Written Answers Nos. 232-41
232. Deputy Bernard J. Durkan asked the Minister for Health the progress in respect of the provision of the new national children's hospital; when the planning procedures will be completed in full; and if he will make a statement on the matter. [28179/15]
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 the Coombe Women and Infants University Hospital, which will re-locate to the campus in due course. In addition to the main hospital, the project includes two satellite centres at the campuses of Tallaght and Connolly Hospitals.
Design development for the hospitals and satellite centres is ongoing and a planning submission is to be made in the coming weeks. 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 early 2016.
233. Deputy Bernard J. Durkan asked the Minister for Health the extent to which dialogue has been entered into and settlement arrangements made with the victims of symphysiotomy in accordance with Government's decision in this regard; the extent to which the individual requirements of the women concerned in respect of redress have been met; if access to the courts remains available to any victim receiving a redress payment; when all outstanding issues are likely to be met with particular reference to keeping in mind the serious and long-standing suffering of the victims; and if he will make a statement on the matter. [28180/15]
View answerThe Surgical Symphysiotomy Payment Scheme commenced on 10 November 2014. It was estimated that 350 women would apply to the Scheme, but in fact 577 applications have been accepted. Applications are being assessed by former High Court Judge Maureen Harding Clark and the Scheme has in the region of €34 million available.
The Scheme has brought to an end years of uncertainty and costs for women who have undergone surgical symphysiotomy. Judge Clark has informed my officials that as at 6 June 2015, 216 offers have been made to women including 1 offer that was rejected. 200 of those offers have been accepted with 15 offers awaiting a response. Of the 200 offers accepted by applicants, 122 were assessed at €50,000, 73 at €100,000 and 5 at €150,000.
Where there was a delay arising in the compilation of a woman's supporting documentation due to difficulty in obtaining medical records, applications were accepted by the Scheme, provided the application was received within the time period set out in the Scheme, with a written explanation of the reasons for the absence of the documentation.
The Scheme continues to contact applicants who have provided incomplete documentation. The applicants are encouraged to engage with the Scheme and to make the Scheme aware of any particular problems. The Scheme seeks to provide every assistance possible to the women in a fair, transparent and person centred manner, to assist them to complete their applications and provide relevant evidence of disability.
The Scheme was designed to be simple, straightforward and non-adversarial and aims to minimise the stress for all women concerned. The Scheme was designed following meetings with all three support groups, two of which have welcomed its establishment. It was set up to give women who do not wish to pursue their cases through the courts an alternative option in which payments are made to women who have had a surgical symphysiotomy, whether or not negligence is proven. The Scheme is voluntary and women did not waive their rights to take their cases to court as a precondition to participating in the Scheme. Women may opt out of the Scheme at any stage in the process, up to the time of accepting their award. It is only on accepting the offer of an award that a woman must agree to discontinue her legal proceedings against any party arising out of a symphysiotomy or pubiotomy.
There have been two High Court cases in recent months in relation to symphysiotomy. The first, where the woman underwent a symphysiotomy following the birth of her child by Caesarean section, was settled in February 2015 without admission of liability in the sum of €200,000. It should be noted that applicants to the Symphysiotomy Payment Scheme with this type of symphysiotomy are entitled to the highest award of €150,000 on submission of the necessary documentary proofs, for example, the relevant hospital records indicating that this procedure was carried out.
The second case ran in the High Court for 15 days and judgment was delivered on 1 May, 2015. In this case the Judge dismissed the claim for damages by a 74 year old woman who had a symphysiotomy 12 days before the birth of her baby in 1963 and who had also taken legal proceedings against the Hospital. The Judge ruled that even though the woman has suffered since the operation, the practice of prophylactic symphysiotomy (that is before the birth of the baby) “was not a practice without justification” in 1963. The Judge also stated in his judgment that 'Though I would in the words of Sir Ranulph Crewe, Chief Justice of England, “take hold of a twig or twine-thread” to uphold the plaintiff’s case, I must find that this remarkable lady whose story indeed deserves to be told must fail in her case against the defendants'.
Judge Clark has commissioned medical experts in the areas of obstetrics and gynaecology, radiology and orthopaedic surgery to assist her in assessing the women's applications, where there is absence of evidence either that the procedure was undertaken, or of its consequences on the health of the woman.
The Government has given careful and detailed consideration to this complex and sensitive matter. It believes that the provision of the Scheme, together with the ongoing provision of medical services by the HSE, including medical cards, represents a comprehensive response to this issue, which should help bring closure for the women, many of whom are elderly, and their families.
234. Deputy Bernard J. Durkan asked the Minister for Health the number of primary care centres fully operational; those pending; and if he will make a statement on the matter. [28181/15]
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.
235. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he and his Department continue to monitor private health insurance with the objective of the continued implementation of lifetime community rating; if he remains satisfied that all insurers incur their fair share of the responsibility to provide for patients across the age spectrum; and if he will make a statement on the matter. [28182/15]
View answerMy Department and the Health Insurance Authority oversee the maintenance of a competitive and sustainable health insurance market, under the provisions of the Health Insurance Acts 1994 to 2014, and monitor developments on an ongoing basis to ensure that the market is regulated appropriately. Community rating is a fundamental cornerstone of the Irish health insurance system. Under community rating, the level of risk that a particular consumer poses to an insurer does not directly affect the premium paid. This means that people who are old or sick do not have to pay more for the same insurance plan than the young and healthy. Insurers are also required to accept all applicants for health insurance, regardless of their health status or age.
For community rating to work we depend on adequate numbers of younger people taking out health insurance to help keep premium prices down for everybody. Lifetime community rating, which came into operation on 1 May 2015, modifies community rating so that the premium that individuals pay for health insurance increases with the age at which they enter the health insurance market. Late entry loadings now apply for people aged 35 and over when taking out health insurance for the first time. Lifetime community rating encourages people to take out health insurance at a younger age, thereby helping to spread the health costs of older and less healthy people across all insured persons. It is a necessary measure to help support the viability of community rating within our system of health insurance.
An effective and robust Risk Equalisation Scheme is in place to support to community rating by equalising the risk of insuring older or less healthy people across the market. The scheme involves the payment of risk equalisation credits to insurers which are funded by stamp duties levied on insurers, based on all policies written. All insurers receive payments from the Risk Equalisation Fund in respect of their older customers and the number of overnight stays in hospital incurred by their customers. The Risk Equalisation Scheme offsets some of the additional cost of insuring older and less healthy members. This allows all insured persons to continue to pay the same net amount for a given health insurance product and helps to support affordable premiums for all.
236. Deputy Robert Troy asked the Minister for Health if he is aware that the parental accommodation at Our Lady's hospital in Crumlin in Dublin 12 is at such a low standard that parents, after spending the whole day with their sick son, were placed in a room which had sick on the bed and floor, and which provided one single bed with no pillow or blanket for the two parents; and if he will allocate sufficient funding to the hospital to ensure it will provide an adequate standard of accommodation for parents, who must be with their children 24 hours a day, seven days a week. [28184/15]
View answerIt is acknowledged that parental accommodation at Our Lady’s Hospital Crumlin is not adequate. That is why the new children’s hospital accommodation will be designed to ensure that children and young people receive their care in the best organised and most clinically suitable setting. The planned accommodation will include facilities for inpatients, day care patients, outpatients, operating theatres and emergency care. All of the in-patient beds at the new children’s hospital will be single en-suite rooms with in-room parent accommodation. In addition a 52 bed family accommodation unit for families of long stay patients is to be included in the planning application. This is a separate building, the construction and operations of which are proposed to be funded through a charitable foundation with experience in delivering these services.
The new hospital will be co-located with St James's Hospital, and ultimately tri-located with the Coombe Women and Infants University Hospital, which will relocate to the campus in due course. In addition to the main hospital, the project includes two satellite centres at the campuses of Tallaght and Connolly Hospitals.
Design development for the hospitals and satellite centres is ongoing and a planning submission is to be made in the coming weeks. 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 early 2016.
In relation to the specific case raised, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
237. Deputy Tom Fleming asked the Minister for Health if he will examine an application for a medical card in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [28186/15]
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.
238. Deputy Tom Fleming asked the Minister for Health if he will review the criteria and means test for families who have third level students who are not grant-aided and who are only allowed €78 per student in the assessment of means, even though the education costs and expenses are substantial; if, in exceptional medical conditions for parents or students, he will allow an appropriate rate to correspond with the student costs in the means assessment; and if he will make a statement on the matter. [28187/15]
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.
239. Deputy Bernard J. Durkan asked the Minister for Health if any evaluation has been completed throughout the public health system with a view to determining the precise scale and location of the backlog in respect of the various procedures in the public hospital system; if any additional accommodation is likely to be required in the short and medium term; if adequate procedures are in place to achieve this; and if he will make a statement on the matter. [28192/15]
View answerAs this is a service matter, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
240. Deputy Bernard J. Durkan asked the Minister for Health the extent to which prescription costs have fallen or have stabilised; and if he will make a statement on the matter. [28193/15]
View answerBetween 2009 and 2014, the HSE's expenditure on reimbursed medicines has remained stable at under €2 billion.
Aggregate spending on the General Medical Services (GMS) Scheme, the Drugs Payment Scheme (DPS) and the Long Term Illness (LTI) Scheme has reduced since 2009, despite an increase in numbers eligible for the scheme and the introduction of more expensive new medicines. The average price of an item dispensed on the GMS scheme has reduced to below the price paid in 2002, while the average item price dispensed under the DPS and LTI schemes is now below the price paid in 2000.
However, expenditure on high tech medicines increased from €315 million to €485 million between 2009 and 2014. This increase is due to the introduction of highly expensive new medicines and the increased use of existing medicines.
The reductions achieved to date are due to a sustained and ongoing programme of price reductions which includes the implementation of price reduction Agreements with the Irish Pharmaceutical Healthcare Association and the Association of Pharmaceutical Manufacturers in Ireland. Cumulative savings and cost avoidance generated from these Agreements between 2006 and 2014 amount to approximately €1.5 billion.
The introduction of generic substitution and reference pricing, as provided for by the Health (Pricing and Supply of Medical Goods) Act 2013, has also contributed to the reductions in the cost of medicines. The prices of reference priced products are generally of the order of 70-80% lower than the prices paid when medicines were on patent. On the date of introduction of the 2013 Act, the HSE was reimbursing in excess of €22 million per month on medicines reference priced in 2014. By December 2014, this had reduced to €10.3 million due to the combination of reference pricing, increases in generic utilisation and generic price reductions prior to reference prices. Reference pricing has delivered savings of over €47 million in 2014 and is expected to generate a further €25 million in savings in 2015.
241. Deputy Bernard J. Durkan asked the Minister for Health the extent to which procurement throughout the health services continues to achieve the best results for the taxpayer; and if he will make a statement on the matter. [28194/15]
View answerThe HSE has achieved significant savings over the last number of years through the on-going reform of its procurement process. Since January 2014 the HSE has achieved cost reductions of circa €50m - €31m in 2014 and circa €19m to end May 2015. Since 2010 and with the development of a central procurement function the total savings achieved to date is €250m.
In addition, the HSE is implementing, on a phased basis, its National Distribution Centre (NDC) Plan. Its purpose is to consolidate stock holding across the HSE, improve contract compliance, increase stock management at point of use, and control and deliver efficiencies in transactional costs. Work has commenced on a Data Warehouse and Business Intelligence System which will, inter alia, enable reporting and data analysis. A Health Procurement Plan 2016-2019 is being prepared in consultation with budget managers. A Procurement Programme Management System is being developed to manage future multi-annual procurement plans and to provide up to date reporting on progress and outcomes. The HSE has commenced a training programme for the relevant senior managers which outlines the importance of compliance with procurement rules and national financial regulations. To date over 100 staff have received training. The HSE continues to work with and support the Office of Government Procurement in delivering the Government’s commitment to Public Sector Reform which includes public procurement reform.
All of these measures will further streamline the procurement function and help to generate savings into the future. There is no single approach which will deliver best results and the extent to which HSE procurement processes continues to achieve the best practise will be determined by the success of these initiatives and future developments which can respond to the constantly changing business environment.
