Questions Nos. 780 and 781 answered with Question No. 778.

Health Care Professionals

Questions (782)

Michael McGrath

Question:

782. Deputy Michael McGrath asked the Minister for Health if his attention has been drawn to the different treatment of members of the Medical Council and the Dental Council of Ireland who are over 65 years of age by way of the annual subscription as opposed to other ordinary members of these organisations; his plans to introduce a new policy in this area; and if he will make a statement on the matter. [19159/17]

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Written answers (Question to Health)

I assume the Deputy is referring to the fees applied by the Dental Council and the Medical Council of Ireland to professionals for retention on their respective registers.

The Dental Council and Medical Council of Ireland are both self funding and mainly generate their income from the registration fees of members. The Medical Council of Ireland charges annual retention fees of €605 to doctors who have been on the register for three years or more and €560 to doctors who have been on the register for less than three years. It has set a fee of €70 for doctors aged over 70 for a 3 year period to 2018 and will review all rates and advise the Minister further on the matter in 2018. The Dental Council charges a retention fee of €220 to all dentists. Both regulatory bodies operate independently of each other and are not required to implement a common fees structure. There are no plans to introduce a new policy in this regard.

General Practitioner Services

Questions (783)

Clare Daly

Question:

783. Deputy Clare Daly asked the Minister for Health the safeguards in place in order that general practitioners administering the maternity and infant care scheme cannot claim fees twice (details supplied); the complaints mechanism that exists should this happen to a person; the sanctions in place should it be discovered that a general practitioner is engaging in such a practice; and if he will make a statement on the matter. [19160/17]

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Written answers (Question to Health)

As this question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply.

Nursing Home Beds Data

Questions (784)

Michael Healy-Rae

Question:

784. Deputy Michael Healy-Rae asked the Minister for Health the number of public nursing homes, private nursing homes and voluntary nursing homes, respectively, in existence in each of the years 1997 to 2016; the number of long-term beds only in public nursing homes, private nursing homes and voluntary nursing homes, respectively, in each of the years 2014 to 2016; and if he will make a statement on the matter. [19162/17]

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Written answers (Question to Health)

Between 1997 and 2013 the Department of Health carried out a survey of long-stay units each year. Each long-stay unit (public, private and voluntary) is sent a questionnaire and the responses are collated by the Department. The aim of the survey is to provide statistics on the number of beds available for long-term care, how these beds are used and the types of residents who occupy these beds.

The results of the surveys are used to prepare the Long-Stay Activity Statistics Reports which are published on the Department's website and can be accessed at www.doh.ie. Each report provides a breakdown of the data by Local Health Office and Category of Unit. The Deputy should be mindful that these are self-reported survey results and have variable response rates.

The Health Information and Quality Authority (HIQA) is an independent statutory authority established to drive high quality and safe care for people using health and social care services in Ireland. Since 2009 HIQA have maintained a register of all nursing homes whether public or private. The register can be accessed at www.hiqa.ie.

The Health Service Executive maintains a public register for long stay residential care. The following information, detailing the number of public beds is set out in the HSE operational plans which are also available on line.

HSE Operational Plan

Long stay beds

Other beds

Total

2014

5,392

1,861

7,253

2015

5,287

1,840

7,127

2016

5,255

2,005

7,260

Medical Card Eligibility

Questions (785)

Michael McGrath

Question:

785. Deputy Michael McGrath asked the Minister for Health his views regarding persons here that hold a full medical card by virtue of time spent working in the United Kingdom and who do not receive a social welfare pension; his plans to raise the issue in the upcoming Brexit negotiations; and if he will make a statement on the matter. [19163/17]

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Written answers (Question to Health)

Regulation (EC) 883/2004 deals with the coordination of social security, including health care, for those moving within the European Union. Under its provisions, persons residing in Ireland who are attached to the social security system of another member state, are entitled to receive health care services in Ireland at the cost of that member state provided they are not subject to Irish social security legislation. Persons in this category are entitled to full eligibility and receive a medical card as evidence of their entitlement.

In relation to health services, ensuring that there is minimum disruption and that essential services are maintained on a cross-border, all-Island and Ireland/UK basis will be a key concern for the Department of Health over the period ahead. As part of its analysis and contingency planning in relation to Brexit, the Department of Health is currently examining these issues and planning for a range of possible scenarios. However, it is important to be clear that until the UK formally withdraws from the Union, it remains a full member, with all of its existing rights and obligations and that there are no immediate changes in the area of health as a consequence of the UK's decision to leave the EU.

Hospitals Building Programme

Questions (786)

Jackie Cahill

Question:

786. Deputy Jackie Cahill asked the Minister for Health the appeal mechanism in place for subcontractors on a hospital project to ensure they get paid for works carried out when there is a dispute between the contractor and subcontractor; and if he will make a statement on the matter. [19170/17]

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Written answers (Question to Health)

The management of the healthcare property estate and the delivery of health care projects is a service matter. Therefore, the Health Service Executive has been requested to reply directly to you in relation to your question on the appeals mechanism for disputes between subcontractors and contractors.

Health Services Data

Questions (787)

Mattie McGrath

Question:

787. Deputy Mattie McGrath asked the Minister for Health the amount charged in 2016 to the NHS for Britons being treated here by the HSE; the number of persons this charge applied to; the cost to the HSE for Irish persons being treated by the NHS; and if he will make a statement on the matter. [19177/17]

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Written answers (Question to Health)

Regulation (EC) 883/2004 and Implementing Regulation 987/2009 provide for the coordination of social security systems, including healthcare, within the EU/EEA and Switzerland. Under these provisions, persons who are insured with (covered by) the healthcare service of one EU member state are entitled to receive healthcare in the public system of another member state in certain circumstances, at the cost of the member state in which they are insured. Such persons may include:

- visitors to one member state from another;

- pensioners of one member state who reside in another and their dependants;

- dependent families of persons who are employed in another member state; and

- persons referred for treatment in another member state.

Ireland and the United Kingdom operate a bilateral healthcare reimbursement arrangement, in respect of health services provided under the Regulations, covering temporary visitors between the two countries, pensioners of one country and their dependants residing in the other country, and the dependant families of persons employed in the other country. Under the arrangement net liability between the two countries is calculated on a lump sum basis rather than an individual basis.

The amount payable in any one year is based on an estimate of the numbers of persons within the categories eligible for reimbursement and for whom each country is liable and an estimate of the average cost of providing healthcare treatment. The amount payable is agreed following compilation of the necessary data and discussions between the two administrations. An initial payment on account is made for the relevant year and is subject to final settlement once all necessary statistical and financial information is complete. The finalisation of accounts is normally some years in arrears to facilitate collation of relevant statistics and for the approval of the average cost prepared by each country for the year concerned at EU level. Total payments in any one year can as a consequence relate to both final settlements in respect of previous years' liabilities and the payment on account in respect of the current and/or previous years.

The net payment received by Ireland from the United Kingdom in 2016 was €277.6m, of which an amount of €97m related to the settlement of final accounts for previous years, and an amount of €180.6m related to the payment on account for 2016. The relative values of this amount attributable to each country are as follows:

Payable by the UK to Ireland

€193.1m

Temporary Visitors (based on an estimate of 15,725,000 visitor days)

€ 12.6m

Pensioners and their dependants (based on an estimate of almost 35,000 persons)

€180.5m

Payable by Ireland to the UK

€ 12.5m

Temporary Visitors (based on an estimate of 13,272,000 visitor days)

€ 8.1m

Pensioners and their dependants (based on an estimate of 1,260 persons)

€ 4.4m

Net paid by UK to Ireland

€180.6m

Entirely separate arrangements apply to patient referrals for scheduled treatment in the other country whereby the costs arising are reimbursed on an actual costs basis. These arrangements are administered by the Health Service Executive. In 2016 the HSE issued 867 forms to approved patients who availed of healthcare in the United Kingdom at a cost of €9,169,452. In relation to UK patients who received healthcare in Ireland, data for 2016 is not yet available, however in 2015 the HSE submitted claims totalling €1,857,764 in respect of 14 approved UK patients who received healthcare in Ireland.

Hospital Staff Recruitment

Questions (788)

Brian Stanley

Question:

788. Deputy Brian Stanley asked the Minister for Health when a replacement ophthalmologist will be recruited to replace a person (details supplied) in the children's eye clinic in Portlaoise hospital. [19182/17]

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Written answers (Question to Health)

As this is a service matter, I have asked the HSE to respond to you directly.

Hospitals Building Programme

Questions (789)

Mattie McGrath

Question:

789. Deputy Mattie McGrath asked the Minister for Health the status of plans for a major trauma centre in Dublin; if the project has been sent to tender; the tender criteria for the project; the hospitals which have been invited to bid for the major trauma centre; if such hospitals are being asked to submit major incident plans for their hospitals; if considerations are being given to facilities for paediatric trauma; the closing date for submission of tenders; when a decision is expected on the tender process; and if he will make a statement on the matter. [19189/17]

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Written answers (Question to Health)

The development of a policy on a trauma system for Ireland is a joint initiative from the Department of Health and the HSE in recognition that we do not have a coordinated trauma network structure in Ireland. The primary aim of developing this policy is to improve patient outcomes and to lead to a reduction in preventable death and disability for a particular, small category of patients who sustain traumatic injuries.

The Steering Group has been working with the Department of Health, the HSE and all relevant HSE National Clinical Leads, including Surgery, Pre-Hospital Emergency Care, Critical Care, Orthopaedics and Trauma on the development of the policy. It is expected that the Trauma Steering Group's report will be completed shortly.

Legislative Reviews

Questions (790)

Clare Daly

Question:

790. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 14 of 8 March 2017, the status of the promised review of the provisions in the Health (Amendment) Act 2013 for the charging of private patients in public hospitals (details supplied); the likely date for completion of that review; and if he will make a statement on the matter. [19190/17]

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Written answers (Question to Health)

As stated in PQ 12346/17 of 8 March 2017 my Department is conducting an analysis of trends in private activity in public hospitals since the Health (Amendment) Act 2013 commenced. It is expected that the report will be completed before the end of May and I will share this analysis with the Deputy once it is finalised.

Hospitals Discharges

Questions (791)

Caoimhghín Ó Caoláin

Question:

791. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the position regarding the roll-out of the new early supported discharge teams as part of the national stroke programme; the details of the staffing team for each inclusive of grade and cost of same; the timescale for the roll-out of these programmes; and if he will make a statement on the matter. [19194/17]

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Written answers (Question to Health)

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.

National Stroke Programme Implementation

Questions (792, 1071, 1072, 1073, 1074, 1077)

Caoimhghín Ó Caoláin

Question:

792. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the cost of providing one whole-time equivalent physiotherapist, occupational therapist and nurse and a 0.5 whole-time equivalent occupational therapist and 0.5 medical social worker that would meet the acceptable international standards for early supported discharge teams; and if he will make a statement on the matter. [19195/17]

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Billy Kelleher

Question:

1071. Deputy Billy Kelleher asked the Minister for Health if his attention has been drawn to the fact that the outgoing clinical lead of the HSE’s national stroke programme has warned of an imminent crisis due to the failure to invest in services to meet an expected 50% increase in stroke within the next eight years; and if he will make a statement on the matter. [20543/17]

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Billy Kelleher

Question:

1072. Deputy Billy Kelleher asked the Minister for Health if his attention has been drawn to the fact that due to a lack of modest investment in services, the average length of stay of stroke patients in acute hospitals is now increasing and direct discharge to nursing homes is up by 2.3%, which alone has added €17.25 million to the cost of nursing home care to the State; and if he will make a statement on the matter. [20544/17]

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Billy Kelleher

Question:

1073. Deputy Billy Kelleher asked the Minister for Health his plans to ensure ongoing clinical leadership within the national stroke programme in the face of the challenges to service delivery caused by a soaring stroke rate; and if he will make a statement on the matter. [20545/17]

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Billy Kelleher

Question:

1074. Deputy Billy Kelleher asked the Minister for Health his plans to improve the rate of admissions to stroke units; and if he will make a statement on the matter. [20546/17]

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Billy Kelleher

Question:

1077. Deputy Billy Kelleher asked the Minister for Health the cost of rolling out early supported discharge programmes nationally for stroke patients in circumstances in which this would improve patient outcomes and free up acute hospital beds; and if he will make a statement on the matter. [20549/17]

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Written answers (Question to Health)

I propose to take Questions Nos. 792, 1071 to 1074, inclusive, and 1077 together.

The HSE National Clinical Programme for Stroke has been in place since early 2010. The vision of the programme is to design standardised models of integrated care pathways for the delivery of clinical care to ensure sustained quality clinical operational management. Overall, the programme aims to improve quality, access and cost-effectiveness of stroke services in Ireland.

The programme can point to many improvements in Stroke care since its inception. The HSE has previously advised my Department that emergency thrombolysis is provided now to patients in all regions of the country by improved hospital and ambulance protocols, health professional training and the appointment of new physicians.

There is national 24/7 access to safe stroke thrombolysis, the rate of which has increased from 1% in 2006 to a current rate of 13%. This exceeds the national target of 9%.

Access to stroke unit care has been shown to improve stroke patient outcomes through reduced mortality rates, reduced dependency and shorter lengths of stay in hospital by patients. Since the commencement of the National Clinical Programme for Stroke, nine new stroke units have been opened, bringing the total number of stroke units in acute hospitals to twenty-two. This is a major improvement from the first national stroke care audit report in 2008 which reported one stroke unit in the country.

The programme has also developed a range of care pathways to assist the streamlining and standardisation of stroke care delivery.

The cost objectives of the programme have also been met with more stroke patients experiencing improved clinical outcomes. Examples include:

- Less stroke patients are dying in hospital: The rate has dropped from 16.2% in 2009 to 14.1% in 2014 – an overall percentage reduction of 12.9%;

- Less stroke patients are discharged to nursing homes – and therefore with improved disability outcomes: This has reduced from 17.7% in 2009 to 13.8% in 2014 – an overall percentage reduction of 22.1%;

- More stroke patients are discharged directly to home from acute hospitals: The rate has increased from 50.7% in 2009 to 51.6% in 2014;

- The median acute hospital length of stay for stroke has fallen from 10 days in 2009 to 9 days in 2014, with an estimated 19,000 bed days saved in the 2011-2014 period.

This is all good news for stroke patients.

As these questions are service matters, they have been referred to the Health Service Executive for attention and direct reply to each Deputy.

Hospitals Discharges

Questions (793)

Caoimhghín Ó Caoláin

Question:

793. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the number of persons across each operating site that have been discharged home via early supported discharge for stroke patients since the first ESD rollout in 2011; the percentage of this category compared to total stroke discharges; and if he will make a statement on the matter. [19196/17]

View answer

Written answers (Question to Health)

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.

Hospital Appointments Status

Questions (794)

Martin Ferris

Question:

794. Deputy Martin Ferris 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. [19211/17]

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Written answers (Question to 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.

Health Services Provision

Questions (795)

Seán Fleming

Question:

795. Deputy Sean Fleming asked the Minister for Health his plans regarding removing a service from a health centre (details supplied) in County Laois. [19212/17]

View answer

Written answers (Question to Health)

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

Departmental Funding

Questions (796)

Noel Grealish

Question:

796. Deputy Noel Grealish asked the Minister for Health the LGBT groups and organisations that have received funding from his Department or the HSE in 2016 and to date in 2017; the amount of funding that has been provided; the purpose for which the funding was provided; and if he will make a statement on the matter. [19226/17]

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Written answers (Question to Health)

In 2016 the Department of Health arranged for the transmission of funding of €45,600 to 'Belong To' in respect of an initiative being undertaken in the North Inner City Drug and Alcohol Task Force on drugs and alcohol abuse in the LGBT community. In addition a once off payment of €5,000 was allocated to 'Belong To' in 2016 to support a drug project as part of the Taoiseach's initiative on the development of North East Inner City, Dublin.

To date in 2017 the Department of Health has allocated €22,800 to ' Belong To' for the continuation of its initiative on drugs and alcohol abuse in the LGBT community. This amounts to 50% of the 2017 funding allocation of €45,600 for this initiative.

Up until the end of 2016 the Department of Health disbursed national lottery funding to successful applicants. Details of lottery grants made are available on the Department's website at http://health.gov.ie/about-us/lottery-funding-2009-2016/. The Department of Health no longer operates a National Lottery Fund. The HSE operates a similar scheme and continues to provide grants to health agencies and other organisations from National Lottery funds. Details can be found on its website at http://www.hse.ie/eng/services/list/1/schemes/National-Lottery-Grants-2017/.

As the Deputy's question asks about funding received from the HSE, I have forwarded your question to the HSE for a direct reply.

Nursing Homes Support Scheme

Questions (797)

Eamon Scanlon

Question:

797. Deputy Eamon Scanlon asked the Minister for Health if the budget for the nursing home support scheme affects in any way local HSE service budgets on a yearly basis; and if he will make a statement on the matter. [19236/17]

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Written answers (Question to Health)

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.

The Scheme operates under the Nursing Homes Support Scheme Act, 2009. The maximum prices to be paid in public facilities, and referred to as the cost of care, are set by the HSE, laid before the Houses of the Oireachtas, and are published on the HSE website. The Scheme 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 everyday living;

- Laundry service

The Scheme has a national ring-fenced budget of €940 million in 2017, providing support to just over 23,600 people by the end of the year. The budget is administered by the NHSS National Office in Tullamore. In order to manage the available funds within the budget throughout the year, a national placement list is operated by the HSE. Funding approvals issue to applicants in chronological order. In 2017 the time applicants to the Scheme spend on the placement list for funding should not exceed 4 weeks.