Tuesday, 5 Jul 2016

Written Answers Nos. 510 - 534

Hospital Waiting Lists

Questions (510)

Éamon Ó Cuív

Question:

510. Deputy Éamon Ó Cuív asked the Minister for Health when an operation will be provided for a person (details supplied); the reason for the delay; and if he will make a statement on the matter. [19316/16]

Written answers

Minister for Health

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 HSE, 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 the Deputy directly. If the Deputy has not received a reply from the HSE within 15 working days please he should contact my Private Office and my officials will follow the matter up.

Hospital Appointments Delays

Questions (511)

Barry Cowen

Question:

511. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) can expect an appointment for admission to the National Rehabilitation Hospital, Dún Laoghaire. [19317/16]

Written answers

Minister of State at the Department of Health

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

As the Deputy's question relates to an individual case, 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.

Infectious Disease Epidemics

Questions (512)

Gino Kenny

Question:

512. Deputy Gino Kenny asked the Minister for Health the public health advice he has issued regarding the 2016 Olympics in Brazil and the Zika virus; how he has publicised this advice; and if he will make a statement on the matter. [15309/16]

Written answers

Minister for Health

Zika is a viral infection that usually causes a mild illness, with approximately 80% of infected people having no symptoms. It is transmitted by mosquitoes. Infection with Zika virus in pregnant women has been linked with a serious birth condition called microcephaly where babies are born with unusually small heads. Cases of a neurological illness (called Guillain-Barré Syndrome) possibly caused by Zika virus infection are also being investigated.

Environmental conditions in Ireland do not support the natural reservoirs or vectors of the Zika virus. Consequently, the risk of onward transmission in Ireland is considered low.

Based on national and international expert medical guidance, the Department of Foreign Affairs and Trade strongly recommends that pregnant women consider postponing their travel to affected areas, and in particular to areas classified as having an increasing or widespread transmission of the Zika virus. This is consistent with advice from the European Centre for Disease Prevention and Control.

The HSE Health Protection Surveillance Centre has been liaising with the Department of Foreign Affairs and Trade to ensure appropriate and up to date advices are available to Irish travellers to affected countries. There is also ongoing liaison between the Health Protection Surveillance Centre and the Olympic Council of Ireland concerning preparations for the Games in Rio later this year.

There are a number of preventative measures citizens can take to reduce their exposure to mosquito bites. These include:

- using of mosquito repellents;

- wearing long-sleeved shirts and long trousers, especially during the hours of highest mosquito activity; and

- using of mosquito nets in accommodation which is not adequately screened or air-conditioned.

Travel advices for Irish citizens travelling to Brazil are available on the Department of Foreign Affairs and Trade website (www.dfa.ie). Further practical information is available on the websites of the Health Protection Surveillance Centre (www.hpsc.ie) and the European Centre for Disease Prevention and Control. (ecdc.europa.eu).

Home Help Service Provision

Questions (513)

Bernard Durkan

Question:

513. Deputy Bernard J. Durkan asked the Minister for Health if home help will be restored in the case of a person (details supplied); and if he will make a statement on the matter. [19321/16]

Written answers

Minister of State at the Department of Health

As this is a service matter it has been referred to the Health Service Executive for direct reply. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and they will follow up the matter with the HSE.

Hospital Waiting Lists

Questions (514)

Éamon Ó Cuív

Question:

514. Deputy Éamon Ó Cuív asked the Minister for Health when a person (details supplied) will be transferred to Galway University Hospital to undergo an operation; the reason for the delay; and if he will make a statement on the matter. [19324/16]

Written answers

Minister for Health

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 particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and my officials will follow the matter up.

Drugs Payment Scheme Coverage

Questions (515)

Peter Burke

Question:

515. Deputy Peter Burke asked the Minister for Health if he will fund the drug Ampligen for suffers of myalgic encephalomyelitis; and if he will make a statement on the matter. [19325/16]

Written answers

Minister for Health

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. Prior to reimbursing any item, the HSE considers a range of statutory criteria, including clinical need, cost-effectiveness and the resources available.

The holder of a market authorisation for a product may apply to the HSE to have the product reimbursed in Ireland. The HSE has advised that it does not currently have an application for reimbursement of the drug in question.

Hospital Appointments Status

Questions (516)

Barry Cowen

Question:

516. Deputy Barry Cowen asked the Minister for Health the status of the case of a person (details supplied), including when the person will receive an appointment. [19326/16]

Written answers

Minister for Health

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 HSE, 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 the Deputy directly. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and my officials will follow the matter up.

Hospital Appointments Status

Questions (517)

Barry Cowen

Question:

517. Deputy Barry Cowen asked the Minister for Health the status of the case of a person (details supplied), including when the person will receive an appointment. [19327/16]

Written answers

Minister for Health

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 the Deputy directly. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and my officials will follow the matter up.

Hospital Appointments Status

Questions (518)

Barry Cowen

Question:

518. Deputy Barry Cowen asked the Minister for Health the status of the case of a person (details supplied), including when the person will receive an appointment. [19328/16]

Written answers

Minister for Health

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 the Deputy directly. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and my officials will follow the matter up.

Hospital Appointments Status

Questions (519)

Barry Cowen

Question:

519. Deputy Barry Cowen asked the Minister for Health the status of the case of a person (details supplied), including when the person will receive an appointment. [19329/16]

Written answers

Minister for Health

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 the Deputy directly. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and my officials will follow the matter up.

Hospital Appointments Status

Questions (520)

Peter Burke

Question:

520. Deputy Peter Burke asked the Minister for Health the status of an appointment for a person (details supplied). [19330/16]

Written answers

Minister for Health

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 the Deputy directly. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and my officials will follow the matter up.

Home Help Service Provision

Questions (521)

Éamon Ó Cuív

Question:

521. Deputy Éamon Ó Cuív asked the Minister for Health to provide home help hours for a person (details supplied); and if he will make a statement on the matter. [19335/16]

Written answers

Minister of State at the Department of Health

As this is a service matter it has been referred to the Health Service Executive for direct reply. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and they will follow up the matter with the HSE.

Hospital Appointments Status

Questions (522)

Barry Cowen

Question:

522. Deputy Barry Cowen asked the Minister for Health the status of an appointment for a person (details supplied). [19349/16]

Written answers

Minister for Health

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 the Deputy directly. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and my officials will follow the matter up.

Smoking Ban

Questions (523)

Bernard Durkan

Question:

523. Deputy Bernard J. Durkan asked the Minister for Health his plans, if any, to ensure that smoking areas in public places are not open to the elements with risk of contracting colds, influenza and discomfort; and if he will make a statement on the matter. [19353/16]

Written answers

Minister of State at the Department of Health

Smoking areas in public places are not regulated for by legislation in Ireland. However, section 47(7) the Public Health Tobacco Act 2002 as substituted by Section 16 of the Public Health (Tobacco) Act 2004 provides an exemption from the general prohibition on smoking in a workplace in respect of certain places. The exemption applies to "an outdoor part of a place or premises covered by a fixed or movable roof, provided that not more than 50 per cent of the perimeter of that part is surrounded by one or more walls or similar structures (inclusive of windows, doors, gates or other means of access to or egress from that part)".

Exposure to second-hand smoke in confined spaces is a serious health hazard and even brief exposure can cause damage. Second-hand smoke consists of over 7,000 chemicals, including more than 60 known carcinogens. Medical and scientific evidence shows that exposure to second-hand smoke increases the risk of serious medical conditions, such as lung cancer, cardiovascular disease, respiratory disease and sudden infant death syndrome.

Given that the Government's policy is to achieve a tobacco free Ireland by 2025, there are no plans to amend the current legislation.

Dental Services

Questions (524)

Michael Healy-Rae

Question:

524. Deputy Michael Healy-Rae asked the Minister for Health his views on correspondence (details supplied) regarding oral health and hygiene; and if he will make a statement on the matter. [19360/16]

Written answers

Minister for Health

There is a commitment in the Programme for a Partnership Government to introduce a preventive dental health programme for children under 12 and adult medical card holders. The National Oral Health Policy, which the Department of Health is currently developing, will inform future provision of dental services. This project is being led by the Chief Dental Officer and includes a needs assessment, a review of resources and involves consultation with stakeholders, including dental professionals and the public.

These are matters which I intend to consider in the context of the implementation of the Health commitments in the Programme for Government and having regard to the funding available to facilitate such measures. Detailed financial analysis will be required in order to establish as accurately as possible the expected costs to the Exchequer in each case.

Hospital Waiting Lists

Questions (525)

Michael Healy-Rae

Question:

525. Deputy Michael Healy-Rae asked the Minister for Health the status of an operation for a person (details supplied); and if he will make a statement on the matter. [19361/16]

Written answers

Minister for Health

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 HSE, 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 the Deputy directly. If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and my officials will follow the matter up.

Hospitals Funding

Questions (526)

John Lahart

Question:

526. Deputy John Lahart asked the Minister for Health the funding granted to the National Rehabilitation Hospital in each of the years 2010 to 2016, in tabular form. [19363/16]

Written answers

Minister of State at the Department of Health

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

The Deputy may be aware that the Government announced a major development of the National Rehabilitation Hospital which will deliver a purpose built hospital on the site with 120 beds and include support therapies, paediatric and acquired brain injury wards, a hydrotherapy unit and a sports hall.

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.

Departmental Expenditure

Questions (527)

John Lahart

Question:

527. Deputy John Lahart asked the Minister for Health the funding totals from his Department allocated to the treatment of spinal injuries, in tabular form. [19364/16]

Written answers

Minister of State at the Department of Health

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

The treatment of spinal injuries takes place across the full range of health services, including trauma centres, acute hospitals (national centres and regional specialties), rehabilitation, community care and primary care.

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.

Long-Term Illness Scheme Eligibility

Questions (528)

John Lahart

Question:

528. Deputy John Lahart asked the Minister for Health why paralysis is not classed as a long-term illness; and if he will make a statement on the matter. [19365/16]

Written answers

Minister for Health

The Long Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act, 1970 (as amended). Regulations were made in 1971, 1973 and 1975 specifying the conditions covered by the LTI Scheme, which are as follows: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide. There are no plans to extend the list of conditions covered by the LTI Scheme.

Under the Drugs Payment Scheme, no individual or family pays more than €144 per calendar month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals incurring ongoing expenditure on medicines.

Under the provisions of the Health Acts, medical cards are provided to persons who are unable, without undue hardship, to arrange health services for themselves and their dependants. In the assessment process, the HSE can take into account medical costs incurred by an individual or a family.

Medical Card Eligibility

Questions (529)

John Lahart

Question:

529. Deputy John Lahart asked the Minister for Health the criteria that must be met for a person with spinal injuries to be granted a medical card; and if he will make a statement on the matter. [19366/16]

Written answers

Minister for Health

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has recently issued to Oireachtas members.

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

Hospital Waiting Lists

Questions (530)

Robert Troy

Question:

530. Deputy Robert Troy asked the Minister for Health to intervene and schedule an appointment for a person (details supplied). [19391/16]

Written answers

Minister for Health

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 the Deputy directly. If the Deputy has received a reply from the HSE within 15 working days contact my Private Office and my officials will follow the matter up.

Nursing Homes Support Scheme Expenditure

Questions (531)

Jack Chambers

Question:

531. Deputy Jack Chambers asked the Minister for Health if he will seek the policy reasons from the Health Service Executive as to why it refuses to publish revised costs of care in public nursing homes; if he is aware that this is outstanding for five years; if he is concerned about transparency in the HSE; and if he will make a statement on the matter. [19396/16]

Written answers

Minister of State at the Department of Health

The Nursing Homes Support Scheme Act, 2009 provides that the components that make up the cost of care in public residential facilities must be laid before the Houses of the Oireachtas, and the HSE have complied with this requirement. There is no legal obligation under the Act for the HSE to publish the public cost of care.

Over the past number of years the cost of care for public nursing homes under the Scheme as published on the HSE website was not updated by the HSE as the costs of public long stay and short stay care services were being reviewed. This work was acknowledged in the Review of the Nursing Homes Support Scheme, which was published by the Department of Health in July 2015. The HSE will, however, publish the cost of care for public residential care centres in September 2016 in the interests of transparency, and the HSE continues to work to improve the value for money that is delivered by public facilities.

Nursing Homes Support Scheme Expenditure

Questions (532)

Jack Chambers

Question:

532. Deputy Jack Chambers asked the Minister for Health if he is satisfied with his Department's implementation of the Nursing Home Support Scheme Act 2009; if he is aware that under the Act private and voluntary nursing homes are being forced to provide care for fees that are on average 58% below those paid to their public counterparts nationally; and if he will make a statement on the matter. [19397/16]

Written answers

Minister of State at the Department of Health

The Nursing Homes Support Scheme (NHSS) is a system of financial support for those assessed as needing long-term nursing home care. Participants contribute according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate setting.

The legislation underpinning the Scheme requires each private nursing home to negotiate and agree a price for long-term residential care services with the National Treatment Purchase Fund (NTPF) should they wish to be an approved nursing home for the purposes of the Scheme. The NTPF has statutory independence in the performance of its function, and negotiates with each nursing home on an individual basis. The Department of Health has no role in such negotiations. The NTPF may examine the records and accounts of nursing homes as part of the process with the objective of setting a fair price which delivers value for money to the individual and the State.

In negotiating with nursing homes, the NTPF has regard to:

- Costs reasonably and prudently incurred by the nursing home and evidence of value for money,

- Price(s) previously charged,

- Local market price, and

- Budgetary constraints and the obligation on the State to use available resources in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the public.

When the NHSS commenced in 2009, a commitment was made that it would be reviewed after three years. The Report of the Review was published in July 2015. A number of issues have been identified for more detailed consideration, including a review of pricing mechanisms by the NTPF, with a view to:

- Ensuring value for money and economy, with the lowest possible administrative costs for clients and the State and administrative burden for providers,

- Increasing the transparency of the pricing mechanism so that existing and potential investors can make as informed decisions as possible, and

- Ensuring that there is adequate residential capacity for those residents with more complex needs.

A Steering Committee has been established to oversee the review of the pricing system for private long-term residential care facilities. This Steering Committee is chaired by the NTPF and includes representatives from the Department of Health, the Department of Public Expenditure and Reform, and the NTPF, and has commenced its work in this area.

There are a number of reasons why the costs of public facilities are generally higher than those in the private sector. More complex and highly dependent residents are more generally catered for by the public system which has obvious cost implications. In addition, conditions of employment and tenure differ between private and public residential care facilities.

However, it is important that public facilities operate as efficiently and economically as possible, and towards that end the HSE is already engaged in a comprehensive exercise to review and streamline the operation and cost structures of public facilities, and the Department of Health will work closely with the HSE in that context to ensure that value for money is delivered.

Nursing Homes Support Scheme

Questions (533, 534)

Jack Chambers

Question:

533. Deputy Jack Chambers asked the Minister for Health his plans to act on the report, Accounts of the Public Services 2010, published in 2011 where the Comptroller and Auditor General informed him that the cost of care in Health Service Executive nursing homes was significantly higher than in private nursing homes; if his attention has been drawn to the comments in the report that residents were wrongly charged some €52 million for medicines and therapeutic services in public nursing homes; and if he will make a statement on the matter. [19398/16]

Jack Chambers

Question:

534. Deputy Jack Chambers asked the Minister for Health if he is aware that independent research undertaken by the Dementia Services Information and Development Centre states private nursing homes are the majority providers of specialist dementia care; if he is further aware that three quarters of persons who avail of nursing home care are of high or maximum dependency, with 80% of the care provided by the private and voluntary nursing home sector; if he accepts the Health Service Executive claims that it is providing more specialist care as the reason for its higher cost; and if he will make a statement on the matter. [19399/16]

Written answers

Minister of State at the Department of Health

I propose to take Questions Nos. 533 and 534 together.

I am aware of the research referred to by the Deputy.

Long–term nursing home care is provided through a mix of public and private provision, with the public sector providing about 20% of all beds.

There are a number of reasons why the costs of public facilities are generally higher than those in the private sector. I do accept that many residents with higher or more complex care needs are often catered for by the public system which has obvious cost implications. From an acute hospital discharge perspective the challenge to find suitable placements for those with more complex needs is often resolved in public centres where nurse staffing levels in particular can cater for their needs.

The Review of the Nursing Homes Support Scheme which was published last year reported that HSE long-term residential care facilities have the highest proportion of maximum dependent older people at just over 60% compared to that of private nursing homes with almost 35%. The most expensive of the HSE's public nursing homes generally accommodate a cohort of young chronic sick clients. These patients are complex cases with high dependency requiring significant nursing care. There are also nursing homes that specialise in the care of residents with Alzheimer’s and who need a secure environment and others who care for residents with challenging behaviours.

However, there are other reasons why costs are higher in the public system. Conditions of employment and tenure for staff are also different and the capacity of a public facility to adjust its costs in response to changed circumstances is very different. However, the NHSS Review acknowledged that even allowing for the fact that residents in public facilities may have higher care needs, costs for public facilities appear to be in excess of what applies in private facilities.

The HSE is committed to ensuring that all services, including residential services, represent good value for the taxpayer. My Department will be working closely with the HSE to examine the costs of public facilities and to address any elements that are unacceptable or inappropriate.

The National Treatment Purchase Fund (NTPF) has responsibility for setting prices in private and voluntary facilities. In negotiating with nursing homes, the NTPF has regard to:

- Costs reasonably and prudently incurred by the nursing home and evidence of value for money,

- Price(s) previously charged,

- Local market price, and

- Budgetary constraints and the obligation on the State to use available resources in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the public.

The Accounts of the Public Services 2010 report referred to by the Deputy notes that the HSE charged €52 million to the long-term residential care subhead in respect of medicines and therapeutic services to residents. Residents themselves were not charged for these services. In 2012 the HSE took the steps necessary to correct the position.