Friday, 16 Sep 2016

Written Answers Nos. 1039-1057

General Medical Services Scheme Administration

Questions (1039)

Aengus Ó Snodaigh

Question:

1039. Deputy Aengus Ó Snodaigh asked the Minister for Health if there is provision for financial assistance for a person (details supplied) [24472/16]

Written answers

Minister for Health

The Health Service Executive operates the General Medical Services (GMS) scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. Under the provisions of the Health Act 1970 (as amended), eligibility for health services in Ireland is based primarily on residency and means. The Act provides that persons who are unable, without undue hardship, to arrange GP services for themselves and family can qualify for a medical card. The HSE can only award medical cards in accordance with the Health Act and, therefore, assesses applicants on the overall financial situation of the applicant and his or her spouse or partner. The HSE gives effect to this legislation through its Medical Card National Assessment Guidelines.

Patients who are not eligible for the GMS or Long Term Illness schemes can avail of the Drugs Payment Scheme (DPS), which provides protection from excessive ongoing expenditure on medicines. Under this scheme, an individual or family pays up to the first €144 each month for approved prescription items, with any cost above that threshold paid by the State. There is no prescription charge under the DPS.

Anybody who lives in Ireland and has a personal public service number is entitled to join the DPS. You can register at http://www.hse.ie/eng/services/list/1/schemes/ or at any community pharmacy.

Respite Care Services Provision

Questions (1040, 1089)

John Brassil

Question:

1040. Deputy John Brassil asked the Minister for Health if the necessary respite supports will be provided to persons (details supplied); and if he will make a statement on the matter. [24473/16]

Michael Healy-Rae

Question:

1089. Deputy Michael Healy-Rae asked the Minister for Health the status of the case of a person's (details supplied) respite services; and if he will make a statement on the matter. [24633/16]

Written answers

Minister for Health

I propose to take Questions Nos. 1040 and 1089 together.

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 Programme for Partnership Government states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability.

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.

Respite Care Services

Questions (1041)

John Brassil

Question:

1041. Deputy John Brassil asked the Minister for Health if he will allocate funding for additional residential respite care services to meet the requirements for the Health Information and Quality Authority, most especially in the Kerry area; and if he will make a statement on the matter. [24474/16]

Written answers

Minister for 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 Programme for Partnership Government states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability. 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.

Blood Donations

Questions (1042)

Clare Daly

Question:

1042. Deputy Clare Daly asked the Minister for Health his new policy and the revised criteria for donating blood; and the date upon which gay persons can present themselves to blood transfusion services in order to perform their civic duty [24476/16]

Written answers

Minister for Health

Having reviewed the Irish Blood Transfusion Service (IBTS) report regarding a change in deferral policies for blood donation by men who have sex with men, I have accepted its recommendation to reduce the current lifelong ban from donating blood to a one-year deferral. I have also accepted its recommendation to defer those with a history of a sexually transmitted infection for five years after that infection.

My officials are engaging with the IBTS on the development of a plan to support the implementation of this change in blood donation policy and to communicate the policy change clearly to all potential blood donors and recipients of blood and blood products, as well as to the general public.

A date for implementation of the amended policy has not been finalised at this stage.

Nursing Home Services

Questions (1043)

Noel Grealish

Question:

1043. Deputy Noel Grealish asked the Minister for Health if his attention has been drawn to the fact that some nursing homes are now adding a weekly surcharge to nursing home fees, which must be paid in addition to charges for discretionary items; his plans to have these surcharges added to the nursing home fees when calculating the clients contribution as part of the fair deal, as this is putting some clients under significant financial pressure; and if he will make a statement on the matter. [24493/16]

Written answers

Minister for Health

The Nursing Homes Support Scheme (NHSS) is a system of financial support for people who require long-term nursing home care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost.

The NHSS covers the cost of the standard components of long-term residential care which are:

- Nursing and personal care appropriate to the level of care needs of the person;

- Bed and board;

- Basic aids and appliances necessary to assist a person with the activities of daily living; and

- Laundry service.

A person's eligibility for other schemes, such as the medical card scheme or the drugs payment scheme, is unaffected by participation in the NHSS or residence in a nursing home.

Although the NHSS covers core living expenses, residents can still incur some costs in a nursing home, e.g. social programmes, newspapers or hairdressing. In recognition of this, anyone in receipt of financial support under the NHSS retains at least 20% of their income. The minimum amount that is retained is the equivalent of 20% of the State Pension (Non-Contributory). An operator should not seek payment from residents for items which are covered by the NHSS, the medical card or any other existing scheme.

Part 7 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 stipulates that the registered provider of the nursing home must agree a contract in writing with each resident on their admission to the nursing home. This contract must include details of the services to be provided to that resident and the fees to be charged. Residents should never be charged fees which are not set out in the contract. The Department of Health and the HSE are not a party to such contracts which are concluded between each resident and their nursing home.

Registered providers of nursing home care are obliged to provide an accessible and effective complaints procedure. Concerns about additional charges should in the first instance be taken up with the nursing home provider. The Office of the Ombudsman can examine complaints about the actions of a range of public bodies and, from 24 August 2015, complaints relating to the administrative actions of private nursing homes. The Office of the Ombudsman normally only deals with a complaint once the individual has already gone through the complaints procedure of the private nursing home concerned.

The Review of the Nursing Homes Support Scheme, published in July 2015, looked at the issue of additional costs in private nursing homes and made the following recommendations:

- Nursing homes should have a published fee schedule showing all the costs associated with being a resident.

- Consideration should be given to introducing a new provision under the scheme to prohibit the levying of additional charges for any service or facility from which residents can not readily opt out without penalty while remaining as residents of that facility, or in which they cannot participate because of their level of dependency.

- Consideration should be given to including in the price contracts with facilities, details of what additional charges are proposed, of the opt-out arrangements that exist for residents and confirmation that residents will not be charged for extra services that they cannot participate in because of their dependency or lack of capacity.

An Interdepartmental/Agency Working Group has been established to progress the recommendations contained in the Review. A specific date has not been set for the Group to conclude its work, but it is in the process of reporting on its progress to date to the Cabinet Committee on Health. This will be done shortly, in line with the Committee's own scheduling requirements.

Home Help Service Provision

Questions (1044)

Martin Kenny

Question:

1044. Deputy Martin Kenny asked the Minister for Health when budgetary provision will be made available to meet the demand for home help hours (details supplied). [24495/16]

Written answers

Minister for Health

Home support services across the country are being stretched by demands from more people, and for more hours in the evenings and at weekends, all of which cost more. Activity in the first quarter of 2016 was ahead of the same period last year as efforts continued to alleviate pressure on the acute hospital system.

I am delighted that the Government has been able to respond to this demand by providing an extra €40m for home care in 2016. As a result, not only are we maintaining home care services at 2015 levels, but increasing them in 2016. This will ensure that the HSE will provide 270,000 extra home help hours and 2,000 Home Care Packages more than what was planned for in 2015.

The Programme for a Partnership Government commits to increasing provision for home care in the years ahead. The planning and management of future health expenditure will be considered as part of the annual estimates and budgetary process which seeks to balance available funding across all service areas to achieve the best possible outcomes for the greatest number of service users.

Disability Support Services

Questions (1045, 1046, 1340)

Joe Carey

Question:

1045. Deputy Joe Carey asked the Minister for Health the position in regard to the formulation and introduction of a new motorised transportation grant; and if he will make a statement on the matter. [24496/16]

Joe Carey

Question:

1046. Deputy Joe Carey asked the Minister for Health the position in regard to the introduction of a new mobility allowance scheme; and if he will make a statement on the matter. [24497/16]

Shane Cassells

Question:

1340. Deputy Shane Cassells asked the Minister for Health when he will introduce the promised schemes to replace the mobility allowance and the motorised transport grant schemes, which were discontinued for new applicants, pending a review which was announced in February 2013; and if he will make a statement on the matter. [25770/16]

Written answers

Minister for Health

I propose to take Questions Nos. 1045, 1046 and 1340 together.

Conscious of the reports of the Ombudsman in 2013 regarding the legal status of both the Mobility Allowance and Motorised Transport Grant Schemes in the context of the Equal Status Acts, the Government decided to close both schemes. Both schemes remain closed.

The Government also decided that monthly payments will continue to be made by the Health Service Executive to 4,700 people who were in receipt of the Mobility Allowance at the time the scheme closed, on the basis that this would prevent hardship and, on an interim basis, alleviate stress, anxiety and uncertainty among a vulnerable group in society.

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.

I am pleased to inform the Deputies that the Programme for Partnership Government acknowledges the ongoing drafting of primary legislation for a new Transport Support 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 is affordable on its introduction and on an ongoing basis.

Speech and Language Therapy

Questions (1047)

Mattie McGrath

Question:

1047. Deputy Mattie McGrath asked the Minister for Health the number of speech and language therapists and occupational therapists currently on HSE panels; and if he will make a statement on the matter. [24506/16]

Written answers

Minister for Health

I have asked the HSE to respond to the Deputy directly on this matter.

Health Strategies

Questions (1048)

Mattie McGrath

Question:

1048. Deputy Mattie McGrath asked the Minister for Health the status of the work and composition of the National Advisory Committee on Bioethics; and if he will make a statement on the matter. [24507/16]

Written answers

Minister for Health

The National Advisory Committee on Bioethics was established by the then Minister for Health, Dr. James Reilly, in March 2012. The task of this Committee is to advise the Minister for Health on the ethical and social implications of scientific developments in human medicine and healthcare. In particular, this includes:

1) Providing advice in the form of expert reports on priority issues of national significance as requested by the Minister;

2) Providing recommendations and assistance towards the development of healthcare policy and associated legislation;

3) Representing Ireland at international fora on bioethics and collaborating, communicating and exchanging information with other national bioethics committees regarding developments in health policy.

The National Advisory Committee on Bioethics’ membership is multi-disciplinary and consists of members who were invited to join the Committee by virtue of their personal expertise, distinction and authority and not as representatives of particular bodies or professions. The full list of Committee members can be viewed on the Committee’s webpage on the Department of Health’s website here: http://health.gov.ie/national-advisory-committee-on-bioethics/

The National Advisory Committee on Bioethics has considered a number of complex and sensitive issues that society in general, and the healthcare system, in particular, are currently facing. The most recent work published by the National Advisory Committee on Bioethics was the opinion document on nudging, which is entitled “Nudging in Public Health – An Ethical Framework”. This document was published in April 2016.

The National Advisory Committee on Bioethics has also produced opinion documents in relation to the topics of:

- Specific consent for blood transfusion; and

- The detention of voluntary and involuntary patients in mental health facilities.

Further information about the activities of the National Advisory Committee on Bioethics is available on the Committee's webpage on the Department of Health’s website.

No decision has yet been made regarding the next topic on the work programme for the National Advisory Committee on Bioethics.

Assisted Human Reproduction

Questions (1049)

Mattie McGrath

Question:

1049. Deputy Mattie McGrath asked the Minister for Health if he has made a decision with respect to the provision of public funding for AHR in conjunction with the introduction of the planned legislation; and if he will make a statement on the matter. [24508/16]

Written answers

Minister for Health

In February of this year my colleague Deputy Leo Varadkar, the then Minister for Health, announced his intention to provide public funding for assisted human reproduction (AHR) treatment in conjunction with the introduction of specific legislation in this area. In order to determine the most appropriate funding model for AHR in the State, based on existing evidence, Minister Varadkar engaged the Health Research Board (HRB) to conduct a comprehensive review of international public funding models. This HRB evidence review is due to be completed before the end of 2016.

Separately to this evidence review, officials in my Department are currently drafting a General Scheme of legislative provisions dealing with AHR and associated research. Once the General Scheme is completed and the AHR legislation is subsequently enacted, the Government will be in a position to provide fertility treatments based on the best model of funding for Ireland.

Health Services

Questions (1050)

Mattie McGrath

Question:

1050. Deputy Mattie McGrath asked the Minister for Health the funding or support his Department has given to the pursuit of research related to induced pluripotent stem cells and their medical applications; and if he will make a statement on the matter. [24509/16]

Written answers

Minister for Health

The Department of Health supports research in health through the Health Research Board (HRB). The HRB is a statutory body under the aegis of the Department of Health and is the lead agency in Ireland supporting and funding health research.

The HRB has informed me that it supports research on Mesenchymal stem cells and induced pluripotent stem cells. In the past ten years, it has invested over €6.5 million in research. This offers considerable therapeutic potential for the treatment of a number of often debilitating diseases. The therapeutic targets of this research include inter alia :

- Retinal disorders;

- Cancer;

- Nerve tissue repair;

- Crohn's Disease; and

- Sepsis.

Health research projects in Ireland, including those related to Mesenchymal stem cells and Pluripotent stem cells, can also take place in many other fora including universities and hospitals. Information on these research projects would not be routinely collected by my Department.

Medical Card Eligibility

Questions (1051)

Mattie McGrath

Question:

1051. Deputy Mattie McGrath asked the Minister for Health to clarify proposals to automatically grant medical cards to families in receipt of a domiciliary care allowance; and if he will make a statement on the matter. [24510/16]

Written answers

Minister for Health

The Deputy will be aware that the Programme for Government states that "We will extend the entitlement to a medical card for all children in receipt of the Domiciliary Care Allowance (DCA) in Budget 2017. Approximately 10,000 children would benefit from this initiative". In early July, I meet with representatives of Our Children's Health. At that meeting, and in the debate on the Private Members Motion on the DCA on the 19 of July, I reaffirmed the Government's commitment in its Programme to providing medical cards to all children that qualify for the DCA.

I also confirmed that this commitment was a priority for me in the upcoming budget discussions. Subject to the required resources being secured in the upcoming budget negotiations primary legislation will be required to give effect to this measure and it is my objective to have this prepared and brought to the Oireachtas as quickly as possible after the Budget.

Assisted Human Reproduction

Questions (1052)

Mattie McGrath

Question:

1052. Deputy Mattie McGrath asked the Minister for Health the status of legislation governing assisted human reproduction; the areas which will be covered by such legislation; and if he will make a statement on the matter. [24511/16]

Written answers

Minister for Health

As the Deputy will be aware, in February 2015, the Government gave its approval to my colleague Deputy Leo Varadkar, the then Minister for Health, to draft a General Scheme of legislative provisions dealing with assisted human reproduction (AHR) and associated research. This comprehensive piece of legislation will regulate a range of practices for the first time, including: gamete (sperm or egg) and embryo donation for AHR and research; surrogacy; pre-implantation genetic diagnosis (PGD) of embryos; posthumous assisted reproduction; and stem cell research.

Officials in my Department are currently drafting the General Scheme and it is envisaged that it will be published in 2017. At that stage my Department will undertake a consultation process to seek the views of both the general public and stakeholder groups on the General Scheme. In addition, the General Scheme will be submitted to the Joint Oireachtas Committee on Health and Children for the purposes of pre-legislative scrutiny.

Legislative Measures

Questions (1053)

Mattie McGrath

Question:

1053. Deputy Mattie McGrath asked the Minister for Health if there is any legislation defining a human embryo or human foetus; if legislation is planned in this regard; and if he will make a statement on the matter. [24512/16]

Written answers

Minister for Health

The Children and Family Relationships Act 2015, in the context of Parts 2 and 3 of that Act, which relate to donor-assisted human reproduction (DAHR), defines an embryo as "a human embryo formed by the fertilisation of a human egg by a human sperm".

As the Deputy will be aware, officials in my Department are currently drafting the General Scheme of legislative provisions relating to the area of assisted human reproduction as a whole. The provisions in the General Scheme, including particular definitions, will, where relevant, be consistent with the provisions of the Children and Family Relationships Act 2015.

Hospital Appointments Status

Questions (1054)

Pearse Doherty

Question:

1054. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) will receive a hospital appointment; and if he will make a statement on the matter. [24518/16]

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 you directly.

Special Educational Needs Service Provision

Questions (1055)

Mary Butler

Question:

1055. Deputy Mary Butler asked the Minister for Health the number of children currently waiting for a full diagnostic assessment for autism in University Hospital Waterford; the composition of the team; if all the positions are covered; the number of psychologists on the autism team who will provide a full diagnostic assessment; the length of time it will take to recruit staff; the detail of the Health Service Executive interim plans in the absence of a fully trained psychologist to undertake the assessment procedure; and if he will make a statement on the matter. [24525/16]

Written answers

Minister of State at the Department of Health (Deputy Finian McGrath)

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 service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Organ Donation

Questions (1056)

Louise O'Reilly

Question:

1056. Deputy Louise O'Reilly asked the Minister for Health to provide an update on the legalisation for the organ donation op-out system; the publicity programme which would be put in place to explain the op-out system to the public; the potential amount of funding which would be allocated to such a public information programme [24526/16]

Written answers

Minister for Health

Legislation to introduce an opt-out register for organ donation will be developed in line with the Programme for Government. Under the proposed system, consent will be deemed unless the person has, while alive, registered his/her wish not to become an organ donor after death. However, it is proposed that, even though consent is deemed, the next-of-kin will in practice always be consulted prior to removing any organ.

It is envisaged that a publicity programme will be put in place when the legislative changes are taking effect. The details of the publicity programme, and the funding involved, will be finalised at that time.

Respite Care Services

Questions (1057)

Mattie McGrath

Question:

1057. Deputy Mattie McGrath asked the Minister for Health if he will increase the level of funding to the Brothers of Charity to improve the levels of respite services for adults in County Tipperary; the current respite services available; the number of those requiring respite services in County Tipperary; his views on whether there are sufficient services to meet the demands; the measures he proposes to increase the level of services in County Tipperary; if the HSE will consider carrying out advance planning for the needs of those who are already in the disability services system in order that when children graduate to adult services, plans can be in place in advance to avoid unnecessary stress on the families who are left seeking services; and if he will make a statement on the matter. [24537/16]

Written answers

Minister of State at the Department of Health (Deputy Finian McGrath)

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 Programme for Partnership Government states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability.

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.