Written Answers Nos 108-118
108. Deputy Margaret Murphy O'Mahony asked the Minister for Health his plans to extend medical card entitlement to persons with chronic medical conditions in circumstances in which the family income is over the threshold; and if he will make a statement on the matter. [13241/18]
View answerThe HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards on the basis of illness and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. The Expert Group also concluded that a person’s means should remain the main qualifier for a medical card. This position remains unchanged.
Medical card provision is based on financial assessment. 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. 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. Where the applicant's income is within the income guidelines, a medical card or GP visit card will be awarded.
Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. It should be noted, in certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds his or her 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.
109. Deputy Martin Kenny asked the Minister for Health the position regarding the podiatrist and chiropodist service in County Leitrim; and if he will make a statement on the matter. [13243/18]
View answerAs this is a service matter it has been referred to the HSE for direct reply to the Deputy.
110. Deputy Michael McGrath asked the Minister for Health if a reply will issue to correspondence (details supplied) regarding funding for a hospital in Cork city. [13245/18]
View answerThe allocation and prioritisation of capital funding is a matter for the Health Service Executive. On receipt of the Deputy's correspondence, a report was requested from the Executive in relation to the matters raised. I have again now asked the Health Service Executive to respond to you directly as soon as possible.
111. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) was given wrong information in hospitals. [13246/18]
View answerAs this is a service matter concerning an individual, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
112. Deputy Mary Butler asked the Minister for Health his plans to amend legislation under the Health Information and Quality Authority medicines management guidelines October 2015 on self-management of medication applying to patients and service users of an organisation (details supplied); and if he will make a statement on the matter. [13249/18]
View answerHIQA’s Medicines Management Guidance, published in October 2015, was developed with the aim of guiding service providers in the provision of high-quality, safe and effective care for people living in residential settings. The guidance aims to assist service providers to meet regulations and implement national standards.
The purpose of medicines management is to reduce medicine-related incidents, adverse events and inappropriate prescribing among vulnerable people who may be at risk. These people may be considered at risk due to the nature of their illness, the characteristics of the medicines they are taking and the complexity of their medicines regime.
I understand that the HIQA Guidance indicates that residents may choose to self-administer medicines with or without help and support from staff, where the risks of doing so have been comprehensively assessed, and that the assessment should consider the resident’s wishes, the amount of support needed to independently use medicines, the resident’s cognitive and physical abilities, and other factors. I also understand that any changes to this risk assessment must be recorded and arrangements for self-administration of medicines kept under review.
The Medicinal Products (Prescription and Control of Supply) Regulations 2003, as amended (S.I. 540 of 2003) set out the controls applicable to the prescription and supply of medicines to the public.
In relation to service users of care services that are unable to administer medicines due to a physical disability, Regulation 4A(1)(a) provides that one person may administer to another a non-prescription medicine. Furthermore, Regulation 4A(1)(c) provides that a person may administer to another person a prescription-only medicine, in accordance with the directions of a registered medical practitioner or dentist.
These Regulations do not affect the autonomy or capacity of individual users of care services to self-manage their medicines. Consequently there are no plans at present to amend the Regulations.
113. Deputy John Curran asked the Minister for Health his plans to issue guidelines to hospitals in order that all persons undergoing cancer treatment receive free car parking in view of the financial burden of car parking on patients with long-term illnesses and their families; and if he will make a statement on the matter. [13255/18]
View answerEarlier this month, I requested that the HSE to carry out a review of hospital car parking charges, with the aim of establishing clear national guidelines on this area. I expect that this review will be done quite quickly and I anticipate that the outcome will result in a more compassionate and fairer approach to parking charges which will see the financial burden reduced on patients who are visiting our hospitals most frequently.
I have also asked the HSE to engage with the Irish Cancer Society and other patient advocacy groups, in order to ensure that the review takes account of the circumstances of patients, particularly those who require long-term care.
114. Deputy Margaret Murphy O'Mahony asked the Minister for Health if a medical card may be provided to a person in a family with chronic illness in circumstances in which the family income is over the threshold; and if he will make a statement on the matter. [13265/18]
View answerThe HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards on the basis of illness and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. The Expert Group also concluded that a person’s means should remain the main qualifier for a medical card. This position remains unchanged.
Medical card provision is based on financial assessment. 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. 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. Where the applicant's income is within the income guidelines, a medical card or GP visit card will be awarded.
Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. It should be noted, in certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds his or her 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.
115. Deputy Barry Cowen asked the Minister for Health when a person (details supplied) will receive an appointment for an MRI scan at the Midland Regional Hospital, Tullamore. [13269/18]
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 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 the Deputy directly.
116. Deputy Eamon Scanlon asked the Minister for Health his plans to increase staffing levels and improve efficiency in the medical card unit in view of ongoing delays in the processing of medical card applications, particularly for applicants recently diagnosed or undergoing treatment for serious illness; and if he will make a statement on the matter. [13277/18]
View answerThe Health Service Executive (HSE) National Medical Card Unit (NMCU) has responsibility over the management of staffing levels to ensure sufficient medical card turnaround times.
A key performance indicator within the NMCU is the processing of Medical Card and GP Visit Card applications within 15 working days of receipt of application. The HSE has advised that the NMCU are currently working within a 15 day turnaround for all completed applications including applicants diagnosed or undergoing treatment of a serious illness.
It is useful to note that on the 15th January the HSE launched its new National Medical Card online service www.medicalcard.ie. This new system enables people to make an online application for a medical card that is faster and more convenient than the current paper based system.
117. Deputy Margaret Murphy O'Mahony asked the Minister for Health if the case of a child (details supplied) who is waiting for an ASD assessment since 2016 will be examined; and if he will make a statement on the matter. [13279/18]
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 service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
118. Deputy Margaret Murphy O'Mahony asked the Minister for Health his plans to extend the long-term illness list of conditions for persons with chronic illness, for example, rheumatoid arthritis; and if he will make a statement on the matter. [13281/18]
View answerThe Long Term Illness (LTI) Scheme was established under section 59(3) of the Health Act 1970 (as amended). The conditions covered by the LTI are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide. Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. There are no plans to extend the list of conditions covered by the Scheme.
For people who are not eligible for the LTI scheme, there are other arrangements which protect them from excessive medicine costs.
Under the Drug Payment Scheme, no individual or family pays more than €134 a month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. In the assessment process, the HSE can take into account medical costs incurred by an individual or a family.
People who are not eligible for a medical card may still be able to avail of a GP visit card, which covers the cost of GP consultations.
