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Tuesday, 19 Jul 2016

Written Answers Nos. 605-619

Medical Card Eligibility

Questions (605)

Brendan Griffin

Question:

605. Deputy Brendan Griffin asked the Minister for Health if he will direct the HSE to discontinue the highly insensitive practice of requesting parents to provide medical evidence confirming their children's diagnosis of Down's syndrome for the review of medical cards; and if he will make a statement on the matter. [22176/16]

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Written answers

In accordance with the Health Act 1970, as amended, 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. The determination of eligibility for a medical card is the responsibility of the HSE and the HSE reserves the right to review eligibility at any point in time to confirm that a person continues to meet the qualifying criteria required to continue holding eligibility.

Under the review process, applicants are not asked if they, or a family member, still has a lifelong condition or illness as medical cards are not awarded based on a medical condition and, in this regard, such like questions would be neither pertinent nor appropriate.

However, the HSE is obliged under the review process to ensure that full account is taken of any costs that a family may have that arise from a change in their circumstances, perhaps an exacerbation of an illness or a secondary illness. Any questions on change in circumstances refer to the resultant financial impact and do no not refer to a person still having the particular life-long condition or particular illness.

The HSE has a very structured protocol in place for the review process and makes every effort to ensure on-going engagement with clients during this process. If the HSE is made aware that a person has special needs, whether at application or review stage, assistance will be afforded to help that person complete the application whether at application stage or at review stage. The local health office can be contacted or LoCall 1890 252 919 to request this assistance.

Hospital Groups

Questions (606)

Jack Chambers

Question:

606. Deputy Jack Chambers asked the Minister for Health the name of the CEO or equivalent of each hospital and each hospital group on 1 July 2013, 1 July 2014, 1 July 2015 and 1 July 2016 for each public and voluntary hospital within each hospital group; the number of these who received their appointment following an open competition; the number holding the position in an acting or temporary capacity in each appointment on each date; if any of the appointed persons on each date has subsequently been appointed to other roles within the HSE or hospitals; if so, the details of such subsequent appointments; and if these subsequent appointments were the result of open competition. [22204/16]

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Written 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 on the matter with them.

Hospital Appointments Status

Questions (607)

John McGuinness

Question:

607. Deputy John McGuinness asked the Minister for Health further to Parliamentary Question No. 708 of 17 May 2016, if he will arrange treatment as a matter of urgency for a person (details supplied); the reason for the delay; and if he will make a statement on the matter. [22205/16]

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Written answers

As 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.

Charitable and Voluntary Organisations

Questions (608)

Lisa Chambers

Question:

608. Deputy Lisa Chambers asked the Minister for Health if there is funding available for an organisation (details supplied); and if he will make a statement on the matter. [22206/16]

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Written 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.

General Practitioner Services Provision

Questions (609)

Lisa Chambers

Question:

609. Deputy Lisa Chambers asked the Minister for Health the funding allocated to general practitioners for house calls out of hours; whether a person who is housebound is entitled to a GP visit upon request; if not, the waiting time persons are expected to wait for a visit from their GP; his views on whether it is proper practice for a GP to refuse a house call; and if he will make a statement on the matter. [22207/16]

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Written answers

As these are service matters, I have asked the HSE to respond directly to the Deputy on these issues. 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 Appointments Status

Questions (610)

Michael Healy-Rae

Question:

610. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for dental treatment for a person (details supplied); and if he will make a statement on the matter. [22221/16]

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Written answers

As 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.

Services for People with Disabilities

Questions (611)

Thomas Pringle

Question:

611. Deputy Thomas Pringle asked the Minister for Health if he is aware of the premature removal of funding by HSE Donegal for special education needs grants for children with disabilities attending mainstream preschool education; if he is aware of the potential consequences of this removal of funding to the new access and inclusion model recently launched as a cross-departmental initiative between the Department of Children and Youth Affairs, the Department of Education and Skills, and his Department; and if he will make a statement on the matter. [22234/16]

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Written answers

The Early Childhood Care and Education (ECCE) Programme is the responsibility of the Minister for Children and Youth Affairs. The Department of Children and Youth Affairs has brought forward a new model of supports to facilitate the full participation of children with a disability in the ECCE Programme. The new model, called the Better Starts Access and Inclusion Model (AIM) provides supports including enhanced continuing professional development for early years practitioners; grants for equipment, appliances and minor alterations; and access to therapeutic intervention. Funding of €15m has been provided to phase these supports in during 2016. Full year costs for these supports are estimated to be €33 from 2017 onwards. This model of supports was launched on 18th November last by the Minister for Children and Youth Affairs with the full support of both the Department of Health and the Department of Education and Skills.

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.

Improving access to therapy services for children in primary care and in disability services is a particular priority for the Government. Building on additional investment in recent years, funding of €8m is being provided to the HSE in 2016 to expand the provision of Speech and Language Therapy in primary care and the further development of early intervention therapy services under the Progressing Disabilities Programme to facilitate the inclusion of children with a disability in mainstream pre-school settings, as part of the roll out of the new inclusive pre-schools model.

It should be noted that while the Health Services executive has no statutory obligation to provide assistant supports for children with special needs wishing to avail of the ECCE scheme, it has, to date, worked at local level and in partnership with the relevant disability services to address individual needs as they arise. This has been done for example, by funding special pre-schools that cater specifically for children with disabilities. In some limited and specific cases at local level, disability services have in the past also facilitated children with a disability to attend mainstream pre-schools by providing additional supports where possible and where resources are available. When introducing AIM, there was specific emphasis on the fact that all existing supports, should remain in place until the new model is fully embedded in the system. This approach was agreed by the three Government Departments involved in the development of the model and remains the policy position.

Within this context, I have asked the HSE to respond directly 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 Appointments Status

Questions (612)

Niamh Smyth

Question:

612. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) has not received an appointment for a procedure; if a time can be arranged as soon as possible; and if he will make a statement on the matter. [22236/16]

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Written 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.

Hospital Facilities

Questions (613)

Tom Neville

Question:

613. Deputy Tom Neville asked the Minister for Health the status of the bid made to the HSE national capital steering group for €800,000 funding for a new building to house the early pregnancy assessment unit for the University Maternity Hospital, Ennis Road, Limerick, and for the perinatal bereavement counselling services; and the proposed extended operating times for the proposed newly located early pregnancy assessment unit. [22238/16]

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Written 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.

Electronic Health Records

Questions (614)

Alan Kelly

Question:

614. Deputy Alan Kelly asked the Minister for Health the status of the introduction of electronic health records; if he will consider a period of public consultation with regard to the data collected and its use; and the timeline for the roll-out of e-health records. [22258/16]

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Written answers

Since 2013 and the publication by the Government of the eHealth Strategy for Ireland good progress is being made in furthering the eHealth agenda. The strategy sets out a number of objectives and a road map for the delivery and implementation of eHealth, part of which is the development of an electronic health record (EHR) programme. The Office of the Chief Information Officer in the HSE has recently submitted a detailed business case for the programme. My Department is currently evaluating how this might be progressed particularly in delivering an EHR in the context of the work being planned for the New Children’s Hospital which aspires to be the first digital hospital facility in the country. In developing a national electronic health record programme we must build on the progress to date in ICT deployment but also on the lessons learnt from other jurisdictions in developing an optimum solution for Ireland. This programme, if progressed, will require a substantial investment in healthcare ICT. It also offers the opportunity for a more patient centred and a more integrated approach along with significant efficiencies. The business case highlights a number of optional timescales and investment approaches which will need to be considered. The scale of the task in implementing an electronic health record programme is very large and requires a complex procurement and approval process. It is a five to ten year programme of work depending on the scale of resources deployed.

Two current legislative initiatives will help support the EHR - the Health Identifiers Act, 2014 is providing a legal basis for a system of identifiers in the health sector and the Health Information and Patient Safety Bill, currently being drafted, includes provisions for the making of standards to support interoperability of health care computer systems. An EHR implementation will however require a robust legal framework to ensure confidentiality and security of patient data and must be consistent with the new EU data protection regulation, Regulation (EU) 2016/679. My Department is currently examining the appropriate information framework that will provide the optimum environment to support eHealth and the deployment of electronic health records in the future. The health care delivery system straddles both the public and private domains and requires an information governance environment to ensure the right information about the right patient is available securely, in the right place and at the right time. A critically important aspect in the deployment of an EHR is the empowerment of patients to access and partake in managing their own data. In developing new information structures to support health care, substantial engagement with patients and the public will be required along with other stakeholders such as the Office of the Data Protection Commissioners and the Health Information and Quality Authority.

Patient Data

Questions (615)

Alan Kelly

Question:

615. Deputy Alan Kelly asked the Minister for Health the number of people here suffering from coeliac disease; and if he will make a statement on the matter. [22259/16]

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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 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.

Accident and Emergency Services Provision

Questions (616)

Alan Kelly

Question:

616. Deputy Alan Kelly asked the Minister for Health if he will guarantee that trauma care services in emergency departments in Cavan, Naas, Portiuncula in Ballinasloe, Mullingar, Portlaoise, Saint Luke's in Kilkenny, Wexford, South Tipperary in Clonmel and Mercy University Hospital in Cork will not be removed; and if he will make a statement on the matter. [22260/16]

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Written answers

I would like to reassure the Deputy that the work underway in developing a policy on a national trauma policy is about getting the best outcomes for a particular, small category of patients who sustain traumatic injuries. It is not about closing Emergency Departments or diminishing services. There are currently no plans to close or remove trauma services from any hospital.

A trauma patient needs access to the best service that has the right resources to match their often multiple and critical needs in the shortest time possible. The aim of developing national policy on trauma networks is to ensure that trauma patients are brought to the right place at the right time for the right care so they can make the best recovery possible. It is about building on the strengths of pre-hospital care, all of our acute hospitals and post-acute services to provide an optimal configuration of trauma services. The implementation of Hospital Groups provides an opportunity for hospitals to work together to enhance trauma services for patients.

The need for a national trauma system has been recognised for many years. In June 2015 the National Clinical Programme for Trauma and Orthopaedic Surgery published the Model of Care for trauma and orthopaedic surgery and strongly recommended that a national approach to trauma services should be taken. The RCSI (the professional body representing all surgeons and emergency medicine specialists) also called for its establishment at their annual scientific meeting last year.

Last year, the then Minister for Health appointed a National Steering Group to develop policy on a major trauma system for Ireland. This is a joint initiative from the Department of Health and the HSE, developed in recognition that we do not have a coordinated trauma network structure in Ireland.

The Steering Group has been working with the Department of Health, the HSE and all relevant HSE National Clinical Leads, including Surgery, Pre-Hospital Emergency Care, Critical Care, Orthopaedics and Trauma on the development of the policy. The group has not yet reported, I have not seen any output from this group and the Group's recommendations are not expected until later this year.

Services for People with Disabilities

Questions (617)

Alan Kelly

Question:

617. Deputy Alan Kelly asked the Minister for Health if he will clarify the eligibility criteria and application process for patients with muscular dystrophy who require a personal assistant. [22261/16]

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Written answers

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.

With regard to assisted living services, the Health Service Executive's (HSE's) priority in the 2016 National Service Plan is to protect the level of services provided in 2015 and to provide 1.3 million hours of Personal Assistant services to 2,000 people with a physical/sensory disability and 2.6 million hours of Home Support to 7,300 people with a range of disabilities. The provision of Personal Assistant services has an annual cost of €30 million, with an annual cost of €52 million for Home Support services.

Applicants are accessed through an application process or through referrals from public health nurses or other community based staff. The needs of the person applying are evaluated against the prioritisation for the particular service and then decisions are made in relation to the allocation of resources. Resource allocation is determined by the needs of the individual, compliance with prioritisation criteria and the level of resources available. While the resources for the provision of assisted living services, including Personal Assistant services, are substantial, they are finite.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the HSE for direct reply to the Deputy for a more comprehensive reply. 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. Furthermore, if the Deputy has a particular case in mind, he should contact the HSE with the details and it will arrange to have the matter followed up.

Maternity Services

Questions (618)

Alan Kelly

Question:

618. Deputy Alan Kelly asked the Minister for Health if he will consider the introduction of a single clinical guideline for the use of 0xytocin during labour as advocated for by the Institute of Obstetricians and Gynaecologists and the clinical strategies and programmes division of the HSE. [22262/16]

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Written answers

The National Maternity Strategy 2016-2026 sets out a roadmap for the future delivery of maternity services in Ireland and recommends a risk-based approach to inform the use of three care pathways. The Strategy states that, in determining the new model of care, patient safety is the first and overriding principle. Integral to this are guidelines to assess and place women in the appropriate risk category which will ensure that their care is managed their care in line with best evidence.

To this end, the Strategy underlines that this new model of care will be underpinned by evidence-based guidelines which will provide the necessary patient safety assurances, and help to ensure consistency in practice across the country.

The Strategy recommended that the National Clinical Effectiveness Committee (NCEC) prioritises a set of National Clinical Guidelines for maternity services.

The NCEC which is a Ministerial Committee has commenced the commissioning of these guidelines. It is intended that the maternity guidelines will prioritise intrapartum care and will include a guideline on oxytocin use during labour.

The guidelines once complete will be quality assured by the NCEC to ensure that they have been developed to an international standard. They will be submitted to the Chief Medical Officer and the Minister for approval in order that they become mandated for full implementation across all maternity services.

Drug Treatment Programmes

Questions (619)

Alan Kelly

Question:

619. Deputy Alan Kelly asked the Minister for Health for a list of all pharmacies engaged in the provision of methadone to patients; the number involved in the pharmacy needle exchange programme; and if he will make a statement on the matter. [22263/16]

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Written answers

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

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 them.

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