Michael Healy-Rae
Question:406. Deputy Michael Healy-Rae asked the Minister for Health the status of an application for equipment by a person (details supplied) in County Kerry. [41569/15]
View answerMedical Aids and Appliances Provision
Questions (406)
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 (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 they will follow the matter up with the HSE.
General Medical Services Scheme
Questions (407)
Noel Harrington
Question:407. Deputy Noel Harrington asked the Minister for Health if there has been a change in the cost of international normalised ratio testing for patients on a medical card who are prescribed warfarin for a blood test; the reason for this change; and if he will make a statement on the matter. [41574/15]
View answerWritten answers
Persons covered by the General Medical Services (GMS) Scheme should not be charged for routine phlebotomy services provided by their GP, or the Practice Nurse on behalf of the GP, which are required to either assist in the diagnosis of a patient or to monitor a diagnosed condition. Furthermore, a GP is precluded from demanding or accepting payments, other than payments from the HSE as provided for under his/her contract, for services covered by the GMS contract, such as issuing a letter of referral to another service/clinician.
Whereas INR blood tests are not mentioned specifically in the GMS contract, such tests are carried out by some general practitioners as a matter of course in their practices and I welcomes this. This provides their patients with an option of receiving this service locally in a primary care setting rather than attending an acute hospital for this service. Warfarin testing is available free of charge in hospitals.
Consultation fees charged by general practitioners outside the terms of the GMS contract are a matter of private contract between the clinicians and the patients. While I have no role in relation to such fees, I would expect clinicians to have regard to the overall economic situation in setting their fees.
A Memorandum of Understanding signed in February 2015 commits the Department of Health, the HSE and the IMO to substantive negotiations on a new comprehensive GP contract. These discussions have commenced and the appropriate arrangements in relation to phlebotomy services and anti-coagulation therapy will be considered in this context.
Mental Health Services Funding
Questions (408)
Tom Fleming
Question:408. Deputy Tom Fleming asked the Minister for Health if he will provide funding in the 2016 mental health budget (details supplied) in compliance with A Vision for Change, the mental health services report for 2006, which recommended that a minimum of 8.5% of the health budget should be allocated to mental health to implement its recommendations, including a comprehensive 24 hour, seven day community-based service; and if he will make a statement on the matter. [41588/15]
View answerWritten answers
In line with the Programme for Government, my priority as Minister has been to modernise our mental health services, and to prioritise new resources to underpin the implementation of A Vision for Change. This Government, despite severe financial pressures overall, has provided additional ring-fenced funding of €125 million up to end 2015, for new developments in mental health. However, on a year-by-year basis the HSE mental health budget has also been subject to downward adjustments for pay and procurement savings, similar to other HSE service areas.
I am pleased that I have secured a further €35 million for mental health for 2016. This means that during the lifetime of this Government, we will have provided a total of €160 million ring-fenced funding for mental health up to the end of 2016, to develop and enhance our mental health services. My priorities for next year include the development of quality counselling services across both primary and secondary care, the expansion of the Jigsaw youth mental health service to Dublin and Cork city centres, investment in improved 24/7 responses and liaison services and Psychiatry of Later Life. The level of health services to be provided within the available funding will be set out in the HSE’s 2016 National Service Plan, which is expected to be finalised shortly.
The staff of our health service is our largest and most important resource. In relation to the staffing level, at the end of 2006, the mental health services employed 9,985 WTE staff. It currently stands at approximately 9,300 WTE staff. It is acknowledged that, notwithstanding the additional 1,150 new posts approved for mental health since 2012, the numbers employed in the service have been reducing over recent years for a number of reasons including retirements, staff leaving to take up other posts, and the moratorium on recruitment etc. However, while staffing levels have fallen there are some positives that must be acknowledged:
- Many of the staff numbers lost were supporting the excessive numbers of beds which are no longer part of the service user recovery focused modern community based-service model for mental health.
- We have been able to mitigate the overall reduction in numbers thanks to the priority ring-fenced Programme for Government investments since 2012.
- This investment has allowed us to begin to re-balance the staff skill mix in mental health to introduce new staff in the historically under represented disciplines recommended in Vision i.e. psychologists, social workers and occupational therapists.
I can assure the Deputy that this Government remains committed to prioritising and improving our mental health services.
HSE Funding
Questions (409)
Clare Daly
Question:409. Deputy Clare Daly asked the Minister for Health his views on the underfunding of a community organisation (details supplied) in County Kilkenny; if funding in line with the needs of its residents will be provided, as it has less than three months' reserve, and will have to issue protection notices; and if he will make a statement on the matter. [41591/15]
View answerWritten answers
The Government is committed to protecting frontline health and personal social services needs for people with disabilities. The Government currently provides funding of approximately €1.5 billion to the Disability Services Programme through the Health Service Executive's National Service Plan for 2015.
In 2015, the HSE is seeking to maximise the provision of services within available resources and to maintaining a consistent level to that provided in 2014, by providing the following specialist disability services:
- residential services to around 9,000 people with a disability;
- day services to over 22,000 people with intellectual and physical disabilities;
- respite residential support of 190,000 overnights for people with intellectual and physical disabilities;
- 3.9 million hours of Personal Assistant / Home Support Hours.
Additional funding of €6 million has been allocated in the HSE National Service Plan in 2015 to provide day places for an estimated 1,400 young people finishing school and rehabilitative (life-skills) training. €4m in additional funding has also been allocated in the Plan to deliver an increase in the services for children with disabilities and reduce waiting lists under the Progressing Disability Services for Children and Young People (0-18s) Programme.
The HSE provides funding to L'Arche Community for the provision of health and personal social services under Section 39 of the Health Act 2004. My Department has not held any formal meetings with the HSE in relation to the current difficulties facing L'Arche. However, I am aware of the financial challenges facing L’Arche Community at this time and that the HSE has been in ongoing contact with the management of L’Arche in an effort to find a solution to these difficulties.
I understand from the HSE that these difficulties stem from compliance issues with the regulatory environment, which require that the model of service previously provided by L’Arche be reviewed and enhanced.
The HSE has been working with all voluntary service providers on improving compliance during 2015, addressing the highest risk areas as a priority. These efforts will continue in 2016 and preparation of the HSE’s Service and Operational Plans will be underpinned by a focus on making the best use of the resource invested in disability services.
I have been assured by the HSE that it will continue to work with L’Arche Community and be as supportive as possible within current financial constraints.
Hospital Appointments Status
Questions (410)
Mary Mitchell O'Connor
Question:410. Deputy Mary Mitchell O'Connor asked the Minister for Health the status of a referral for a hospital appointment for a person (details supplied) in County Dublin; and if he will make a statement on the matter. [41596/15]
View answerWritten answers
Under 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 scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. 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.
Primary Medical Certificates Provision
Questions (411)
Pat Breen
Question:411. Deputy Pat Breen asked the Minister for Health the reason a person (details supplied) in County Clare has not been facilitated with a primary medical certificate; and if he will make a statement on the matter. [41601/15]
View answerWritten answers
A Primary Medical Certificate is issued by the Health Service Executive to confirm that a person is severely and permanently disabled for the purpose of the Revenue Commissioners' Disabled Drivers and Disabled Passengers (Tax Concessions) scheme. Where the issue of a Primary Medical Certificate is refused, the applicant may appeal this refusal to the Disabled Drivers Medical Board of Appeal. The criteria for the scheme is a matter for the Minister for Finance. As 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 they will follow the matter up with the HSE.
Ambulance Service Response Times
Questions (412)
Billy Kelleher
Question:412. Deputy Billy Kelleher asked the Minister for Health his views regarding the ambulance response time in respect of a person (details supplied) in County Meath; and if he will make a statement on the matter. [41602/15]
View answerWritten answers
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.
Primary Care Centres
Questions (413)
Thomas P. Broughan
Question:413. Deputy Thomas P. Broughan asked the Minister for Health when a primary care health centre will be opened and operational in Coolock in Dublin 17; and if he will make a statement on the matter. [41613/15]
View answerWritten answers
The HSE has responsibility for the provision, maintenance and operation of Primary Care Centres. Therefore, this matter has been referred to the HSE for attention and 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.
Hospital Staff Data
Questions (414)
Thomas P. Broughan
Question:414. Deputy Thomas P. Broughan asked the Minister for Health the differences in core standards of Dublin hospitals; the hospital that has the highest number of staff vacancies; the number of nursing, doctor and consultant vacancies in each Dublin hospital; and if he will make a statement on the matter. [41614/15]
View answerWritten answers
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.
Hospital Waiting Lists
Questions (415)
Thomas P. Broughan
Question:415. Deputy Thomas P. Broughan asked the Minister for Health the number of persons on outpatient waiting lists at each Dublin hospital; the hospital with the shortest waiting time; and with the longest waiting time; and if he will make a statement on the matter. [41615/15]
View answerWritten answers
The National Treatment Purchase Fund (NTPF) is responsible for the collection, collation and publication of Out Patient waiting lists. Waiting list information is published on the NTPF website at the end of each month. The information is presented in different report formats, i.e. by National/Trend, by Hospital/Group, and by Specialty.
The most recent Out Patient / In-patient/Day Case waiting list data, for end of October 2015, may be found at http://www.ntpf.ie/home/pdf//2015/10/hospitals/in-patient/0922.pdf and the most recent Outpatient Waiting List may be found at http://www.ntpf.ie/home/pdf//2015/10/hospitals/out-patient/0922.pdf.
In relation to the specific waiting list data in respect of each Dublin Hospital, this information is also available on the NTPF Website, 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.
Home Care Packages
Questions (416)
Eoghan Murphy
Question:416. Deputy Eoghan Murphy asked the Minister for Health if he will provide a solution to a home care problem (details supplied). [41624/15]
View answerWritten answers
As 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 they will follow up the matter with them.
Health Services Provision
Questions (417)
Eoghan Murphy
Question:417. Deputy Eoghan Murphy asked the Minister for Health if he will provide assistance to a person (details supplied) in Dublin 6. [41629/15]
View answerWritten answers
Under 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.
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.
Hospital Procedures
Questions (418)
Michael Healy-Rae
Question:418. Deputy Michael Healy-Rae asked the Minister for Health the status of a person (details supplied) in County Kerry who is waiting for an operation. [41636/15]
View answerWritten answers
Under 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.
Medical Card Delays
Questions (419)
Dara Calleary
Question:419. Deputy Dara Calleary asked the Minister for Health why a discretionary medical card has not been issued to a person (details supplied) in County Leitrim; if he will agree that it is disgraceful that seriously ill patients do not have an automatic right to medical cards; if he will explain the delay in processing this person's application; and if he will make a statement on the matter. [41645/15]
View answerWritten answers
Under 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 nearly 96,000 at the beginning of November 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.
In relation to the particular query raised, I have asked the HSE, which operates the General Medical Services scheme, to respond directly to the Deputy. If a reply from the HSE has not been received within 15 working days, please contact my Private Office and my officials will follow the matter up.
Hospital Procedures
Questions (420)
Michael Healy-Rae
Question:420. Deputy Michael Healy-Rae asked the Minister for Health the status of the case of a person (details supplied) in County Kerry who is waiting for an operation; and if he will make a statement on the matter. [41656/15]
View answerWritten answers
Under 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.
Services for People with Disabilities
Questions (421)
Colm Keaveney
Question:421. Deputy Colm Keaveney asked the Minister for Health the whole-time equivalents working in the intellectual disability sector, the number employed by the Health Service Executive, and the number employed by agencies, by grade, in tabular form; and if he will make a statement on the matter. [41657/15]
View answerWritten answers
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.
Universal Health Insurance
Questions (422)
Billy Kelleher
Question:422. Deputy Billy Kelleher asked the Minister for Health the cost of the recent Economic and Social Research Institute report on universal health insurance; if upon deciding the commission of research into the estimated costs of universal health insurance, he invited tenders for the conduct of this research. [41661/15]
View answerWritten answers
The report by the Economic and Social Research Institute (ESRI), An examination of the potential costs of Universal Health Insurance in Ireland, ESRI Research Series Number 5, (September, 2015) was undertaken as part of a three-year Research Programme on Healthcare Reform agreed between the ESRI and the Department of Health. The agreed average annual cost of this programme, which aims to apply economic analysis to explore issues in relation to health services, health spending and population health, is €393,000.
As the report was undertaken as part of a research programme and all final outputs under the research programme are public goods, tendering requirements did not apply. The ESRI operates similar research programmes with other public bodies.
Accident and Emergency Department Waiting Times
Questions (423)
Pearse Doherty
Question:423. Deputy Pearse Doherty asked the Minister for Health why more than 2,600 persons have been on trolleys in Letterkenny General Hospital in County Donegal since 1 January 2015; and if he will make a statement on the matter. [41683/15]
View answerWritten answers
ED overcrowding is a key priority issue for the Government. Significant progress has been made to date on the overall ED Taskforce plan, with reductions in delayed discharges and waiting times for NHSS funding, allied with increased provision for transitional care funding, home care packages and nursing home beds. All hospitals have escalation plans to manage not only patient flow but also patient safety in a responsive, controlled and planned way that supports and ensures the delivery of optimum patient care.
In preparation for the 2015/16 winter period, hospital groups have provided comprehensive winter resilience plans to the HSE, outlining how they will implement an integrated approach across primary, community, social and acute services to manage winter pressures. This approach is intended both to avoid unnecessary admissions to acute hospitals and to expedite discharges from hospital efficiently. Within hospitals themselves, a total of 129 beds which had been closed for refurbishment or for infection control purposes during 2015 are to be re-opened by the end of November. A further 301 beds are being added nationally to support the acute hospital system over the winter period across various locations, including Letterkenny, which is to open an 10 additional beds. €18m in funding has been provided to support these developments.
As the trolley issues referred to in Letterkenny are 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.
Services for People with Disabilities
Questions (424)
Ciaran Lynch
Question:424. Deputy Ciarán Lynch asked the Minister for Health when an assessment of needs will be provided for a person (details supplied) in County Cork who is on the autism spectrum; and if he will make a statement on the matter. [41706/15]
View answerWritten answers
As the particular issue raised by the Deputy relates to an individual case, this is a service matter for the Health Service Executive. Accordingly, I have arranged for the question to be referred to the HSE 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.
Departmental Schemes
Questions (425)
Denis Naughten
Question:425. Deputy Denis Naughten asked the Minister for Health when the replacement schemes for the currently suspended motorised transport grant scheme and the mobility allowance scheme will be introduced; if the proposal for an alternative scheme has been brought to Cabinet; if such a proposal has been included on the agenda of the Cabinet sub-committee; if the proposals have been referred to the Office of the Parliamentary Counsel; when it will be published; and if he will make a statement on the matter. [41719/15]
View answerWritten answers
The Government decided that the detailed preparatory work required for a new Transport Support Scheme and associated statutory provisions should be progressed by the Minister for Health. The Department is seeking a solution which would best meet the aim of supporting people with severe disabilities who require additional income to contribute towards the cost of their mobility needs, while remaining within the available budget and satisfying all legal and equality concerns.
Work is ongoing on the policy proposals to be brought to Government for the drafting of primary legislation for a new scheme. The proposals seek to ensure that:
- There is a firm statutory basis to the Scheme's operation;
- There is transparency and equity in the eligibility criteria attaching to the Scheme;
- Resources are targeted at those with the greatest needs; and
- The Scheme is capable of being costed and it is affordable on its introduction and on an ongoing basis.
Heads of Bill have now been developed in draft form and are currently subject to detailed legal examination. The approval of a General Scheme and Heads of Bill by the Government will be followed by publication and pre-legislative scrutiny by the Oireachtas Health and Children Committee. The Health (Transport Support) Bill is included in the Government Legislation Programme.