Written Answers Nos. 982-1003
982. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) in County Donegal will receive an appointment for a CT angiogram at Letterkenny University Hospital; and if he will make a statement on the matter. [14025/17]
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.
983. Deputy Aengus Ó Snodaigh asked the Minister for Health if, in a case (details supplied) whereby there is a lien on a home in lieu of medical bills and the person dies but there are still relatives in the house, it is normal practice by the HSE to insist on the property being sold, thus rendering the relatives homeless; and if he will make a statement on the matter. [14026/17]
View answerAs this is a service matter, I have asked the HSE to respond to you directly.
984. Deputy Paul Kehoe asked the Minister for Health his plans for the disused health centre in Shillelagh, County Wicklow; the avenue for submitting a proposal for its future use as a community facility; and if he will make a statement on the matter. [14027/17]
View answerThe Deputy's question has been referred to the Health Service Executive for direct reply as the management of the healthcare property estate is a service matter.
985. Deputy Pat Casey asked the Minister for Health the status of the public health centre, Millbank, Shillelagh, County Wicklow, which has been unused for a number of years; the future proposed for it, in view of the request from community groups to use the building for community services in this isolated rural area; and if he will make a statement on the matter. [14028/17]
View answerThe Deputy's question has been referred to the Health Service Executive for direct reply as the management of the healthcare property estate is a service matter.
986. Deputy Bernard J. Durkan asked the Minister for Health when a medical card will issue in the case of a person (details supplied); and if he will make a statement on the matter. [14030/17]
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 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.
987. Deputy Kevin O'Keeffe asked the Minister for Health the exact annual cost of leasing a new premises for the HSE (details supplied). [14031/17]
View answerAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
988. Deputy Richard Boyd Barrett asked the Minister for Health if he will instruct the HSE to find a residential placement for a person (details supplied); and if he will make a statement on the matter. [14051/17]
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.
989. Deputy Charlie McConalogue asked the Minister for Health the supports, financial or otherwise, that are in place for a family to take a person (details supplied) home to Ireland from England; and if he will make a statement on the matter. [14054/17]
View answerThe Nursing Homes Support Scheme (NHSS), commonly referred to as A Fair Deal, 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. The applicant can choose any public, voluntary or approved private nursing home. The home must have availability and be able to cater for the applicant's particular needs. In order to apply for the Scheme, an applicant must be ordinarily resident in the State (i.e. living in the State for at least a year or intending to live in the State for at least a year). The Scheme does not cover transportation costs.
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 care needs assessment is carried out to identify whether or not an applicant needs long-term nursing home care. If long-term care is indeed required, a financial assessment is then carried out by the HSE to determine how much a participant in the Scheme will contribute to the cost of their care. Participants in the Scheme contribute up to 80% of their assessable income and a maximum of 7.5% per annum of the value of assets held. In the case of a couple, the applicant’s means are assessed as 50% of the couple’s combined income and assets. The first €36,000 of an individual's assets, or €72,000 in the case of a couple, is not counted at all in the financial assessment. The capital value of an individual’s principal private residence is only included in the financial assessment for the first three years of their time in care.
The nursing home loan (Ancillary State Support) is an optional benefit of the Nursing Homes Support Scheme, the purpose of which is to ensure that a person does not have to sell their home during their lifetime to pay for long-term nursing home care. Where a person’s assets include land and property in the State, the contribution based on such assets (7.5% of the value of such assets per annum) may be deferred. The loan can be repaid at any time but will ultimately fall due for repayment upon the applicant’s death.
The Scheme has a number of important safeguards built into the financial assessment which ensures that:
- Nobody will pay more than the actual cost of care;
- An applicant will keep a personal allowance of 20% of his/her income or 20% of the maximum rate of the State Pension (non-Contributory), whichever is greater. This is in recognition of the fact that, although the NHSS covers core living expenses, residents can still incur some costs in a nursing home, such as social programmes, newspapers or hairdressing;
- If an applicant has a spouse/partner remaining at home, he/she will be left with 50% of the couple’s income or the maximum rate of the State Pension (non-Contributory), whichever is greater;
- If both members of a couple enter nursing home care, they each retain at least 20% of their income, or 20% of the maximum rate of the State Pension (non-Contributory), whichever is greater;
- Certain items of expenditure, called allowable deductions, can be taken into account for the financial assessment, including health expenses, payments required by law, rent payments and borrowings in respect of a person’s principal private residence;
- A person’s eligibility for other schemes, such as the Medical Card Scheme or the Drug Payment Scheme, is unaffected by participation in the Nursing Homes Support Scheme or residence in a nursing home.
I note that the Deputy has indicated that the individual in question is dependent on social welfare. The applicant or his family can obtain further information on the supports available through the Scheme, including a list of public, private and voluntary nursing homes in Ireland, from Nursing Homes Support Offices located throughout the country. Contact details are available from the HSE website at http://www.hse.ie/eng/services/list/4/olderpeople/nhss/#offices.
990. Deputy Richard Boyd Barrett asked the Minister for Health the number of employees across his Department and each agency or organisation under the aegis of his Department who are suspended from work without prejudice and on full pay pending an investigation; and if he will provide, in the case of there being one employee or more in this situation, details with regards to the suspensions, in tabular form (details supplied). [14063/17]
View answerThere are no employees in my Department on suspension pending an investigation.
I asked the HSE to respond to the Deputy directly on the aspect of the question that relates to their employees. In relation to the Non-Commercial State Agencies under the remit of my Department, this information is being sought and will be forwarded to the Deputy when collated.
991. Deputy Richard Boyd Barrett asked the Minister for Health the way the HPRA is funded; the proportion of that funding which is from pharmaceutical companies; the measures taken by his Department to prevent undue influence by the pharmaceutical industry on HPRA decisions on drug policy and appointments to the HPRA; and if he will make a statement on the matter. [14076/17]
View answerThe Health Products Regulatory Authority (HPRA) has confirmed that in 2016, 77% of the Authority's total income was obtained via regulatory fees charged to the pharmaceutical industry. These fees reflect the costs associated with regulatory activities such as the assessment of medicinal products and the inspection of manufacturing and distribution sites. These regulatory activities are critical to ensuring the quality, safety and efficacy of medicinal products on the Irish market. Such fees ensure that the industry (and not the public) covers the majority of the costs related to the regulation of their activities. My Department provided 15% of the HPRA’s total income for 2016.
Competent Authorities in other European countries and in other countries such as the USA, Canada and Australia also charge fees to pharmaceutical companies to reflect the costs associated with the regulation of medicines. Similarly, other Irish regulatory authorities also charge fees to the industries that they regulate.
The HPRA fully complies with the Ethics in Public Office Acts, 1995 and 2011. In addition, the Irish Medicines Board Acts 1995 and 2006 have specific provisions in relation to the disclosure of interests by HPRA Board members, employees and members of advisory committees. The HPRA also operates in accordance with the Code of Practice for the Governance of State Bodies.
The HPRA’s Code of Conduct and Conflicts of Interest Policy reflect the above requirements. All Authority/Committee members, external experts and HPRA staff are required to provide declarations of interests at the time of their initial appointment (and subsequently on an annual basis), not just in relation to their personal interests but also interests related to close family members and any other matters or personal connections which could represent a conflict of interest. Any declared interests are systematically evaluated and appropriate restrictions are put in place to avoid any potential conflicts.
All Authority / Committee members, external experts and HPRA staff must also comply with specific provisions in relation to gifts, hospitality, invitations to speak, fees, external activities and employment as outlined in the HPRA’s Conflicts of Interest Policy.
992. Deputy Richard Boyd Barrett asked the Minister for Health if the HPRA has met representatives of the pharmaceutical industry or other interested parties to discuss the Cannabis for Medicinal Use Regulation Bill 2016; if there are minutes of these meetings; if so, the outcomes of such meetings; and if he will make a statement on the matter. [14077/17]
View answerThe Health Products Regulatory Authority (HPRA) has confirmed that it has not held meetings with pharmaceutical industry or other interested parties to discuss the Cannabis for Medicinal Use Regulation Bill 2016.
In the course of preparing the HPRA Cannabis Scientific Review report requested by me, the HPRA held meetings or teleconferences with some companies that are manufacturing and/or supplying cannabis products, as well as with regulators, clinical and scientific researchers, and patient representatives.
993. Deputy Richard Boyd Barrett asked the Minister for Health the funding for HSE and other voluntary agencies which is provided for residential care for persons with disabilities; the way the level of service is agreed with these agencies; the way these agencies are accountable for keeping to service level agreements; and if he will make a statement on the matter. [14078/17]
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 service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
994. Deputy Richard Boyd Barrett asked the Minister for Health the indirect State funding, through tax deductible medical expenses, including health insurance or other tax breaks, on building or developing health facilities which was made available to private sector health care providers, including a group (details supplied); the information which is collected by his Department on these private sector health care providers' staffing, bed numbers and health outcomes; and if he will make a statement on the matter. [14079/17]
View answerI am informed by the Minister for Finance that capital expenditure incurred on qualifying private hospitals qualifies for capital allowances, in the form of an industrial building annual allowance at the rate of 15% over 6 years and 10% in the seventh year. Capital allowances are granted for such capital expenditure incurred on the construction or refurbishment of a building providing that the building is in use for the purposes of the trade. In this regard capital expenditure must have been incurred during the period 15 May 2002 to 31 December 2009 for private hospitals generally and 28 March 2003 to 31 December 2009 for day-case hospitals. This termination period was extended to 30 June 2010, and further extended to 31 December 2013 in some cases, both extensions limited to certain specified circumstances.
A qualifying hospital must meet certain conditions in order to qualify for allowances and the following categories of claimants are precluded from getting relief: companies; trustees of a trust; any consultant or other individuals associated with the operation or management of a private hospital, whether employed or self-employed or involved in any other capacity; and property developers or connected persons in certain circumstances. Consultants' rooms and offices are excluded from qualifying and this exclusion applies even where consultants’ rooms might be used exclusively for the assessment or treatment of patients.
Expenditure on the construction or refurbishment of qualifying mental health centres also qualifies for capital allowances subject to certain conditions. Qualifying expenditure can be written off at a rate of 15% over 6 years and 10% in the seventh year. The allowances were originally available for qualifying expenditure incurred during the period 23 January 2007 to 31 December 2009. This termination period was extended to 30 June 2010, and further extended to 30 June 2011 in some cases, both extensions limited to certain specified circumstances.
I am advised by the Revenue Commissioners that, due to taxpayer confidentiality reasons, they are unable to provide information in relation to individual or specific healthcare groups. In addition, information on private healthcare providers is not separately available. I am advised that a Costs of Tax Expenditures Table is available on the Revenue Statistics webpage at http://www.revenue.ie/en/about/statistics/costs-expenditures.html. This table provides an annual breakdown of the cost to the Exchequer for the 'Medical Insurance Premiums' and 'Health Expenses' reliefs from the years 2004 to 2014, the latest year for which data are available. The table will be updated in due course as newer data become available. A second table, available at http://www.revenue.ie/en/about/statistics/property-reliefs.html, lists information on certain property-based tax incentives including some which relate to hospitals. Finally, my Department does not hold or collate the information requested with regard to private healthcare providers.
995. Deputy Seán Haughey asked the Minister for Health the reasons persons with private health insurance are now charged for using emergency departments in public hospitals; the reason for this practice; and if he will make a statement on the matter. [14085/17]
View answerEmergency department (ED) services provided in a public hospital are classified as out-patient services. The current statutory charge for ED attendance is €100 under the Health (Out-Patient Charges) Regulations 2013, which applies to out-patient services provided at any of the following locations: an emergency department; an accident and emergency department; a casualty department; a minor injury unit; an urgent care centre; a local injury unit or any other facility providing similar services. This charge is subject to a number of exemptions under Article 3 of the Regulations including exemptions for medical card holders and those who have a letter of referral from a registered medical practitioner.
Public and private in-patient charges only apply from the day of admittance as an in-patient. Only a hospital doctor who has the right to can admit a person as an in-patient. ED hospital doctors do not have admitting rights in public hospitals.
Once a person is admitted to hospital, they can opt to be treated as a public or private patient. Since the introduction of the Health (Amendment) Act 2013, all private patients who have waived their eligibility to public health care are now subject to the private in-patient charge. My Department is currently reviewing the operation of the Act on my request.
996. Deputy Gerry Adams asked the Minister for Health the reason the minor injuries unit at Louth County Hospital can only treat persons over the age of 14; his plans to enable the unit to treat persons below age 14; and if he will make a statement on the matter. [14087/17]
View answerIn response to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
997. Deputy Gerry Adams asked the Minister for Health the number of surgical beds located in Louth County Hospital; the number of surgical procedures which have been undertaken in Louth County Hospital in 2016 and to date in 2017; the operating times of the theatre at Louth County Hospital; and if he will make a statement on the matter. [14088/17]
View answerIn response to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
998. Deputy Gerry Adams asked the Minister for Health if oncology outpatient treatment is available at Louth County Hospital; if not, if he will consider introducing oncology outpatient clinics at the hospital for the administration of cancer medications and other treatments; and if he will make a statement on the matter. [14089/17]
View answerThe Deputy's questions relate to service delivery matters and accordingly I have asked the HSE to respond directly to him.
999. Deputy Dara Calleary asked the Minister for Health the current waiting time for each relevant hospital for MRI scans under the public system. [14090/17]
View answerIn relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
1000. Deputy Catherine Murphy asked the Minister for Health if governance issues have been resolved regarding the proposed new national maternity hospital at a site owned by a religious group (details supplied); his views on whether Holles Street hospital may be eliminated as an independent entity if it has no role in governance at the facility; and if he will make a statement on the matter. [14091/17]
View answerLast November, following mediation discussions, agreement was reached between the National Maternity Hospital (NMH) and St Vincent's Hospital Group (SVHG) on a new governance structure for the co-located hospitals on the St Vincent's campus. The agreement provides for the establishment of a new company - The National Maternity Hospital at Elm Park DAC (limited by shares). The new company will have clinical and operational independence in the provision of maternity, gynaecology and neonatal services, as well as financial and budgetary independence. The agreement protects the identity and branding of the NMH and the right to the use of the new maternity hospital facility. I am therefore assured that the long and distinguished identity, ethos and tradition of the NMH will remain.
The development of the new NMH at St Vincent's, which will cater for up to 10,000 births per annum, will constitute the largest single investment ever to be made in maternity services in Ireland. I am delighted to confirm that the project has recently progressed to planning stage.
1001. Deputy Billy Kelleher asked the Minister for Health the details of the paediatric and maternity services at Portlaoise hospital; if they are to be downgraded, the locations these services will move to; and if he will make a statement on the matter. [14092/17]
View answerMy Department and the HSE are committed to securing and developing the role of Portlaoise Hospital within the Dublin Midlands Hospital Group. A report published in December 2016, which HIQA undertook at the request of the Department of Health, shows how much services have improved for the women using maternity services at the hospital. The extent of progress in patient safety measures in Portlaoise maternity services demonstrates the commitment of the staff and the leadership team at Portlaoise Hospital and the team at Hospital Group level.
Reports on Portlaoise Hospital in recent years point to the need for reconfiguration of some services to ensure that patients are treated in the most appropriate setting by specialist staff that can safely meet their needs. The HSE has submitted a draft Action Plan to my Department and it is currently being reviewed in detail.
The most important issue in relation to any changes at Portlaoise Hospital is that patient safety and good quality outcomes must come first. Any changes to services at Portlaoise, once approved, will be undertaken in a planned and orderly manner to further improve services for patients at the hospital and will take account of existing patient flows and demands in other hospitals, as well as the need to develop particular services at Portlaoise in the context of the overall service configuration in the Dublin Midlands Hospital Group.
1003. Deputy Bernard J. Durkan asked the Minister for Health the details of the efforts undertaken to date to raise awareness concerning the dangers of meningitis with particular reference to ongoing or planned vaccination programmes and the plans to address any deficiencies in this area in the future; and if he will make a statement on the matter. [14101/17]
View answerThe immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The NIAC is a committee of the Royal College of Physicians of Ireland comprising of experts in a number of specialties including infectious diseases, paediatrics and public health. The committee's recommendations are informed by public health advice, international best practice, and a cost effective analysis conducted by the National Centre for Pharmacoeconomics. All vaccines administered through the Primary Childhood Immunisation Schedule (PCIS) are provided free of charge.
There are three vaccines in the PCIS protecting children against meningitis.
- Haemophilus Influenzae type B (Hib) was a major cause of meningitis in infants but has now been almost entirely eliminated following the introduction of the Hib vaccine as part of the Primary Childhood Immunisation Programme in 1992.
- Meningococcal C (MenC) vaccine was introduced in October 2000 as part of the routine childhood immunisation and is currently given at 4 and 6 months and a combined Hib/MenC booster at 13 months. Immunity reduces over time so a booster vaccine for MenC was introduced into the Health Service Executive (HSE) schools immunisation programme in September, 2014 for 12-13 years olds.
- Children born on or after 1 October, 2016 are now receiving the Meningococcal B (Men B) vaccine at 2, 4 and 12 months of age. Ireland is the second country in Europe to make this vaccine available free of charge as part of its national immunisation programme.
The HSE are working hard to maximise uptake rates for all vaccines in the PCIS. Uptake rates for Hib are 95% and uptake rates for MenC have increased from 80% in 2010 to close to 90% (89% Q3 2016).
Immunisation policy is based on providing a safe, sustainable and cost-effective programme of immunisation. The introduction of any new meningitis vaccine into the primary childhood immunisation schedule will be considered in the context of recommendations from NIAC, the outcome of cost-effective analysis, and resource availability.
