Thursday, 14 Dec 2017

Written Answers Nos. 395-409

Palliative Care Services

Questions (395)

Billy Kelleher

Question:

395. Deputy Billy Kelleher asked the Minister for Health if he will report on the implementation of each of the ten recommendations from the palliative care support beds review, in tabular form. [53846/17]

Written answers

Minister of State at the Department of Health

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Minor Ailments Scheme

Questions (396)

Billy Kelleher

Question:

396. Deputy Billy Kelleher asked the Minister for Health if he will report on the evaluation of the 2016 pharmacy-based minor ailment scheme pilot project; and if the project will be extended further. [53847/17]

Written answers

Minister for Health

As the HSE has responsibility for this matter, I have asked the HSE to respond directly to the Deputy on this issue.

Medical Card Data

Questions (397, 398)

Billy Kelleher

Question:

397. Deputy Billy Kelleher asked the Minister for Health the number of persons covered by medical cards on 1 December 2017. [53848/17]

Billy Kelleher

Question:

398. Deputy Billy Kelleher asked the Minister for Health the number of persons covered by general practitioner visit cards on 1 December 2017. [53849/17]

Written answers

Minister for Health

I propose to take Questions Nos. 397 and 398 together.

As these questions relate to service matters, I have arranged for the questions to be referred to the Health Service Executive (HSE) for direct reply.

Mental Health Services Data

Questions (399)

Billy Kelleher

Question:

399. Deputy Billy Kelleher asked the Minister for Health the number of children that have attended a CAMHS service in 2017. [53850/17]

Written answers

Minister of State at the Department of Health

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Health Services Expenditure

Questions (400)

Billy Kelleher

Question:

400. Deputy Billy Kelleher asked the Minister for Health when multi-annual plans and budgets for health expenditure both current and capital will be brought forward. [53851/17]

Written answers

Minister for Health

The Programme for Partnership Government set out the Government's intention to work with the Oireachtas to sustain appropriate annual increases in the Health Budget. Expenditure is to be based on multi-year budgeting supported by a five year Health Service Plan based on realistic and verifiable projections; at present, the Health System is not in a position to make realistic, verifiable projections using a “bottom up” approach. The Department is currently considering how best to practically implement this commitment and work is on-going in the development of the different elements required, and there are some existing building blocks already in place including:

(i) Planning for Health – Trends and Priorities to Inform Service Planning

The HSE publishes a report titled “Planning for Health – Trends and Priorities to inform Health Service Planning” on an annual basis.

(ii) ESRI Medium-Term Projection Model of Healthcare Demand

Important work is currently underway as part of the joint Department of Health/ESRI Research Programme in Healthcare Reform that will assist in achieving the objective of introducing multi-annual budgeting supported by a 5 year Health Service Plan.

(iii) Activity Based Funding

Since January of 2016, funding for inpatient and daycase activity in the 38 largest public hospitals has been on an ABF basis. Hospitals are now given fixed ABF allocations, with any funding associated with inpatient and day case activity effectively being withdrawn, and subsequently earned back following delivery of agreed ABF activity targets, up to a maximum of the fixed ABF budget. Performance in this regard is monitored on a monthly basis.

(iv) Other Initiatives

Other important initiatives in this regard include work relating to the community costing programme, the development of a new model of care for the health service and the Bed Capacity Review.

In the meantime, in the context of the annual Estimates process, the HSE are undertaking work on Budgeting and Service Planning for 2018 and, as with previous years, the National Service Plan for 2018 is expected to be published in December 2017.

(v) Capital funding

The Exchequer Capital Envelopes 2018-2021 and outcomes of the Mid-Term Review of the Capital Plan were published in the context of Budget 2018. Health capital funding for 2018 was outlined in the recently published Public Service Estimates for 2018 and the HSE is currently developing its Capital Plan for 2018-2021.

HSE National Service Plan

Questions (401)

Billy Kelleher

Question:

401. Deputy Billy Kelleher asked the Minister for Health when the HSE will publish a five-year service plan. [53852/17]

Written answers

Minister for Health

The Programme for Partnership Government set out our intention to work with the Oireachtas to sustain appropriate annual increases in the Health Budget. Expenditure will be based on multi-year budgeting supported by a five year Health Service Plan based on realistic and verifiable projections. The funding increases provided to the HSE since this Government came into office, and the enhanced performance and accountability framework introduced by the HSE, provide an important basis for planning multi-annual health expenditure and the operation of the health services within the limits determined by the Oireachtas. These will be key to the sustainability of this approach.

The development of such a multi-year service plan will have to align with the future implementation plan for the Sláintecare report, which was published earlier this year.

My Department is currently working on a response to the Sláintecare report to bring to Government and a plan on how best to progress the many recommendations in the report. This response is being developed with input from the HSE. I expect to be in a position to bring this to Government very early in the new year.

In the meantime, the HSE formally submitted their National Service Plan for 2018 to the Department on 8th December. Following the submission of the National Service Plan, the legislation provides 21 days for me to examine the proposed Plan and where necessary to seek amendment to, or approve, the Plan. The National Service Plan must be laid before the Houses of the Oireachtas within 21 days of its approval. Once the Service Plan is laid before the Houses of the Oireachtas the HSE will ensure it is published at the earliest possible time.

National Treatment Purchase Fund

Questions (402)

Billy Kelleher

Question:

402. Deputy Billy Kelleher asked the Minister for Health if he will report on the allocation of the €15 million in 2017 to fund the National Treatment Purchase Fund to urgently address waiting lists for those persons waiting longest; the amount of this funding that has now been spent; and the number of persons that will receive scheduled treatment as a result of this expenditure. [53853/17]

Written answers

Minister for Health

I acknowledge that waiting times are often unacceptably long and I am conscious of the burden that this places on patients and their families.

Reducing waiting times for the longest waiting patients is one of this Government's key priorities. Consequently, Budget 2017 allocated €20 million to the NTPF with €15 million of this allocation set aside for the treatment of those patients waiting longest for inpatient and daycase procedures.

In order to reduce the numbers of long-waiting patients, the HSE developed Waiting List Action Plans for 2017 in the areas of Inpatient/Daycase, Scoliosis and Outpatient Services. The Inpatient/Daycase Action Plan was delivered through a combination of normal hospital activity, as well as insourcing and outsourcing initiatives utilising NTPF funding.

The NTPF has advised that to date under their initiatives over 18,400 patients have been authorised for treatment, over 8,800 patients have accepted an offer of treatment and that over 4,700 patients have received their procedure. Patient treatment under these initiatives will continue until year end.

Mental Health Services

Questions (403)

Billy Kelleher

Question:

403. Deputy Billy Kelleher asked the Minister for Health the way in which his Department is honouring the commitment to fully implement A Vision for Change. [53854/17]

Written answers

Minister of State at the Department of Health

'A Vision for Change' set out a 10-year policy framework for Ireland's mental health services. It recommended that interventions should be aimed at maximising recovery from mental illness, building on service user and social network resources to achieve meaningful integration and participation in community life. In addition, it recommended that mental health services should be organised nationally in catchment areas for populations of between 250,000 and 400,000 and that specialist expertise should be provided by community mental health teams - expanded multidisciplinary teams of clinicians who work together to fulfil the needs of service users.

Progress, while slower than originally anticipated, continues to be made in implementing the Report’s recommendations. A number of service improvements have been implemented in parallel with the accelerated closure of old psychiatric hospitals and their replacement with bespoke new facilities, better suited to modern mental health care. Service improvements include the development of adult and child & adolescent services, shorter episodes of in-patient care, the adoption of a recovery approach in the delivery of services, and the involvement of service users in service planning and delivery.

Other ongoing developments include the development of counselling services across both primary and secondary care, including early intervention at primary care level; a greater awareness of fostering mental health promotion in society through campaigns; the publication of the Expert Review Group Report on the Mental Health Act 2001 and the Suicide Prevention Strategy 'Connecting for Life'; and the commencement of work on the new National Forensic Hospital to replace the Central Mental Hospital in Dundrum. In addition, funding has been made available to facilitate the transfer of some patients from the Forensic Mental Health Services to the community, investment in high observation in acute mental health units, the improvement of 24/7 services through additional liaison psychiatry services, new clinical programmes and provision of additional clinical space in community services.

'A Vision for Change' came to the end of its 10-year term in 2016 and preparations for a review and updating of policy have been underway since early last year. An external evidence and expert review was completed on 17 February 2017 which provides evidence to determine the policy direction for a revision of A Vision for Change, both in terms of international best practice and the experience of implementing A Vision for Change. An Oversight Group has been established to produce a high-level policy framework which sets out future service priorities. This Group will oversee the development of a refreshed policy for mental health based on the recommendations arising out of the Expert Review. The policy review process will also involve consultation with key stakeholders.

Ambulance Service Data

Questions (404)

Billy Kelleher

Question:

404. Deputy Billy Kelleher asked the Minister for Health the number of ambulance attendances at each emergency department nationwide in November 2017; the number of such ambulances that waited longer than 20 minutes to hand over patients, get their trolleys back and return to responding to calls; and the number that waited longer than 40, 60, 90, 120 and 180 minutes for same, in tabular form. [53855/17]

Written answers

Minister for Health

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

Medicinal Products Prices

Questions (405)

Billy Kelleher

Question:

405. Deputy Billy Kelleher asked the Minister for Health the number of medicines that have had their price reduced as of 1 December 2017 further to the framework agreement on the supply and pricing of medicines; the details of each medicine; and the extent of the price cut. [53856/17]

Written answers

Minister for Health

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013.

The four-year Framework Agreement on the Supply and Pricing of Medicines (IPHA Agreement), signed in July 2016, provides for an annual price realignment, which will ensure that the prices of medicines in Ireland reduce in line with price reductions across the reference countries. The details of this realignment is published by the HSE's Corporate Pharmaceutical unit on their website, the details of which can be found at the following link: https://www.hse.ie/eng/about/Who/cpu/IPHA-Price-Reduction-2017/.

Primary Care Reimbursement Service Payments

Questions (406)

Billy Kelleher

Question:

406. Deputy Billy Kelleher asked the Minister for Health if online primary care reimbursement service, PCRS, processing has now been extended to dentists and clinical dental technicians. [53857/17]

Written answers

Minister for Health

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

Medical Card Applications

Questions (407)

Billy Kelleher

Question:

407. Deputy Billy Kelleher asked the Minister for Health when the web-based paperless medical card application process to reduce the number of paper-based applications will be introduced. [53858/17]

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.

Health Services

Questions (408, 409)

Billy Kelleher

Question:

408. Deputy Billy Kelleher asked the Minister for Health the progress that has been made on considering the further recommendations of the clinical advisory group including conclusions on the assessment of the burden of disease as agreed for implementation by the HSE and his Department. [53859/17]

Billy Kelleher

Question:

409. Deputy Billy Kelleher asked the Minister for Health if the HSE has developed a burden of illness assessment tool. [53860/17]

Written answers

Minister for Health

I propose to take Questions Nos. 408 and 409 together.

The Clinical Advisory Group (CAG) was established by the Director General of the Health Service Executive (HSE) in January 2015 to provide clinical oversight and guidance to the operation of a more compassionate and trusted medical card system.

This group has been working on the development of the assessment form which will seek to capture the additional financial costs associated with an illness and which will assist the HSE in assessing an individual for a discretionary medical card.

The CAG is continuing to work on the development of guidance on assessing medical card applications involving significant medical conditions. As the group was established by reports to the HSE, I have forward the Deputy's question to the HSE for direct reply.