Tuesday, 10 Jun 2014

Written Answers Nos. 463-480

Medical Card Eligibility

Questions (463)

Terence Flanagan

Question:

463. Deputy Terence Flanagan asked the Minister for Health if he will respond to a query (details supplied) regarding medical cards; and if he will make a statement on the matter. [24138/14]

Written answers

Minister of State at the Department of Health

If the question refers to a medical card review under the over-70 medical card scheme, the HSE is required to identify those persons who no longer have full eligibility as a result of the changes to the gross income limits from 1st January 2014. The HSE has written to some 60,000 over-70s persons advising them that their eligibility for a medical card is under review in line with the new income limits. Those contacted can complete the review form on-line or on the form enclosed with the letter. In both cases, all documentary evidence requested must be provided.

If, however, the review is in respect of a medical card awarded following the exercise of discretion, the HSE has suspended reviews in progress where discretion was involved and extended eligibility. Families affected have been so advised in the normal way.

This is following on from the Government's decision to develop a new ground of eligibility for the award of medical and/or GP visit cards on the basis of having specific on-going medical conditions which give rise to significant health care costs. The HSE has established an Expert Panel to examine the range of conditions that should be considered as a basis of eligibility and has been asked to make an early report to Government.

Legislative Measures

Questions (464)

Seán Fleming

Question:

464. Deputy Sean Fleming asked the Minister for Health the legislative provisions in respect of his Department which have been passed by the Oireachtas since 2011 but have not come into effect to date; and if he will make a statement on the matter. [24152/14]

Written answers

Minister for Health

Please see following table.

Name of Act	Provisions of Act not yet commenced	Status
Nurses and Midwives Act 2011	Sections 4(2), 9(2)(g)(ii), 17(3), 37(2)(a), 39-45, 59(1) (b) (so far as it relates to a professional competence scheme), 59(2)(d), 64(5) and (6), 65(1)(b) , 84, Part 11, Sections 102(2), (3) and (5), 103	This is a comprehensive piece of legislation which is being commenced on a gradual basis.
Health (Alteration of Criteria for Eligibility) Act 2013	Section 4	The Department is in on-going consultations with the Attorney General’s Office re commencement.
Health (Pricing and Supply of Medical Goods) Act 2013	Section 36	This section will be commenced with effect from 1 July 2014 in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013 (Commencement) Order 2014 (S.I No. 205 of 2014)
Health (Amendment ) Act 2013	Section 4 Sections 7(e)(ii), 8, 9, 10, 11(b), 12 and 19	To be commenced but no plan at present. Preparations for implementation as early as possible in 2014, including the finalisation of Regulations and Guidelines, are ongoing.

Hospital Appointment Status

Questions (465)

Barry Cowen

Question:

465. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) in County Offaly may expect an appointment with the orthopaedic department, Our Lady's Hospital for Sick Children, Crumlin, Dublin. [24164/14]

Written answers

Minister for Health

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

Hospital Waiting Lists

Questions (466)

Micheál Martin

Question:

466. Deputy Micheál Martin asked the Minister for Health if he will expedite the case of a person (details supplied) in Dublin 12 who is waiting for a double bypass heart surgery at St. James's Hospital, Dublin; and if he will make a statement on the matter. [24165/14]

Written answers

Minister for Health

The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, 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.

Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she would be in the best position to take the matter up with the consultant and hospital involved. In relation to the specific patient query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.

Medicinal Products Availability

Questions (467, 470, 502, 504, 572)

Ciara Conway

Question:

467. Deputy Ciara Conway asked the Minister for Health when Fampyra will be included on the drug payment scheme or other schemes such as the general medical services scheme or the long-term illness scheme; and if he will make a statement on the matter. [24173/14]

Brendan Griffin

Question:

470. Deputy Brendan Griffin asked the Minister for Health if the MS drug Fampyra has been taken off the long-term illness scheme; if so, the reason for same; the person who made this decision; if it will be reinstated; if he is aware of the benefits that the drug brings to MS sufferers; if his Department will apologise to the persons affected for the distress caused at this time of already great difficulties in their lives; the way he plans to hold the person or persons responsible for this decision to account; and if he will make a statement on the matter. [24214/14]

Tom Fleming

Question:

502. Deputy Tom Fleming asked the Minister for Health if he will make available the MS drug Fampyra at an early date as it is the only drug that assists MS patients in their walking; and if he will make a statement on the matter. [24356/14]

Jonathan O'Brien

Question:

504. Deputy Jonathan O'Brien asked the Minister for Health if he will ensure that Fampyra will be made available on the medical card; and his plans to ensure that those who have benefited from Fampyra may continue to take this drug regardless of financial circumstances. [24364/14]

Dara Calleary

Question:

572. Deputy Dara Calleary asked the Minister for Health if a drug (details supplied) can be re-registered on the long-term illness scheme. [24796/14]

Written answers

Minister of State at the Department of Health

I propose to take Questions Nos. 467, 470, 502, 504 and 572 together.

Fampridine (Fampyra®) was never available to MS patients through the community drugs schemes, including the Long Term Illness (LTI) Scheme. I understand the manufacturer of Fampyra supplied the drug free of charge to some patients prescribed the drug by their clinician. However, the manufacturer has recently decided to stop supplying the drug free of charge and, as a consequence, these patients are now faced with financing the drug themselves if they wish to continue with this drug treatment.

The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013.

The HSE received an application for the inclusion of Fampridine in the GMS and community drugs schemes. The application was 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 National Centre for Pharmacoeconomics (NCPE) conducted a pharmacoeconomic evaluation of Fampridine and concluded that, as the manufacturer was unable to demonstrate the cost effectiveness of Fampridine in the Irish health care setting, it was unable to recommend the reimbursement of the product. The report is available on the NCPE's website (www.ncpe.ie). 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. Due to the very difficult and challenging economic environment in which the Government targeted additional savings in health expenditure of €619 million in 2014, which must be achieved while protecting front line services to the most vulnerable to the greatest extent possible, the HSE decided it was not in a position to add the drug to the List of Reimbursable Items supplied under the GMS and other community drug schemes.

It is open to the supplier, at any time, to submit a new application to the HSE incorporating new evidence which demonstrates the cost effectiveness of Fampridine. The HSE will then re-consider the application to add this product to the List of Reimbursable Items, in line with the agreed procedures and timescales for the assessment of new medicines.

Dental Services Provision

Questions (468)

Patrick O'Donovan

Question:

468. Deputy Patrick O'Donovan asked the Minister for Health the funding assistance available for persons who cannot afford major dental work for children under the age of 16; and if he will make a statement on the matter. [24178/14]

Written answers

Minister of State at the Department of Health

Such funding assistance is not available as dental services for children up to 16 years of age and persons of all ages with special needs are provided by the Public Dental Service of the HSE through its dental clinics. All HSE dental clinics prioritise emergency care for children up to 16 years of age, treatment for special needs patients and screening of children aged from 11 to 13 years, including referral for orthodontic services where necessary. The HSE provides orthodontic treatment to patients based on their level of clinical need. Oral and maxillofacial surgery is also provided in hospitals. Other services, including screening of children 6 to 8 years, are provided but may be deferred in clinics where there is pressure on resources.

Health Services Staff Recruitment

Questions (469)

Martin Heydon

Question:

469. Deputy Martin Heydon asked the Minister for Health the reason for the change to remove the mandatory requirement for a third level qualification in the eligibility criteria for the recruitment of senior management positions in the new hospital groups; if this will be reviewed; and if he will make a statement on the matter. [24196/14]

Written answers

Minister for Health

As this is an operational matter, I have referred the question to the HSE for direct reply.

Question No. 470 answered with Question No. 467.

Medical Card Delays

Questions (471)

Pearse Doherty

Question:

471. Deputy Pearse Doherty asked the Minister for Health the reason for the delay in processing the medical card application of a family (details supplied) in County Donegal; if same will be processed as a matter of urgency; and if he will make a statement on the matter. [24220/14]

Written answers

Minister of State at the Department of Health

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 Delays

Questions (472)

Pearse Doherty

Question:

472. Deputy Pearse Doherty asked the Minister for Health the reason for the delay in processing the medical card application in respect of a person (details supplied) in County Donegal; and if he will make a statement on the matter. [24221/14]

Written answers

Minister of State at the Department of Health

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.

Departmental Schemes

Questions (473)

Terence Flanagan

Question:

473. Deputy Terence Flanagan asked the Minister for Health the reward or bonus schemes in place for staff in his Department and in the Health Service Executive that highlight wasteful practices and cost savings that could be made; if he will outline the success of these schemes in the past five years; his plans to review the schemes in this area; and if he will make a statement on the matter. [24243/14]

Written answers

Minister for Health

A Staff Suggestion Scheme operating under the Department's Partnership banner was established in my Department in May 2013.

This structured Scheme is designed to proactively promote an ideas and innovation culture within the Department and facilitate staff, at all levels, with the opportunity to contribute as fully as possible to the Department's work. Ideas from all staff members on an individual or group basis in respect of any area of the Department or the health system that can lead to greater efficiencies or the achievement of improved performance are welcome through the Scheme.

The current Scheme will be reviewed by the Partnership Committee by the end of 2014 and this review, if appropriate, will include recommendations for changes to the operation of the Scheme.

The HSE has no reward or bonus schemes in place and has had no performance reward scheme since 2007.

Health Services Staff

Questions (474)

Terence Flanagan

Question:

474. Deputy Terence Flanagan asked the Minister for Health if there are exit interviews for those working in front-line positions who leave the health service; and if he will make a statement on the matter. [24244/14]

Written answers

Minister for Health

As this is an operational issue, I have referred the question to the HSE for direct reply.

National Children's Hospital

Questions (475)

Terence Flanagan

Question:

475. Deputy Terence Flanagan asked the Minister for Health the position regarding the new children's hospital; the budget, and timeframe involved; and if he will make a statement on the matter. [24245/14]

Written answers

Minister for Health

The new children's hospital is a commitment in the Programme for Government and is a priority for me and for this Government. The National Paediatric Hospital Development Board is responsible for delivering the new hospital on schedule, to optimal design and value for money. The Board’s membership reflects the skills and expertise required to achieve that, including construction, planning, engineering, procurement and architecture as well as clinical and stakeholder involvement. The Board is now in the final phase of the selection process for the appointment of a design team. The full design team is expected to be appointed shortly, following which design development will begin, with the aim of submitting an application for planning permission in February 2015. Construction is scheduled to commence in August 2015, and the transition of services to the new hospital is on schedule to commence at the end of 2018.

In October 2013, the Minister for Public Expenditure & Reform announced that up to €200m would be made available for the new children’s hospital from the sale of the National Lottery, adding to the existing €450m Exchequer funding and underlining the Government's commitment to the project. Philanthropic / non-Exchequer funding will be sought as appropriate. The business case for the hospital is currently being revised and updated, and this will set out outline capital costs for the hospital on the St James's campus and potential future revenue savings arising from operational efficiencies. Estimates set out in the revised business case will be reviewed and refined at each stage of the project.

Health Services

Questions (476)

Terence Flanagan

Question:

476. Deputy Terence Flanagan asked the Minister for Health the checks his Department or the Health Service Executive carry out to measure the experience of patients when they exit hospital or primary care centres; if there is a measurement in this area; and if he will make a statement on the matter. [24246/14]

Written answers

Minister for Health

As this is a service matter, the question has been referred to the HSE for attention and direct reply to the Deputy.

Health Services Staff

Questions (477)

Terence Flanagan

Question:

477. Deputy Terence Flanagan asked the Minister for Health the necessary management skills that middle and senior managers in the Health Service Executive have; the continued professional training and development to which managers are subject; and if he will make a statement on the matter. [24247/14]

Written answers

Minister for Health

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

Health Services Staff

Questions (478)

Terence Flanagan

Question:

478. Deputy Terence Flanagan asked the Minister for Health if he has considered having all middle and senior management spend a day in the life of a patient in order that they know what a patient's experience is; and if he will make a statement on the matter. [24248/14]

Written answers

Minister for Health

As this is a service matter, the question has been referred to the HSE for attention and direct reply to the Deputy.

Health Services

Questions (479)

Terence Flanagan

Question:

479. Deputy Terence Flanagan asked the Minister for Health if he has considered a national health check for humans to be proactive regarding people's well-being and health; and if he will make a statement on the matter. [24249/14]

Written answers

Minister for Health

Healthy Ireland - the Framework for Improved Health and Wellbeing 2013 – 2025 is the national framework for action to improve the health and well-being of the country over the coming generations. Healthy Ireland supports a whole-of-government approach to address the determinants and predictors of health and well-being, many of which fall outside the health sector, e.g. housing, transportation, education, workplaces and environment along with an individual’s socioeconomic status.

Critical to the success of Healthy Ireland is an active, central Government policy driven approach where Healthy Ireland’s actions are systematically embedded into the policies and programmes of relevant government departments, local authorities and statutory agencies. It is equally important that there is active engagement at local level, empowering and encouraging individuals to take the steps which they may need to take to protect their own health and well-being.

Early detection and prevention are an integral part of our health strategy. It is intended that this will be a focus of a new GP contract and many screening programmes are currently under way in our health Service.

Primary Care Centre Provision

Questions (480)

Terence Flanagan

Question:

480. Deputy Terence Flanagan asked the Minister for Health if he will provide an update on his proposed primary care centres to include the budget, services to be provided and the date on which they will open; and if he will make a statement on the matter. [24250/14]

Written answers

Minister of State at the Department of Health

The development of primary care is central to the Government's objective to deliver a high quality, integrated and cost effective health care system. Supporting infrastructure, procured through a combination of public and private investment, will facilitate the delivery of multi-disciplinary primary health care. Considerable progress has been achieved to date. 37 primary care centres have been opened since March 2011 and infrastructure development is underway or planned at a further forty three locations.

In addition to the rank of the locations as a result of the 2012 prioritisation exercise, the mechanism and timescale for delivery of primary care infrastructure is dependent on a number of factors including GP participation. Regardless of the delivery mechanism, all potential primary care centres are also subject to suitable locations being offered/provided/available and to successful planning processes. In addition, the operational lease mechanism is subject to market pressures such as the developers' access to sufficient financing.

As regards the PPP project, the National Development Finance Agency (NDFA) published a Prior Indicative Notice (PIN) / Pre-Qualification Questionnaire in the OJEU on 19 December 2013. Four submissions were received by the closing date which was 10 March 2014. Information can be located at the following web address - http://www.ndfa.ie/TenderCompetitions/PrimaryCareCentresPPPProgramme.htm. It is expected that 10-14 sites (indicative number 12 based on affordability) will be delivered as part of a single PPP contract with the remaining centres to be delivered by the HSE using other procurement means.

As with all capital projects this programme must be considered within the overall capital envelope available to the health service. There will always be more projects than can be funded by the Exchequer. There is limited funding available for new projects over the period 2014-2018 given the level of commitments and the costs to completion already in place. Nevertheless, where possible, the HSE's capital programme will include provision to progress primary care centres with the highest ranking following the 2012 national prioritisation exercise by direct/own-build in the event that other delivery mechanisms are not feasible.

It is expected that the PPP primary care locations will be delivered by late 2016 / early 2017 and that the locations underway by HSE direct/own-build and the lease initiative will be delivered over the period 2014 to 2016.

As regards budget, the construction costs in relation to the lease initiative PCCs are borne by the developer. For reasons of commercial sensitivity, it would not be appropriate at this stage to provide estimated construction costs for the PPP project or those to be delivered by HSE direct/own-build.

Health care services to be delivered at the PPP locations will include General Practitioner (GP) services and in addition a number of centres will include a wider range of community based services, for example, dental services, community mental health services, child and adolescent mental health services, early intervention teams, and doctor on call services.

The following spreadsheet provides the information on primary care infrastructure available at end April 2014.

- Primary care infrastructure opened since March 2011

- Primary care infrastructure underway

- The PPP project.

Primary Care Centres opened since March 2011	-	-	-	Update at 30 April 2014	-
Count	HSE Region	County / Area	PCT Name / Location	Delivery Method	Open
1	DML	Dublin	Inchicore	Direct Build	2011 Q4
2	DML	Dublin	Ballyfermot	Direct Build	2012 Q3
3	DML	Dublin	Rathfarnham	Lease	2012 Q4
4	DML	Dublin	Churchtown	Operational Lease	2012 Q4
5	DML	Dublin	Dublin City at James's St	Operational Lease	2012 Q4
6	DML	Kildare	Newbridge	Operational Lease	2013 Q2
7	DML	Laois	Portarlington	Operational Lease	2011 Q3
8	DML	Longford	Longford Town	Operational Lease	2013 Q2
9	DML	Westmeath	Athlone at Clonbrusk	Operational Lease	2014 Q1
10	DML	Dublin	Bride St / Liberties (Old Meath Hospital Campus)	Operational Lease	2014 Q2
11	DNE	Dublin	Blanchardstown	Operational Lease	2013 Q4
12	DNE	Meath	Dunshaughlin	Direct Build	2012
13	DNE	Meath	Ashbourne	Operational Lease	2013 Q1
14	DNE	Meath	Summerhill	Operational Lease	2014
15	DNE	Louth	Carlingford	Direct Build	2012
16	DNE	Louth	Ardee	Direct Build	2012
17	DNE	Cavan	Cootehill	Direct Build	2012
18	DNE	Cavan	Bailieborough	Direct Build	2012 Q4
19	DNE	Cavan	Cavan Town	Operational Lease	2012 Q1
20	DNE	Cavan	Kingscourt	Operational Lease	2012 Q3
21	DNE	Cavan	Cavan Town at Connolly Court	Operational Lease	2013 Q2
22	South	Wexford	Gorey	Operational Lease	2012 Q3
23	South	Kilkenny	Kilkenny at Grange's Road	Operational Lease	2011 Q3
24	South	Kilkenny	Callan	Operational Lease	2011 Q3
25	South	Waterford	Tramore	Operational Lease	2011 Q4
26	South	Cork / South Lee	Cork City at Mahon	Operational Lease	2011 Q4
27	South	Cork / North Lee	Macroom	Operational Lease	2012 Q1
28	South	Cork	Schull	Operational Lease	2013 Q4
29	South	Kerry	Kenmare	Operational Lease	2012 Q3
30	South	Kerry	West Kerry (Dingle)	Direct Build	2013
31	West	Limerick	Limerick City at Abbey St Mary's	Operational Lease	2012 Q1
32	West	Galway	Galway City East	Operational Lease	2011 Q2
33	West	Galway	Athenry	Operational Lease	2013 Q3
34	West	Mayo	Ballina	Operational Lease	2011 Q2
35	West	Roscommon	Castlerea	Operational Lease	2012 Q3
36	West	Roscommon	Monksland South Roscommon	Operational Lease	2012 Q4
37	West	Donegal	Glenties	Direct Build	2012 Q3

Primary Care Centres Infrastructure - Underway	-	-	-	Update at 30 April 2014
Count	HSE Region	County / Area	PCT Name / Location	Delivery Method
1	DML	Wicklow	South Wicklow / Carnew	Operational Lease
2	DML	Wicklow	Wicklow Town	Operational Lease
3	DML	Dublin	Kilnamanagh / Tymon	Operational Lease
4	DML	Kildare	Clane	Operational Lease
5	DML	Kildare	Rathangan / Monasterevin	Operational Lease
6	DML	Dublin	Springfield	Operational Lease
7	DML	Longford	Edgeworthstown	Direct-own / build
8	DNE	Dublin	Finglas	Direct-own / build
9	DNE	Dublin	Grangegorman	Direct-own / build
10	DNE	Dublin	Corduff	Direct-own / build
11	DNE	Meath	Laytown / Bettystown	Direct-own / build
12	DNE	Monaghan	Monaghan Town	Direct-own / build
13	South	Carlow	Tullow / Rathvilly / Hacketstown	Direct-own / build
14	South	Cork	Cork City NW at St Mary's Hospital Campus	Direct-own / build
15	South	Cork	Carrigtwohill	Operational Lease
16	South	Cork	Kinsale	Operational Lease
17	West	Limerick	Limerick City - Market / Garryown	Operational Lease
18	West	Limerick	Limerick City - Castletroy	Operational Lease
19	West	Galway	Loughrea	Direct-own / build
20	West	Mayo	Swinford	Operational Lease
21	West	Sligo	Sligo Town at Nazareth House	Direct-own / build
22	West	Leitrim	Manorhamilton	Direct-own / build
23	West	Leitrim	Ballinamore	Direct-own / build
24	West	Leitrim	Carrick-on-Shannon	Operational Lease
25	West	Donegal	Derrybeg / Bunbeg	Operational Lease
26	West	Donegal	Ballyshannon	Direct-own / build
27	West	Donegal	Dungloe	Direct-own / build

Primary Care Centres - PPP Project	-	-	Update at 30 April 2014
Count	HSE Region	County / Area	PCT Name / Location
1	DML	Kildare	Kilcock
2	DML	Dublin	Crumlin / Drimnagh at Curlew Road
3	DML	Dublin	Knocklyon / Rathfarnham
4	DNE	Dublin	Coolock / Darndale
5	DNE	Dublin	Summerhill, north inner city
6	South	Wexford	Wexford Town
7	South	Waterford	Dungarvan
8	South	Waterford	Waterford City
9	South	Tipperary	Carrick-on-Suir
10	West	Limerick	Limerick City
11	West	Galway	Tuam
12	West	Mayo	Claremorris
13	West	Mayo	Ballinrobe
14	West	Mayo	Westport
15	West	Sligo	Ballymote
16	West	Roscommon	Boyle

The Deputy's parliamentary question has been forwarded to the HSE for reply in relation to the health care services to be delivered from the PCC locations under way.