Caoimhghín Ó CaoláinQuestion:
513. Deputy Caoimhghín Ó Caoláin asked the Minister for Health when a decision will be made to introduce a vaccination for meningitis B; and if he will make a statement on the matter. [11606/14]View answer
Written Answers Nos. 513-531
513. Deputy Caoimhghín Ó Caoláin asked the Minister for Health when a decision will be made to introduce a vaccination for meningitis B; and if he will make a statement on the matter. [11606/14]View answer
The National Immunisation Advisory Committee (NIAC) has not made any recommendation in relation to the use of Bexsero in the primary childhood immunisation programme in Ireland. However NIAC has issued guidance in relation to the use of Bexsero in the control of clusters or outbreaks of Meningococcal B disease.
514. Deputy Caoimhghín Ó Caoláin asked the Minister for Health when the EU cross-border health care directive will be implemented in full here; the impact this will have on those persons and groups seeking medical treatment abroad that is available here; the impact this will have on those persons and groups seeking medical treatment abroad that is not available here; the proposed method, process and timeline for implementation; the way in which the scheme will be administered; and if he will make a statement on the matter. [11617/14]View answer
The Directive on Patients’ Rights in Cross Border Healthcare provides rules for the reimbursement to patients’ of the cost of receiving treatment abroad, where the patient would be entitled to such treatment in their home Member State (Member State of Affiliation) and supplements the rights that patients already have at EU level through the legislation on the coordination of social security schemes (regulation 883/04).
The Directive seeks to ensure a clear and transparent framework for the provision of cross-border healthcare within the EU, for those occasions where the care patients seek is provided in another Member State rather than in their home country. However, it should be emphasised that the vast majority of EU patients receive healthcare in their own country and prefer to do so. The Department of Health is continuing to work on the necessary statutory provisions to fully implement the Directive and will have them in place as soon as possible.
Nevertheless, there are arrangements in place in respect of the key provision of the Directive in relation to a national contact point (NCP), which has been set up within the HSE and will administer the information and reimbursement aspects of the Directive. The principal function of the NCP is to facilitate exchange of information for patients concerning their rights and entitlements relating to receiving healthcare in another Member State, in particular the terms and conditions for reimbursement of cost, the procedures for accessing and determining those entitlements. The NCP also has a responsibility to ensure that all enquirers are informed of the rights, if any, that they may have through the legislation on the coordination of social security schemes (regulation 883/04) and which may be more beneficial to them. The NCP will be able to inform patients what the cost of their treatments would be in Ireland to allow them make a comparison with the costs they are being quoted for comparable treatment in another Member State.
The Directive allows Irish residents to avail of healthcare in other EU member states that they would be entitled to within the public health system in Ireland, and which is not contrary to Irish legislation. The costs must be born by the individual and he/she then seeks reimbursement for the cost of the healthcare upon return to Ireland. Costs will only be reimbursed up to the level that would have been arisen if the healthcare had been provided in Ireland or the actual cost of the healthcare in the other member state, whichever is the lesser. Where the medical treatment being sought is not available in Ireland, patients may, as at present, apply for the Treatment Abroad Scheme operated by the HSE under EU Regulation 883/04.
Question No. 516 answered with Question No. 508.
515. Deputy Michael Healy-Rae asked the Minister for Health his views on correspondence (details supplied) regarding the proposal to reduce the sick leave arrangements in the public sector for nurses and all other office grades. [11622/14]View answer
The Minister for Public Expenditure and Reform has announced the introduction of a new Public Service Sick Leave Scheme for Public Service employees commencing on 31st March 2014. The new Scheme provides for the payment of the following financial support to staff during periods of absence from work due to illness or injury:
- A maximum of 92 days on full pay in a year
- Followed by a maximum of 91 days on half pay
- Subject to a maximum of 183 days paid sick leave in a rolling four year period.
- In addition, the Sick Leave Scheme provides for a Critical Illness Protocol (CIP) which sets out the arrangements for extended paid sick leave for staff that are critically ill or seriously injured, as well as temporary rehabilitation pay which may follow up paid sick leave.
I am satisfied that the new scheme will ensure that staff who have serious illness are protected.
517. Deputy Jack Wall asked the Minister for Health when an MRI scanner will be installed at a hospital (details supplied) in Dublin 12; and if he will make a statement on the matter. [11642/14]View answer
As this is a service matter, I have asked the HSE to respond directly to the Deputy.
518. Deputy Brendan Griffin asked the Minister for Health if home help hours will be reinstated in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [11650/14]View answer
As this is a service matter it has been referred to the Health Service Executive for direct reply.
Question No. 520 answered with Question No. 505.
519. Deputy Clare Daly asked the Minister for Health with respect to the hepatitis C tribunal accounts for 2008 and 2009, if he will accept that the amount entered for total payments for 2008 in its 2009 document does not remotely match its entry in the 2008 document and that an equivalent distortion occurred in two other entries further down that column of data; and if, in view of these fundamental errors and the lack of transparency provided to Dáil Éireann in previous replies, he will instruct the tribunal to hand over its financial records, including all of its banking records, to an independent auditor and that an independent audit then be laid before Dáil Éireann. [11658/14]View answer
As pointed out in my response to recent parliamentary questions, there was an error in the published accounts of the Hepatitis C and HIV Compensation Tribunal for 2009. This error impacted on both the 2009 and 2008 figures included in the 2009 publication. The 2008 Total Payments figure, as documented in the published accounts for 2008, and as set out in my response to Question No. 238 of 6 February 2014, was €62,744,412. This is incorrectly listed as €1,205,465 in the published accounts for 2009. This incorrect figure fed into the calculation of a surplus for the year as €73,596,535 (rather than the correct figure of €12,057,588) and to the calculation of a surplus carried forward to the following year of €56,210,708 (rather than a deficit of €5,328,239). As pointed out previously, I do not propose to have an audit undertaken on the matter.
521. Deputy Michael Colreavy asked the Minister for Health when the decommissioned mammography equipment at Sligo Regional Hospital will be replaced and staffed; and if he will make a statement on the matter. [11677/14]View answer
The HSE is continuing to make extensive efforts to provide an outreach service but this has not proved possible largely due to pressure on mammography staff resources at Galway University Hospital where recruitment of mammographers has proven extremely difficult. The priority is to ensure that patients have their follow up mammographies in a timely manner. Women availing of symptomatic breast services at Galway University Hospitals have access based on clinical need to an excellent nationally accredited service. The National Cancer Control Programme has set national standards against which all symptomatic breast cancer services are measured and the Galway/Letterkenny service has consistently delivered on these standards, ensuring that the best possible services are provided to women in the catchment area of the West / North West Hospitals Group.
522. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will review the circumstances in which persons are exempted from the €100 emergency department fee, with particular reference to road traffic victims (details supplied). [11678/14]View answer
557. Deputy Willie O'Dea asked the Minister for Health if he will consider abolishing the €100 emergency department charge for families-next of kin who are grieving following the death of a loved one in road traffic accidents; and if he will make a statement on the matter. [12026/14]View answer
567. Deputy Mattie McGrath asked the Minister for Health if he will instruct the Health Service Executive to abolish the practice of charging grieving families of those who have died in road traffic accidents a €100 fee; and if he will make a statement on the matter. [12083/14]View answer
I propose to take Questions Nos. 522, 557 and 567 together.
Currently those exempted from the Emergency Department charge are persons with a medical card, persons who have a referral letter from a General Practitioner, a person whose attendance results in admission as an in-patient or other exemptions as provided for by the Health (Out-Patient Charges) Regulations 2013 (S.I. No 45 of 2013) made under Section 56 of the Health Act 1970 (as amended). The charge is currently €100 per visit. The Emergency Department charge is levied as a contribution towards the costs of providing emergency services to all patients requiring treatment. There are no plans at the moment to review the exemptions to this charge.
523. Deputy Charlie McConalogue asked the Minister for Health when a paediatric diabetes clinical nurse specialist post will be approved for Letterkenny General Hospital in view of the fact that the Health Service Executive's diabetes expert advisory group recommends one paediatric diabetes clinical nurse specialist per 100 children-adolescents with type 1 diabetes and there are 143 children in County Donegal with type 1 diabetes; and if he will make a statement on the matter. [11693/14]View answer
529. Deputy Dara Calleary asked the Minister for Health if a dedicated diabetes paediatric clinical nurse specialist is to be appointed at Letterkenny General Hospital in County Donegal; and if he will make a statement on the matter. [11729/14]View answer
I propose to take Questions Nos. 523 and 529 together.
The National Clinical Programme for Diabetes has created a new post for an Integrated Diabetes Clinical Nurse Specialist, operating from Letterkenny General Hospital. As a result, the nursing resource in Letterkenny General Hospital will be restructured, delivering benefits to both children and adults with Diabetes. The current resource of two Clinical Nurse Specialist posts and one Staff Nurse post in the Diabetic service at Letterkenny General Hospital will remain unchanged. One of the two hospital Clinical Nurse Specialist posts will have a focus on children with diabetes and the other will have a focus on adults with diabetes. The existing midwifery allocation to support pregnant women with diabetes will also continue unchanged.
The new post of Integrated Diabetes Clinical Nurse Specialist is an additional resource which will link hospital-based diabetic services to community-based diabetic care services. This role is an essential resource in empowering patients to achieve optimum diabetes control by utilising clinically sound collaborative links between primary care and secondary care providers, as envisaged in the National Integrated Care Diabetes Programme developed by the National Clinical Programme for Diabetes.
The outcome of these changes will be that nursing support for children with diabetes within the hospital will remain at current levels. Overall services will be enhanced through the support of the Integrated Services Clinical Nurse Specialist, who will work across both the hospital and the community. In addition to the enhanced nursing resources outlined above, the hospital is in the process of recruiting permanent Consultants to two vacant posts within the Paediatric service. One of these posts is being advertised as a Consultant Paediatrician with a Special Interest in Diabetes. In the interim, Consultant cover for children with diabetes is currently being provided by a locum Consultant Paediatrician.
524. Deputy Aodhán Ó Ríordáin asked the Minister for Health the practical actions his Department has taken to try and reduce the cost of the drug (details supplied) for those suffering from Addison's disease; and if he will make a statement on the matter. [11695/14]View answer
The State has introduced a series of reforms in recent years to reduce pharmaceutical prices and expenditure. There has been a general price freeze in operation in Ireland for medicines supplied under the community drug schemes since the mid 1990s. These have resulted in reductions in the price of thousands of medicines. Price reductions of the order of 30% per item reimbursed have been achieved between 2009 and 2013; the average cost per items reimbursed is now running at 2001/2002 levels.
Price increases have only been allowed under the national pricing agreements in exceptional circumstances. Approximately 60 products have been granted price increases since 2006. Included in this are essential medicines such as epilepsy medicines and cortico-steroids. Price increases are only allowed in extremis to maintain supplies of required medicines in the Irish market and require the provision of detailed supporting evidence including international pricing.
In relation to hydrocortisone, it is appreciated that for an individual patient, the increase in its price is substantial. However, if an increase had not been agreed, the manufacturer was insistent that it would remove the product from the Irish market. If that had occurred, patients would have had to pay for an even more expensive unlicensed product. There is still only a single supplier of hydrocortisone in the Irish market, which suggests that the HSE made the right decision in allowing the price increase in order to maintain supply.
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.
525. Deputy Aengus Ó Snodaigh asked the Minister for Health the circumstances in which a child may be granted special needs assistant support in order to avail of his or her entitlement to a free preschool year; and the application procedure and Health Service Executive points of contact for same. [11696/14]View answer
The free pre-school year is provided through the Early Childhood Care and Education Programme, which is the responsibility of my colleague, the Minister for Children and Youth Affairs. The objective of this scheme is to make early learning in a formal setting available to eligible children in the year before they commence primary school. I understand that certain flexibilities are built into the scheme in an effort to accommodate children with special needs, such as an overage exemption, or waiver, for children with special needs who do not meet the age criteria and the option to avail of the free pre-school year over two years.
As the Health Service Executive has no statutory obligation to provide assistant supports for children with special needs wishing to avail of the free pre-school year, there is no standardised national application procedure in place. However, it works at local level and in partnership with the relevant disability service providers to address individual needs as they arise. This is done in a number of ways such as by providing grant-aid to support pre-school provision in community pre-schools and by funding special pre-schools that cater specifically for children with disabilities. In some cases at local level disability services have also facilitated children with disabilities to attend mainstream pre-schools by providing assistant supports where possible.
The HSE’s role in supporting children with disabilities involves it working in close co-operation with the disability service providers that it funds, with the education sector, with the Department of Children and Youth Affairs and with the parents and families of the children in question. However, there is a need to strengthen these arrangements. A dedicated Cross-Sectoral Team, comprising representatives of my Department, the HSE, the Department of Education and Skills and the Department of Children and Youth Affairs plays a key role in fostering greater collaboration on children’s disability issues and to build on the cross-sectoral working arrangements that are already in place. A sub group of this Cross-Sectoral Team has been set up to examine the issues around the integration of children with disabilities into mainstream pre-school settings, building on previous analysis in this area. Representatives of the Departments of Health, Children and Youth Affairs, Education and Skills, the Health Service Executive and of the City and County Childcare Committees are members of this group and it is chaired by the Department of Health. The issue of supports for children with disabilities in mainstream pre-school settings is being looked by this sub-group.
526. Deputy Jack Wall asked the Minister for Health when a person (details supplied) in County Kildare will receive a hospital appointment date; and if he will make a statement on the matter. [11712/14]View answer
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.
527. Deputy Bernard J. Durkan asked the Minister for Health the progress to date in the determination of an application for long-term illness card in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [11713/14]View answer
The HSE is responsible for the administration of the Long Term Illness Scheme, therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
Question No. 529 answered with Question No. 523.
528. Deputy Catherine Byrne asked the Minister for Health when a person (details supplied) will receive an appointment to be assessed for a specially adapted pram that is urgently needed; and if he will make a statement on the matter. [11714/14]View answer
As the Deputy's question relates to service matters I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
530. Deputy Michael Healy-Rae asked the Minister for Health his views on correspondence (details supplied) regarding health care; and if he will make a statement on the matter. [11737/14]View answer
The Government committed to improving the waiting times for Consultant outpatient appointments and commenced work on this with the publication of the first validated Outpatient waiting list in March 2013. In the 9 months between when these figures were first collated and the end of 2013, the total number of patients awaiting first Outpatient referral appointments has reduced by 25% from 399,951 to 300,752 . Of these, 295,815 are waiting less than 12 months, a level of 98.4% compliance with the Government target of 12 months.
- Numbers waiting 12-24 months have reduced by 94%, from 67,529 down to 3,990
- Numbers waiting 24-36 months have reduced by 97%, from 23,726 down to 706
- Numbers waiting 36-48 months have reduced by 97%, from 7,802 down to 197
- Numbers waiting 48+ months have reduced by 99%, from 7,795 down to 44
Of course, referrals for first time appointments are only one part of the activity taking place in Outpatient clinics. In 2013 the 736,960 new referrals seen by consultants accounted for approximately 30% of their total Outpatient workload: a further 1,720,850 return appointments brought the full number of attendances at Outpatient clinics to 2,457,810. A key part of the management of outpatient waiting lists, is addressing the loss of 16% of the total potential outpatient capacity due to patients not attending scheduled outpatient appointments (often referred to as the ‘Do Not Attend’ or ‘DNA’ rate). Through the introduction of validation of current waiting lists, revised control processes in respect of patients who fail to attend booked appointments, using texts and/or letters to prompt patients about forthcoming appointments, facilitating patient choice in the arrangement of appointments and the use of electronic referral systems, it is intended to reduce the ‘DNA’ rate to 10% in 2014.
Finally, it should be borne in mind that a patient's first point of call should always be to their GP, rather than seeking direct self-referral or referral from another source, as the patient's GP is most likely to have a greater knowledge of their previous medical history, current co-morbidities and other factors which may be essential to the consultant in order to provide the most appropriate and effective care.
531. Deputy Michael Healy-Rae asked the Minister for Health his views on correspondence (details supplied) regarding consultant referrals; and if he will make a statement on the matter. [11738/14]View answer
The development of Primary Care Services is a priority under the Programme for Government and is an essential component of the health service reform process. The aim is to provide up to 95% of health and social care in local communities and this will be achieved by increasing activity in the primary care setting and the redirecting of services away from acute hospitals to the community.
The Government has planned to implement the following key measures in primary care during its term in office and significant progress has already been made in these areas:
- Introduction of a universal GP service free at the point of access;
- Introduction of a new GP contract;
- Phased roll out of chronic disease management programmes;
- Expansion of the primary care workforce; and
- Continued development of the primary care infrastructure.
I am satisfied that the implementation of the above key measures will play a significant part in the re-focussing of health services in line with the Government's health reform programme and consequently, ensuring that more patients are treated in the community, reducing unnecessary hospital appointments.
In relation to waiting times for public patients to see consultants, a maximum waiting time target of 12 months has been set for a first time consultant-led outpatient appointment and this is reflected in the HSE's National Service Plan. 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 HSE, sets out the processes that hospitals are to implement to manage waiting lists.
With regard to arrangements for the referral of private patients to consultants, neither my Department nor the HSE have any function in the matter.