Tuesday, 23 Jan 2018

Written Answers Nos. 335-349

Long-Term Illness Scheme Coverage

Questions (335)

Michael McGrath

Question:

335. Deputy Michael McGrath asked the Minister for Health when FreeStyle Libre will be available under the long-term illness scheme; and if he will make a statement on the matter. [2845/18]

Written answers

Minister for Health

Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Hospital Waiting Lists

Questions (336)

James Lawless

Question:

336. Deputy James Lawless asked the Minister for Health if his attention has been drawn to the fact that some persons are experiencing delays in the outpatient appointment system at Tallaght hospital (details supplied) in relation to the department of gastroenterology; and if the matter will be investigated. [2853/18]

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 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.

Hospital Appointments Status

Questions (337)

Éamon Ó Cuív

Question:

337. Deputy Éamon Ó Cuív asked the Minister for Health when a hip operation will be provided for a person (details supplied); the reason for the delay in issuing a date for this procedure; if the person can undergo the procedure through the treatment purchase fund scheme or in another manner; and if he will make a statement on the matter. [2854/18]

Written answers

Minister for Health

Reducing waiting times for patients is one of the Government's key priorities. October's Budget announced a total 2018 allocation of €55m for the National Treatment Purchase Fund for 2018. This significant increase in funding more than doubles their 2017 total allocation of €20m.

In 2018 the NTPF will continue to arrange the provision of treatment for Inpatient/Daycase patients across a range of specialties including orthopaedic procedures.

The HSE and NTPF are working together to develop Waiting List Action Plans for 2018. These plans will see a continued focus on long-waiting patients and overall waiting lists.

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 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 response to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to you directly.

Medical Card Drugs Availability

Questions (338)

Robert Troy

Question:

338. Deputy Robert Troy asked the Minister for Health if the drug menotonian will be covered under the medical card. [2857/18]

Written answers

Minister for Health

Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Psychological Assessments Waiting Times

Questions (339)

James Browne

Question:

339. Deputy James Browne asked the Minister for Health the number of persons in each CHO waiting for a psychology appointment in primary care; and the numbers waiting from zero to 12 weeks, 12 to 26 weeks, 26 to 52 weeks, and more than 52 weeks, respectively. [2860/18]

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.

Hospital Appointments Status

Questions (340)

John Brassil

Question:

340. Deputy John Brassil asked the Minister for Health the status of an operation for a person (details supplied); and if he will make a statement on the matter. [2863/18]

Written answers

Minister for Health

Reducing waiting times for patients is one of the Government's key priorities. October's Budget announced a total 2018 allocation of €55m for the National Treatment Purchase Fund for 2018. This significant increase in funding more than doubles their 2017 total allocation of €20m.

Cataracts are among the most common procedures carried out in the Ophthalmology specialty and were a key focus of the NTPF initiatives in 2017 with significant progress achieved. Between July and December the overall cataract waiting list was reduced by 2,000 and the number waiting over 15 months was reduced from almost 1,600 to just over 300. NTPF figures for the end of December showed more than half of cataract patients are waiting less than 6 months and 72% are waiting less than 9 months. In 2018 the NTPF will continue to arrange the provision of treatment for Inpatient/Daycase patients across a range of specialties and procedures including the provision of cataract operations and I expect to see further progress due to the increased Government funding being made available.

The NTPF work with public and private hospitals in order to provide access for patients to treatment and the hospitals and initiatives are evaluated in line with standard procurement practice. This criteria consists of a combination of price per treatment and the experience of the hospital in providing similar treatments to its patients.

The HSE and NTPF are working together to develop Waiting List Action Plans for 2018. These plans will see a continued focus on long-waiting patients and overall waiting lists.

In response to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to you directly.

Hospital Services

Questions (341)

Michael Healy-Rae

Question:

341. Deputy Michael Healy-Rae asked the Minister for Health the reason consultant radiologists in University Hospital Kerry are carrying out radiographers' work at night; and if he will make a statement on the matter. [2867/18]

Written answers

Minister for Health

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.

Treatment Abroad Scheme

Questions (342)

Catherine Murphy

Question:

342. Deputy Catherine Murphy asked the Minister for Health his views on updating the travel policy regarding the treatment abroad scheme implemented in 2009; if his attention has been drawn to the fact that the current travel policy does not cover the reimbursement of the costs to hospital accompaniment stays for parents of minors who have no choice but to be with their children while they are receiving treatment abroad; if his attention has been drawn to the fact that in some other European countries this accompaniment cost is covered by some hospitals; and if he will make a statement on the matter. [2881/18]

Written answers

Minister for Health

The HSE operates the Treatment Abroad Scheme (TAS) for persons entitled to treatment in another EU/EEA Member State or Switzerland under EU Regulation (EC) No. 883/2004, as per the procedures set out in EU Regulations (EC) No. 987/2009, and in accordance with Department of Health Guidelines.

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.

Nursing Homes Support Scheme

Questions (343, 344)

James Browne

Question:

343. Deputy James Browne asked the Minister for Health the position regarding a person whose fair deal contribution plus their prescription charges exceed their weekly pension sum received; and if he will make a statement on the matter. [2884/18]

James Browne

Question:

344. Deputy James Browne asked the Minister for Health his plans to address the problem of nursing homes seeking mandatory contributions from persons who are in the fair deal scheme; and if he will make a statement on the matter. [2885/18]

Written answers

Minister of State at the Department of Health

I propose to take Questions Nos. 343 and 344 together.

The 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 have met with both Nursing Homes Ireland and Age Action 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 have also recently met with the National Treatment Purchase Fund, the Office of the Ombudsman and HIQA 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. As part of this work, Officials from the Department of Health and the HSE are to preform an examination of the issue of additional charges in nursing homes. They will report their findings and recommendations to the Interdepartmental/Agency Working Group for consideration.

In the past week I have met with the Competition and Consumer Protection Commission (CCPC) who are undertaking a project to develop guidelines for the contracts between nursing homes and their residents. I fully support the CCPC in this work and I have already asked my Department to engage with the CCPC as required to assist with its work. In that regard, officials have already met with the CCPC project team to assist with its enquiries.

In relation to the Deputy's reference to prescription charges, I can confirm that from the 1st January 2018 the prescription charge for all medical card holders is €2, with a monthly cap of €20. The Programme for a Partnership Government contains a commitment to reduce the cost of medicines for Irish citizens and further reductions in the prescription charge may be considered in the future, having regard to the funding available.

Home Care Packages Provision

Questions (345)

James Browne

Question:

345. Deputy James Browne asked the Minister for Health his plans to extend the fair deal scheme to home care; and if he will make a statement on the matter. [2886/18]

Written answers

Minister for Health

Improving home care services so that people can continue to live with confidence, dignity and security in their own homes for as long as possible is a key commitment of the Government. However, the only statutory scheme in place at present to support older people is the Nursing Home Support Scheme. The Government intends to address this by establishing a new stand-alone statutory scheme for the financing and regulation of home care services. The Department of Health is currently engaged in a detailed process to progress this.

The statutory scheme for home care will introduce clear rules in relation to the services for which individuals are eligible and in relation to how decisions are made on allocating services. It will therefore be an important step in ensuring that the system operates in a consistent and fair manner for all those who need home care services. It will also help to improve access to the home care services that people need, in an affordable and sustainable way. The system of regulation for home care will help to ensure that the public can be confident that the services provided are of a high standard.

As an initial step in this process, the Department commissioned the Health Research Board to undertake a review of the home care systems in four other European countries. This review, which was published in April 2017, will help us to learn from the experiences of other jurisdictions and will inform the debate and future consideration of approaches to formal home care financing and regulation here in Ireland. I, along with Minister Daly, also launched a public consultation process in July 2017 which closed in October 2017. The purpose of this consultation was to allow all those with views on this topic to have their say, including older people themselves, their families, and healthcare workers. There was a very high response rate to the consultation process with approximately 2,600 submissions received. It is intended to publish a report of the findings of the consultation process in the coming months. Further consultation with stakeholders, including service users, will take place later this year.

The development of a new home care scheme is a complex undertaking which will involve significant legislative, operational and financial resources. A considerable amount of detailed work remains to be undertaken before final decisions are taken on the form of a home care scheme and the regulation of these services. This is necessary if reforms are to be successful, affordable and sustainable.

Medicinal Products Availability

Questions (346)

Niamh Smyth

Question:

346. Deputy Niamh Smyth asked the Minister for Health if a drug (details supplied) was used here; and if he will make a statement on the matter. [2889/18]

Written answers

Minister for Health

The Health Products Regulatory Authority (HPRA) is the competent authority for the regulation of medicines in Ireland. The HPRA has stated that Hormonal Pregnancy Tests (HPTs) such as Primodos were never authorised (i.e. licensed) for use in Ireland.

The 1975 annual report of the National Drugs Advisory Board (NDAB, a predecessor of the HPRA) outlined the consideration given by the NDAB to the use of hormonal testing for pregnancy. This report related to hormonal pregnancy testing preparations in general, and did not mention any specific product. In April 1975, the NDAB issued a warning letter to practitioners regarding the use of hormonal pregnancy testing preparations. This letter reminded practitioners that these preparations had not been assessed by the NDAB, and that their use as a means of pregnancy testing had not been accepted by the NDAB. The letter also highlighted that these preparations should be avoided, as a firm statement of safety could not be given and other, more efficient methods of pregnancy testing were available.

Between 1976 and 1980, the NDAB received five reports of suspected adverse reactions associated with the use of HPTs. There is very limited information available in relation to these reports.

In the UK, where HPTs were licensed (and where they were used from the early 1950s to 1978), an Expert Working Group of the UK’s Commission on Human Medicines recently completed a review of this issue and published a report on the use of hormone pregnancy tests (HPTs) and adverse effects relating to pregnancy, including possible birth defects. This report concluded that following an extensive and rigorous review, based on the totality of the available data, the scientific evidence does not support a causal association between the use of HPTs such as Primodos and birth defects or miscarriage.

Nursing Staff Recruitment

Questions (347)

Billy Kelleher

Question:

347. Deputy Billy Kelleher asked the Minister for Health the number of nurses newly recruited in 2017 across all sectors of the health service; and the net increase in nursing numbers resulting from this recruitment. [2890/18]

Written answers

Minister for Health

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

Speech and Language Therapy Staff

Questions (348)

Billy Kelleher

Question:

348. Deputy Billy Kelleher asked the Minister for Health the number of speech and language therapists recruited in 2017; the sectors of the health service under which they have been recruited, that is, primary care and acute disability services; and the net increase in speech and language therapist numbers resulting from this recruitment. [2891/18]

Written answers

Minister for Health

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

Occupational Therapy Staff

Questions (349)

Billy Kelleher

Question:

349. Deputy Billy Kelleher asked the Minister for Health the number of occupational therapists recruited in 2017; the sectors of the health service under which they have been recruited, that is, primary care and acute disability services; and the net increase in occupational therapist numbers resulting from this recruitment. [2892/18]

Written answers

Minister for Health

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