Written Answers Nos. 809-826
809. Deputy Denis Naughten asked the Minister for Health when a child (details supplied) in County Roscommon will be called for an appointment; the reason for the delay; and if he will make a statement on the matter. [38100/15]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the Health Service Executive, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as 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.
810. Deputy Tony McLoughlin asked the Minister for Health the current status of the proposed redevelopment works for the Sheil Hospital in Ballyshannon, County Donegal; when work will commence on the ground at this facility; and if he will make a statement on the matter. [38108/15]
View answerFollowing the announcement last month of the health capital allocation of €3,061m for the multi-annual period 2016-2021 the HSE is working on the next Capital Plan for that period. This Plan requires the approval of the Minister for Health together with the consent of the Minister for Public Expenditure and Reform. The overall plan will include provision of additional funding towards the later years of the period for the development of Community Nursing Units. The additional funding will, building upon the existing projects, enable an enhanced programme to replace, upgrade and refurbish long term care facilities and will significantly improve the standard of residential facilities and facilitate person centred care. The Department is working with the HSE to prioritise the available funding.
811. Deputy Tom Fleming asked the Minister for Health why no doctor contacted a person (details supplied) or that person's primary carer in Tralee, County Kerry, after the person had a seizure, to explain what happened to the person and what measures were to be taken; and if he will make a statement on the matter. [38116/15]
View answerAs this is a service issue, 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 it will follow up the matter with the Executive.
812. Deputy Tom Fleming asked the Minister for Health why it takes from three to seven hours for persons to get a bed in a ward in Kerry General Hospital after they have been informed by a doctor in the accident and emergency unit in the hospital that they are being admitted; and if he will make a statement on the matter. [38120/15]
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.
813. Deputy Terence Flanagan asked the Minister for Health to deal with a matter (details attached) regarding medical cards; and if he will make a statement on the matter. [38122/15]
View answerUnder the Health Act, 1970, medical cards are provided to persons who are, in the opinion of the HSE, unable without undue hardship to arrange GP services for themselves and their dependants and every application must be assessed on that basis. In accordance with the Act, the assessment for a medical card is determined primarily by reference to the means, including the income and expenditure, of the applicant and his or her partner and dependants. Where deemed appropriate in particular circumstances, the HSE may exercise discretion and grant a medical card even though an applicant exceeds the income guidelines but where they who face difficult financial circumstances, such as extra costs arising from an illness.
It is clear that there are people with medical needs and it is important that they should be able to access necessary assistance in a straight forward manner. Greater discretion is being exercised by the HSE because the number of discretionary medical cards in circulation has increased from about 52,000 in mid-2014 to over 94,000 at the beginning of October this year. This followed the measures announced by Minister Varadkar and I last year, when the "Keane" Report of the Expert Panel on Medical Need for Medical Card Eligibility was published. The Deputy may be aware that a key recommendation of that report was that a person’s means should remain the main qualifier for a medical card. It also recommended that it is neither feasible nor desirable to list conditions in priority order for medical card eligibility.
Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information and documentation to fully take account of all the relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses.
On foot of the Keane Report, the HSE established a Clinical Advisory Group to develop clinical oversight and guidance for the operation of a more compassionate and trusted medical card system. The Director General of the HSE accepted an interim recommendation of the Group to award medical card eligibility to all children under 18 years of age with a diagnosis of cancer, effective from 1 July 2015. Any child not 18 and who has had a diagnosis of cancer within the preceding 5 years ending 30 June 2015 may be awarded a medical card under the terms of this decision for such period, not to exceed five years, as seems appropriate in the individual circumstances. The Group is continuing its work on the development of guidance on assessing medical card applications involving significant medical conditions.
We do not have a universal eligibility system for primary and community health services. Until we have universal health care and everyone is entitled to health care, one will always have anomalies and injustices. There will always be somebody who is just above the means threshold, or who does not have the prescribed disease, or whose condition is not sufficiently severe and, as a result, these individuals will not meet the assessment criteria.
814. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the revenue raised in each year from 2007 to date from hospital charges on patients by emergency department charges; from inpatient charges, etc., each in tabular form. [38129/15]
View answerYour question has been referred to the Health Service Executive for direct reply. If you have not received a reply from the HSE within 15 working days please contact my Private Office which will follow up the matter.
815. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the estimated cost of replacing hospital charges for patients with Exchequer funding; and if this total is unknown, if he will outline as much information on the matter as is available. [38130/15]
View answerThe issue of hospital financing has been the subject of recent Departmental reports. In the case of public acute hospital care, a prospective, casemix-adjusted activity based system was recommended. It has been recommended that the existing ‘per diem’ charging regime for private activity in public hospitals be replaced by a case-based charge using DRGs. Taking account of international evidence and of the detailed analysis already undertaken in the context of the above reports it was advised that the Programme for Government commitment on ‘Money Follows the Patient’ should be realised through the introduction of a prospective Diagnosis-Related Group (DRG) case-based payment system. Since January, 2014 the Diagnosis Related Group (DRG) grouping system has been used to facilitate the introduction of a new prospective, case-based funding model for public hospital care called Activity Based Funding (ABF - also known as Money Follows the Patient).
Activity Based Funding is being rolled-out on a phased basis and full implementation will take a number of years. The ABF approach is initially being applied to in-patient and daycase activity in public hospitals. It is the Government’s intention to develop policy proposals for the introduction of a case-based charging system for private patients in public hospitals. However, it must be acknowledged that given the complexity and breadth of the issues to be examined and addressed, significant preparatory policy work must be undertaken. This work must take full account of eligibility and legal issues, private income issues and the need for a sustainable mechanism for meeting the cost of private patients in public hospitals. It would require substantial technical work and analysis on the financial impact on public hospitals. The focus for the short to medium term is on implementing ABF in the public system, as outlined in the recently launched HSE ABF Implementation Plan 2015 – 2017. Until this further work has been completed it will not be possible to present the Deputy with the figure requested.
The Health Service Executive’s Financial Statements 2014 (page 105) provided the following breakdown for patient income which will inform the Deputy on the sums generated by patient charges.
|
2014 |
2013 |
|
|
€m |
€m |
|
|
Private charges * |
298.010 |
239.187 |
|
In-patient charges * |
18.011 |
36.613 |
|
Emergency Department charges |
9.225 |
9.225 |
|
Road Traffic Accident charges |
4.841 |
4.841 |
|
Long Stay charges |
79.820 |
80.140 |
|
EU Income - E111 Claims |
0.015 |
0.015 |
|
409.922 |
371.124 |
* With effect from 1 January 2014, a revised charging structure was introduced for in-patient services provided under Section 55 of the Health Act 1970 (as amended by Health (Amendment) Act 2013.) These include charging all private patients, including those accommodated in a public-designated or non-designated bed, which could not be billed for previously, and a reduction in statutory charges applicable to private patients.
816. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the savings that were targeted on each occasion that hospital charges for patients have been increased. [38131/15]
View answerThe Health (Amendment) Act, 2013 (No. 31 of 2013) provided for the introduction of a revised private in-patient charge for all patients receiving private in-patient services. As a result of discussions between my Department and the private insurance industry during the Act's passage through the Oireachtas, in order to agree a phasing-in of the charges for all private in-patients, it was decided to implement the charges from 1 January 2014 at a rate calculated to raise an additional €30 million in hospital revenue in 2014.
817. Deputy Derek Keating asked the Minister for Health the funding provided to a charity (details supplied) for each of the years, 2011 to 2014, and for 2015 to date. [38133/15]
View answerAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy. If the Deputy has not received a reply from the HSE within 15 working days, he can contact my Private Office and it will follow up the matter with the HSE.
818. Deputy Ruth Coppinger asked the Minister for Health the regulations in place to ensure the quality of training received by service dogs to assist people living with disabilities; and if he will make a statement on the matter. [38139/15]
View answer819. Deputy Ruth Coppinger asked the Minister for Health if he is aware of complaints against a service dog training company (details supplied); and if he will make a statement on the matter. [38140/15]
View answer820. Deputy Ruth Coppinger asked the Minister for Health the State support available to children and adults living with disabilities, whose doctors recommend the use of a service dog to improve their quality of life, or to increase their independence. [38141/15]
View answerI propose to take Questions Nos. 818 to 820, inclusive, together.
The Minister for Health has no function in relation to legislation governing the definition or provision of assistance/service dogs for use by children or adults with disabilities. In accordance with the Disability Act and in the context of Government policy on mainstreaming, every Department has responsibility for disability within its own policy remit. Responsibility for existing legislation regarding the control of dogs, rests with the Department of Environment and Local Government.
The Department of Health does not commission the provision or training of assistance/service dogs for children or adults with disabilities and matters relating to specific dog training companies do not come within its remit. The Health Service Executive's (HSE's) focus is on the protection of core activities such as residential, respite, day and core-therapy provision. The provision of assistance / service dogs to people with a disability is not considered a core health service and is not prioritised for funding by the HSE.
821. Deputy Mary Mitchell O'Connor asked the Minister for Health the long-term nursing home care available a person, without applying under the fair deal scheme, and without paying privately, especially when the person is not old; and if he will make a statement on the matter. [38144/15]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply. If you have not received a reply from the HSE within 15 working days please contact my Private Office and it will follow up the matter with the HSE.
822. Deputy Tony McLoughlin asked the Minister for Health if the Health Service Executive will increase the financial supports offered to the Sligo and Leitrim Acquired Brain Injury Ireland service centre, as it currently has to organise cycles and walks in Sligo to raise money to pay for the rent of its newly opened resource centre in Sligo town; if consideration will be given to the recruitment of a family support worker for the centre; and if he will make a statement on the matter. [38145/15]
View answerAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy. If the Deputy has not received a reply from the HSE within 15 working days, he can contact my Private Office and it will follow the matter up with the HSE.
824. Deputy Tom Fleming asked the Minister for Health if he will examine and expedite a hospital appointment for a person (details supplied) in County Kerry who is waiting to be seen at the plastic surgery clinic in Kerry General Hospital; and if he will make a statement on the matter. [38161/15]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the Health Service Executive, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, as 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.
825. Deputy Jack Wall asked the Minister for Health if assistance is available to a person (details supplied) in County Kildare with the cost of specialised items required on medical grounds, which are not covered by the medical card; and if he will make a statement on the matter. [38162/15]
View answerAs this is a service matter, it has been referred to the Health Service Executive (HSE) for attention and direct reply. If you have not received a reply from the HSE within 15 working days please contact my Private Office and it will follow up the matter with the HSE.
