient, inpatient and day cases performed in private hospitals in each quarter of 2013; the cost in each category in each quarter; and if he will make a statement on the matter. [5811/14]
View answerIn relation to the detailed information requested by the Deputy, as this is a service matter, I have asked the Health Service Executive to respond to him directly.
181. Deputy Derek Keating asked the Minister for Health if his attention has been drawn to the condition commonly known as EDS Ehlers-Danlos Syndrome; if his attention has been drawn to the fact there is no specialist in Ireland who is trained to deal with this life threatening condition; his plans to address this problem; if there is justification for a medical card for those who are diagnosed with this chronic condition; his plans to address the deficit in medical treatment here; if his attention has been drawn to the fact that patients have to travel to the UK for treatment at their own expense; if it could be included on the travel abroad scheme; and if he will make a statement on the matter. [5818/14]
View answerMedical cards are provided to persons who, under the provisions of the Health Act 1970, are in the opinion of the HSE unable without undue hardship to arrange GP services for themselves and their dependants. The assessment for a medical card is determined primarily by reference to the means, including the income and reasonable expenditure, of the applicant and his or her partner and dependants. Under the legislation, determination of eligibility for a medical card is the responsibility of the HSE.
The HSE operates a Treatment Abroad Scheme (TAS), for persons to receive treatment in another EU/EEA member state or Switzerland under EU Regulation 1408/71, as per the procedures set out in EU Regulations 574/72, and in accordance with Department of Health Guidelines. Within these governing EU Regulations and the Department of Health Guidelines, the TAS provides for the cost of approved treatments in another EU/EEA member state or Switzerland through the issue of Form E112 (IE). A decision is made on each application in accordance with this legislation and guidelines and on the basis of a review by clinical experts. The cost of the treatment is not a deciding factor when approving an application. The treatment must not be available within the State or not available within a time normally necessary for obtaining it.
The TAS allows for an Irish based medical consultant to refer a patient that is normally resident in Ireland for treatment, in a public hospital, in another EU/EEA member state or Switzerland, where the treatment in question meets the following criteria: (a) The application to refer a patient abroad has been assessed and a determination given before that patient goes abroad; (b) Following clinical assessment, the referring Consultant certifies the following: they recommend the patient be treated in another EU/EEA country or Switzerland; the treatment is medically necessary and will meet the patient’s needs; the treatment is a proven form of medical treatment and is not experimental or test treatment; the treatment is in a recognised hospital or other institution and is under the control of a registered medical practitioner; the hospital outside the state will accept EU/EEA form E112 (IE).
The HSE TAS processes applications based on the treatment that the patient is being referred for, which is not available in Ireland. The presence of a rare illness, such as Ehlers Danlos Syndrome, is not of itself criteria for availing of treatment abroad: most cases of rare diseases are treated without the need for recourse to services in other jurisdictions.
Patients, in conjunction with their Irish based public referring hospital consultant, have the ability to apply to the HSE TAS seeking access to public healthcare outside the state through model form E112. Applications to TAS are processed and a determination given in accordance with the statutory framework prior to a patient travelling to avail of treatment. Approved applicants/patients' hospital treatment costs are covered through the issue of form E112 (IE) for the specific identified episode of care. Once a patient is discharged from a specific episode of care abroad, their care immediately reverts to their Irish based consultant.
Each application to the HSE TAS is reviewed individually on its own merits and there are no restrictions, regarding age or otherwise, on a person making an application to the HSE TAS for review and decision. Previous approvals or declines are not used as an influencing factor on subsequent applications. Each application is for an individual episode of care unless otherwise specified by the consultant on the application form. Each application to TAS is processed and given a formal written decision. If that decision is one of decline, the reason for that decision is clearly outlined and the option of an appeal is afforded. Furthermore, as above the decision on an application does not restrict future applications for an individual patient or indeed other patients seeking treatment abroad that is not available in Ireland.
The Health Service Executive has been asked to examine the specific matter referred to by the Deputy and will 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.
182. Deputy Michael P. Kitt asked the Minister for Health when the review of the mobility allowance scheme and the motorised transport grant scheme will be completed; if details will be provided on the scheme; and if he will make a statement on the matter. [5821/14]
View answerIn November 2013, the Government decided that the detailed preparatory work required for a new travel subsidy scheme and associated statutory provisions should be progressed by the Minister for Health, in consultation with other relevant Ministers. The Department of Health is working to progress this matter in line with the Government's decision. The Department will draw on the work, last year, of the Review Group on Transport Supports for People with Disabilities and the Inter-Departmental Group tasked by Government to consider details of a statutory replacement for the discontinued Mobility Allowance and Motorised Transport Grant Schemes.
183. Deputy Caoimhghín Ó Caoláin asked the Minister for Health his Department's calculation of the actual annual spend on health in each of the past three years, 2011 to 2013, inclusive, across each of the following: the State spend, private health insurance contributions across the range of competitor companies, private practice direct payments by patients attending consultants, GPs, specialist and other services, including therapy services drugs and medicines payments up to the drug refund scheme threshold and the prescription charge paid by medical card holders and any other identifiable expenditure across the broad health spectrum. [5822/14]
View answerTotal public expenditure on health for each of the years 2011 and 2012 was €14,075 million and €14,137 million respectively. The estimated figure for 2013 is €13,881 million.
Estimates of private health expenditure are compiled by the Central Statistics Office (CSO) and are principally based on data derived from the Household Budget Survey (HBS). The HBS is carried out every 5 years with the last survey having taken place in 2010. Estimated annual expenditure is based on grossing up the survey data for the full year and the total population. The following table presents estimated results across a range of categories of out of pocket health expenditure, including medical consultations, for 2010. Out of pocket expenditure on prescribed medicines is also included in the table. It should be noted that it is not possible to exclude prescription payments which may subsequently have been refunded under the drug payments scheme (DPS). Where a person has a DPS card and fills prescriptions in a specified pharmacy, there is no payment once the monthly limit has been exceeded. However, if the prescription is filled in a different pharmacy then payment must be made prior to a refund being claimed. Prescription charges for medical card holders amounted to €27.6 million, €29.7 million and €85.0 million for 2011, 2012 and 2013 respectively.
The CSO and the Department of Health are currently cooperating on a major initiative to produce more detailed annual public and private health expenditure data for Ireland based on the System of Health Accounts (SHA). Implementation of the SHA will enable more comprehensive reporting of health expenditure by provider, funder and types of care. It will also improve estimation of health expenditure for national accounts purposes. It is expected that full reporting based on the SHA will be available in 2016.
Household Budget Survey, Estimated Private Expenditure on Health by Category, 2010
|
# |
2010 |
|
# |
€m |
|
Expenditure on private health insurance |
1,671 |
|
Expenditure on prescribed medication |
626 |
|
Medical services (physiotherapist, orthodontist, consultant, etc.) |
335 |
|
Dentist |
315 |
|
Doctor (not consultant) |
249 |
|
Hospital charges (net of insurance refunds) |
112 |
|
Spectacles & lenses |
103 |
|
Services of private medical auxiliaries (e.g. chiropodist) |
52 |
|
Optician |
28 |
|
Other medical products (plasters, bandages, etc.) |
17 |
|
Therapeutic equipment – non optical items (e.g. wheelchair) |
8 |
|
Services of medical analysis labs |
5 |
|
Accessories & repairs to spectacles & lenses |
3 |
|
Other non hospital services |
3 |
Source: CSO, Household Budget Survey
184. Deputy Dan Neville asked the Minister for Health if he will include the condition Attention Deficit Disorder in the long term illness card scheme. [5841/14]
View answerMental Illness (under 16) is one of the illnesses covered under the LTI Scheme. Attention Deficit Hyperactivity Disorder (ADHD) is a qualifying condition covered under this heading. Attention Deficit Disorder is sometimes used to describe one sub-type of the ADHD condition. Following a review of the operation of the Scheme with reference to ADHD, the HSE issued appropriate national guidelines in September 2013, to be implemented with immediate effect. The implementation of the guidelines will ensure that in future all children with ADHD are treated equally under the Long Term Illness Scheme.
