Peter Burke
Question:146. Deputy Peter Burke asked the Minister for Health if he will address a matter (details supplied) regarding the fair deal scheme; and if he will make a statement on the matter. [34015/16]
View answerNursing Homes Support Scheme
Questions (146)
Written answers
The Nursing Homes Support Scheme (NHSS) is a system of financial support for those in need of long-term nursing home care. Participants contribute to the cost of their care according to their income and assets 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 settings. A financial assessment is carried out by the HSE to determine how much a participant in the Scheme will contribute to the cost of their care. The Programme for a Partnership Government has committed to reviewing the NHSS to remove any discrimination against small business and family farms.
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. Arising out of the Review, a number of key issues have been identified for more detailed consideration across Departments and Agencies, including the treatment of business and farm assets for the purposes of the financial assessment element of the Scheme. This work is currently underway and the IFA has made a submission in this context to the Interdepartmental Group which is overseeing the Review. Changes arising from this Review may require legislative implementation.
Health Services
Questions (147)
John Brassil
Question:147. Deputy John Brassil asked the Minister for Health the name of the consultant ophthalmologist that has been assigned to assess a person (details supplied); if he will expedite the person's assessment and operation; and if he will make a statement on the matter. [33885/16]
View answerWritten answers
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, I have asked the HSE to respond to you directly.
Health Services
Questions (148)
John Brassil
Question:148. Deputy John Brassil asked the Minister for Health the name of the consultant ophthalmologist that has been assigned to a person (details supplied); if he will expedite the assessment and operation; and if he will make a statement on the matter. [33891/16]
View answerWritten answers
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the 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.
Hospital Services
Questions (149)
David Cullinane
Question:149. Deputy David Cullinane asked the Minister for Health further to Parliamentary Question No. 369 of 4 October 2016, with regard to the risk requirement for a second cath lab being placed on the South/South West Hospital Group risk register in April 2016 rated at 16, if the rating of 16 was changed or revised upwards or downwards; when changes took place; the basis for any changes; the person or body that makes the decision to alter the risk rating; and if he will make a statement on the matter. [33892/16]
View answerWritten answers
I have been advised by the HSE that neither University Hospital Waterford nor the South/South West Hospital Group have changed their risk ratings in relation to out of hours access to interventional cardiology services in the six months prior to 19 September 2016. However, as the management of the South/South West Hospital Group risk register is an operational matter, I have asked the HSE to reply directly to you.
Orthodontic Services Waiting Lists
Questions (150)
Éamon Ó Cuív
Question:150. Deputy Éamon Ó Cuív asked the Minister for Health when a person (details supplied) will be issued with a date for an orthodontic appointment; the reason for the cancellation of an appointment in view of the fact that this person had an appointment to undergo treatment in October 2016; if he will confirm that the dental equipment to undergo treatment is available for persons who are depending on same; and if he will make a statement on the matter. [33898/16]
View answerWritten answers
As this is a service matter it has been referred to the HSE for reply to the Deputy.
HSE Staff
Questions (151)
Pearse Doherty
Question:151. Deputy Pearse Doherty asked the Minister for Health if he will clarify that it is HSE policy that it is the responsibility of individual home help workers to secure cover during periods of planned annual leave; if workers are prevented from taking planned leave should they be unable to find suitable cover; the role the employer takes to source cover during such periods; and if he will make a statement on the matter. [33899/16]
View answerWritten answers
As this is a service matter it has been referred to the Health Service Executive for direct reply.
Mental Health Services Expenditure
Questions (152)
Róisín Shortall
Question:152. Deputy Róisín Shortall asked the Minister for Health the total amount of spending on mental health as recently announced in budget 2017 broken down by capital and current spending, in tabular form; the percentage and absolute spending change in each category from budget 2016; the total projected budget for new services coming on stream in 2017; and if he will make a statement on the matter. [33906/16]
View answerWritten answers
The following table shows the projected current and capital expenditure for 2016 and 2017.
|
Mental Health |
Year |
Current €m |
Capital €m |
|
Expenditure – projected 2017 |
2017 |
€851.3m |
€54.6m |
|
Expenditure estimated to end year 2016 |
2016 |
€826.6m* |
€15.3m |
|
Increase |
€24.7m |
€32.3m |
|
|
Percentage Increase |
3% |
215% |
* it should be noted that €7 million of the current expenditure for 2016 was spent on capital works.
The estimate for Mental Health current spending in 2017 is €851.3 million, an increase of €24.7 million, or approximately 3%, over 2016. In addition, a further €50 million will be provided for the construction of the new national forensic hospital in Portrane. This development is long overdue and the signing of the main construction contract will allow for its completion in line with A Vision for Change.
I am initiating €35 million in new mental health services in 2017. Key priorities to be addressed in the HSE's 2017 Service Plan include youth mental health, further improvement to child & adolescent and adult services, older people's services and further enhanced out of hours response for those in need of urgent services. Recognising the time lag in new staff taking up posts and the completion of preparations for the introduction of these services, it is estimated that the revenue spend in 2017 associated with this increased allocation will be some €15 million. There will also be a further additional spend of €9.7 million in mental health associated with increased pay rates.
Following the Budget announcement and the issue of the letter of determination the HSE is working on its 2017 National Service Plan which will be submitted to the Department of Health shortly for the consideration of the Minister for Health prior to approval and publication.
Residential Institutions
Questions (153)
John Brassil
Question:153. Deputy John Brassil asked the Minister for Health the persons who should be assigned next of kin to sanction and sign the form with regards to St Mary's of the Angels, Beaufort, County Kerry and the addition of the residents' names to the Kerry County Council local authority housing list (details supplied); the person or body that sanctioned this in view of the fact the families and next of kin of the residents were not the signatories nor were they made aware of this process; the reason the families and next of kin were not the acting signatory; and if he will make a statement on the matter. [33907/16]
View answerWritten answers
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
Emergency Departments
Questions (154)
Michael D'Arcy
Question:154. Deputy Michael D'Arcy asked the Minister for Health the reason persons with a medical card living in County Wexford have to pay a fee for accident and emergency at Dublin dental hospital while persons with the same medical card from counties Dublin, Wicklow and Kildare do not; and if he will make a statement on the matter. [33912/16]
View answerWritten answers
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 was issued to Oireachtas members.
Mental Health Services Funding
Questions (155)
Seán Haughey
Question:155. Deputy Seán Haughey asked the Minister for Health the development funding announced in budget 2017 to implement the national mental health policy, A Vision For Change; the money available to the HSE in 2017 for this purpose; if he will increase this funding in order to allow for much needed improvements in mental health care; and if he will make a statement on the matter. [33921/16]
View answerWritten answers
The allocation for Mental Health in 2017 will be €851.3 million, an increase of €24.7 million, or approximately 3%, over 2016. In addition, a further €50 million will be provided for the construction of the new national forensic mental health service in Portrane.
I am initiating €35 million in new services in 2017 to further implement "A Vision For Change". Key priorities to be addressed in the HSE's 2017 Service Plan include youth mental health, further improvement to child & adolescent and adult services, older people's services and further enhanced out-of-hours response for those in need of urgent services. Recognising the time lag in new staff taking up posts and the completion of preparations for the introduction of these services, it is estimated that the revenue spend in 2017 associated with this increased allocation will be some €15 million. There will also be a further additional spend of €9.7 million in mental health associated with increased pay rates.
Hospital Appointments Status
Questions (156)
Michael Healy-Rae
Question:156. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment in respect of a person (details supplied); and if he will make a statement on the matter. [33946/16]
View answerWritten answers
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the 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.
Services for People with Disabilities
Questions (157)
Brendan Smith
Question:157. Deputy Brendan Smith asked the Minister for Health when a person (details supplied) will be provided with a residential place as discussed at a recent meeting; if funding for this is available in view of the urgency of the case; and if he will make a statement on the matter. [33948/16]
View answerWritten 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.
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.
Hospital Services
Questions (158)
Róisín Shortall
Question:158. Deputy Róisín Shortall asked the Minister for Health if he will establish the circumstances of a case (details supplied); if he will address the apparent system failures in the handling of this case; and if he will make a statement on the matter. [33956/16]
View answerWritten answers
The Deputy's question relates to service delivery matters and accordingly I have asked the HSE to respond directly to her.
Mental Health Services Funding
Questions (159)
Brendan Griffin
Question:159. Deputy Brendan Griffin asked the Minister for Health his views on a matter (details supplied) regarding funding for mental health; and if he will make a statement on the matter. [33971/16]
View answerWritten answers
The allocation for Mental Health in 2017 will be €851.3 million, an increase of €24.7 million, or approximately 3%, over 2016. In addition, a further €50 million will be provided for the construction of the new national forensic mental health service in Portrane.
I am initiating €35 million in new services in 2017. Key priorities to be addressed in the HSE's 2017 Service Plan include youth mental health, further improvement to child & adolescent and adult services, older people's services and further enhanced out of hours response for those in need of urgent services. Recognising the time lag in new staff taking up posts and the completion of preparations for the introduction of these services, it is estimated that the revenue spend in 2017 associated with this increased allocation will be some €15 million. There will also be a further additional spend of €9.7 million in mental health associated with increased pay rates.
Hospital Staff
Questions (160)
Billy Kelleher
Question:160. Deputy Billy Kelleher asked the Minister for Health the way in which he plans to ensure that the 80:20 percentage division between public and private practice in public hospitals for consultants is vigorously observed; and if he will make a statement on the matter. [33993/16]
View answerWritten answers
The current consultant contract which was negotiated in 2008 provides for the regulation of private practice and includes mechanisms for ensuring compliance by consultants with the permitted ratio of public to private practice.
Section 20 of the Consultant Contract 2008 provides for the regulation of private practice and the mechanisms for ensuring compliance with the 80:20 ratio of public to private practice. Section 4 b), states that “both the Consultant and the Employer shall co-operate in giving effect to such arrangements as are put into place to verify the delivery of the Consultant’s contractual commitments” and Section 12 l), requires the Consultant “to participate in and facilitate production of all data/information required to validate delivery of duties and functions and inform planning and management of service delivery.”
I have asked the HSE to respond to the Deputy directly on this matter.
Health Insurance Data
Questions (161)
Billy Kelleher
Question:161. Deputy Billy Kelleher asked the Minister for Health his plans to review the legislation in view of claims data submitted by insurers (details supplied) and the negative impact on the affordability of private health insurance; and if he will make a statement on the matter. [33994/16]
View answerWritten answers
Insurance companies operate as commercial providers and make their own decisions about the price of their health insurance plans. The cost of private health insurance is influenced by a number of factors such as the number of persons in the market, the age profile of those holding private health insurance and ongoing medical innovations. Each of these are contributors to the cost of care, the cost of claims and therefore the cost of premia payable.
While everyone is entitled to use a public hospital, some people choose to be treated privately, in which case they have chosen to pay the consultant and the hospital. Prior to the Health (Amendment) Act 2013, private in-patients in public hospitals were, in the case of an emergency admission where a private bed was not available, accommodated in a public bed for which they were charged €75 per day (to a maximum of €750 for 10 nights per annum) although they continued to pay the fees of their hospital consultant. The Comptroller and Auditor General pointed out in his 2010 Annual Report that almost 45% of in-patients being treated privately by consultants were not paying the designated charge to the public hospitals in which they were being treated, because they did not occupy a designated private bed. This represented a significant loss of income to the public hospital system, to taxpayers and was an indirect subsidy to private insurance companies, who cover most private patients.
On the basis that users of private services should pay for the costs of providing these services even when they are provided by a public hospital the previous Government introduced legislation in 2013 to amend Section 55 of the Health Act 1970 to provide for the charging of private in-patients whenever they have opted to be treated as a private patient by their hospital consultant. The charging regime as introduced was intended to decrease but not eliminate any gap in providing services to private in-patients and that target is being reached. There are no plans to reverse this policy.
It should also be noted that under the 2013 Act, all private patients are charged in a similar manner, and this enabled the legislation to provide for an average reduction of 9% in the daily charges for private patients in public hospitals. The private in-patient charge goes not only towards meeting accommodation costs but also towards meeting part of the cost of providing the hospital's services to private patients, for example, the cost of non-consultant doctors, nursing, administration and support staff, diagnostic services (such as x-rays and other scans), medical and surgical supplies, operating theatres, laboratory services (such as blood tests etc) and capital costs.
Health Promotion
Questions (162)
Billy Kelleher
Question:162. Deputy Billy Kelleher asked the Minister for Health if the Government will consider supporting healthier choices in the workplace with the introduction of initiatives to incentivise companies to support the health and wellbeing of staff as part of its healthy Ireland framework to improve the health and wellbeing of persons here (details supplied); and if he will make a statement on the matter. [33995/16]
View answerWritten answers
There is a growing interest in and understanding internationally of the contribution healthy workplaces can make to healthier societies and the benefits of this to business both in terms of more productive workforces and the ability to attract and retain the best employees.
The World Health Organization (WHO) considers workplace health programmes as one of the best-buy options for prevention and control of Non-Communicable Diseases (NCDs) and for mental health. Such programmes can help achieving the WHO objective of reducing the avoidable deaths of NCDs and the burden of mental ill health and to protect and promote health at the workplace.
My Department, with the Department of Jobs, Enterprise and Innovation, is leading a subgroup to develop a National Healthy Workplace Framework. This work primarily involves development of a framework to encourage and support the development of Health and Wellbeing programmes in all places of employment. The objective is to support employers to develop individual, practical plans identifying how they will protect and promote the physical, mental and social wellbeing of their employees, within the context of their own size, sector, location, number of employees, etc.
There are schemes currently in place which support and encourage employees to make healthier choices, such as the Taxsaver Commuter Scheme, Cycle to Work Scheme and the Smarter Travel Workplaces public awareness programme.
In addition, the workplace wellbeing element of the Health and Wellbeing (Calorie posting and workplace wellbeing) Bill which is in development will require all public sector workplaces to have and report on a healthy workplace policy.
Health Services Provision
Questions (163)
Billy Kelleher
Question:163. Deputy Billy Kelleher asked the Minister for Health the way in which he plans to address the way the delivery and funding of high quality health care in the context of a major demographic challenge (details supplied); his plans to help keep health insurance affordable in the long term, in view of the fact that claims significantly increase with age; and if he will make a statement on the matter. [33996/16]
View answerWritten answers
The Committee on the Future of Healthcare was established in June this year and has been specifically tasked with examining and costing different funding models for the health service and to make recommendations on a funding approach that is best suited to the Irish context. The committee will present its final report to the Dáil by 23 January 2017.
In relation to private health insurance, in Ireland we have a system of community rated private health insurance which is supported by a Risk Equalisation Scheme. Under the Risk Equalisation Scheme, insurers receive risk equalisation and hospital utilisation credits to compensate for the additional cost of insuring older and less healthy members. The credits are funded by stamp duty levies payable by insurers in respect of each life covered. The Risk Equalisation Scheme ensures that some of the higher cost of insuring older and less healthy members is shared across the market. The Health Insurance Authority closely monitors claims paid by insurers and demographic changes in the private health insurance market. The Authority takes these into account each year when recommending the level of credits and associated stamp duties to apply under the Risk Equalisation Scheme.
The overall cost of private health insurance is influenced by a number of factors including the number of people in the market, the age profile of those holding private health insurance and medical innovations which can have an impact on the cost of care and the cost of claims. An increase in the number of younger and healthy people taking out health insurance helps to control premium inflation, thereby keeping health insurance more affordable for older and less healthy people. Lifetime Community Rating was introduced in 2015 and has encouraged people to take out health insurance at a younger age. In a community rated market this helps to spread the costs of older and less healthy people across all insured persons. The introduction of young adult rates in 2015 has also helped to increase the number of young insured people in the market.
Hospital Waiting Lists
Questions (164)
Timmy Dooley
Question:164. Deputy Timmy Dooley asked the Minister for Health when a person (details supplied) will have their surgery; and if he will make a statement on the matter. [33997/16]
View answerWritten answers
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the 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.
Services for People with Disabilities
Questions (165)
Billy Kelleher
Question:165. Deputy Billy Kelleher asked the Minister for Health his views that a number of section 38 disability voluntary providers are experiencing considerable financial challenges, which has resulted in some providers having to engage in agreed defaulting of revenue payments to ensure that services are not impacted; and if he will make a statement on the matter. [34001/16]
View answerWritten 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.
The particular issue raised by the Deputy is a service matter for the HSE. Accordingly, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
Respite Care Services Provision
Questions (166)
Mattie McGrath
Question:166. Deputy Mattie McGrath asked the Minister for Health the status of reports on plans to introduce a charge for respite care; and if he will make a statement on the matter. [34007/16]
View answerWritten answers
Long stay charges for in-patient services - which may include in-patient respite care - apply to the further provision of in-patient services, other than acute services and nursing home services in public nursing homes supported under the Nursing Homes Support Scheme (Fair Deal), to persons who have already received at least 30 days of in-patient services during the immediately preceding 12-month period, irrespective of where those 30 days of in-patient services have been received.
Charges for the maintenance element of long-stay in-patient services are currently provided for under the Health (Amendment) Act 2005 and the Health (Charges for In-Patient Services) Regulations 2005, as amended. The Regulations provide for two different classes of income-based charges in respect of the maintenance element of the in-patient services provided:
- Class 1 relates to charges for those receiving in-patient services on premises where 24-hour nursing care is provided, subject to a current maximum of €175 per week for a person whose income is €208 or more, and
- Class 2 charges apply where 24-hour nursing care is not provided, subject to a current maximum of €130 per week for a person whose income is €194 or more.
Affordability and the avoidance of financial hardship are built-in features of the charging provisions under the 2005 Act and Regulations:
- Firstly, the Act caps the amount which may be charged – at 80% of the non-contributory State Pension weekly rate. At present, that means an upper limit of €177.60 per week.
- Secondly, the charges are structured to ensure that those paying them retain a reasonable income for personal use: at least €33 per week for those paying Class 1 rates and at least €64 per week for those paying Class 2 rates.
- Thirdly, the Act provides that the HSE may reduce or waive a charge imposed on a person if necessary to avoid undue financial hardship.
To assist in the fair application of the provisions of the 2005 Act and Regulations, the HSE has developed national guidelines for the determination of long-stay charges for in-patient services. These include the need to have regard to the individual circumstances of each service user and his or her dependants. The guidelines ensure that the applicable charge is determined taking account of each person’s income and necessary outgoings while receiving care, including reasonable regular financial commitments. This avoids any unfair burden on the service user or his or her dependants.
Legislation to commence Residential Support Services Maintenance and Accommodation Contributions (long stay contributions) will come into operation on 1 January 2017. They will replace the existing system of long stay charges.
The key features of the existing long-stay charges system will be retained including the above mentioned 30 day rule and comprehensive waiver provisions to ensure that contribution requirements are in line with what people can afford.