Tuesday, 2 Dec 2014

Written Answers Nos. 396-412

Water Fluoridation

Questions (396)

Finian McGrath

Question:

396. Deputy Finian McGrath asked the Minister for Health if fluoride in our water system is a dangerous neurotoxin; and if he will make a statement on the matter. [46057/14]

Written answers

Minister of State at the Department of Health

The level of fluoride in drinking water in Ireland has been set at between 0.6-0.8 parts per million. This level of fluoride is deemed optimal for protecting the oral health of all age groups. European Council Directive 98/83 allows for a maximum permitted concentration of fluoride in drinking water up to 1.5mg/litre (or parts per million), almost twice the maximum level permitted in Ireland. In 2011 a review by the European Union Scientific Committee on Health and Environmental Risk (SCHER) concluded that there are no known negative health implications from fluoridating water at levels used in the EU. The balance of scientific evidence worldwide confirms that water fluoridation, i.e. the adjustment of the natural concentration of fluoride in drinking water to the optimal recommended level for the prevention of dental caries, does not cause any ill effects and protects the oral health of the population.

A number of studies which claim an effect on children's IQ at very high levels of naturally occurring fluoride were assessed by the Irish Expert Body on Fluorides and Health in 2011. They were found to be of no relevance to Ireland, given our regulated fluoridation levels.

The most recent study on this topic reviewed by the Expert Body was the paper on 'Community Water Fluoridation and Intelligence: Prospective Study in New Zealand (Broadbent et al 2014). Broadbent et al state that 'findings do not support the assertion that fluoride exposure in the context of CWF (Community Water Fluoridation) can affect neurologic development or IQ". The study suggests that study members who lived in areas with CWF before age 5 years had slightly higher IQ's (on average) in adulthood than those who had not, although the difference was not statistically significant.

The Department of Health keeps the policy of water fluoridation under constant review. As part of this ongoing work, a review of evidence on the impact of water fluoridation at its current level on the health of the population is being conducted by the Health Research Board on behalf of the Department. This review is due to be completed by the end of this year.

HSE Funding

Questions (397)

Finian McGrath

Question:

397. Deputy Finian McGrath asked the Minister for Health the position regarding funding for a men's group in north Dublin (details supplied); and if he will make a statement on the matter. [46058/14]

Written answers

Minister of State at the Department of Health

As this is a service issue this question has been referred to the HSE for direct reply. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.

Vaccination Programme

Questions (398)

Billy Kelleher

Question:

398. Deputy Billy Kelleher asked the Minister for Health if his attention has been drawn to a continuing shortage of BCG vaccines; the action the Health Service Executive is taking to deal with same; and if he will make a statement on the matter. [46066/14]

Written answers

Minister for Health

I am aware that there are currently issues concerning the supply of BCG vaccine available in Europe. The Health Service Executive has been working to secure supplies of the vaccine as quickly as possible. The National Immunisation Office (NIO) has been informed by the contracted supplier that the earliest possible delivery date for the next shipment of the vaccine will be the week commencing December 8th.

Medical Card Applications

Questions (399)

Bernard Durkan

Question:

399. Deputy Bernard J. Durkan asked the Minister for Health the position regarding a medical card application in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [46075/14]

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.

If the Deputy has not received a reply from the HSE within 15 working days, please contact my Private Office who will follow up the matter with them.

HSE Staffing

Questions (400)

Billy Timmins

Question:

400. Deputy Billy Timmins asked the Minister for Health if he will provide a list of all personnel working in the Health Service Executive area for all regions of County Wicklow (details supplied); and if he will make a statement on the matter. [46106/14]

Written answers

Minister for Health

I have asked the HSE to respond to the Deputy directly on this matter. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.

Dental Services Provision

Questions (401)

Billy Timmins

Question:

401. Deputy Billy Timmins asked the Minister for Health the position regarding dental services for pupils in Baltinglass national schools and the pupils from national schools in the west Wicklow area who now have to travel for treatment; his plans to reinstate this service in Baltinglass, County Wicklow; and if he will make a statement on the matter. [46107/14]

Written answers

Minister of State at the Department of Health

Dental services for children up to 16 years are provided by the Public Dental Service of the HSE. The service is targeted at children at key stages in their development. Children are given dental examinations and any follow-up treatment required at these stages. When required, emergency dental treatment is available to all children up to 16 years. The HSE has been asked to examine the specific query raised by the Deputy in relation to west Wicklow and to reply to him as soon as possible.

If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.

Dental Services Provision

Questions (402)

Billy Timmins

Question:

402. Deputy Billy Timmins asked the Minister for Health the position regarding dental services in County Wicklow for national school pupils; the number of dental clinics held; the frequency with which they are held; the venues at which they are held.; and if he will make a statement on the matter. [46108/14]

Written answers

Minister of State at the Department of Health

Dental services for children up to 16 years are provided by the Public Dental Service of the HSE. The service is targeted at children at key stages in their development. Children are given dental examinations and any follow-up treatment required at these stages. When required, emergency dental treatment is available to all children up to 16 years. The HSE has been asked to examine the specific query raised by the Deputy in relation to County Wicklow and to reply to him as soon as possible.

If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.

Dental Services Provision

Questions (403)

Billy Timmins

Question:

403. Deputy Billy Timmins asked the Minister for Health the position regarding dental services in County Wicklow for national school pupils; the number of pupils waiting to be assessed for treatment; the length of time that they are on the waiting list for treatment; and if he will make a statement on the matter. [46109/14]

Written answers

Minister of State at the Department of Health

Dental services for children up to 16 years are provided by the Public Dental Service of the HSE. The service is targeted at children at key stages in their development. Children are given dental examinations and any follow-up treatment required at these stages. When required, emergency dental treatment is available to all children up to 16 years. The HSE has been asked to examine the specific query raised by the Deputy in relation to County Wicklow and to reply to him as soon as possible.

If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.

Orthodontic Service Provision

Questions (404)

Pat Deering

Question:

404. Deputy Pat Deering asked the Minister for Health his plans to provide more orthodontists to deal with the backlog in the Carlow-Kilkenny and south Tipperary health services area; and the way he plans to reduce the current waiting list of three to four years [46110/14]

Written answers

Minister of State at the Department of Health

Over the next three years orthodontic treatment for certain categories of misalignment will be provided by a panel of independent practitioners under contract to the HSE. A national procurement process is currently underway and is due to be ready for commencement in January 2015. This initiative will especially focus on those waiting for 4 years or longer. It is expected that this initiative will have a positive impact on waiting times.

I have asked the HSE to reply directly to the Deputy on the specific issues he has raised on orthodontic treatment in the Carlow/Kilkenny and South Tipperary area. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.

HSE National Service Plan

Questions (405)

Gabrielle McFadden

Question:

405. Deputy Gabrielle McFadden asked the Minister for Health when the national service plan for 2015 will be published; and if he will make a statement on the matter. [46116/14]

Written answers

Minister for Health

The Health Service Executive's 2015 National Service Plan was considered at Government on Tuesday last and approved by me on Wednesday 26th November. The Plan, setting out the type and volume of health and social care services to be provided by the Executive with the funding allocated by Government during the course of next year, was published by the HSE on Thursday, 27th November.

Hospital Charges

Questions (406)

Billy Kelleher

Question:

406. Deputy Billy Kelleher asked the Minister for Health the reason the Health Service Executive will be introducing charges for the provision of inpatient respite care services - which it has not done up to now - in January 2015; the estimated revenue that will be raised from this charge in 2015; and if he will make a statement on the matter. [46120/14]

Written answers

Minister for Health

I do not propose to introduce any new charges from 1 January 2015.

In accordance with the Health (Charges for In-Patient Services) Regulations 2005-2011, charges apply for in-patient services other than for acute hospital care and for long-term residential care services supported under the Nursing Homes Support Scheme (Fair Deal), both of which are subject to separate charging regimes. Under these Regulations, the HSE must apply charges (subject to certain exemptions) to all those who receive in-patient services for in excess of 30 days over a rolling 12 month period.

In the interests of fairness and equity, the HSE circulated directions to ensure the standard and consistent application of the 2005 legislation on charges for in-patient respite care services across all HSE areas at the end of March 2013. This was intended to bring any remaining areas not charging for in-patient respite care services into line with other areas that were already doing so.

The level of the charges is based on income and cannot exceed 80% of the weekly non-contributory State pension. The Regulations provide for a maximum charge of €175 per week where in-patient care is provided in a setting with 24-hour nursing care or a maximum of €130 per week where in-patient care is provided in other settings. The charging legislation provides that the HSE may reduce or waive charges where necessary to avoid financial hardship, having regard to individual financial circumstances (including whether there are dependants).

The HSE does not collate details regarding respite-specific income.

General Practitioner Services

Questions (407, 408)

Billy Kelleher

Question:

407. Deputy Billy Kelleher asked the Minister for Health in view of the fact that the National Association of General Practitioners has secured a negotiating licence, if it will be included in any negotiations or consultations he, his Department or the Health Service Executive will undertake with regard to GP services and contracts, and with specific regard to those under six years of age and those over 70; and if he will make a statement on the matter. [46121/14]

Billy Kelleher

Question:

408. Deputy Billy Kelleher asked the Minister for Health in view of the challenges facing rural general practitioners practices and in more deprived urban areas, if the National Association of General Practitioners will be involved in any negotiations or consultations he, his Department or the Health Service Executive will undertake; and if he will make a statement on the matter. [46122/14]

Written answers

Minister of State at the Department of Health

I propose to take Questions Nos. 407 and 408 together.

Under a Framework Agreement signed on 4th June 2014, the Department of Health, the HSE and the Irish Medical Organisation (IMO) are engaged intensively on the introduction of GP services without fees for children aged under 6. The Government's aim is to have universal GP care without fees for children under 6 years implemented early next year, subject to the conclusion of the present discussions and the completion of a fee-setting process.

The Government will prioritise persons aged 70 and over in the second phase of the introduction of a universal GP service. This measure will be facilitated under the existing General Medical Services contract after the relevant legislation has been passed by the Oireachtas.

The Framework Agreement also makes provision for discussions to commence on the overall GMS contract while work on the under 6 contract is progressing. The HSE/Department and the IMO have commenced talks on a new GP contract. A priority of these discussions will be the inclusion of issues about the provision of GP services to rural and deprived areas.

Formal engagement on contractual issues is conducted through a process of negotiations with the IMO, which has represented the interests of GPs, as independent contractors, for the past number of decades and which is a party to the current agreement upon which GMS GP contracts are legally founded.

I am open to receiving the views of any interested party in the development of GP services as a key component of the overall health system. In this context, Leo Varadkar TD, Minister for Health and I met with the National Association of General Practitioners on 6th November 2014 and there is likely to be further engagement in future.

HSE Staffing

Questions (409)

Terence Flanagan

Question:

409. Deputy Terence Flanagan asked the Minister for Health the number of individuals in the various management grades in the Health Service Executive; the changes and recommendations that have been made to him regarding making changes in this area; and if he will make a statement on the matter. [46130/14]

Written answers

Minister for Health

The total numbers employed in management grades in the Health Service Executive stood at 3,031 at the end of October 2014. The vast majority of these (2,183) are employed at middle management level which includes those working in supervisory roles. The numbers of employees working in management grades has reduced by close to 6% since September 2007.

The distinction between the ‘front line’ and management or between ‘front line’ and ‘back office’ hides the realities in the provision of health services to the public. No consultant will operate efficiently without diagnostics or a secretary to schedule care. No hospital can operate without a manager to look after budgets, staff and buildings. No public health department can prepare for emergencies or plan for a flu pandemic, nor can any of our services exist without recruitment or payroll. Staff have to be recruited, managed employed and paid. Patients have not only to be treated but they must also be cared for in clean and maintained surroundings, be fed and transported.

Medical Card Administration

Questions (410)

Róisín Shortall

Question:

410. Deputy Róisín Shortall asked the Minister for Health in view of the proposed changes to the medical card system, if he will ensure that, in respect of applicants over the age of 70 years, their net income will be considered when assessing their means rather than their gross income, as is the case at present, in order to simplify the process and ensure its fairness; and if he will make a statement on the matter. [46131/14]

Written answers

Minister of State at the Department of Health

The Deputy will be aware, that applications for medical cards for persons aged 70 years and older can be assessed both on the basis of the standard national assessment guidelines using a "net income" approach and on the basis of the guidelines for persons aged 70 years or over using a "gross income" approach. Furthermore, persons aged over 70 years may still be eligible for a medical card where discretion is exercised where they face undue hardship in arranging medical services as a result of medical or social circumstances.

I can advise the Deputy there are no plans to review the assessment process for medical cards for persons aged 70 years and over.

Medical Card Applications

Questions (411)

Michael Healy-Rae

Question:

411. Deputy Michael Healy-Rae asked the Minister for Health if a medical card will be approved in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [46135/14]

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.

If the Deputy has not received a reply from the HSE within 15 working days, please contact my Private Office who will follow up the matter with them.

Graduate Nursing Scheme

Questions (412)

Dan Neville

Question:

412. Deputy Dan Neville asked the Minister for Health his views on postgraduate preceptorship programmes (details supplied); his further views that such programmes would benefit nursing graduates here; his plans to allocate funding for these programmes; and if he will make a statement on the matter. [46138/14]

Written answers

Minister for Health

Preceptorship programmes are provided for Registered nurses to prepare them for the role of preceptor, to support nursing students undertaking undergraduate nurse education programmes. Additionally nurses undertaking post-graduate education programmes, in the main, are supported by clinical education facilitators, for example nurses undertaking the Higher Diploma in Intensive Care Nursing. Resources are currently in place to fund preceptorship programmes and clinical facilitation.