Written Answers Nos. 521-535
521. Deputy Margaret Murphy O'Mahony asked the Minister for Health the number of persons on the speech and language therapy assessment waiting list; the numbers waiting less than four months; the number waiting four to 12 months; and the number waiting more than 12 months for each local health area in tabular form. [32923/17]
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.
522. Deputy Margaret Murphy O'Mahony asked the Minister for Health the number of persons on the speech and language therapy treatment waiting list; the numbers waiting less than four months; the number waiting four to 12 months; and the number waiting more than 12 months for each local health area, in tabular form. [32924/17]
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.
523. Deputy Margaret Murphy O'Mahony asked the Minister for Health the number of persons currently on the occupational therapy first-time assessment waiting list; the numbers waiting less than four months, the number waiting four to 12 months; and the number waiting more than 12 months; and the numbers waiting for each category aged 0 to 4, 5 to 17, 18 to 64 and 65 years of age plus, respectively for each local health area, in tabular form. [32925/17]
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.
524. Deputy Margaret Murphy O'Mahony asked the Minister for Health the number of persons on the occupational therapy treatment waiting list; the numbers waiting less than four months, the number waiting four to 12 months; and the number waiting more than 12 months; and the numbers for each category waiting aged 0 to 4, 5 to 17, 18-64 and 65 years of age plus, for each local health area, in tabular form. [32926/17]
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.
525. Deputy Billy Kelleher asked the Minister for Health the number of home help hours provided in each local health office area, for each month to date in 2017; if he will provide same for each month and each local health office; and the way in which it compares against the target, in tabular form. [32929/17]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
526. Deputy Niamh Smyth asked the Minister for Health further to Parliamentary Question No. 1292 of 20 June 2017, if additional support can be provided for a person (details supplied); and if he will advise if alternative solutions are available; and if he will make a statement on the matter. [32931/17]
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.
527. Deputy Billy Kelleher asked the Minister for Health the progress made in implementing the recommendations of the review of the nursing home support scheme, a fair deal, in tabular form. [32961/17]
View answerThe 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.
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.
An Interdepartmental/Agency Working Group has been established to progress the recommendations contained in the Review. This Group is chaired by the Department of Health and includes representatives from the Department of the Taoiseach, the Department of Public Expenditure and Reform, the HSE, the Revenue Commissioners, and when required, the National Treatment Purchase Fund (NTPF). These recommendations include:
- Examining the treatment of business and farm assets for the purposes of the financial assessment element of the Scheme;
- The implementation of administrative reforms to the Scheme (Chapter Four of NHSS Review);
- A review by the NTPF of present pricing arrangements in private residential facilities.
This work is currently underway.
The following is the position in relation to administrative reform recommendations contained in Chapter four of the Review, as of 30th June 2017.
|
No |
Recommendation |
Position – June 2017 |
|
1 |
Centralise certain elements of the scheme where appropriate, with built in appropriate management and training processes to ensure customer service is maintained |
Following consideration, this recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Working Group. The elements of the Scheme relating to this recommendation are functioning well. |
|
2 |
Consolidate local NHSOs (from 17 to 4) |
Work in Progress |
|
3 |
Develop a web based form to enable nursing homes to submit invoices electronically |
Work in Progress |
|
4 |
Centralise the processing of invoices |
Following consideration, this recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Working Group. The elements of the Scheme relating to this recommendation are functioning well. |
|
5 |
Centralise the calculation of loan repayments |
Following consideration, this recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Working Group. The elements of the Scheme relating to this recommendation are functioning well. |
|
6 |
Clarify for how long the application form/documentation and the CSAR form remain valid without any new processes or medical checks |
Implemented |
|
7 |
Provide additional information regarding nursing homes to assist with the process of identifying one that is suitable |
Following consideration, this recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Working Group |
|
8 |
Review documents and application forms with advice from the National Adult Literacy Agency to ensure they are sufficiently user-friendly and informative and that they include clear guidance on where relevant information/documentation can be obtained |
Implemented |
|
9 |
Consider whether any additional questions should be included in the application form |
Implemented |
|
10 |
Make sample completed application forms available |
Implemented |
|
11 |
Include in the application form a mechanism for an applicant to authorise a representative to submit the application on their behalf |
Implemented |
|
12 |
Consider the need to establish an NHSS Best Practice Group (consisting of NHSO/national office staff) to share experiences and agree on best practice |
Implemented |
|
13 |
Consider splitting application form into two parts to avoid delaying the care needs assessment while financial information and documentation is being assembled |
Following consideration, this recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Working Group. The assessment process works well and delays do not usually arise in this part of the application process. |
|
14 |
Standardise informal advice provided to applicants regarding the nursing home loan, including clarity re legal aspects |
Implemented |
|
15 |
Provide advice regarding the possibility of claiming tax relief for medical expenses/nursing home fees |
Implemented |
|
16 |
Review current letter templates and, where possible, replace with alternative, quicker forms of communication |
Work in Progress |
|
17 |
Review content of correspondence to ensure it is as clear as possible |
Work in Progress |
|
18 |
Examine the possibility of scanning/electronic transmission of forms and documentation from NHSOs to the national office |
Following consideration, this recommendation is not being progressed at this time as agreed with the NHSS Inter Departmental Working Group |
|
19 |
Clarify that the involvement of a solicitor is not required in order to apply for the loan |
Implemented |
|
20 |
Consider making it a condition of availing of the loan that the required details, including the PPSN of the responsible person are provided |
Implemented |
|
21 |
Complete analysis of home ownership levels |
Implemented |
|
22 |
Establish what databases exist that may contain useful data for the financial assessment and establish the access by NHSOs to these, including standard operating procedures, requiring review, of such information sources |
Work in Progress |
|
23 |
Develop a consistently applied standard operating procedure for the initial financial assessment based on available resources of information |
Implemented |
|
24 |
Introduce a policy of undertaking random spot checks of financial data |
Work in Progress |
|
25 |
Follow up with the Revenue Commissioners on the scope for improved validation of declarations of income/assets |
Work in Progress |
|
26 |
Consider the options to encourage realistic valuations of declared property assets |
Work in Progress |
|
27 |
Standardise procedures in relation to reviews across NHSOs and ensure that all available information is utilised and accessed |
Implemented |
|
28 |
Consider amending legislation to provide for fluctuating values of assets and incomes |
Changes to the Scheme which require legislative implementation will be addressed collectively once all relevant Review recommendations have been considered. |
|
29 |
Continue to operate the national placement list in chronological order |
Implemented |
|
30 |
Increase time for recovery of loan to 18 months |
Changes to the Scheme which require legislative implementation will be addressed collectively once all relevant Review recommendations have been considered. |
|
31 |
Amend definition of ordinarily resident to ‘those who have been living in Ireland for at least a year’ |
Work in Progress |
|
32 |
Consideration should be given to whether a cap should be applied to the charge for nursing home care based on non-residential productive assets which are passed on to a direct family member after, or in the five years prior to, the death of an NHSS participant, and where the new owner carries on the farm or other business as their principal livelihood |
The 2015 NHSS Review recommended examination of the position of family farms and businesses. Subsequently a commitment was included in the Programme for a Partnership Government to deal with this issue. This examination is ongoing and at an advanced stage. It is important to remember that the NHSS is largely underpinned by primary legislation, and as such any changes to the Scheme will require legislative implementation. I have committed to prioritising and fast tracking this examination of family farms and businesses and bringing forward changes to the legislation to deal with the uncertainty that is being felt by farming and business families in line with the Programme for a Partnership Government. |
The Review of the NHSS also recommended a review of pricing mechanisms by the NTPF, with a view to:
- Ensuring value for money and economy, with the lowest possible administrative costs for clients and the State and administrative burden for providers;
- Increasing the transparency of the pricing mechanism so that existing and potential investors can make as informed decisions as possible; and
- Ensuring that there is adequate residential capacity for those residents with more complex needs.
A Steering Committee has been established to oversee the review of the pricing system for private long-term residential care facilities. This Steering Committee is chaired by the NTPF and includes representatives from the Department of Health, the Department of Public Expenditure and Reform, and the NTPF, and work in this area is ongoing and well advanced.
A Value For Money and Policy Review of the differences in the comparative cost of public and private long-term residential care is expected to commence in 2017 to assess reasons for and components of current cost differentials.
An initial report on the progress of the NHSS Review recommendations was submitted to the Cabinet Committee on Health in September 2016.
528. Deputy Billy Kelleher asked the Minister for Health the estimated full-year cost of amending the fees charged under the nursing homes support scheme, NHSS, to enable nursing home residents with an assessed weekly income of €300 or less to retain a minimum of €60 weekly. [32962/17]
View answerAs this is a service matter it has been referred to the Health Service Executive for direct reply.
529. Deputy Mary Butler asked the Minister for Health his views on the findings and recommendations of a briefing paper (details supplied) on regulating nursing home charges. [32963/17]
View answerThe Nursing Homes Support Scheme (NHSS), commonly referred to as A Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost.
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 person's eligibility for other schemes, such as the medical card scheme or the drugs payment scheme, is unaffected by participation in the NHSS or residence in a nursing home. In determining the services covered by the NHSS it was considered very important that the care recipient and the taxpayer would be protected and would not end up paying for the same services twice. For this reason, medications and aids that are already prescribed for individuals under an existing scheme are not included in the services covered by the NHSS, as this would involve effectively paying twice for the same service.
Although the NHSS covers core living expenses, residents can still incur some costs in a nursing home, such as social programmes, newspapers or hairdressing. In recognition of this, anyone in receipt of financial support under the NHSS retains at least 20% of their income. The minimum amount that is retained is the equivalent of 20% of the State Pension (Non-Contributory). An operator should not seek payment from residents for items which are covered by the NHSS, the medical card or any other existing scheme.
Part 7 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 stipulates that the registered provider of the nursing home must agree a contract in writing with each resident on their admission to the nursing home. This contract must include details of the services to be provided to that resident and the fees to be charged. Residents should never be charged fees which are not set out in the contract. The Department of Health and the HSE are not a party to such contracts which are concluded between each resident and the private or voluntary nursing home.
Registered providers of nursing home care are obliged to provide an accessible and effective complaints procedure. Concerns about additional charges should in the first instance be taken up with the nursing home provider. The Office of the Ombudsman can examine complaints about the actions of a range of public bodies and, from 24 August 2015, complaints relating to the administrative actions of private nursing homes. The Office of the Ombudsman normally only deals with a complaint once the individual has already gone through the complaints procedure of the private nursing home concerned.
I welcome the briefing paper prepared by Age Action which highlights this issue. I have recently met with both Age Action and Nursing Homes Ireland to discuss this issue in detail. In order to improve the transparency of these additional charges, I outlined that a schedule of charges should be provided to potential residents on enquiry to an individual nursing home, rather than at the point of admission. Nursing Homes Ireland undertook to advise their members to do so. I will also be meeting with both the National Treatment Purchase Fund and HIQA over the coming weeks to discuss this matter further.
I have asked the Interdepartmental/Agency Working Group established to oversee the implementation of certain recommendations contained in the 2015 Review of the Nursing Homes Support Scheme to also consider this matter and examine the options that might be available, as part of its ongoing work.
I am committed to ensuring that our older population are protected, that they get the care that they deserve, and that they have access to all of the information they need in order to be able to make an informed decision, especially at such a vulnerable stage in their lives.
530. Deputy Louise O'Reilly asked the Minister for Health the reason a person (details supplied) has not been given a date for surgery and is facing severe waiting times; and if he will make a statement on the matter. [33000/17]
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 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.
531. Deputy Hildegarde Naughton asked the Minister for Health the reason a free breast check and smear test service is not available to women under 50 years of age; and if he will make a statement on the matter. [33046/17]
View answerThe HSE's National Screening Service provides evidence based screening programmes for breast, cervical and bowel cancer. These services operate in line with screening protocols internationally which are underpinned by National Guidelines for Quality Assurance and further supported by European policy guidelines.
CervicalCheck provides free smear tests to women between the ages of 25 and 60. Since its introduction, CervicalCheck has detected 1,082 invasive cervical cancers, 41,417 high-grade abnormalities and 29,508 low-grade abnormalities.
To date, BreastCheck has detected over 8,500 cancers. Until recently, BreastCheck offered free mammograms every two years to all women aged 50-64 years. The roll out of BreastCheck to women aged 65-69 began in late 2015.
International evidence does not support the introduction of population based breast screening below the age of 50. BreastCheck emphasise that anyone under the age of 50 who has any concerns about their breast health should contact their GP immediately, who can refer them to a symptomatic breast disease clinic.
532. Deputy John Brassil asked the Minister for Health if he will expedite the treatment of a person (details supplied); the consultant this person has been referred to at the hospital; and if he will make a statement on the matter. [33060/17]
View answerAs this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
533. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a three-day general practitioner service (details supplied) in Rathmore; and if he will make a statement on the matter. [33061/17]
View answerAs this question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply.
534. Deputy Róisín Shortall asked the Minister for Health the number of persons on a waiting list for physiotherapy in primary care by CHO, age category and time waiting. [33064/17]
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.
535. Deputy Róisín Shortall asked the Minister for Health the number of persons on a waiting list for occupational therapy by CHO, age category and time waiting. [33065/17]
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.
