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Tuesday, 1 Apr 2014

Written Answers Nos. 511-526

Departmental Funding

Questions (511)

Patrick O'Donovan

Question:

511. Deputy Patrick O'Donovan asked the Minister for Health the progress that his Department has made in respect of auditing those sections 38 and 39 organisations funded from his Department; the level of compliance in those organisations in respect of pay practices; and if he will make a statement on the matter. [14698/14]

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Written answers

At my request, the HSE has taken urgent action to ensure Section 38 agencies which have been found to be in breach of health sector pay policy are brought into compliance.

The process which has been ongoing with the Section 38 Agencies to reach compliance with government pay policy is nearing completion. Since the beginning of the year the Regional Directors of Performance and Integration (RDPI's), with support from Regional HR, have been working with each Agency to verify where there are deviations from pay policy and to assist the Agencies to become compliant with health sector pay policy.

In line with the pay policy, organisations which wished to continue payment of an unapproved allowance were invited to submit their business cases for consideration by the HSE. Business cases were also required for the continued payment of allowances which are not encompassed by or in line with the Department of Health Consolidated Salary Scales but may have been sanctioned in the past. A total of 202 business cases have now been received. Where the HSE is satisfied that there are legitimate reasons for the continuation of an allowance, these will be submitted to the Department of Health for sanction. The Department of Health will liaise as appropriate with the Department of Public Expenditure and Reform.

An Internal Review Panel, made up of members of the HSE Leadership Team, have reviewed each business case in detail and a report on their deliberations is expected shortly. 143 business cases were received in respect of Senior Managers, i.e. those at a salary level of Grade VIII and above, for consideration by the Internal Review Panel. In addition, 59 business cases in respect of employees on a salary level below Grade VIII have been reviewed by the Regional Directors of Performance and Integration with support from Regional HR.

As indicated above the Internal Review Panel process in the HSE is nearing completion. The Department expects to receive a report on the outcome of the Review Panel's conclusions shortly and will then consider any business cases that the Review Panel consider may be justified, in consultation with the Department of Public Expenditure and Reform.

Due to the complexity of the issues involved, it is difficult to give a precise timescale as to when this issue will be brought to a satisfactory conclusion, however, I am determined that the payment of unapproved allowances to senior executives will be eliminated in an expeditious manner.

Employees of Section 39 organisations are not public servants. They are not included in the HSE employment control ceiling, are not bound by the Department of Health Consolidated Salary Scales and are not members of a public service pension scheme. The Government, however is determined to ensure that public pay policy is respected across the health service and to that end, at my request, the Director General of the HSE has written to 353 Section 39 funded agencies in receipt of HSE funding of more than €250,000, requesting that they have due regard to public pay policy particularly in respect of senior managers.

Departmental Funding

Questions (512)

Clare Daly

Question:

512. Deputy Clare Daly asked the Minister for Health if an organisation (details supplied) is a charitable organisation, compliant with public pay policy and with public policy as it relates to Health Service Executive-funded charities on employer contributions to employee pensions; if it has been so compliant since 2004; and if not, the steps that have been taken to remedy this. [9363/14]

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Written answers

The organisation referred to is a Section 39 funded organisation. Staff in such organisations are not classified as public servants, not counted in public service numbers, do not have public service pensions and are not bound by the Department of Health Consolidated Salary Scales.

As this is a service matter it has been referred to the Health Service Executive for direct reply.

Medical Card Applications

Questions (513)

Michael Healy-Rae

Question:

513. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a medical card in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [14790/14]

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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.

Prescriptions Charges

Questions (514)

Róisín Shortall

Question:

514. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 220 of 13 March 2014, the steps a medical card holder who paid the prescription charge in 2013 when the person had an underlying entitlement to the long-term illness card needs to take to claim a back-payment of those charges. [14793/14]

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Written answers

Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the primary care schemes, including the Long Term Illness Scheme.

As stated in reply to Parliamentary Question No. 220 of 13 March 2014, the HSE is currently in the process of identifying LTI eligible persons who paid prescription charges prior to 1 December 2013 with a view to putting arrangements in place to refund such charges.

Ambulance Service Provision

Questions (515, 537)

Brendan Ryan

Question:

515. Deputy Brendan Ryan asked the Minister for Health his views on the Health Service Executive's review of the ambulance service in Dublin, particularly in the context of a leaked HSE document that details the HSE plans to take back the ambulance service from Dublin city fire brigade; and if he will make a statement on the matter. [14794/14]

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Peter Mathews

Question:

537. Deputy Peter Mathews asked the Minister for Health his plans to review the role of Dublin ambulance and fire services; his plans to remove the ambulance service duties from Dublin fire brigade; and if he will make a statement on the matter. [14950/14]

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Written answers

I propose to take Questions Nos. 515 and 537 together.

Dublin Fire Brigade (DFB) provides emergency ambulance services in Dublin city and county, by arrangement between Dublin City Council and the HSE. The HSE National Ambulance Service (NAS) provides some emergency capacity in the greater Dublin area, as well as non-emergency patient transport.

The ongoing development of pre-hospital emergency care involves a range of initiatives, including the development of a single national control and dispatch system for the State. This new system, which is expected to be completed in 2015, will deploy all emergency ambulance resources in the State, including emergency ambulances, rapid response and intermediate care vehicles, first responders, aeromedical services and ambulances in Dublin.

In the context of the development of the national control system, the Dublin City Manager and the HSE's Chief Operating Officer have commissioned a joint review of DFB ambulance services in Dublin City and County. The review will consider all aspects of ambulance operations provided by DFB within the Dublin area, including the capacity and capability of ambulance services.

The review will inform consideration of the best model for provision of emergency medical services in the greater Dublin area. It is part of the process of ensuring a clinically driven, nationally co-ordinated system, supported by improved technology, so that emergency pre-hospital care can continue to modernise and services can be delivered in an appropriate and timely manner, to the benefit of patients.

There has been speculation about this review and I am aware of the concerns expressed by some about the future of the service. I want to assure those concerned that I appreciate the service the Fire Brigade provides. This review is not a negative reflection on that service. It is being conducted in parallel with the HIQA review of the National Ambulance Service and the NAS capacity review. The intention behind all of these reviews is to examine our pre-hospital emergency care services throughout the country, with a view to identifying the best way to enable them to meet the challenges of the future. I look forward to the recommendations of all three reviews, which I am certain will enable us to ensure that we provide a service capable of delivering the best possible outcomes for the public.

Medical Card Applications

Questions (516)

Bernard Durkan

Question:

516. Deputy Bernard J. Durkan asked the Minister for Health if and when a medical card will issue in respect of a person (details supplied) in County Meath; and if he will make a statement on the matter. [14798/14]

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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 Administration

Questions (517)

Martin Heydon

Question:

517. Deputy Martin Heydon asked the Minister for Health the way medical card numbers are allocated; if they are reused when they become redundant; and if he will make a statement on the matter. [14801/14]

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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.

National Treatment Purchase Fund

Questions (518, 519, 520, 521)

Billy Kelleher

Question:

518. Deputy Billy Kelleher asked the Minister for Health if he has directed the National Treatment Purchase Fund to force nursing homes to charge for social programmes and then pass the discount onto the NTPF, or if it is acting alone; and if he will make a statement on the matter. [14813/14]

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Billy Kelleher

Question:

519. Deputy Billy Kelleher asked the Minister for Health the amount of money it has been estimated that the National Treatment Purchase Fund is saving the State with the discount it is requesting by forcing nursing homes to charge for social programmes; and if he will make a statement on the matter. [14814/14]

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Billy Kelleher

Question:

520. Deputy Billy Kelleher asked the Minister for Health the number of nursing homes in the past 12 months that have been told by the auditors sent in by the National Treatment Purchase Fund to increase their nursing home fees; and if he will make a statement on the matter. [14815/14]

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Billy Kelleher

Question:

521. Deputy Billy Kelleher asked the Minister for Health his views on whether it is a fair and honourable policy by his Department, the Health Service Executive and the National Treatment Purchase Fund to force vulnerable elderly persons in nursing homes to have to spend their legal 20% retention of their pensions on basic social provisions that should be providing for the elderly; and if he will make a statement on the matter. [14816/14]

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Written answers

I propose to take Questions Nos. 518 to 521, inclusive, together.

In order for a nursing home to be an “approved nursing home” for the purposes of the Nursing Homes Support Scheme it must have agreed the maximum amount that will be charged for the provision of long-term residential care with the National Treatment Purchase Fund.

The NTPF has statutory independence in the performance of this function and, in carrying it out, it must ensure value for money for both the individual and the State. The NTPF negotiates with each nursing home proprietor on an individual basis and under the Nursing Homes Support Scheme Act may examine the records and accounts of nursing homes as part of the process.

The NTPF assesses nursing homes under four criteria:

- costs reasonably and prudently incurred by the nursing home and evidence of value for money;

- price(s) previously charged;

- local market price; and

- Budgetary constraints and the obligation on the State to use available resources in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the public.

Under the NHSS 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.

While the Deed of Agreement between the NTPF and the nursing home sets the maximum price an approved nursing home may charge for long term care under the Scheme the provision of all services is the subject of a separate contract between the approved nursing home and the person in receipt of those services, or his/her representatives. The NTPF Deed of Agreement states: "The Proprietor shall not demand or accept, from or on behalf of the resident or the HSE, any payment or consideration, over and above those described in remuneration for the provision of Long-term Residential Care Services to any Resident. For the avoidance of doubt and for the purpose of demonstrating that it has met this condition, the Proprietor agrees to make clear in its contract with the Resident the full extent of the services that are included in the price agreed with the NTPF under the Scheme."

The NTPF have confirmed that it refutes absolutely any suggestion that it endorsed reductions in price for long term care being passed directly or indirectly onto residents in the form of extra charges (as opposed to proprietors reducing profit levels or introducing cost efficiencies).

It has also confirmed that if similar such allegations are made, or similar price negotiating tactics used, by nursing home proprietors they will be robustly challenged and defended by the NTPF.

Abortion Services Provision

Questions (522)

Terence Flanagan

Question:

522. Deputy Terence Flanagan asked the Minister for Health the number of abortions that have taken place to date under the Protection of Life During Pregnancy Act; and if he will make a statement on the matter. [14818/14]

View answer

Written answers

The Protection of Life During Pregnancy Act provides that I, as the Minister for Health, must publish a report covering the operation of the Act in the preceding year by 30th June each year and lay it before the Houses of the Oireachtas. As the Act was commenced on 1st January 2014, the first annual report covering its operation will be published in June 2015.

Abortion Legislation

Questions (523)

Terence Flanagan

Question:

523. Deputy Terence Flanagan asked the Minister for Health his views on a matter (details supplied) regarding abortion; and if he will make a statement on the matter. [14819/14]

View answer

Written answers

No additional measures are required to support the Protection of Life During Pregnancy Act 2013. I will write to the Deputy shortly to provide an answer to his query.

Vaccination Programme

Questions (524)

Caoimhghín Ó Caoláin

Question:

524. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if the Health Service Executive has given a vaccine for meningitis B to any persons since it was approved in January 2013. [14822/14]

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Written answers

The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The NIAC is a committee of the Royal College of Physicians of Ireland comprising of experts in a number of specialties including infectious diseases, paediatrics and public health.

NIAC has not made any recommendation in relation to the use of Meningitis B vaccine in the primary childhood immunisation programme in Ireland. However NIAC has issued guidance in relation to the use of the Meningitis B vaccine in the control of clusters or outbreaks of Meningococcal B disease.

As the Deputy's question relates to a service matter it has been referred to the HSE for a direct reply.

Vaccination Programme

Questions (525)

Caoimhghín Ó Caoláin

Question:

525. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he has, or will, consult with NIAC to determine the reason it has not made a decision regarding the introduction of a vaccine for meningitis B into the national immunisation schedule. [14823/14]

View answer

Written answers

The National Immunisation Advisory Committee (NIAC) has not made any recommendation in relation to the use of Meningitis B vaccine in the primary childhood immunisation programme in Ireland. However NIAC has issued guidance in relation to the use of the Meningitis B vaccine in the control of clusters or outbreaks of Meningococcal B disease.

Hospital Accommodation Provision

Questions (526)

Jonathan O'Brien

Question:

526. Deputy Jonathan O'Brien asked the Minister for Health further to the Health Information and Quality Authority's 2013 report on Macroom Community Hospital which recommended that an upgrade to the hospital be carried out by July 2015 and in view of the fact that planning permission has been granted for this upgrade, his plans to implement HIQA's 2013 recommendations for this hospital; and if he will make a statement on the matter. [14830/14]

View answer

Written answers

The HSE is concentrating on applying the limited funding available for capital works in the most effective way possible to meet residential need now and in the future.

I have asked the HSE to respond directly to the Deputy in relation to the specific issues to be addressed in the light of the HIQA report.

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