Written Answers Nos. 586-606
586. Deputy Brendan Griffin asked the Minister for Health if Ehlers-Danlos syndrome will be covered under the treatment abroad scheme in respect of a person (details supplied) in County Kerry in view of the fact that the expertises for the treatment of this rare disease is currently not available in this country; and if he will make a statement on the matter. [17519/14]
View answerThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
587. Deputy Brian Walsh asked the Minister for Health the steps involved in having the medicinal product (details supplied) included under the GMS scheme; and if he will make a statement on the matter. [17529/14]
View answerThe first step for a medicine to be placed on the Irish market involves the manufacturer seeking an authorisation from the Irish Medicines Board (IMB) or in the case of certain medicinal products, the European Medicines Agency (EMA). A determination on the application for authorisation is based on a rigorous scientific assessment of the application against legal and regulatory requirements.
Once authorised on the Irish market, the supplier must make an application to the HSE for the product to be included on the list of products covered under the GMS and other community drug schemes. The application is considered in line with the procedures and timescales agreed by the Department of Health and the HSE with the Irish Pharmaceutical Healthcare Association (IPHA) for the assessment of new medicines. In accordance with these procedures, the HSE may ask the National Centre for Pharmacoeconomics (NCPE) to conduct a pharmacoeconomic evaluation of the new product which provides detailed information on the potential budget impact of the medicine. It also assesses whether the product is cost effective at the price quoted by the company in question. The NCPE report is an important input to assist the HSE in its decision making process and informs further discussions between the HSE and the supplier. The HSE assessment process is intended to arrive at a decision on the funding of new medicines that is clinically appropriate, fair, consistent and sustainable. As the HSE has statutory responsibility for the management of the primary care schemes, the HSE has been asked to examine the specific query raised by the Deputy and to reply to him as soon as possible.
588. Deputy Aengus Ó Snodaigh asked the Minister for Health if he will consider reinstating medical cards for coeliacs; and if he will make a statement on the matter. [17531/14]
View answerUnder the provisions of the Health Acts, medical cards are provided to persons who are, in the opinion of the Health Service Executive, unable without undue hardship to arrange GP services for themselves and their dependants. Under the legislation, there is no - and there never has been - entitlement to a medical card based on a particular disease or illness.
The HSE is obliged to operate within the legal parameters as set out in the Health Act, while also responding to the variety of circumstances and complexities faced by persons who apply for a medical card on an individual basis. However, if an applicant’s means are above the financial thresholds as set out in the national guidelines, the HSE routinely examines for indications of medical or social circumstances which might result in undue financial hardship in arranging medical services and, exercising discretion, may grant eligibility for a medical card on this basis. Where persons submit an application, as a new applicant or a renewal/review, without additional medical documentation and are refused, they will receive a letter giving a calculation of the guideline thresholds and where these have been exceeded. Also, at this stage, they are informed of the option to furnish further medical documentation, to demonstrate medical expenditure related to an illness or disease, in support of their application.
Where discretion is exercised with regard to an applicant with an illness or disease, it is the effect of medical costs and necessary expenses of that condition on a person's financial situation that is relevant to the assessment for a medical card. In accordance with the legislation, it is not possible to award a medical card by virtue of an illness or a disease or the severity thereof.
589. Deputy Billy Timmins asked the Minister for Health the position in relation to including illnesses such as lupus in the long-term illness scheme; and if he will make a statement on the matter. [17536/14]
View answerThere are no plans to extend the list of conditions covered by the Long Term Illness scheme. 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.
590. Deputy Billy Kelleher asked the Minister for Health if the ambulance service in the Youghal and greater east Cork area is meeting the target response times as set out by the Health Information and Quality Authority; and if he will make a statement on the matter. [17539/14]
View answerAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
591. Deputy Billy Kelleher asked the Minister for Health if he will reinvestigate complaints about the quality of the SouthDoc service being provided to Youghal, County Cork, following persistent claims of refusal to travel to Youghal or instances of failure to show up; and if he will make a statement on the matter. [17540/14]
View answerAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
592. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a hearing aid in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [17541/14]
View answerThe Health Service Executive Community Audiology service administers and monitors hearing tests for adults who are at risk for hearing loss. Appointments for the audiology service are sent in a strict chronology according to clinical priorities and date of receipt of referral. The HSE has been asked to examine this matter and to reply to the Deputy as soon as possible.
593. Deputy Bernard J. Durkan asked the Minister for Health if two hours of home help will be provided in respect of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [17544/14]
View answerAs this is a service matter it has again been referred to the Health Service Executive for direct reply.
594. Deputy Robert Dowds asked the Minister for Health the position regarding the progress of the 2011 national strategy and policy for the provision of neurorehabilitation services; and his views on the recent report on the Neurological Alliance of Ireland's survey findings that 42% of respondents have found it more difficult to access speech and language therapy services over the past three years, 45% of respondents have found it more difficult to access respite care over the past three years, 46% of respondents have found it more difficult to access appropriate day services over the past three years, and 47% of respondents have found it more difficult to access aid for specialist appliances or equipment over the past three years. [17556/14]
View answer612. Deputy Maureen O'Sullivan asked the Minister for Health if reform of neurorehabilitation care will be included as part of universal health insurance; if it will address the long waiting lists, including up to a year for patients in comas or semi-responsive states, and the fact there are only seven rehabilitation programmes when the Neurological Alliance of Ireland states the country needs 26; and if he will make a statement on the matter. [17678/14]
View answerI propose to take Questions Nos. 594 and 612 together.
Neuro-rehabilitation health services are provided across a range of settings, by different organisations and by many health professionals and carers. The Government has a plan, with a series of recommendations, under the National Policy and Strategy for the Provision of Neuro-Rehabilitation Services in Ireland. The Health Service Executive (HSE) has established a steering group to develop an implementation plan for the Strategy working with the National Clinical Programme on Rehabilitation Medicine.
In relation to specialist disability support services, the HSE will spend €1.4 billion and employ a staff level of approximately 15,000 whole time equivalents in 2014 to deliver its Disability Services Programme. The HSE is embarking on a large scale reform programme, which will transform our model of service to a community-based model of person-centred care. This Government is also committed to a significant strengthening of primary care services. The HSE has provided additional funding and filled 200 additional primary care team posts including public health nurses, physiotherapists, occupational therapists and speech and language therapists.
The White Paper on Universal Health Insurance (UHI), published by Government on 2 April 2014, indicates that under UHI citizens will have access to a package of primary and acute hospital services, including acute mental health services. Decisions on the composition of the future health basket in will be informed by the Expert Commission which the Government will establish shortly. The Commission will be tasked with providing a series of costed options to the Government on the range of services to be included within the UHI standard package of services. It will provide details on the nature and type of the service including any conditions and targeting that should apply in relation to coverage of services. It will also advise on the services to be provided within the overall health basket. The inclusion of nuero-rehabilitation care services in the standard package of UHI will be considered as part of this process. It is the Government's intention that UHI will be introduced by 2019.
The Government recognises that neurological illness or injury has significant implications for the individual and their family, which impacts on their social, educational, vocational and recreational participation. Waiting times, access, treatment and quality of care, are a priority for reform for this Government, despite budgetary constraints.
595. Deputy Eamonn Maloney asked the Minister for Health the timeframe for the introduction of the ambulance call centre to be located in close proximity to the Square, Tallaght, Dublin 24. [17577/14]
View answerAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
596. Deputy Eamonn Maloney asked the Minister for Health the timeframe for the construction of the urgent care centre to be located at Tallaght hospital, Dublin 24; and if he will make a statement on the matter. [17578/14]
View answerI announced in January this year that satellite centres of the new children's hospital would be built on the campuses of Tallaght and Connolly hospitals. These satellite centres will be an integral part of, and come under the governance of, the new children’s hospital. The centres will provide services and environments of the same quality as those delivered in the new children’s hospital and staff working in the satellite centres will rotate through the main hospital. In advance of the opening of the new children’s hospital, the satellite centres will be managed as part of the Children’s Hospital Group.
The decision to develop the hub-and-spoke model of a main hospital with satellite centres is based on the need to provide high quality, safe, accessible acute and secondary general care to the children of the Greater Dublin Area. These two satellite centres will each provide urgent care, to be established well in advance of the main hospital opening. Each centre will also provide secondary outpatient services including rapid access general paediatric clinics. This configuration improves geographic access to urgent care for a significant number in the Greater Dublin Area, supports primary and community care paediatrics and significantly reduces Emergency Department and outpatient attendance on the main site. All other services will be provided on the main site at the St James's campus including all in-patient care.
The satellite centres are expected to be built by mid-2016, enabling them to become operational well in advance of the transition of services to the main hospital on the St James's campus, which is expected to commence at the end of 2018.
597. Deputy Terence Flanagan asked the Minister for Health if he will deal with a matter (details supplied) regarding hospital equipment; and if he will make a statement on the matter. [17588/14]
View answerIn relation to the particular patient query raised by the Deputy, as this is a service matter, I have asked the Health Service Executive to respond to him directly.
598. Deputy Robert Dowds asked the Minister for Health if he will provide an indication of the average premium for health insurance under the universal health insurance system; if this premium will be in the order of €3,000 per annum; if the State will provide subsidies for persons who currently are not eligible for a medical card; and if he will make a statement on the matter. [17598/14]
View answerIt is, as yet, not possible to say what the cost of UHI premiums will be when the system is fully implemented in 2019. Determining the cost of universal health insurance is a complex matter and will require expert analytical support and time to undertake. The cost will depend on a range of factors, including decisions on the basket of services to be provided under UHI, estimating future demand for health services and decisions in relation to the scope and design of the financial support system. Officials in the Department of Health will progress the necessary work in relation to this major costing exercise during 2014.
There will be a system of financial protection whereby the State will fully or partially subsidise insurance premiums for people who qualify on the basis of a means test. Officials from my Department will progress proposals for this subsidy scheme which will be designed to ensure that citizens can afford the premiums for a standard UHI package of services.
It is my intention to have all the necessary groundwork for UHI in place by early 2016 and to then proceed to have the new system implemented by 2019.
599. Deputy Robert Dowds asked the Minister for Health if he will provide an overview of the UHI system; the way it will operate; his views on whether those who are currently health insurance holders will benefit from or be disadvantaged by its introduction; and if he will make a statement on the matter. [17599/14]
View answerThe delivery of a single tier health system, supported by universal health insurance (UHI), where there is fair access to services based on need and not on ability to pay, is a central pillar of the Government’s major reform programme for the health system. The White Paper on Universal Health Insurance, which was published on 2nd April 2014 and is available on the Department’s website, www.health.gov.ie, provides detailed information on the UHI model for Ireland.
Broadly, under UHI, everyone will be insured for the same standard package of services. In addition, everyone will have a choice of health insurer. Health insurers will purchase health services on behalf of their customers from healthcare providers. There will be a system of financial protection whereby the State will pay for or partially subside the cost of UHI premiums for those who qualify. All individuals, whether paying for their UHI policy premium themselves, or having them fully or partially paid for by the State, will access the UHI package of services on the same basis, that is, on the basis of health need. Insurers and providers will not be allowed to sell faster access to services covered in the UHI standard package of care. Individuals will still be able to pay privately for services not included in the standard UHI package or purchase supplemental health insurance cover for these. However, these supplemental policies will not be subject to community rating.
600. Deputy Terence Flanagan asked the Minister for Health if he will deal with a matter (details supplied) regarding hospital appointments; and if he will make a statement on the matter. [17616/14]
View answerIn relation to the particular patient query raised by the Deputy, as this is a service matter, I have asked the Health Service Executive to respond to him directly.
601. Deputy Joe Higgins asked the Minister for Health if he will appoint a person (details supplied) from the Health Service Executive to discuss a matter with a person in County Wexford who suffers from an aggressive from of motor neuron disease and is in need of invasive ventilation. [17617/14]
View answerAs this is a service related matter the Health Service Executive has been asked to reply directly to the Deputy on this matter as soon as possible.
602. Deputy Willie O'Dea asked the Minister for Health the scheme that has been put in place to support those who previously depended upon the motorised transport grant; and if he will make a statement on the matter. [17619/14]
View answerIn light of the reports of the Ombudsman regarding the legal status of the Motorised Transport Grant in the context of the Equal Status Acts, the Government decided to close the grant last year. The position, therefore, is that the Motorised Transport Grant remains closed. The Government has decided that the detailed preparatory work required for a new travel support payment and associated statutory provisions should be progressed by the Minister for Health. Work in this regard is under way at present.
603. Deputy Paul J. Connaughton asked the Minister for Health the options open to families who have no further resources to maintain a family member in a nursing home when that member has been recommended for the fair deal scheme but the funding has not come through; and if he will make a statement on the matter. [17624/14]
View answerThe HSE's National Guidelines for the Standardised Implementation of the Nursing Homes Support Scheme provide that State Support and Ancillary State Support should be paid from either the date that the release of funding is approved, or date of admission to the nursing home, whichever is the later. If payment were made from the earlier date fewer people could be supported overall.
The current average time for processing properly completed application forms received by the HSE is 4-6 weeks nationally. Applicants are placed on the national placement list for funding in chronological order by the date of determination of their application. Funding issues to applicants in this chronological order to ensure equity of access nationally. As of the 25th March it was taking approximately 36 days for funding to issue to applicants from date of determination.
604. Deputy Pearse Doherty asked the Minister for Health when a response will issue to Parliamentary Question No. 225 of 23 January 2014; and if he will make a statement on the matter. [17635/14]
View answerI wrote to Deputy Doherty earlier last week when I received the report from the HSE, the detail of which is restated below.
Persons who hold medical card or GP visit card eligibility are subject to periodic assessment review to determine continuing eligibility. The review notification that issues includes the HSE contact information, should they require assistance, clarification or wish to make an inquiry in relation to the review. Persons calling the number provided, will be greeted by an automated message, voicing a menu of options from which the caller is invited to select to access the particular service area of choice. The automated message also includes a notification that connected calls to this line “may be recorded for training and quality purposes". The ‘training and quality purposes’ referred to relate to the monitoring of staff performance in meeting expected service standards. This is part of routine staff performance appraisal in which call handling is assessed or is part of a performance review originating from a customer complaint expressing dissatisfaction with how his/her phone query was handled.
The HSE considers it among its legitimate interests to performance manage its staff and monitor the service standards being provided to the public in responding to their call queries relating to medical card/GP visit card eligibility. Having access to a recording of these calls is integral to the purposes of performance management and service quality appraisal. Section 2A of the Data Protection Acts permits the processing (including obtaining, recording, keeping or using) of personal data if the following conditions are complied with:
(a) Data is obtained fairly and processed fairly i.e. the data subject is informed of the purpose that the data is to be used for and that this purpose is not likely to cause substantial and unwarranted distress to the data subject
(b) Data is obtained only for a specified, explicit and legitimate purpose and that the data is used and/or disclosed in ways compatible to this purpose
(c) Data is adequate, relevant and not excessive for the purpose collected/used
(d) Data is kept secure and retained only for the duration it is needed
(e) Processing of the data is necessary for the purposes of the legitimate interests pursued by the data controller.
The HSE is satisfied that the automated recorded message that each caller to the HSE help-line receives, informing that the call may be recorded and used for training and quality purposes, is sufficiently transparent to meet the obligations above owed to the data subject. In addition, the HSE is satisfied that recording call contacts to the helpline and using this information for performance appraisal and quality assurance purposes is a legitimate interest of the HSE, pursued in a manner that is proportionate in safeguarding the privacy rights of individuals as required under the Data Protection legislation.
An individual/data subject has the right under section 6A of the Data Protection Acts to object to the recording/use of his/her personal data if the use/processing of this information would cause substantial and unwarranted damage or distress to the individual concerned. A person can exercise this right by writing to the HSE requesting, in this instance, that the HSE cease or not begin to use information about the individual recorded in call contacts to the medical card/GP visit card helpline because it is having or would have the effect as stated under Section 6A. Also, an individual/data subject may exercise the right to access call recordings to the helpline that relate to him/herself, by making a request to the HSE under section 4 of the Data Protection Acts (to include payment of €6.35 application fee) or under section 7 of the Freedom of Information Acts.
605. Deputy Pearse Doherty asked the Minister for Health the reason the drug Daxas will no longer be available to medical card holders; and if he will make a statement on the matter. [17636/14]
View answerThe HSE is responsible for the administration of primary care schemes, therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
606. Deputy Damien English asked the Minister for Health if he will evaluate the prospects of reducing the unacceptable length of time patients aged under 14 years must wait to receive surgery at the orthodontic department of the oral surgery clinic in Louth County Hospital; and if he will make a statement on the matter. [17642/14]
View answerThe HSE provides orthodontic treatment to patients based on their level of clinical need. An individual's access to orthodontic treatment is determined against a set of clinical guidelines and priority is given to patients with greatest needs. The HSE has been asked to examine the specific query raised by the Deputy and to reply to him as soon as possible.
