Written Answers Nos. 333-351
333. Deputy Hildegarde Naughton asked the Minister for Health if his attention has been drawn to the fact that the HSE received a donation of €300,000 intended for use by a children's cancer charity (details supplied) in 2009 but only ever provided €50,000 of the money to the intended beneficiary; if the rest of the funds will now be supplied; and if he will make a statement on the matter. [33458/16]
View answerThe Deputy's question relates to service delivery matters and accordingly I have asked the HSE to respond directly to her.
334. Deputy Hildegarde Naughton asked the Minister for Health the details of proposals for the development of a new day surgery and additional theatres at Merlin Park University Hospital contained in the capital plan, including the scale, purpose and proposed cost of the development, in addition to a timeline within which it is expected to be completed [33459/16]
View answerThe HSE has advised that the Merlin Park project in question is with the HSE National Capital and Property Steering Committee for review and prioritisation. The role of this Committee is to review and prioritise projects for inclusion in the multi-annual Capital Plan. A review of estimated costs was sought and is awaited. As the project has not been yet been approved for inclusion in the Capital Plan, it is therefore not possible to provide a timeline for delivery at this point.
All healthcare infrastructure developments, including this development, must comply with the HSE's Estates Protocol, DPER guidelines and EU directives. A lead-in time will be required to complete the various stages, which include project appraisal, project brief, design feasibility, cost review, sketch design stage, detailed design / pre-tender cost review and planning permission, among others.
Funding is dependent on the costing and timing of the project, the availability of resources in the context of competing demands in a national context, the future capital envelope for the health service and the overall priorities for future service development in the Saolta University Health Care Group.
335. Deputy Kevin O'Keeffe asked the Minister for Health if he will request the HSE to intervene in a hospital (details supplied) to ensure that staff payroll is not reduced. [33461/16]
View answer342. Deputy Kevin O'Keeffe asked the Minister for Health if annual funding to a hospital (details supplied) has been reduced in respect of its day-to-day running costs. [33494/16]
View answer348. Deputy Sean Sherlock asked the Minister for Health if a hospital (details supplied) is being considered for an increase in the rate per bed under the National Treatment Purchase Fund. [33511/16]
View answer350. Deputy Sean Sherlock asked the Minister for Health if his attention has been drawn to the funding shortfall at a hospital (details supplied); and if his attention has further been drawn to the fact that local management is seeking cost savings through wage restrictions across non-nursing, nursing and management sectors. [33513/16]
View answerI propose to take Questions Nos. 335, 342, 348 and 350 together.
Cobh Community Hospital is a voluntary organisation providing long term residential and short term care. The Nursing Homes Support Scheme provides financial support for residents at the facility who are participants in the Scheme. The legislation underpinning the Nursing Homes Support Scheme requires each private and voluntary 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 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.
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 individual negotiations.
The HSE also provides funding to Cobh Community Hospital under Section 39 of the Health Act. As this is a service matter it has been referred to the Health Service Executive for direct reply.
336. Deputy Mattie McGrath asked the Minister for Health if an analysis has been carried out by his Department in anticipation of the removal of the eighth amendment; and if he will make a statement on the matter. [33462/16]
View answerThe Government has established a Citizen’s Assembly, in line with its Programme for Partnership Government commitment, to consider a number of matters including constitutional reform. The establishment and terms of reference of the Assembly were approved by a resolution of both Houses of the Oireachtas in July of this year. The Assembly is required to first consider the Eighth Amendment of the Constitution (Article 40.3.3°) and report with its recommendations on the matter to the Oireachtas in the first half of 2017. The Assembly’s recommendations will be acted upon by a Special Oireachtas Committee, which will be asked to report in six months.
Ms Justice Mary Laffoy, a Justice of the Supreme Court, is chairing the Assembly comprised of 99 citizens randomly chosen from the population. The first meeting of the Assembly took place in Dublin Castle on 15 of October and a list of dates has been agreed to discuss the Eighth Amendment over the next number of months.
My Department will consider carefully the outcome of the Oireachtas deliberation on Article 40.3.3° and assess any necessary policy or legal changes that may arise.
337. Deputy Mattie McGrath asked the Minister for Health the status of plans to utilise facilities at Our Lady's Hospital, Cashel, County Tipperary; and if he will make a statement on the matter. [33463/16]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
338. Deputy Peadar Tóibín asked the Minister for Health if he will ensure that a person (details supplied) receives the necessary speech and language services that they require and are entitled to. [33466/16]
View answerThe 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.
339. Deputy Brendan Griffin asked the Minister for Health when a date for a cataracts operation will be provided to a person (details supplied) in County Kerry; and if he will make a statement on the matter. [33480/16]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the 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 you directly.
340. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) in County Donegal can expect a report from University Hospital Galway to be finalised; and if he will make a statement on the matter. [33481/16]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
341. Deputy Catherine Martin asked the Minister for Health the number of respite beds reserved exclusively for persons with dementia provided for in south Dublin; and if he will make a statement on the matter. [33482/16]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
343. Deputy Kevin O'Keeffe asked the Minister for Health if he will assist a community hospital (details supplied) in County Cork. [33496/16]
View answerThe Health Information and Quality Authority is the independent authority established under the Health Act 2007 to drive continuous improvement and to monitor safety and quality in Ireland’s health and personal social care services. Since 2009 all nursing homes - public, voluntary and private have been registered and inspected by HIQA.
The functions of the Minister for Health in relation to HIQA and the Chief Inspector of Social Services are prescribed in the Act, and in this respect the Chief Inspector is independent in the exercise of these functions.
344. Deputy Billy Kelleher asked the Minister for Health his views on the concerns of the private and voluntary nursing home sector regarding the failings of the fair deal funding model and their push for greater equality in fees payable for the provision of nursing home care; and his further views on whether the fair deal budget and fees payable to nursing homes should be resourced to recognise the escalating cost environment in which nursing homes are operating. [33500/16]
View answer345. Deputy Billy Kelleher asked the Minister for Health if he will justify private and voluntary nursing home operators receiving fees that are up to seven times below those provided to HSE counterparts; and if his attention has been drawn to the fact that the fees payable to HSE nursing homes do not encompass costs such as capital works and commercial rates, whereas private and voluntary nursing homes are expected to absorb such costs within the considerably reduced fees payable to them. [33501/16]
View answer346. Deputy Billy Kelleher asked the Minister for Health his views on fair deal payments being indexed in recognition of the increasing cost environment in which nursing homes are operating. [33502/16]
View answer347. Deputy Billy Kelleher asked the Minister for Health his views on an independent appeals process that would enable nursing homes to have recourse to appeal a fee offered by the NTPF that the provider does not view is fair or sustainable. [33503/16]
View answer355. Deputy Jack Chambers asked the Minister for Health if, in view of the huge variances in fees payable between the HSE and private and voluntary nursing homes, he recognises the imperative and urgent requirement for the review of the nursing home support scheme pricing mechanism to support residents requiring nursing home care across all settings, that is, public, private and voluntary; and if he will make a statement on the matter. [33559/16]
View answer356. Deputy Jack Chambers asked the Minister for Health if his attention has been drawn to the criticism by a previous Minister of State with responsibility for older persons of the way in which fees for nursing home care are deciphered and the research undertaken by a consultancy firm (details supplied) that highlights considerable failings of the funding model in deciphering and incorporating true costs incurred for provision of nursing home care; and if he will make a statement on the matter. [33560/16]
View answerI propose to take Questions Nos. 344 to 347, inclusive, 355 and 356 together.
The legislation underpinning the Nursing Homes Support 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 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.
The Review of the Nursing Homes Support Scheme, which was published in July 2015, committed to 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.
The issue of an appeals process will also be considered in this context.
Work has been underway on this Review for a number of months now and it is expected to be completed in the coming months.
The HSE has recently published the cost of care for all public nursing homes. There are a number of reasons why the costs of public facilities are generally higher than those in the private sector, including a higher nurse staffing ratio and the impact of public service rates of pay and conditions of employment.
The geographical spread of residential placements is also a factor. In some rural areas long stay beds are provided for geographical reasons in smaller centres which would not be profitable for a private provider to supply, e.g. Achill Island; Donegal.
With that said, it is important that public facilities operate as efficiently and economically as possible and deliver the best possible value for money. Towards that end the HSE is already engaged in a comprehensive exercise to review and streamline the operation and cost structures of public facilities. Differences in the comparative cost of public and private long-term residential care will be the subject of a Value for Money and Policy Review to be undertaken by the Department of Health in 2017 to assess reasons for and components of current cost differentials.
349. Deputy Sean Sherlock asked the Minister for Health the current NTPF rates per bed for hospitals (details supplied). [33512/16]
View answerMidleton Community Hospital, St. Patrick's Community Hospital, Fermoy, and Bandon Community Hospital are public nursing homes. The National Treatment Purchase Fund (NTPF) has no role in setting or negotiating prices for public residential care facilities. The maximum prices to be paid in public facilities, and referred to as the cost of care, are set by the HSE. The cost for each public nursing home is determined using the definition of long-term residential care services underpinned by an agreed set of cost components which have been laid before the Houses of the Oireachtas. These include pay and non-pay goods and services.
The HSE has recently published the cost of care for all public nursing homes on their website http://www.hse.ie/eng/services/list/4/olderpeople/nhss/costofcareHSE.pdf.
The weekly cost of care in each of the aforementioned nursing homes is as follows:
|
Name of Public Centre |
Cost of Care |
|
Midleton Community Hospital and Long Stay Unit (Our Lady of Lourdes) |
€1,410 |
|
St. Patrick's Community Hospital, Fermoy |
€1,370 |
|
Bandon Community Hospital |
€1,524 |
351. Deputy Margaret Murphy O'Mahony asked the Minister for Health if the clinical trial of the drug Respreeza, which treats emphysema caused by severe alpha-1, will continue to be made available to the 21 patients who are currently receiving the drug; if it will be made available to approximately 40 more patients if current assessments are favourable; and if he will make a statement on the matter. [33553/16]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. Prior to deciding whether to reimburse a medicine, the HSE considers a range of statutory criteria, including clinical need, cost-effectiveness and the resources available.
The decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds by the HSE, on the advice of the National Centre for Pharmacoeconomics (NCPE). The NCPE conducts health technology assessments (HTAs) of pharmaceutical products for the HSE, and can make recommendations on reimbursement to assist the HSE in its decision-making process.
The NCPE is currently conducting an assessment of Respreeza as maintenance treatment of emphysema in adults with documented severe alpha1-proteinase inhibitor deficiency. Once this assessment is completed, a summary report will be published on the NCPE website. The HSE will then consider the NCPE assessment as part of its decision-making process when considering the drug for reimbursement.
As the NCPE's assessment of Respreeza is ongoing, it is not possible to provide further details at this time.
I understand that for patients currently accessing Respreeza on a compassionate use basis, the company CSL Behring, will continue to provide and administer the drug until the end of the year. However the operation of compassionate access schemes are at the discretion of manufacturers. I have previously asked manufacturers to show compassion to reopen or maintain compassionate access schemes to patients during the assessment process by the HSE.
