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Wednesday, 17 Sep 2014

Written Answers Nos. 1041-1084

Medical Card Applications

Questions (1042)

Tom Fleming

Question:

1042. Deputy Tom Fleming asked the Minister for Health the position regarding a medical card application in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [34050/14]

View answer

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.

Long-Term Illness Scheme Eligibility

Questions (1043, 1058, 1063, 1160)

Ciara Conway

Question:

1043. Deputy Ciara Conway asked the Minister for Health if the expert panel has finished its work or made any findings in terms of their review of illnesses for inclusion in the long-term illness scheme; and if he will make a statement on the matter. [34052/14]

View answer

Catherine Murphy

Question:

1058. Deputy Catherine Murphy asked the Minister for Health if he will consider adding irritable bowel disease and related chronic gastrointestinal disorders to the list of conditions covered under the long term illness scheme and to the list of illnesses which would create an entitlement to a medical card; and if he will make a statement on the matter. [34150/14]

View answer

Thomas Pringle

Question:

1063. Deputy Thomas Pringle asked the Minister for Health the progress made in the proposal to grant medical cards based on medical need; and if he will make a statement on the matter. [34171/14]

View answer

Billy Kelleher

Question:

1160. Deputy Billy Kelleher asked the Minister for Health if medium chain acyl coa will be considered as one of the qualifying illnesses for automatic entitlement for a medical card; and if he will make a statement on the matter. [32952/14]

View answer

Written answers

I propose to take Questions Nos. 1043, 1058, 1063 and 1160 together.

The Government decided that, in consultation with the Office of the Attorney General and the Department of Public Expenditure, the Minister for Health would revert to Government with options for providing eligibility for a range of health services on the basis of specific and defined medical conditions. The Government has not specified that a person with a particular medical condition, such as medium chain acyl coa, irritable bowel disease or related chronic gastrointestinal disorders, would qualify for a medical card per se. Instead, it will take into consideration the recommendations of specific medical conditions by an expert panel examining the issue.

In support of this work, the Director-General of the Health Service Executive established an Expert Panel to examine and recommend the range of medical conditions that should be considered as a basis of eligibility. The Expert Panel is chaired by Professor Frank Keane, past-president of the Royal College of Surgeons in Ireland and clinical lead of the National Clinical Programme for Surgery. The panel includes a range of 23 clinical experts from primary care, specialist services and therapies. The panel also includes a patient representative to ensure that the views of patients are central to the process. The Expert Panel is to report to the Director General of the HSE, who will then advise the Minister of the outcome of the deliberations of the Expert Panel.

The Long Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act, 1970 (as amended). Regulations were made in 1971, 1973 and 1975 specifying the conditions covered by the LTI Scheme, which are as follows: Acute Leukaemia; Mental handicap; Cerebral Palsy; Mental Illness (in a person under 16); Cystic Fibrosis; Multiple Sclerosis; Diabetes Insipidus; Muscular Dystrophies; Diabetes Mellitus; Parkinsonism; Epilepsy; Phenylketonuria; Haemophilia; Spina Bifida; Hydrocephalus; and conditions arising from the use of Thalidomide. There are no plans to extend the list of conditions covered by the LTI Scheme.

Medical Card Applications

Questions (1044)

Tom Fleming

Question:

1044. Deputy Tom Fleming asked the Minister for Health the position regarding a medical card application in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [34058/14]

View answer

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 Eligibility

Questions (1045)

Bernard Durkan

Question:

1045. Deputy Bernard J. Durkan asked the Minister for Health if he will review the eligibility for a medical card in the case of a person (details supplied) in County Mayo; and if he will make a statement on the matter. [34060/14]

View answer

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.

Question No. 1046 answered with Question No. 869.

Nursing Homes Support Scheme Administration

Questions (1047)

Finian McGrath

Question:

1047. Deputy Finian McGrath asked the Minister for Health if he will support a matter (details supplied) regarding the fair deal scheme; and if he will make a statement on the matter. [34087/14]

View answer

Written answers

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

Nursing Homes Support Scheme Administration

Questions (1048)

Finian McGrath

Question:

1048. Deputy Finian McGrath asked the Minister for Health his views on a matter (details supplied) regarding the fair deal scheme; and if he will make a statement on the matter. [34088/14]

View answer

Written answers

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

Hospital Services

Questions (1049)

Dara Calleary

Question:

1049. Deputy Dara Calleary asked the Minister for Health his views on the operation of the cancer centre at University Hospital Galway; if he will provide a response to the Health Service Executive risk reports into the operation of the centre; if he will instruct the HSE to increase the number of beds at UCHG that are available to cancer patients; and if he will provide a statement on the operation of the National Cancer Control Program in the West of Ireland. [34108/14]

View answer

Written answers

University Hospital Galway is one of 8 designated cancer centres in Ireland. It has a dedicated floor of 52 in-patient beds for cancer services, including haematology, oncology and radiotherapy. Cancer patients are also cared for in other medical wards in the hospital as required. Services at the hospital also include diagnostic, therapeutic and palliative care teams, as well as translational research, clinical trials and bio banking. A Cancer Care West lodge at University Hospital Galway provides accommodation for patients travelling from outside Galway for radiotherapy treatment.

It is not proposed to increase the number of beds for cancer services in University Hospital Galway.

Hospital Transfers

Questions (1050)

Dara Calleary

Question:

1050. Deputy Dara Calleary asked the Minister for Health the procedures in place for the transfer of cancer patients from Mayo General Hospital to the cancer centre at UCHG; and if he will make a statement on the matter. [34109/14]

View answer

Written answers

The Deputy's question relates to service delivery matters and accordingly I have asked the HSE to respond directly to him.

Ambulance Service Provision

Questions (1051)

Dara Calleary

Question:

1051. Deputy Dara Calleary asked the Minister for Health if he will provide in tabular form the number of ambulances in service in County Mayo, showing emergency ambulance, transfer ambulance, intermediate care and so on, the year and mileage of each ambulance and the conditions of ambulances in County Mayo. [34110/14]

View answer

Written answers

As this is a service matter, I have asked the HSE to respond directly to the Deputy.

Ambulance Service Provision

Questions (1052)

Dara Calleary

Question:

1052. Deputy Dara Calleary asked the Minister for Health the number of occasions in 2013 and to date in 2014 that all of the ambulances on call at any one time based at bases in County Mayo have been outside of the county. [34111/14]

View answer

Written answers

As this is a service matter, I have asked the HSE to respond directly to the Deputy.

Ambulance Service Provision

Questions (1053)

Dara Calleary

Question:

1053. Deputy Dara Calleary asked the Minister for Health the plans for the commissioning of ambulance bases in Mulranny, County Mayo and in Loughlynn, County Roscommon; his plans to allow the Health Service Executive to recruit extra staff to open the units; the total amount of current staff employed by the ambulance service in County Mayo and separately in County Roscommon; if he will provide that information in tabular form showing the grades of those employed; and if he will make a statement on the provision of ambulance services in County Mayo and County Roscommon. [34112/14]

View answer

Written answers

As this is a service matter, I have asked the HSE to respond directly to the Deputy.

Medical Card Applications

Questions (1054)

Michael Healy-Rae

Question:

1054. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a medical card application in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [34121/14]

View answer

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.

Hospital Appointments Status

Questions (1055)

Dara Calleary

Question:

1055. Deputy Dara Calleary asked the Minister for Health when a hospital appointment will be confirmed in respect of a person (details supplied) in County Roscommon; if he will expedite the appointment in view of the long delay experienced; and if he will make a statement on the matter. [34122/14]

View answer

Written answers

In 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.

Medical Card Administration

Questions (1056)

Sandra McLellan

Question:

1056. Deputy Sandra McLellan asked the Minister for Health if he will restore Daxas under the medical card scheme primarily as it keeps sufferers of chronic lung disease out of hospital and in view of the fact that there is no other substitute. [34132/14]

View answer

Written answers

Under the Health (Pricing and Supply of Medical Goods) Act 2013, the Health Service Executive (HSE) has statutory responsibility for the administration of the primary care schemes, therefore the matter has been referred to the HSE for attention and direct reply to the Deputy.

Health Insurance Cover

Questions (1057)

Billy Kelleher

Question:

1057. Deputy Billy Kelleher asked the Minister for Health the number of persons availing of private health insurance at the end of June 2014 in each of the age groups, 17 years and under, 18 to 29 years, 30 to 39 years, 40 to 49 years, 50 to 59 years, 60 to 69 years, 70 to 79 years, 80 years and over. [34134/14]

View answer

Written answers

The Health Insurance Authority, the independent statutory regulator of the private health insurance market in Ireland, provides my Department with Information Returns on a twice-yearly basis showing the numbers insured with in-patient health insurance plans in each age category. This data is compiled in respect of the commercial health insurers and excludes people serving waiting periods and members of Restricted Membership Undertakings (which provide insurance to people who are members of a particular group, normally a vocational group or employees of a particular organisation).

Aged 17 and under: 452,979

Aged 18-29 years: 204,473

Aged 30 to 39 years: 286,310

Aged 40-49 years: 292,718

Aged 50 to 59 years: 261,057

Aged 60 to 69 years: 215,475

Aged 70 to 79 years: 121,637

Aged 80 years and over: 49,925

Question No. 1058 answered with Question No. 1043.

Nursing Homes Support Scheme Administration

Questions (1059)

Michael Lowry

Question:

1059. Deputy Michael Lowry asked the Minister for Health the average waiting time for funding to be released to successful applicants under the fair deal scheme; the way this compares to the waiting period at the same time last year; if he will expedite the release of funding to successful applicants in light of the financial hardship and distress being caused to applicants and the families of applicants; and if he will make a statement on the matter. [34154/14]

View answer

Written answers

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

Hospital Facilities

Questions (1060)

Finian McGrath

Question:

1060. Deputy Finian McGrath asked the Minister for Health the position regarding the boundary issue between a hospital and a housing estate (details supplied) in Dublin 9; the timeframe of the implementation of condition 5 in relation to the temporary gateway into a property (details supplied) for the emergency services vehicles; and if he will make a statement on the matter. [34158/14]

View answer

Written answers

As this is a service matter, I have asked the HSE to respond directly to the Deputy.

Mental Health Services Provision

Questions (1061)

Finian McGrath

Question:

1061. Deputy Finian McGrath asked the Minister for Health his plans to reduce violence in relation to mental health patients (details supplied); and if he will make a statement on the matter. [34159/14]

View answer

Written answers

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

Question No. 1062 answered with Question No. 824.
Question No. 1063 answered with Question No. 1043.

Medical Card Administration

Questions (1064, 1065)

Dara Calleary

Question:

1064. Deputy Dara Calleary asked the Minister for Health when a cancer drug, Vismodegib, will be added to the medical card scheme; and if he will make a statement on the matter. [34175/14]

View answer

Michelle Mulherin

Question:

1065. Deputy Michelle Mulherin asked the Minister for Health the position regarding approval of Vismodegib (details supplied); if he will temporarily approve it as an interim measure while the National Centre for Pharmacoeconomics continues its negotiations with the supplier-manufacturer; and if he will make a statement on the matter. [34181/14]

View answer

Written answers

I propose to take Questions Nos. 1064 and 1065 together.

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, therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Health Insurance Cover

Questions (1066)

Finian McGrath

Question:

1066. Deputy Finian McGrath asked the Minister for Health the position regarding the effect of the Government health insurance levy increase and the reduction of tax relief in relation to private health insurance on the public health system; and if he will make a statement on the matter. [34184/14]

View answer

Written answers

Under the Health Act 1970, everyone who is ordinarily resident in Ireland qualifies for public hospital care. Notwithstanding this, 43.9% of the Irish population has private health insurance and many people opt to be treated privately. The Irish hospital system contains a mix of public and private hospitals, with public hospitals treating both public and private patients. On admittance to a public hospital, patients make a choice to be treated by a medical consultant on a public or private basis.

It is not known how many persons who previously held private health insurance will subsequently present for medical treatment in a public hospital setting over a future period of time, nor is it possible to predict with any certainty how many people currently holding private health insurance will instead choose to be treated as a public patient, as they are fully entitled to do.

My Department will continue to oversee the maintenance of a competitive and sustainable private health insurance market, under the provisions of the Health Insurance Acts 1994 to 2013 and to monitor developments on an ongoing basis, to ensure that the market is regulated appropriately to meet the objectives in the health reform programme.

Accident and Emergency Department Waiting Times

Questions (1067, 1129)

Billy Kelleher

Question:

1067. Deputy Billy Kelleher asked the Minister for Health his views on the statement by the chief executive officer of Beaumont Hospital, Dublin 9, that the hospital is currently unsafe for patients; the action he proposes to take in this regard; and if he will make a statement on the matter. [34192/14]

View answer

Thomas P. Broughan

Question:

1129. Deputy Thomas P. Broughan asked the Minister for Health the steps he will take to address concerns recently outlined by the chief executive of Beaumont Hospital regarding overcrowding and lengthy delays for patients seeking treatment at the hospital. [34757/14]

View answer

Written answers

I propose to take Questions Nos. 1067 and 1129 together.

Beaumont Hospital manages admissions and discharges hourly each day through its Patient Flow hub. On average the hospital currently admits 27% of those attending to the Emergency Department (between 900 and 1,000 per week) and aims to ensure that the 73% of patients who do not require admission are seen in a timely way and are assessed and treated appropriately. Patients of other key areas such as oncology, radiation oncology, emergency neurosurgery and kidney disease may also be admitted directly to those specialties as emergencies if the acuity of their condition requires admission. In the circumstances where admissions exceed discharges the hospital's Escalation Policy is activated.

The hospital recognises that overcrowding in the ED represents a potential safety issue and therefore escalation measures are designed to alleviate such problems. The purpose of the Escalation Policy is to ensure safe patient care by moving patients to inpatient beds as expeditiously as possible.

On Wednesday 27 August, the escalation measures already in place were not sufficiently effective to alleviate a surge of pressure in ED. Further escalation was requested by the CEO and Lead Clinical Director in an internal communication to the consultant body, to ensure that patient safety was not acutely compromised by this surge. Further discharges were made during the remainder of the week and the situation stabilised by Friday 29 August.

The Department and the HSE (National Clinical Care Programmes, SDU, and the Acute Hospitals Directorate) are seeking to achieve sustainable change through the use of key metrics, aligned with a suite of resources to support hospitals to deliver on performance measures, build capacity and  enhance capability so as to improve the overall quality of the patient journey. In addition, measures involving the full health system including primary, community and continuing care services, are regularly invoked to ensure that all available capacity and options are utilised and brought to bear on surges such as that which arose on 27 August in Beaumont.

Medical Card Reviews

Questions (1068)

Bernard Durkan

Question:

1068. Deputy Bernard J. Durkan asked the Minister for Health the progress made to date in the determination of a medical card review in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [34193/14]

View answer

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.

Hospital Services

Questions (1069)

Patrick O'Donovan

Question:

1069. Deputy Patrick O'Donovan asked the Minister for Health his plans to instate a paediatric endocrinologist at University Hospital Limerick; if he will provide details of the current endocrinology service available in County Limerick and the current waiting times for consultations; and if he will make a statement on the matter. [34194/14]

View answer

Written answers

As this is a service matter, I have asked the HSE to respond directly to the Deputy.

Medical Card Eligibility

Questions (1070)

Bernard Durkan

Question:

1070. Deputy Bernard J. Durkan asked the Minister for Health if a medical card will be renewed in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [34195/14]

View answer

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.

Hospital Staff Recruitment

Questions (1071)

Pádraig MacLochlainn

Question:

1071. Deputy Pádraig Mac Lochlainn asked the Minister for Health his plans to deal with the ongoing failure of the Health Service Executive to ensure that training colleges here are providing the requisite number of non-consultant hospital doctors and interns to hospitals throughout the State. [34205/14]

View answer

Written answers

As Minister for Health, the recruitment and retention of doctors – including NCHDs and interns – in the public health system is a priority for me. That is why I am committed to the implementation of the recommendations of the Strategic Review of Medical Training and Career Structure completed earlier this year. The Strategic Review reports identify a range of issues impacting on the recruitment and retention of doctors in our system, and offer solutions and recommendations that will enable us to build a sustainable medical workforce for the future. My Department and the HSE are currently working together to put in place arrangements to oversee the continued implementation of the recommendations of the Review.

With regard to intern training posts, under the provisions of the Medical Practitioners Act 2007 it is a matter for the Health Service Executive (HSE) to assess, on an annual basis, the number of intern training posts required by the health service. My Department is in regular contact with the HSE in relation to the issue of intern places with the aim, in so far as is possible, of providing a sufficient number of intern places for Irish/EU graduates from Irish medical schools.

In recent years the HSE has embarked on a process of expanding the number of posts to meet the demand of the growing number of graduates from Irish medical schools. In 2012 the number of intern posts available was 572, and in 2013 this increased to 640 positions. In 2014 an additional 45 intern places were created, resulting in 685 intern posts being available for the academic year 2014–2015.

Hospital Staff Data

Questions (1072)

Pádraig MacLochlainn

Question:

1072. Deputy Pádraig Mac Lochlainn asked the Minister for Health the numbers of non-consultant hospital doctors, NCHDs, that are employed on a locum basis in hospitals throughout the State; the numbers of NCHDs that are employed on a contract basis; and the difference in cost to employ a NCHD on a locum basis as opposed to a contract basis. [34206/14]

View answer

Written answers

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

Cosmetic Surgery

Questions (1073)

Ruth Coppinger

Question:

1073. Deputy Ruth Coppinger asked the Minister for Health his views on the regulation of the advertising of elective ophthalmology procedures, such as laser refractive surgery; and his views regarding any inappropriate sales practices that may exist. [34214/14]

View answer

Written answers

Following concerns expressed in relation to the safety and quality of surgical cosmetic procedures in Ireland, the Office of the Chief Medical Officer prepared, in collaboration the Irish Association of Plastic Surgeons, a short guideline containing a number of recommendations for individuals who may be considering surgical cosmetic procedures. Much of this guidance and the recommendations for patients, which was issued in July 2012, is equally relevant to those patients considering laser refractive surgery and cosmetic procedures. The guidance is available on the Department's website.

With regard to the provision of information to the public and advertising by a registered medical practitioner, the Medical Council guidance states that a medical practitioner must make sure that the information published in the advertisement is true, verifiable, does not make false claims or have the potential to raise unrealistic expectations. This should include information about any inherent risks associated with the services provided.

All medical and surgical procedures contain a certain element of risk and patients should seek to inform themselves of both the risks and benefits of any procedures before making a decision to proceed. A very important consideration is the qualifications of the person carrying out the procedure and the quality of care and after-care provided.

Alcohol Pricing

Questions (1074)

Seán Kyne

Question:

1074. Deputy Seán Kyne asked the Minister for Health the progress to date in introducing legislative measures concerning minimum unit pricing for alcohol; and the level of engagement between his Department and the Department of Justice and Equality in relation to legislative measures regarding the sale of alcohol. [34218/14]

View answer

Written answers

The Government has approved an extensive package of measures to deal with alcohol misuse to be incorporated in a Public Health (Alcohol) Bill. These measures are based on the recommendations contained in the Steering Group Report on a National Substance Misuse Strategy, 2012. The package of measures to be implemented will include provision for minimum unit pricing, regulation of the marketing and advertising of alcohol, regulation of sports sponsorship, structural separation of alcohol from other products in mixed trading outlets and labelling of alcohol products. Work on developing a framework for the necessary Department of Health legislation is continuing and is hoped to publish a General Scheme of a Bill in the Autumn.

My Department and the Department of Justice and Equality are engaging on a regular basis on alcohol control measures being taken by the respective Departments.

Medicinal Products Availability

Questions (1075)

Seán Kyne

Question:

1075. Deputy Seán Kyne asked the Minister for Health if additional funding can be allocated to the Health Service Executive West so that insulin pump treatment for young persons aged five and over with diabetes can commence immediately, thus ending a regional disparity and in light of the training that has already been provided to parents and patients in the use of this innovative treatment; and if he will make a statement on the matter. [34225/14]

View answer

Written answers

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

Hospital Staff

Questions (1076)

Seán Kyne

Question:

1076. Deputy Seán Kyne asked the Minister for Health the progress to date in ensuring compliance with the EU's working time directive, with particular reference to junior hospital doctors; and if he will make a statement on the matter. [34226/14]

View answer

Written answers

The provisions of the European Working Time Directive encompass a number of measures to protect workers' welfare and safety, including a maximum 48 hour working week - averaged over a reference period, the granting of breaks, minimum daily and weekly rest periods and the granting of compensatory rest where the working day exceeds 13 hours.

The HSE is focused on advancing implementation of the Directive and progress has been made in respect of NCHDs. Data from the HSE shows that average working hours for NCHDs in 2009 was 60 hours a week, 54 hours per week in 2012 and just over 51 hours at the end of 2013. Intensive negotiations conducted at the Labour Relations Commission in September and October 2013 resulted in agreement on a joint approach, involving hospital management, the IMO and NCHDs to achieve EWTD compliance, with an immediate focus on eliminating shifts in excess of 24 hours. Data for June 2014 shows 93% compliance with this target, and 99.5% compliance in relation to elimination of working weeks in excess of 68 hours.

NCHD recruitment and retention is required in order to facilitate the achievement of EWTD compliance. Achievement of full compliance will also require reorganisation of the delivery of certain services within Hospital Groups.

In the July 2014 NCHD rotation there have been additional posts created to achieve EWTD compliance. These are incorporated into the overall recruitment process. Given the additional numbers in the system, the net effect is that with the July 2014 intake there are more NCHDs currently employed than for the same time period in 2013. The ongoing issue for hospital services remains the preference for NCHDs to take positions in major teaching sites in greater urban areas. Where posts are vacant and suitable candidates cannot be sourced, locums are retained or alternative arrangements are made to ensure the continued delivery of the service. However, the intention is to move to a position where reliance on agency to fill posts is minimised and permanent staff are appointed.

Health Services Reform

Questions (1077, 1078, 1079)

Billy Kelleher

Question:

1077. Deputy Billy Kelleher asked the Minister for Health in relation to the proposed project 86156-3402 in the provision of a patient level costing system, if he will provide a breakdown of the costings involved in the pilot project; and if he will make a statement on the matter. [34275/14]

View answer

Billy Kelleher

Question:

1078. Deputy Billy Kelleher asked the Minister for Health in relation to the proposed project 86156-3402 in the provision of a patient level costing system, if he will detail all the parties-users who will have access to this shared information; and if he will make a statement on the matter. [34276/14]

View answer

Billy Kelleher

Question:

1079. Deputy Billy Kelleher asked the Minister for Health in relation to the proposed project 86156-3402 in the provision of a patient level costing system, the way this scheme will be funded; and if he will make a statement on the matter. [34277/14]

View answer

Written answers

I propose to take Questions Nos. 1077 to 1079, inclusive, together.

A Patient Level Costing (PLC) system is being introduced in the context of the implementation of a new funding system for public hospital care called Money Follows the Patient (MFTP). Phase 1 of MFTP commenced in January 2014 and full implementation will take a number of years. MFTP involves moving away from inefficient block grant budgets to a system where hospitals are paid for the actual level of activity undertaken. As such, hospitals will be funded based on the quantity of the services they deliver to patients. They will be liberated, subject to overall budgetary ceilings, to pursue the most cost-effective means of delivering quality care. Budgetary discipline will be delivered through the use of fixed budgets for MFTP activity. The MFTP approach is initially being applied to inpatient and day-case activity in public hospitals. However, it is intended that the payment system will extend over time to cover other hospital activity and community care.

An effective PLC system is essential for the proper operation of the MFTP process. It will enable hospitals to understand their costs and, therefore, to operate effectively in the MFTP funding environment. Although a pilot PLC project has been underway since 2010, the PLC function must now be embedded across all hospitals. This will require investment in skills and also in PLC IT systems and feeder IT systems to improve cost collection. The data provided by the PLC pilot is being used in conjunction with the current speciality costing methodology to set prices for services and this will continue when rolled out to more hospitals.

The HSE published an Invitation to Tender for a PLC System, to include knowledge transfer, in July of this year with a closing date of 26 August. The tenders are currently being evaluated and this process is expected to be completed by October. Assuming a successful outcome, it is intended to establish a contract for the provision of the solution the fourth quarter of this year.

I have asked the HSE to respond directly in relation to the additional detailed information requested by the Deputy.

Mental Health Services Provision

Questions (1080)

Thomas P. Broughan

Question:

1080. Deputy Thomas P. Broughan asked the Minister for Health his plans to build the new Central Mental Hospital on the grounds of St. Ita's Hospital, Portrane, County Dublin; the reason a decision was made to close some existing facilities at St. Ita’s Hospital and to relocate the Central Mental Hospital to the site; and if he will provide a timeline of when it is expected that the new CMH will be completed. [34296/14]

View answer

Written answers

As this is a service issue this question has been referred to the HSE for direct reply.

Mental Health Services Provision

Questions (1081)

Thomas P. Broughan

Question:

1081. Deputy Thomas P. Broughan asked the Minister for Health the number of psychiatric residents of St. Ita’s Hospital for the years 2011, 2012, 2013 and to date in 2014; the number of persons receiving psychiatric day services at St. Ita’s Hospital in those years; the current status of psychiatric services at St. Ita’s Hospital; and if he will provide a breakdown of where residents were transferred to upon the phased closure of some units at St. Ita's Hospital. [34297/14]

View answer

Written answers

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

Services for People with Disabilities

Questions (1082)

Thomas P. Broughan

Question:

1082. Deputy Thomas P. Broughan asked the Minister for Health the number of residents of St. Joseph's intellectual disability unit, located on the grounds of St. Ita's Hospital, Portrane, County Dublin, in the years 2011, 2012, 2013 and to date in 2014; and the number of people who received day services at St. Joseph's intellectual disability unit in those years. [34298/14]

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Written answers

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.

Hospital Staff Data

Questions (1083)

Pádraig MacLochlainn

Question:

1083. Deputy Pádraig Mac Lochlainn asked the Minister for Health if every hospital here complies with every aspect of the European working time directive; if he will provide the information in tabular form and on a hospital basis; and for the hospitals that do not comply in full, when those hospitals expect to be in a position to comply. [34341/14]

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Written answers

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

Medical Card Applications

Questions (1084)

Timmy Dooley

Question:

1084. Deputy Timmy Dooley asked the Minister for Health the status of a medical card application in respect of persons (details supplied) in County Clare in view of the decision of 17 June 2014 regarding discretionary medical cards and the fact that the file has been under review by a medical officer since early July 2014; and if he will make a statement on the matter. [34345/14]

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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.

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