Tuesday, 31 Jan 2017

Hospital Appointments Administration

Questions (539)

Robert Troy

Question:

539. Deputy Robert Troy asked the Minister for Health if he will schedule an appointment for shoulder and wrist surgery for a person (details supplied); and if he will make a statement on the matter. [4142/17]

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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.

Hospital Services

Questions (540)

Niamh Smyth

Question:

540. Deputy Niamh Smyth asked the Minister for Health the list of services on offer at a hospital (details supplied); if there is room to utilise more of this building; and if he will make a statement on the matter. [4144/17]

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Written answers

Minister for Health

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 (541)

Niamh Smyth

Question:

541. Deputy Niamh Smyth asked the Minister for Health his plans to provide enhancements to services at a hospital (details supplied); if enhancements have been implemented on site in the past 12 months; if additional staff have been acquired; and if he will make a statement on the matter. [4149/17]

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Written answers

Minister for Health

A key part of the Government’s plan for our healthcare system is the most significant reform of our hospital service since the foundation of the State - the establishment of hospital groups operating as single cohesive units with their own governance and management. Hospital Groups enable a better configuration of hospital services with benefits relating to safety, quality, access, cost and sustainable medical staffing and every hospital in the group, large and small, statutory and voluntary, will play a vital role within the Group. Hospitals working together in a Group will be able to support each other, providing a stronger role for smaller hospitals in delivering less complex care, and ensuring that those who require emergency or complex planned care are managed safely in larger hospitals.

The Smaller Hospitals Framework focuses in particular on the future role of smaller hospitals and outlines the wide range of services that can be provided within these smaller hospitals. It also outlines the potential to expand the services delivered in smaller hospitals, especially in services such as:

- day surgery (e.g. cataracts, hernia repairs, gynaecological procedures, and other surgeries that can safely be done in a day-based environment);

- ambulatory care (including chronic disease management and assessment for older persons);

- medical services (including cardiac failure clinics, cardiac rehabilitation, COPD outreach and clinics, rheumatology, dermatology, diabetic day centre, rehabilitation, and a range of others depending on local policies and protocols);

- diagnostics (including blood tests, X-rays, endoscopy, bronchoscopy and sigmoidoscopy).

As a Model 2 hospital, Monaghan does not have a 24/7 Emergency Department or critical care unit. However, in line with the Framework, Monaghan Hospital has a Minor Injuries Unit located on site.

I am committed to securing and further developing the role of our smaller hospitals with the expansion of services delivered in these hospitals, especially in services such as day surgery; ambulatory care; medical services and diagnostics.

The Programme for Partnership Government commits to a review of Medical Assessment Units, Urgent Care Centres and Minor Injuries Units, including the Unit at Monaghan Hospital. Preliminary scoping work on this review is being carried out.

Disabled Drivers and Passengers Scheme

Questions (542)

Richard Boyd Barrett

Question:

542. Deputy Richard Boyd Barrett asked the Minister for Health if he will address the case of a person (details supplied) and outline the provisions and services available to that person; and if he will make a statement on the matter. [4150/17]

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Written answers

Minister of State at the Department of Health

The Drivers and Passengers with Disabilities Tax Relief Scheme, which is operated by the Revenue Commissioners, is the responsibility of my colleague, the Minister for Finance. To qualify for the scheme, an applicant must be permanently and severely disabled within the terms of the Disabled Drivers and Disabled Passengers (Tax Concessions) Regulations Act 1994 and satisfy a range of conditions. The medical criteria for the scheme are set out by the Department of Finance. HSE personnel have no role in setting or amending the criteria.

The Disabled Drivers Medical Board of Appeal is also under the auspices of the Minister for Finance. This Board is independent in the exercise of its functions, to ensure the integrity of its clinical determinations. On that basis, I have no role to play in the exercise of these functions.

The Deputy will be aware of the background to the closure of both the Mobility Allowance and Motorised Transport Grant schemes. I wish to assure the Deputy that detailed preparatory work required for a new Transport Support Scheme and associated statutory provisions are being progressed by my Department. I am pleased to report that work on policy proposals in relation to all matters, including eligibility criteria, are at an advanced stage of development. Once the Government approves the draft Heads of Bill for this new Scheme, they will then be subject to pre-legislative scrutiny.

With regard to the broader issue of transport for people with disabilities, I understand, my colleague, the Minister for Transport, Tourism and Sport, has drawn up a sectoral plan, as provided for under the Disability Act 2005. This plan called Transport for All, lays out specific actions which incrementally improve accessibility of public transport for all persons with mobility, sensory or cognitive impairments. I have been informed that considerable progress has been made under this plan in improving the accessibility of public transport services, including the provision of wheelchair accessible bus and train services, the continuing grant scheme for wheelchair accessible taxis and the roll out of real time passenger information systems.

Health Insurance Community Rating

Questions (543)

Lisa Chambers

Question:

543. Deputy Lisa Chambers asked the Minister for Health the reason members of the Defence Forces whose conditions of service provide for a range of medical health care provisions equivalent to that of a private health plan are nonetheless being obliged to purchase private health insurance plans to avoid lifetime community rating loadings when they retire; and his views on whether it is unfair to effectively compel members of the Defence Forces to purchase private health insurance which they will not need while they are in service. [4156/17]

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Written answers

Minister for Health

Our system of voluntary community-rated health insurance relies on the continued entry of younger people, to help keep premium prices down for everybody. Lifetime Community Rating (LCR) was introduced to the private health insurance market from 1 May 2015, to encourage people to take out insurance at a younger age. It introduced late entry loadings on health insurance premiums for those aged 35 years or older taking out private health insurance for the first time. Without LCR there would be a deterioration in the age profile of the insured population, which in turn would contribute to claims inflation and higher premiums for all.

The medical arrangements in place for Commissioned Officers of the Defence Forces are not private health insurance plans. Given they are not private health insurance plans, they cannot comply with the key principles of community rating, open enrolment, lifetime cover and minimum benefits as required under the Health Insurance Acts.

Private health insurance in Ireland is optional and, similar to any other individual or groups in Ireland, there is no statutory obligation on members of the Defence Forces to purchase private health insurance plans. Where people choose to purchase private health insurance, the application of loadings under LCR applies consistently to all residents of the State, whether purchased during periods of employment or during retirement.

A review of the Lifetime Community Rating regulations, after 30 April 2017, is provided for in the legislation. The independent regulator, the Health Insurance Authority (HIA), has already commenced its public consultation process as the first phase of its review. A consultation paper to inform and assist those who may wish to make a submission can be viewed on its website www.hia.ie . Proposals will be accepted before the deadline of 3 March 2017. When the HIA concludes its review and submits its report to me, I will consider any recommendations made with an open mind.

Autism Support Services

Questions (544)

Seán Sherlock

Question:

544. Deputy Sean Sherlock asked the Minister for Health the reason and status for a young person (details supplied) who has yet to receive a date for an ASD assessment despite HSE officials admitting that another assessment is needed for the person. [4163/17]

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Written answers

Minister of State at the Department of Health

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

As the Deputy's question relates to an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Hospital Appointments Status