Written Answers Nos. 151 - 172
151. Deputy Éamon Ó Cuív asked the Minister for Health the number of meetings of the islands health care committee of the Health Service Executive that have taken place; the number of meetings this committee has had with Comhdháil Oileáin na hÉireann; and if he will make a statement on the matter. [17048/15]
View answerAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy. 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.
152. Deputy Seán Ó Fearghaíl asked the Minister for Health with regard to health insurers, if a company may refuse to provide cover to a person with a pre-existing condition for a set period of time, while providing cover for other illnesses that have not previously occurred; and if he will make a statement on the matter. [17060/15]
View answerOpen Enrolment Regulations, made under the Health Insurance Acts, provide for maximum waiting periods for eligibility for payment under a health insurance contract in relation to first time entry to health insurance (initial) and for pre-existing conditions.
As part of my commitment to supporting the sustainability of the Private Health Insurance market, on 2 March 2015, I signed into law new measures updating the Open Enrolment Regulations that apply to all new health insurance contracts entered into on or after 1 May 2015. The amendments include an updated definition of a pre-existing condition to reflect the onset of ‘signs and symptoms’ in the 6 months prior to taking out insurance. I believe that the revised definition is clearer and will result in less claim disputes. I have also equalised the prescribed waiting periods to be served for all, irrespective of age, to a 26 week initial waiting period, and 5 years for a pre-existing condition that commenced before a person buys health insurance. This amendment will significantly lessen the prescribed waiting period for an older person in particular, in some cases from 10 to 5 years.
The provision of waiting periods help to support community rating by providing an important tool for insurers to combat practices where someone could potentially take out a health insurance policy to avail of a particular treatment and then cancel the policy once treatment had been received, without either penalty or sustained contribution to the community rated model.
153. Deputy Michael McCarthy asked the Minister for Health further to Parliamentary Question No. 93 of 22 April 2015, the criteria now used for the renewal of discretionary medical cards; and if he will make a statement on the matter. [17062/15]
View answerAs advised to the Deputy in my reply of 22nd April, the HSE decided in May 2014 that reviews of existing discretionary medical cards would be suspended and that suspension remains in place.
154. Deputy Tom Fleming asked the Minister for Health further to Parliamentary Question No. 594 of 24 March 2015, if he will urgently contact the Health Service Executive regarding a reply in respect of orthodontic treatment in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [17066/15]
View answerI understand that a reply to your Parliamentary Question of 24 March 2015 was issued to you by the HSE on 31st March 2015.
155. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide the details of a company employed to make deliveries on behalf of a State body (details supplied); if the contract that this body has with the company is currently being breached by pay levels in this company; and if he will make a statement on the matter. [17075/15]
View answerThe Deputy's question relates to service delivery matters and accordingly I have asked the HSE to respond directly to him.
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.
156. Deputy Bernard J. Durkan asked the Minister for Health if and when a medical card renewal will issue in the case of a person (details supplied) in County Dublin; and if he will make a statement on the matter. [17079/15]
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.
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.
157. Deputy Ruth Coppinger asked the Minister for Health his views on governance issues at the St. Vincent's Hospital group raised by the chief executive of the Health Service Executive on 23 April 2015 (details supplied). [17083/15]
View answerThe HSE is the statutory body tasked with the responsibility for the delivery of health and personal social care services in Ireland. In discharging its public accountabilities, the HSE has in place a Governance Framework covering corporate, clinical and financial governance.
In the context of the establishment of the Hospital Groups and Community Healthcare Organisations, the HSE is strengthening its accountability arrangements. The new HSE Accountability Framework, published with the 2015 Service Plan, describes the means by which the Hospital Groups and hospitals will be held to account in 2015 for their efficiency and control in relation to service provision, patient safety, finance, and HR. A new Service Arrangement will be put in place for 2015 and will continue to be the principal accountability agreement between the HSE, Hospital Group CEOs and Section 38 funded Agencies.
St Vincent’s University Hospital is a Section 38 funded agency. Any issues arising in relation to governance at the hospital will be managed by the HSE under the Accountability Framework and Service Level Agreement provisions.
159. Deputy Bernard J. Durkan asked the Minister for Health when a Medical Card renewal will be arranged in the case of a person (details supplied) in County Kildare, who has not received renewal notice; and if he will make a statement on the matter. [17096/15]
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.
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.
160. Deputy Bernard J. Durkan asked the Minister for Health if and when a medical card will be reviewed in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [17097/15]
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.
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.
161. Deputy Róisín Shortall asked the Minister for Health the information available to him on the incidence of foetal alcohol syndrome over the past ten years; and if he will consider introducing a comprehensive testing and education programme to address this significant issue. [17101/15]
View answerThe diagnosis of Foetal Alcohol Spectrum Disorder (FASD) is difficult as there are many features that need to be present along with a history of pre-natal alcohol intake. FASD can be misdiagnosed or unconfirmed. There is no national register of FASD, therefore the number of cases of FASD, Foetal Alcohol Syndrome and Alcohol Related Neurodevelopmental Disorder in Ireland are unknown. This mirrors the situation in many countries in Europe.
The Health Service Executive has advised that the number of newborn discharges with a diagnosis of Foetal Alcohol Syndrome reported to HIPE, 2005-2014 is thirteen. Diagnosis of moderate cases or of FASD may be made at a later stage within primary care services. Such cases are not captured in HIPE data and are not quantifiable at this time.
The Report of the Steering Group on a National Substance Misuse Strategy, 2012 recommended to:
- Implement policies and clinical protocols in all healthcare settings to prevent, assess and respond to issues arising in relation to pregnant women affected by alcohol use;
- Strengthen FASD surveillance in maternity hospitals through the Eurocat Reporting system and promote greater awareness among healthcare professionals of FASD so as to improve the diagnosis and management of FASD.
The current maternity hospital approach to Alcohol and Pregnancy is as follows:
- All mothers are asked about alcohol intake at their first antenatal visit;
- They are advised to avoid alcohol during pregnancy as there is no safe minimal intake. An information leaflet, Alcohol and Pregnancy is readily available. There is an additional booklet, Substance Misuse in Pregnancy, provided by the drug liaison midwifery service, which contains a section on alcohol risks during pregnancy;
- If a mother is identified at the antenatal clinic to be drinking in excess she is referred to the social work department for support and advice;
- Where appropriate, the social workers refer the mother to the GP and other support agencies.
Currently a Senior Psychologist in early intervention services who specialises in FASD provides training to clinical staff in the West and North West area in so far as resources allow. Any additional resources required to develop screening tools for Foetal Alcohol Syndrome or FASD, associated education programmes and specialised follow up services for children with positive diagnosis would have to be considered in the context of emerging priorities, service delivery plans and budgetary controls.
As the Deputy is aware, the General Scheme of the Public Health (Alcohol) Bill was approved by Government on the 3 February 2015. The General Scheme provides labels on alcohol products and will contain, inter alia, health warnings in relation to consuming alcohol during pregnancy.
162. Deputy Seán Kyne asked the Minister for Health the funding and other mechanisms being pursued to encourage the development of non-animal alternative bioscience research methods knowns as the three Rs, replacement, reduction and refinement, to meet the obligations of Article 47 of Directive 2010/63/EU. [17109/15]
View answerMy Department recently nominated a representative to the PARERE Network (Preliminary Assessment of Regulatory Relevance) established under Article 47(5) of Directive 2010/63/EU. The PARERE Network is hosted by the European Union Reference Laboratory for Alternatives to Animal Testing (EURL ECVAM) and was established to expedite the process of regulatory acceptance of alternative methods. It also provides advice on the regulatory relevance and suitability of alternative approaches proposed for validation and provides a framework for the sharing of experience and expertise in this area among Member States.
I have been advised by the Health Product Regulatory Authority (HPRA) that at EU level, the EURL ECVAM promotes the development and dissemination of alternative methods. In addition, the Joint Research Authority (JRA) gathers information on alternative methods useful in assessing the toxicological properties of chemicals. The JRA published a report on alternative methods for regulatory toxicology in 2014.
Furthermore, the HPRA have advised that the European Medicines Agency through its working group on the application of the 3Rs in regulatory testing of medicinal products is active in identifying opportunities for the implementation of the 3Rs in relation to the testing of human and veterinary medicinal products. Progress is being made in this field over the last number of years with the regulatory guidelines for new medicines being adapted to foster the application of the principle of the 3Rs, not only at the European level, but indeed globally.
The HPRA ensures that the 3Rs are applied to the authorisation of projects that are to be conducted in this country.
163. Deputy Seán Kyne asked the Minister for Health the outcomes from the collaboration between the Irish Medicines Board, renamed the Health Products Regulation Authority, and the European Commission regarding the identification and validation of alternative approaches to animal research that could be developed; and if he will make a statement on the matter. [17110/15]
View answerI have been advised by the Health Products Regulatory Authority (HPRA) that the development of alternative methods to animal research is an on-going activity. Along with other Member State competent authorities, the HPRA attends meetings with the EU Commission in relation to progress in this and other areas. Through their participation in these meetings and through the contacts they have established the HPRA is kept informed of new developments in the sector. The HPRA, in turn, apply this knowledge in the assessment of applications for projects involving animals and in the overall regulation of the scientific animal sector.
164. Deputy Lucinda Creighton asked the Minister for Health if he will provide an update on his Department’s proposals to co-locate the Rotunda Hospital, Dublin 1, with Connolly Hospital, Blanchardstown, Dublin 15; and if he will make a statement on the matter. [17136/15]
View answer165. Deputy Lucinda Creighton asked the Minister for Health when a decision on the location of the Coombe Hospital, Dublin 8 will be made; and if he will make a statement on the matter. [17137/15]
View answerI propose to take Questions Nos. 164 and 165 together.
My Department is currently reviewing the recommendations made by KPMG (2008) in relation to the locations for the redevelopment of the Coombe and the Rotunda Hospitals. This review was necessitated by the decision to locate the new National Children’s Hospital at St James’s Hospital, and the consequent need to provide a maternity hospital on that campus in order to have a trilocated adult acute/paediatric/maternity facility.
My officials are currently finalising work in this matter and I expect to receive a submission from them shortly.
166. Deputy Lucinda Creighton asked the Minister for Health his plans to co-locate an existing maternity hospital with the national children’s hospital to be located at St. James's Hospital, Dublin 8; and if he will make a statement on the matter. [17138/15]
View answerThe National Paediatric Hospital Development Board (NPHB) is the statutory body responsible for planning, designing, building and equipping the new children's hospital. Board members have expertise in planning, procurement, engineering, architecture and paediatrics along with stakeholder representatives. The new hospital will be co-located with St James's Hospital. The project also includes two satellite centres at the campuses of Tallaght and Connolly Hospitals.
The Government’s intention is that a maternity hospital will be developed on the campus in the future, achieving tri-location of adult, paediatric and maternity services and providing comprehensive healthcare services to drive improved clinical outcomes for children and mothers. The Project Brief for the children’s hospital acknowledges this key policy recommendation, and accordingly provides for consideration of future maternity hospital requirements in certain shared service areas, underpinning future efficiencies.
Tri-location is consistent with the recommendations of the 2008 KPMG Independent Review of Maternity and Gynaecology Services in the Greater Dublin Area. In 2008, the proposal in the report was that the National Maternity Hospital be relocated to St Vincent's, the Coombe to Tallaght and the Rotunda to the Mater, achieving co-location of maternity and adult services in all cases, and tri-location of adult, paediatric and maternity services at the Mater.
With the decision to move the children’s hospital to the St James’s campus, these previous plans must be reviewed in respect of the Coombe and the Rotunda – the plans to redevelop the National Maternity Hospital on the St Vincent's campus are progressing. That review is ongoing and will be completed in the coming weeks. This is the first step in progressing the future tri-located maternity hospital.
The Development Board has advised that, in submitting its planning application for the children’s hospital, it intends as a matter of good planning practice to provide full information on all known future developments for the St James’s campus, including the tri-located maternity hospital. This will enable An Bord Pleanála to consider the children’s hospital planning application in the context of these future plans for the campus.
167. Deputy Lucinda Creighton asked the Minister for Health if the proposed budget expenditure for the new national children’s hospital includes the cost of equipping the hospital with necessary medical and information technology equipment; and if he will make a statement on the matter. [17139/15]
View answerThe National Paediatric Hospital Development Board is the statutory body responsible for planning, designing, building and equipping the new children's hospital. The new hospital will be co-located with St James's Hospital, and ultimately tri-located with a maternity hospital to be developed on campus. In addition to the main hospital, the project includes two satellite centres at the campuses of Tallaght and Connolly Hospitals. Design development is ongoing and, subject to planning, work is scheduled to commence at the main site at St. James's, and at satellite centre sites at Connolly and Tallaght, in January 2016.
Minister Howlin has committed to making €200m available from the sale of the National Lottery for the new children's hospital, adding to the existing €450m Exchequer funding and underlining the Government's commitment to the project. Current estimates are that the core hospital, including both satellite centres, will be delivered within this envelope. This includes provision for inflation, VAT and contingencies; it does not include equipment or ICT which can be purchased, licensed or leased separately. Philanthropic and commercial funding streams will be targeted as appropriate for supporting elements of the project to include car parking, academic and research facilities, and estimates will be reviewed and refined at each stage of the project.
168. Deputy Finian McGrath asked the Minister for Health if he will support the Disability Federation of Ireland in its efforts to redress cuts to incomes and services in 2015 - 2016 (details supplied); and if he will make a statement on the matter. [17180/15]
View answerThe Disability Federation of Ireland raises a wide range of issues relating to people with a disability in their correspondence. A number of the issues raised are relevant to other Departments and Ministers. My answer relates to the provision of health services.
The Government values the role which people with disabilities play in Irish society and is committed to facilitating the full inclusion of people with disabilities in the life of the community through access to individualised personal social supports and services. In 2015 we will continue to support the major transformation programme underway in disability services, as set out in the Value for Money and Policy Review, and in particular, the reconfiguration of residential services. Continued emphasis will also be maintained on enhancing quality and safety, especially through implementation of the HIQA standards for residential settings, reform of adult day services and children's therapy services, planning for emergency places and changing needs, maximising efficiencies and further development of enhanced governance and accountability arrangements. Our focus is to bring about reforms that will positively impact on the way in which people with disabilities are supported to live the lives of their choice. This will require changes to governance, funding, focus of provision, realignment and reconfiguration of resources as new and sustainable models of service are implemented to meet the changing needs of service users and increased demographic pressures.
Funding of almost €1.5 billion will be provided for health and personal social services through the Health Service Executive’s National Service Plan for 2015. Residential services are provided by almost 60 agencies to around 9,000 people with disabilities at over 1,200 locations, ranging from large congregated settings to community group homes to supported independent living. Day services are provided to around 22,000 people with intellectual, physical or sensory disabilities and autism at 850 different locations by 80 organisations. Approximately 1,400 young people who are due to leave school and Rehabilitative Training programmes in 2015 will receive new placements. In 2015, an additional €6 million has been allocated in the HSE National Service Plan to provide places for these school leavers and graduates. Respite residential support totalling 190,000 overnights will be provided. The target for provision of personal assistant/home support in 2015 is 3.9 million hours. A variety of other services are also provided under the Disability Services Programme, including respite, early childhood/family support, community based medical, nursing and therapy services, rehabilitative training, aids and appliances.
The Minister’s priorities include moving people from institutions to homes in the community and reconfiguring adult day services based on individualised and person-centred supports. In addition, work is advanced on the re-configuration of therapy services for children aged up to 18 years as part of the Executive's Progressing Disability Services for Children and Young People (0-18 years) Programme. The aim of this Programme is to achieve greater equity of access and consistency of service delivery and a clearer pathway for all children with disabilities (including autism) to services, according to need. An additional €4 million was allocated in 2014 to assist in implementing the Programme, equating to approximately 80 additional therapy posts. Further investment of €4 million will also be made to support the development of therapy services in 2015 (equating to €6 million in a fully year).
169. Deputy Paul Murphy asked the Minister for Foreign Affairs and Trade if he will report on discussions held with European Union counterparts regarding a military response to the humanitarian crisis in the Mediterranean; if he is opposed to such military action by European Union states in north Africa; and if he will make a statement on the matter. [17006/15]
View answerThe humanitarian crisis in the Mediterranean is of great concern to Ireland, and to its EU and Southern partners. Solutions must be found jointly to address a crisis on this scale.
On Monday 20 April, I attended a joint meeting of the EU Foreign Affairs and Justice and Home Affairs Councils to discuss migration issues, and in particular the situation in the Mediterranean. At that meeting, Minister Frances Fitzgerald and I, together with our EU partners, confirmed our strong commitment to act to prevent recurrence of such tragedies. We agreed that work would be taken forward along three strands: reinforcing Frontex activities to save lives at sea, a fairer sharing of responsibilities regarding resettlement and relocation projects within the EU and a range of options to combat organized crime networks and human traffickers.
The Taoiseach attended a special meeting of the European Council on 23 April convened to discuss further the evolving situation in the Mediterranean. At that meeting, EU Heads of State and Government agreed that the immediate priority is to prevent more people from dying at sea. They agreed to use all tools at the EU’s disposal and to work in cooperation with countries of origin and transit of migrants to tackle the root causes of the current human emergency.
A comprehensive range of commitments were agreed including at least tripling financial resources for EU Operations Triton and Poseidon, thereby enabling an increase in the search and rescue possibilities within the mandate of FRONTEX. EU leaders also committed to actions to prevent illegal migration flows, to reinforce internal EU solidarity and responsibility in relation to the processing of asylum applications and relocation of migrants, and to combat traffickers in accordance with international law.
The Council did not make a specific commitment in relation to military action. There were two references in the EU statement to possible CSDP actions. The first concerns systematic efforts to identify, capture and destroy vessels before they are used by traffickers, who exploit vulnerable people for profit and put their lives at risk. In this regard the Council invited High Representative Mogherini to begin preparations for a possible CSDP mission. Secondly, EU leaders committed to providing increased support to southern partner countries to monitor and control land borders, building on current civilian CSDP operations in the region.
Ireland will continue to participate actively in discussions in the coming weeks on the various strands of the EU’s comprehensive strategy, and to contribute to EU efforts to prevent further loss of life at sea.
170. Deputy Paul Murphy asked the Minister for Foreign Affairs and Trade his views on the airstrikes by the United States of America in Pakistan on 15 January 2015 that killed two captives (details supplied). [17007/15]
View answerThe Government is concerned by instances where innocent civilians have been killed by drone attacks.
Unmanned Aerial Vehicles (commonly referred to as “drones”) are used for both civilian and military purposes. Under international law, there is no prohibition on Unmanned Aerial Vehicles as such. Their use in armed conflict is subject to international humanitarian law. This sets specific requirements in relation to the use of force in armed conflict, including the principles of necessity, proportionality and distinction.
Any indiscriminate use of drones would clearly be contrary to international law. Every effort must be made to avoid civilian casualties and I am deeply concerned by instances where civilians have been killed by attacks using drones.
Ireland has consistently taken the view that combating terrorism must be conducted in full respect of international law, in particular the law of armed conflict and human rights law. In line with the UN Global Strategy on Counter Terrorism, we believe that effective counter terrorism and the protection and promotion of human rights are mutually reinforcing and not competing goals.
171. Deputy Paul Murphy asked the Minister for Foreign Affairs and Trade if he or any of his staff have discussed with the authorities in the United States of America the drone attacks by that country in Pakistan, Afghanistan and Iraq; his views on these drone airstrikes; and if he will make a statement on the matter. [17008/15]
View answerUnmanned Aerial Vehicles (commonly referred to as “drones”) are used for both civilian and military purposes. Under international law, there is no explicit prohibition on UAVs. Nevertheless, their use in armed conflict is subject to international humanitarian law. This sets specific requirements in relation to the use of force in armed conflict, including the principles of necessity, proportionality and distinction.
Outside of an armed conflict situation, human rights law must apply, including the prohibition on extrajudicial killings. Ireland and its partners in the EU are strongly and consistently opposed to extra-judicial killings. Not only are they contrary to international human rights law, they undermine the very concept of the rule of law, which is a primary element in the fight against terrorism. This principle applies regardless of the means used.
Every effort must be made to avoid civilian casualties and, therefore, any indiscriminate use of drones would clearly be contrary to international law. Together with our EU partners, we have regular discussions with the United States about the legal aspects of combating international terrorism, and the US authorities are well aware of our views on these issues.
172. Deputy Ruth Coppinger asked the Minister for Foreign Affairs and Trade if Ireland will participate in the United Nations committee on sovereign debt restructuring; if he will report on his discussions, and those of the ambassador to the United Nations, held with other states regarding the committee; and if he will make a statement on the matter. [17082/15]
View answerLast September, the UN General Assembly was presented with a draft Resolution on the modalities for the implementation of General Assembly Resolution 68/304 on the establishment of a multilateral legal framework for sovereign debt restructuring processes. The main focus of the resolution was the setting up of an ad hoc committee to elaborate a binding debt resolution mechanism. Following detailed consideration of the proposal and discussions with the EU and other UN partners, Ireland, and our EU partners, were unable to support the Resolution.
Ireland, along with EU partners, engaged actively and in good faith in the process, including through the extensive efforts of our Permanent Representative to the UN. We supported the EU’s statement clarifying the important considerations which informed the negotiating approach on the Resolution, as follows:
“The ad-hoc committee must be limited to the elaboration of a non-binding 'set of principles' which builds upon a market-based voluntary contractual approach to sovereign debt restructuring and aims at furthering its implementation and use. Neither the EU nor Member States will participate in discussions aiming at the establishment of a binding multilateral legal framework for sovereign debt restructuring processes.
The ad-hoc committee should reflect the recent and ongoing work on sovereign debt restructuring undertaken in the IMF, subject to the previous considerations, and should take place in close coordination with and with technical support from the Fund. Discussions should also make reference to the work in other fora on these issues, such as the Paris Club, which has a history of discussing sovereign debt restructuring issues.”
In the event, the Resolution continued to propose the elaboration of a new legal framework and, in these circumstances, Ireland, in common with EU partners, will not be participating in the work of the committee.
Ireland is actively engaged in ongoing global processes to address the issue of sovereign debt restructuring. Work being undertaken at other levels, including in the IMF and at the Third International Conference on Financing for Development to be held in Addis Ababa in July, offer appropriate, established and constructive means for meaningful dialogue on the matter. We are playing our full role, in partnership with our EU colleagues, in working for the success of the Financing for Development Conference in Addis, which is central to the ongoing negotiations on a new framework for global development to follow on from the Millennium Development Goals. These major international negotiations at the UN are being co-chaired by Ireland’s Permanent Representative to the UN, with Kenya.
We recognise the importance of continuing to address global debt issues in a development context and will continue to engage in processes, in appropriate fora, that promote constructive dialogue and propose effective and suitable mechanisms to support the countries most seriously affected.
