Written Answers Nos. 281-91
281. Deputy Róisín Shortall asked the Minister for Health the reason a person (details supplied) in Dublin 9 was awarded a doctor visit card on discretionary grounds, while their spouse was awarded the full medical card on discretionary grounds. [31858/14]
View answerThe 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.
282. Deputy Terence Flanagan asked the Minister for Health the position regarding care centres (details supplied); and if he will make a statement on the matter. [31863/14]
View answerThe Programme for Government highlights the expansion of Primary Care Centres as a priority within the health capital budget. The National Service Plan 2014 provides for the procurement of an additional 21 Primary Care Centres this year. This will create an environment for improved access which will facilitate structured approaches to chronic disease management, enhanced multidisciplinary team working, improved diagnostic capabilities in Primary Care and the integration of services between primary and secondary care.
The Special Delivery Unit is actively driving system improvement in acute hospital services through regular liaison meetings with hospitals. Improvement is promoted through approaches including (but not limited to):
- Operational Management including Demand and Capacity planning capability;
- Use of predicted date of discharge;
- Early morning discharging (home by 11);
- 7 day discharging (underpinned by 7 day working);
- Whole system planning, involving community services;
- Greater use of transitional care, such as rehabilitation / step-down care; and
- Greater provision of home care packages.
All of these measures focus on enhancing patient flow, to ensure that capacity can be created to admit patients who require acute care. The key message remains that wider hospital clinical teams and community services must respond in a coordinated manner, to plan for demand and to maximise the responsiveness of services.
The HSE's Primary Care Division is also working with the Clinical Strategy and Programmes Directorate to improve access to diagnostic tests for GPs, particularly ultrasound. This will greatly assist in early diagnosis, hospital avoidance, greater integrated care and a better, safer, patient experience. This initiative is currently at development stage and it is planned to roll out this service initially in two pilot sites in 2014.
283. Deputy Tom Fleming asked the Minister for Health if the ceiling of the drugs scheme refund level will be reduced; and if he will make a statement on the matter. [31876/14]
View answerUnder 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.
There are no plans to alter the Drug Payment Scheme threshold.
284. Deputy Tom Fleming asked the Minister for Health if he will examine the file of a hip replacement patient (details supplied) in County Kerry; and if he will make a statement on the matter. [31881/14]
View answerThe 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.
In relation to the particular query raised by the Deputy, I have asked the HSE to respond directly to the Deputy on this matter.
285. Deputy Arthur Spring asked the Minister for Health if a further update will be provided regarding the waiting time for a public patient (details supplied) in County Kerry to receive an appointment for an eye operation in the South Infirmary-Victoria University Hospital, in Cork; and if he will make a statement on the matter. [31894/14]
View answerAs this is a service matter it has been referred to the HSE for direct reply.
286. Deputy Gerry Adams asked the Minister for Health the reason the Health Service Executive has decided to cut core funding to an association (details supplied) in County Wicklow by €500,000; if he recognises the detrimental effect such a cut will have to the invaluable range of services provided by this association; if he finds it acceptable that there was no consultation between the HSE and the association prior to the implementation of this cut; the future plans in place for this association; and if he will make a statement on the matter. [31897/14]
View answerAs the Deputy's question relates to service matters, I have arranged for the questions to be referred to the Health Service Executive for direct reply to the Deputy.
287. Deputy Tom Fleming asked the Minister for Health if he will reverse the exhorbitant levy on private health insurers for the use of private beds in public hospitals; and if he will make a statement on the matter. [31901/14]
View answerPrior to January 2014 private in-patients in public hospitals were subject to maintenance charges that generally ranged from €586 to €1,046 per day when they were accommodated in a private designated bed. However, in an emergency admission if a private designated bed was not available and a private in-patient was accommodated in a public bed, the maintenance charge was not levied, although the private in-patient continued to pay the fees of his/her hospital consultant.
The Comptroller and Auditor General estimated in his 2010 Annual Report that 45% of in-patients treated privately by their consultants were not charged for their maintenance in public hospitals because they were not occupying designated private beds. That situation represented a significant loss of income to the public hospital system and an indirect subsidy to private insurance companies, who cover most private patients. In effect, private patients were not meeting the costs of the hospital services they used. It was, and is, my belief that situation could not continue and that the new charges makes sense.
While everyone is entitled to use a public hospital, an essential element of the eligibility arrangements is that the public or private status of a patient must be specified on admission to hospital. Where a patient elects to be treated privately by a consultant the hospital must treat that patient as a private patient.
The Government believes that users of private services should pay for the costs of providing these services even when they are provided by a public hospital and on that basis introduced legislation in 2013 to amend Section 55 of the Health Act 1970 which provides for the charging of private in-patients. Since 1 January 2014, private in-patients in public hospitals are subject to charges that range from €329 to €1,000 per day. There are no plans to reverse this policy.
288. Deputy Jerry Buttimer asked the Minister for Health regarding data protection in the context of expanding use of ICT in the health sector, his views on whether patients' personal information and health data should be treated differently from other data types; and if he will make a statement on the matter. [31932/14]
View answer289. Deputy Jerry Buttimer asked the Minister for Health regarding data ownership, if his Department has considered the impact of different models of data ownership, for example, shared or pseudonymised, on the impact of research potential afforded by greater data collection with the expanding use of technology in the health sector. [31933/14]
View answer290. Deputy Jerry Buttimer asked the Minister for Health in the context of the proposed health information Bill, if measures will be implemented to ensure the accuracy of health data collected and the interoperability of such data in order to facilitate large scale research and studies into health and related matters; and if he will make a statement on the matter. [31934/14]
View answer291. Deputy Jerry Buttimer asked the Minister for Health regarding the proposed health information Bill, if the collection of health data by the public and private sectors, particularly private companies offering mobile health applications, will be treated differently; and if he will make a statement on the matter. [31935/14]
View answerI propose to take Questions Nos. 288 to 291, inclusive, together.
Ownership of personal data has been settled at common law as belonging to the person or body that created the record. However, it is the Data Protection Acts, based on the EU Data Protection Directive, which regulate the processing of personal data. Those Acts are configured on the basis of control of the personal data concerned. Accordingly, considerations concerning the collecting, use, sharing and disclosing of personal data and the anonymisation and pseudo-anonymisation of personal health data are necessarily shaped by the principles of data protection. One of those principles is that personal health data is to be regarded as sensitive personal data and therefore deserving of enhanced care by data controllers, particularly as regards security.
As the Deputy is aware, my Department has undertaken a number of initiatives in relation to health information in recent years with a view to improving the use of information and information technology in the health service. Of particular relevance, for the future, is the eHealth strategy which was launched in December 2013. A key element of that strategy is that access to the right information in the right place and at the right time is of paramount importance in underpinning patient care and progressing efficiency and effectiveness in the health delivery system.
In that regard, my predecessor also introduced the Health Identifiers Bill last December. That Bill, which is now enacted, provides for a system of unique patient identifiers along with identifiers for healthcare organisations and health professionals. This represents not only a major patient safety initiative in terms of ensuring correct identification at the point of care but it will also assist in ensuring that the patient’s medical information will always be uniquely associated with his or her records throughout the health system thereby helping the delivery of speedier and better individual care. The identifier system will also facilitate other desirable health reform initiatives such as money follows the patient.
It is important to point out that the Data Protection Commissioner was consulted extensively on the Bill. This was to ensure privacy considerations were fully addressed and reflected in the robust governance structure underpinning the Bill, including criminal sanctions for inappropriate use of the individual health identifier.
I intend to bring forward a Health Information Bill to Government later this year. The Bill will build on existing data protection legislation which already provides that personal health data collected and kept by data controllers has to be accurate and up to date and adequate, relevant and not excessive. That will continue under the Health Information Bill. Further, as a general principle, rules on the collecting, using and disclosing of personal data under the Data Protection Acts apply equally to data controllers in the private and public sectors and this will also continue to be the case under the Health Information Bill. This includes any persons offering mobile health applications where those applications collect personal data.
It is also envisaged that the Health Information Bill will contain a number of measures designed to enhance the processing of personal data for better patient care and safety at an individual level and the achievement of broader health service goals at a more general level. In doing so, the Bill will seek to balance the benefits of moving towards a modern integrated health care system with due regard to the need to continue to value the privacy and confidentiality of patient information. Such an approach is fundamental to maintaining public support for and confidence in a reforming health system. For that reason, it is also intended that the Bill will expressly provide for an offence in relation to the buying and selling of patient identifiable information. I know there have been recent concerns about this issue.
Health research is, of course, very important to a modern health system and it is intended that the Bill will contain measures designed to promote health research in Ireland: most notably through the creation of a new streamlined national research ethics approval structure for health research not otherwise governed by EU or national law ethics structures.
In all of the above, my Department has engaged extensively with a range of stakeholders in preparing the Health Identifiers Bill and the planned Health Information Bill: including, the Health Information and Quality Authority and the Office of the Data Protection Commissioner.
Consequently, I am of the view that the recent Health Identifiers Act and the forthcoming Health Information Bill along with the eHealth strategy can underpin a governance and development model that will promote public confidence in the increased use of information technology in the health sector and allow us to take advantage of the significant opportunities that such technology can offer.
