Tuesday, 27 Jun 2017

Psychological Services

Questions (372)

Carol Nolan

Question:

372. Deputy Carol Nolan asked the Minister for Health if the child clinical psychology post for County Offaly has been filled; and if he will make a statement on the matter. [29729/17]

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Written answers

Minister for Health

I have asked the HSE to respond to the Deputy directly on this matter.

Occupational Therapy

Questions (373)

Carol Nolan

Question:

373. Deputy Carol Nolan asked the Minister for Health the action he plans to take to address the lengthy waiting lists for occupational therapy in counties Laois and Offaly; and if he will make a statement on the matter. [29730/17]

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Written answers

Minister for 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.

Ambulance Service Provision

Questions (374)

Carol Nolan

Question:

374. Deputy Carol Nolan asked the Minister for Health the details of the service level agreements with private ambulance operators for the transport of public patients; the locations from which the ambulances are being dispatched and the areas covered; the value for money audit mechanisms in place for the service level agreement; and if he will make a statement on the matter. [29732/17]

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Written answers

Minister for Health

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

Ambulance Service Provision

Questions (375)

Carol Nolan

Question:

375. Deputy Carol Nolan asked the Minister for Health the progress to date on the Edenderry ambulance station; and if he will make a statement on the matter. [29733/17]

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Written answers

Minister for Health

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

Elder Abuse

Questions (376)

Carol Nolan

Question:

376. Deputy Carol Nolan asked the Minister for Health the number of complaints received relating to adult abuse per county, in tabular form; and if he will make a statement on the matter. [29734/17]

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Written answers

Minister of State at the Department of Health

As this is a service matter it has been referred to the Health Service Executive for direct reply.

Home Help Service Data

Questions (377)

Carol Nolan

Question:

377. Deputy Carol Nolan asked the Minister for Health the number of persons in receipt of home help hours over each of the past ten years by county, in tabular form; the number of hours granted; and if he will make a statement on the matter. [29736/17]

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Written answers

Minister of State at the Department of Health

As this is a service matter it has been referred to the Health Service Executive for direct reply.

Hospital Appointments Status

Questions (378)

John McGuinness

Question:

378. Deputy John McGuinness asked the Minister for Health if he will arrange an early appointment for a person (details supplied). [29741/17]

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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.

Medical Card Reviews

Questions (379, 380, 381, 398)

Fergus O'Dowd

Question:

379. Deputy Fergus O'Dowd asked the Minister for Health the selection procedures that apply to medical cards holders who are chosen for review; if such reviews are randomly selected; if so, the number of random reviews that have been carried out in 2017 to date; the number of cards withdrawn; the reason given and medical diagnosis; the procedure by which persons with lifelong serious illnesses such as multiple sclerosis or motor neurone disease are chosen for such reviews; his views on whether this is fair; if a personal identifier can be allocated to such persons in order that persons with lifelong serious illnesses can be removed from possible review lists; and if he will make a statement on the matter. [29745/17]

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Fergus O'Dowd

Question:

380. Deputy Fergus O'Dowd asked the Minister for Health the procedure by which persons who are in receipt of medical cards are chosen for review; if these reviews are randomly chosen; if so, the number of randomly chosen reviews that have been carried out in 2017 to date; the procedure by which persons with lifelong serious illnesses such as multiple sclerosis and motor neurone disease are chosen for such reviews; his views on whether this is fair; if he will make the necessary changes in order for persons with lifelong serious illnesses to be removed from possible review lists; and if he will make a statement on the matter. [29748/17]

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Fergus O'Dowd

Question:

381. Deputy Fergus O'Dowd asked the Minister for Health if the medical card review mechanism can be amended in order to simplify the review process for persons with lifelong serious illness by using unique identifier coding and by signing off that their circumstances have not changed since the awarding of the medical card in the first instance, in order to simplify, speed up and reduce unnecessary stress on the person and costs in the area; and if he will make a statement on the matter. [29749/17]

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Fergus O'Dowd

Question:

398. Deputy Fergus O'Dowd asked the Minister for Health if he will intervene in the case of a person (details supplied) who was diagnosed with a terminal illness; and if he will now ensure that medical card holders with terminal illness are exempted from such reviews in the future [29990/17]

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Written answers

Minister for Health

I propose to take Questions Nos. 379 to 381, inclusive, and 398 together.

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 Deputy may be aware of the key recommendation of the Report of the Expert Panel on Medical Need for Medical Card Eligibility that a person’s means should remain the main qualifier for a medical card. The Expert Panel Report also concluded that it is neither feasible nor desirable to list conditions in priority order for medical card eligibility. Therefore, medical card provision is based on financial assessment. Under the legislation, having a particular illness, in itself, does not establish eligibility for a medical card and therefore, the medical conditions of applicants for this scheme are not monitored on that basis. Accordingly, a patient suffering from either MS or MND will not have automatic eligibility for a medical card.

Where the applicant's income is within the income guidelines, a medical card or GP visit card will be awarded. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. The Act obliges the HSE to assess whether a person is unable, without due hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure and every application must be assessed on that basis.

Within the application process, the HSE endeavours to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The legislation allows the HSE, in certain circumstances, to exercise discretion and grant a medical card, even though an applicant exceeds the income threshold, where he or she faces difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information documentation to fully take account of all the relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses.

The HSE is required to undertake reviews of eligibility in order to ensure that a person continues to meet the qualifying criteria required to continue holding eligibility. Where a medical card is due to expire, these cards are reviewed and a renewal notice is sent out to the medical card holder three months in advance of the expiry date. It is important to note that the person under review maintains eligibility for the card while the review is being conducted, including any period where additional information is requested.

I have asked the HSE to examine the particular case to which the Deputy has drawn attention. I have also asked the HSE to supply the data requested on medical card reviews and to reply to the Deputy on these matters as soon as possible.

Services for People with Disabilities

Questions (382)

Frank O'Rourke

Question:

382. Deputy Frank O'Rourke asked the Minister for Health if a transport service can be provided to a person (details supplied) attending a rehabilitative training centre; and if he will make a statement on the matter. [29754/17]

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Written answers

Minister of State at the Department of Health

The provision of transport services is not part of core services within disability services. As a general rule public transport should be used in all circumstances where it is an option. This is in keeping with the principle of mainstreaming with a clear focus on ensuring persons with a disability have access to the normal range of services and participate in community life as far as possible. It must be noted that in general, day service users are in receipt of disability allowance and are automatically entitled to the Free Travel Pass, so there should be no additional cost burden at an individual level.

Funding is not provided for the transportation of young people to and from day services. However when all other options are exhausted and a person cannot avail of a day service because they do not have transport to attend, the service provider is advised to use some of the service money to cover the transport costs – this usually results in the provision of a reduced quantum of service.

Social Care Division have committed in its Operation Plan 2017 to establish a high level cross divisional working group to rationalise the provision of transport and to maximise equitable access and efficiencies and are liaising with the National Transport Authority (NTA) and voluntary providers to progress this issue. The NTA have a total of 17 transport co-ordinating units called Local Link. Local link provides safe secure and reliable public transport services in local and rural areas of Ireland. Local Link provides a combination of scheduled public transport services and door to door services. The services are demand response (e.g. people call Local Link for transport to access a service such as their GP), the NTA have advised that additional funding has been provided for rural transport in 2017.

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.

Drugs Payment Scheme Administration

Questions (383)

Jack Chambers

Question:

383. Deputy Jack Chambers asked the Minister for Health the reason the drug payment scheme limit is €144 per month whether for a couple or a single person; if he will consider reducing this by halving the limit to €72 for unmarried persons, widows and widowers; and if he will make a statement on the matter. [29757/17]

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Written answers

Minister for Health

The Programme for Partnership Government contains a commitment to reduce the cost of medicines by reducing the annual co-payment on the Drugs Payment Scheme and reducing prescription charges for medical card holders. I intend to consider the Drugs Payment Scheme threshold in the context of the health commitments in the Programme for Government, and having regard to the funding available.

Hospital Appointments Delays

Questions (384)

Louise O'Reilly

Question:

384. Deputy Louise O'Reilly asked the Minister for Health the reason a person (details supplied) has been waiting 22 months to see a neurologist and has been told even though the case is urgent it will be a three year minimum wait before they see a specialist neurologist. [29758/17]

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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.

Health Services Provision

Questions (385)

Louise O'Reilly

Question:

385. Deputy Louise O'Reilly asked the Minister for Health the status of the business case submitted to the Health Service Executive for the national intestinal failure centre to be based at St. James's Hospital; and if he will make a statement on the matter. [29765/17]

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Written answers

Minister for Health

Any proposals for the funding for the centre for intestinal failure in St. James's needs to be considered as part of the Hospital Group’s overall priorities for services across the Group in the first instance. It will also need to be considered by the HSE for consideration as part of the overall 2018 estimates process, with regard to competing priorities for resources available in 2018.

My Officials have met with the Group proposing this centre and advised they should engage with the HSE on preparing a business case for their proposal.

Obesity Strategy

Questions (386)

Louise O'Reilly

Question:

386. Deputy Louise O'Reilly asked the Minister for Health the status of the implementation of the 2005 obesity strategy, specifically elements that focus on obesity treatment; and if he will make a statement on the matter. [29766/17]

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Written answers

Minister of State at the Department of Health

The 2005 strategy referred to by the deputy has largely been superseded by A Healthy Weight for Ireland - The National Obesity Policy and Action Plan (OPAP). This was published last September. It is one of the key developments arising from Healthy Ireland, the framework for improving health and wellbeing across the population.

The OPAP covers a ten year period up to 2025 and aims to reverse obesity trends, prevent health complications and reduce the overall burden for individuals, families, the health system, and the wider society and economy.

I wish to emphasise that every sector of our society has a role in reducing the burden of obesity and the OPAP clearly acknowledges this.

The OPAP firstly prescribes 'Ten Steps Forward' to deal with obesity. Step 7 is: Develop a service model for specialist care for children and adults. There are a number of actions under this step including:

1. Plan for and support the development of specialist, consultant-led multidisciplinary care, based on the chosen model of care and the RCPI report, for adults on an equitable geographic basis (one within each hospital group) and one for children at national level;

2. develop and implement integrated clinical care models for adults and children with appropriate clinical care pathways for all patients;

3. develop standards, clinical guidelines and quality assurance programmes for obesity and weight management services in the health sector.

The appointment of a National Clinical Lead for Obesity in the HSE is among the priority actions recommended. The National Clinical Lead will be responsible for providing among other things, a model of care for children and adults and overseeing its implementation. I am pleased to advise the Deputy that the HSE is in the process of appointing a National clinical Lead for Obesity.

The OPAP includes a number of other priority actions including:

- Implementing a 'whole of school' approach to healthy lifestyle programmes which includes nutrition, physical activity and exercise, smoking, alcohol and mental wellbeing;

- agreeing food reformulation targets with the food industry;

- developing a code of practice for food and drinks promotion, marketing, sponsorship and product placement;

- developing a communications strategy to increase knowledge among the public of being a healthy weight and to stimulate health behaviour change;

- developing proposals for a National Nutrition Policy and Action Plan;

- developing legislation for calorie posting to support people in making healthy choices;

- implementing the National Physical Activity Plan;

- developing proposals on evidence-based fiscal measures such as a levy on sugar-sweetened drinks;

- developing research in the area.

I am pleased to advise the deputy that The Healthy Eating/Food Pyramid Guidelines have been revised and updated by a multi-stakeholder Working Group led by my Department. These were launched in December 2016 as the Healthy Food for Life initiative. A Food Reformulation Working Group is being established to reduce the sugar, fat and salt content of foods and beverages, in line with the EU Food Reformulation Project. The development of legislation on calorie posting is also underway.

A Working Group has been established to develop a voluntary Code of Practice on Food Advertising, Promotion and Marketing including retail product placement and sponsorship. My Department has also worked with the Broadcasting Authority of Ireland (BAI) on the marketing of food and drink to children; this arises in the context of the revised Children’s Code to restrict marketing of high fat, high salt and high sugar foods and drinks. My Department will make a submission to the BAI in 2017 on the new code.

The HSE has advised that currently programmes for treatment of obesity include a Weight Management Service in St. Columcille’s Hospital , Loughlinstown, Co. Dublin and a regional bariatric service for patients with severe and complicated obesity at the Saolta University Health Care Group. There is also a programme for children carried out in Temple Street Hospital called W82GO. It is a 12-month family-based obesity treatment programme for children and teenagers, which provides families with health, nutrition, self-esteem, family communication and activity guidance along with support in a safe environment so that families can achieve the healthiest lifestyle for them. The treatment follows best practice and is multidisciplinary. Before starting the programme, the child is reviewed by a paediatrician, paediatric dietician, paediatric physiotherapist and paediatric psychologist. The child completes an exercise test to measure fitness and has baseline blood tests which assess their metabolic health and identifies how at risk they are for obesity-related conditions. Following the initial appointment, families are then invited onto the programme.

Capital Expenditure Programme

Questions (387)

Niall Collins

Question:

387. Deputy Niall Collins asked the Minister for Health the details and county location of capital projects announced by his Department in March, April, May and to date in June 2017. [29784/17]

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Written answers

Minister for Health

Your question has been referred to the Health Service Executive for direct reply as the the HSE is responsible for the delivery of health care infrastructure projects.

Departmental Staff Data

Questions (388)

Mick Wallace

Question:

388. Deputy Mick Wallace asked the Minister for Health the number of Civil Service clerical officers in full-time employment in his Department as of 31 May 2017 by county, in tabular form. [29851/17]

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Written answers

Minister for Health

There were 50 clerical officers in full time employment in my Department in Dublin on 31 May 2017. My Department does not have offices in any other location.

Departmental Staff Data

Questions (389)

Mick Wallace

Question:

389. Deputy Mick Wallace asked the Minister for Health the number of full-time Civil Service clerical officers in his Department who have either retired, resigned or been promoted from 1 January 2015 to 31 May 2017, by county, in tabular form. [29867/17]

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Written answers

Minister for Health

The information requested by the Deputy is detailed as follows.

1 January 2015 to 31 May 2017
Number of Resignations	Number of Promotions	Number of Retirements
4	6	1

The Department of Health is based in Dublin and does not have offices in any other location.

Departmental Staff Data

Questions (390, 391)

Mick Wallace

Question:

390. Deputy Mick Wallace asked the Minister for Health the number of full-time Civil Service clerical officer appointments made in his Department from 1 January 2015 to 31 May 2017 by county, in tabular form. [29891/17]

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Mick Wallace

Question:

391. Deputy Mick Wallace asked the Minister for Health the number of temporary Civil Service clerical officer appointments made in his Department from 1 January 2015 to 31 May 2017 by county, in tabular form. [29909/17]

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Written answers

Minister for Health

I propose to take Questions Nos. 390 and 391 together.

The information requested by the Deputy is detailed as follows.

Year	Number of clerical officer appointments made	Number of temporary clerical officer appointments made
2015	6	0
2016	14	0
2017 (to 31 May)	3	4

All of these appointments were made to our headquarters in Dublin. The Department does not have offices in any other location.