Questions Nos. 1 to 10, inclusive, answered orally.

Medical Card Administration

Question No. 12 answered with Question No. 6.

Questions (11, 15, 43)

Timmy Dooley

Question:

11. Deputy Timmy Dooley asked the Minister for Health the reason the latest Health Service Executive service plan did not contain a 2014 projection for discretionary medical cards as per the 2013 plan; and if he will make a statement on the matter. [21275/14]

View answer

Dara Calleary

Question:

15. Deputy Dara Calleary asked the Minister for Health if the Health Service Executive’s current projection for medical cards as set out in the 2014 service plan still stands; and if he will make a statement on the matter. [21258/14]

View answer

Seán Fleming

Question:

43. Deputy Sean Fleming asked the Minister for Health the number of medical cards the Health Service Executive expects there to be in circulation at the end of 2014; and if he will make a statement on the matter. [21263/14]

View answer

Written answers (Question to Health)

I propose to take Questions Nos. 11, 15 and 43 together.

The HSE National Service Plan for 2014 projects that there will be 1,875,707 medical cards for 2014. This projection is based on the HSE’s analysis of recent trends and the impact of budgetary decisions.

The medical card scheme is a demand led scheme. Persons who currently do not hold a medical card could become eligible due to a change in circumstances either on a means or a discretionary basis.

All medical card and GP visit card holders are subject to a periodic review to determine continuing eligibility. The HSE will conduct reviews of eligibility in a risk-assessed manner in relation to approximately one million medical card holders during 2014. It is challenging to project precisely the potential changes in numbers eligible as the granting and retention of a medical card or GP visit card is subject to individual assessment and review which can result in renewal, change or removal of eligibility.

As a consequence of the multiplicity and complexity of factors, it is not possible to estimate the number of medical cards that may be awarded on a discretionary basis.

Question No. 12 answered with Question No. 6.

General Practitioner Services

Questions (13, 19, 20, 50, 191)

Caoimhghín Ó Caoláin

Question:

13. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will report on progress on the proposed introduction of free general practitioner visits for all children aged five and younger, including engagement with the Irish Medical Organisation; and if he will make a statement on the matter. [21288/14]

View answer

Billy Kelleher

Question:

19. Deputy Billy Kelleher asked the Minister for Health if he will provide an update on his talks about talks with the representative organisations of general practitioners regarding their proposed new contract; and if he will make a statement on the matter. [21252/14]

View answer

Niall Collins

Question:

20. Deputy Niall Collins asked the Minister for Health if he will provide an update on his engagement with GPs on their proposed new contract; and if he will make a statement on the matter. [21266/14]

View answer

Seán Ó Fearghaíl

Question:

50. Deputy Seán Ó Fearghaíl asked the Minister for Health the way he proposes to address the concerns of GPs with regard to the proposed new contract; and if he will make a statement on the matter. [21268/14]

View answer

Bernard Durkan

Question:

191. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he has had discussions with representatives of general practitioners with a view to identification and isolation of issues affecting the delivery of services; and if he will make a statement on the matter. [21769/14]

View answer

Written answers (Question to Health)

I propose to take Questions Nos. 13, 19, 20, 50 and 191 together.

As I have previously stated in this House, the Government is committed to introducing a universal GP service without fees, on a phased basis, within its term of office. The Government's vision for primary care is the development of a single-tier system where access is based on medical need and not on ability to pay.

As announced in the Budget, the Government has decided to commence the roll-out of universal GP services by providing all children under six years with access to a GP service without fees. The Health (General Practitioner Service) Bill 2014 which will give effect to this initiative was published on 23 April 2014. It is expected that the Bill will commence passage through this House in the next few weeks.

The introduction of this service also requires a new contractual framework to be put in place between the HSE and individual general practitioners. In this regard, a draft contract is currently the subject of a consultation process and over 250 submissions have been received.

It has been well documented that there has been some negative reaction to the draft contract; however, I am pleased that the Irish Medical Organisation (IMO), the primary representative body for general practitioners, is supportive of Government policy to introduce GP care free at the point of access, albeit conditional on the provision of adequate resources and full and meaningful negotiations.

I assured the IMO, when I addressed their national GP meeting on 26 April, that the Department and the HSE are fully prepared to engage meaningfully with them and are prepared to negotiate with them on all aspects of the scope and content of the proposed contract. I have also explained that there will be an opportunity for input from the IMO on the fee structure. I invited them to meet me along with officials from the Department and the HSE on a without prejudice basis to explore a potential framework for engagement.

I am pleased to inform the House that the IMO accepted this invitation and we had a useful meeting on Friday last. We have agreed to reconvene for further discussions this afternoon.

I am confident that a process of open discussion has the potential to significantly enhance the draft contract for patients, GPs, the HSE and the Department, thus helping to progress our common goal of free GP care at the point of access.

Hospital Waiting Lists

Questions (14)

Seán Kyne

Question:

14. Deputy Seán Kyne asked the Minister for Health if he will report on the progress of the special delivery unit in tackling waiting times at University Hospital Galway and across the west-north west hospital group; and if he will make a statement on the matter. [21206/14]

View answer

Written answers (Question to Health)

The Special Delivery Unit continues to support front line staff in our hospitals to make significant progress including at University Hospital Galway and all across the West North West Hospital Group, although significant challenges remain. The SDU can confirm that:

- Each site has a documented unscheduled care improvement plan which is continually reviewed and updated;

- Key areas of system performance have been identified and are being progressed;

- Each plan involves a ‘whole system’ approach, addressing review of referrals to the hospital, patient progress through the hospital and supports required to facilitate discharge; and

- The plans support the implementation of the National Clinical Programmes.

SDU officers regularly visit each hospital in this Group to ensure that appropriate performance improvement plans are being actively implemented. In respect of unscheduled care, the overall goal is to ensure that each hospital meets the Government access target for Hospital ‘Patient Experience Time’ (PET), which measures the time from arrival at the ED to departure. 95% of patients should have left the ED within 6 hours of arrival and 100% of patients should have departed within 9 hours of arrival. Nationally, 65% of patients are seen within the 6 hour target and 79% of patients within the 9 hour target. It should be noted that Mayo and Portiuncula Hospitals are among the highest performers in the country; in the latest national report Portiuncula was one of the only hospitals to meet the 9 hour target, with a 100% performance - which should be commended. The SDU also continues to work with the West North West Hospital Group to improve its management of inpatient and day case waiting lists.

Letterkenny General Hospital

Letterkenny has traditionally been amongst the best performing hospitals in the country in terms of ED waiting times. In large part due to extraordinary circumstances arising from the flooding Letterkenny's waiting times in ED have deteriorated.

The following commentary summarises the key information for each site, including PET times.

Table 1 – INMO Trolleys figures at 02/05/2014 – 30 Day Moving Average and Year to Date

Hospital

30 DMA 2014

30DMA 2013

30 DMA %

Change

YTD 2014

YTD 2013

YTD

% Change

Galway

15

17

-11.8%

1361

1435

-5.2%

Letterkenny

11

5

120%

671

297

125.9%

Mayo

9

11

-18.2%

908

838

8.4%

Portiuncula

2

6

-66.7%

290

543

-46.6%

Sligo

8

7

14.3%

804

474

69.6%