Written Answers Nos. 172-181
172. Deputy Thomas P. Broughan asked the Minister for Health the regulations in respect of additional charges to clients of nursing homes run by the HSE and the private sector under the fair deal scheme; and if he will make a statement on the matter. [21016/19]
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 their 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.
The Competition and Consumer Protection Commission (CCPC) is an independent statutory body with a dual mandate to enforce competition and consumer protection law in Ireland. CCPC’s mission is to promote competition and enhance consumer welfare. The CCPC has just published consumer protection guidelines for contracts of care in long-term residential care services for older people. The guidelines set out the obligations and responsibilities that providers must adhere to under consumer protection law and are aimed at providing greater transparency, clarity and certainty for consumers.
This is an important development which will be of invaluable help to those entering nursing homes, nursing home providers and relatives, particularly at a time that can be stressful and difficult for families. The guidelines developed by the CCPC are an important step in improving transparency, clarity and certainty for consumers, particularly in situations where the consumer may be at increased risk of vulnerability. The Guidelines also set out requirements in relation to transparency regarding additional charges and the variation of charges.
It is noted that all providers will receive a formal communication from the CCPC shortly in relation to the new guidelines. The CCPC has stated that nursing homes will be afforded a period to review their contracts and ensure that they meet the requirements of the new guidelines.
173. Deputy Thomas P. Broughan asked the Minister for Health the steps he is taking to reduce eye care outpatient waiting lists and lengthy waits for cataract surgery nationally significantly in 2019; and if he will make a statement on the matter. [21017/19]
View answerBudget 2019 announced that the Government had further increased investment in tackling waiting lists, with funding to the NTPF increasing from €55 million in 2018 to €75 million in 2019. The joint Department of Health, HSE, and NTPF Scheduled Care Access Plan 2019 was published in March.
Under the Plan the HSE, in line with the National Service Plan, will deliver 1.155 million elective inpatient and day case discharges at a value of €1.4 billion in 2019. The Scheduled Care Access Plan includes:
- detailed plans from the NTPF to fund 25,000 IPDC treatments, 5,000 Gastro Intestinal Scopes and 40,000 outpatient first appointments.
- Projections by year end to reduce the overall number of patients on the waiting list (excluding GI scopes) from just over 70,200 in Dec 2018 to under 60,000;
- Within this overall reduction the number of patients waiting longer than 3 months will reduce from 40,200 at the end of 2018 to 31,000 by year end.
It is also projected that for ten identified high volume procedures, including cataracts, all clinically suitable patients waiting more than 6 months will be offered treatment in 2019. These 10 procedures account for over a third of the active inpatient day case waiting list and represent 60% of NTPF planned activity in 2019.
In addition, a key element of the 2019 Plan is the stabilisation of the Outpatient Waiting List which remains a significant challenge. The Scheduled Care Access Plan 2019 includes a target that the number of patients waiting for a first Outpatient appointment will fall from over 516,000 at the end of 2018 to under 509,000.
Under the Plan the HSE, in line with the National Service Plan, will aim to deliver 3.3 million outpatient appointments, of which approximately 1 million will be first appointments and the NTPF will deliver 40,000 first Outpatient appointments.
The NTPF advise that over recent months they have placed a particular focus on engaging with hospital groups and individual hospitals to identify outpatient waiting list proposals. While the NTPF have already approved over 38,000 outpatient appointments, they advise that the impact of these initiatives may not be seen until the end of the year. Approximately 75% of appointments approved relate to 4 high-volume specialties, including Ophthalmology.
The Scheduled Care Access Plan is a key pillar of the project plan to deliver on the Ministerial and Department’s 2019 Priority to improve Acute Hospital Waiting Times. The governance and oversight structures to oversee NTPF and HSE performance in the delivery against the targets set out in the Plan has been expanded to include a Working Group whose remit is to develop initiatives aimed at improving access for patients to scheduled care in a number of high volume specialties including Ophthalmology.
At the end of July 2017, there were 10,024 people waiting for a cataract procedure. Cataracts were one of the specialties targeted by the NTPF under the Inpatient Day Case Access Plan 2018 and by the end December 2018, the numbers waiting had fallen to 6,440, a reduction of 36%. There were 6151 patients waiting for a Cataract procedure at the end of April 2019, with 582 of those waiting over 9 months. This represents a reduction of 3,789 or 87% when compared to July 2017, when there were 4,371 patients waiting over 9 months for a cataract operation.
174. Deputy Marcella Corcoran Kennedy asked the Minister for Health the position regarding the recent announcement by the HSE of a recruitment embargo in respect of candidates who had completed the recruitment process, had made life-changing decisions based on job offers by the HSE and now find themselves in some cases without a job; and if he will make a statement on the matter. [21029/19]
View answerThere is no recruitment embargo in place in the HSE. However, in recent months, officials from my Department have been engaging intensively with the HSE in reaching agreement on a Pay and Numbers Strategy for 2019. The key focus in developing the strategy is to ensure that affordable and appropriate recruitment decisions are made by the HSE and that they need to operate within its pay allocations.
By the end of 2018, the levels of agency, overtime and pay costs had reached unaffordable levels. In light of this, the HSE decided to introduce interim control measures for a consolidation period of three months to the end of June, until they received clarity on plans and financial performance for Q1 2019 from Hospital Groups and CHOs.
I have been very clear that those locations which provide credible, balanced plans will be supported. Similarly, locations which do not submit such plans need to be scrutinised. It should also be noted that the HSE is continuing to recruit all funded development posts.
I have asked the HSE to respond directly to the Deputy on the remaining elements of the question.
175. Deputy Kevin O'Keeffe asked the Minister for Health if funding is to be withdrawn from a specific unit in a hospital (details supplied) in County Cork and redistributed to a hospital in another county; if all funding and resources at the hospital will be maintained at current levels and-or increased; and if the upgrade of a unit at another hospital will have no impact on funding or service levels at the hospital. [21033/19]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible.
176. Deputy Catherine Connolly asked the Minister for Health the number of vacancies in the laundry service at University Hospital Galway; the length of time such positions have been vacant; the grade of vacancies; when they will be filled; and if he will make a statement on the matter. [21035/19]
View answer177. Deputy Catherine Connolly asked the Minister for Health the details of the contract between a company (details supplied) and University Hospital Galway for the washing of soiled articles including mops; and if he will make a statement on the matter. [21036/19]
View answer178. Deputy Catherine Connolly asked the Minister for Health the protocols and procedures in place at the laundry service in University Hospital Galway, particularly regarding infection control; and if he will make a statement on the matter. [21037/19]
View answerI propose to take Questions Nos. 176 to 178, inclusive, together.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to reply to the Deputy directly.
179. Deputy Eamon Scanlon asked the Minister for Health if an association (details supplied) will be supported in its efforts for justice and compensation; and if he will make a statement on the matter. [21039/19]
View answerFollowing an Irish Government Decision in January 1975, the Government granted an ex-gratia sum equivalent to 4 times the German lump-sum and an ex-gratia monthly allowance for life equal to the German monthly allowance, to each of the Irish children found to have thalidomide related injuries. There are currently 29 Irish people in receipt of ex-gratia monthly payments from my Department and all are now in their late 50s.
The German monthly payments are made by the Contergan Foundation, which is established under German legislation. From 01 August 2013, the Foundation substantially increased its monthly payments to thalidomide survivors, including Irish survivors. Both the German payments and the Irish ex-gratia payments made to the survivors are exempt from tax, including DIRT and are not reckonable as means for the purpose of Social Welfare payments. The rate of payment is related to the survivors' level of thalidomide related injury.
In addition to the initial lump sum and the monthly payments for life, the supports provided to each Irish survivor include a medical card on an administrative basis regardless of means, provision of appliances, artificial limbs, equipment, housing adaptations, and access to a full range of primary care, hospital and personal social services. There is a designated senior manager in the Health Service Executive to act as a liaison with regard to the ongoing health and personal social service needs of Irish survivors.
The Contergan Foundation has confirmed that since 2013, it is accepting applications from individuals for compensation for thalidomide related injury. It is open to any Irish person to apply to the Foundation for assessment of their disability as being attributable to thalidomide. Any Irish person who establishes that their injury is attributable to thalidomide, will be offered appropriate supports by the Irish Government commensurate with those currently provided to Irish thalidomide survivors, outlined above.
Work is underway in the Department to bring forward Heads of a Bill to provide on a statutory basis for health and personal social services for the Irish survivors of thalidomide.
180. Deputy John McGuinness asked the Minister for Health if an operation to remove cataracts will be arranged at University Hospital Waterford for a person (details supplied); the timeline for the treatment; and if he will make a statement on the matter. [21040/19]
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, since 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.
181. Deputy John McGuinness asked the Minister for Health the approval process to have a child referred from St. Luke's hospital, Kilkenny, for specialist care at a hospital (details supplied); if the case will be expedited; and if he will make a statement on the matter. [21041/19]
View answerThe HSE currently operates two schemes that facilitate patients accessing treatment abroad.
The Treatment Abroad Scheme (TAS) allows public patients to be referred to another EU/EEA Member State for treatment, in their public healthcare system, that is not available in Ireland, subject to qualifying criteria. A patient's Irish based consultant is responsible for referring the patient abroad under the terms of the TAS, after having exhausted all treatment options including tertiary care within Ireland. The HSE provides information for patients on the TAS on its website.
An alternative where the treatment is available in Ireland is the Cross Border Directive (CBD), which the HSE operates in Ireland. Under the terms of the CBD patients in Ireland can be reimbursed for medical treatment, that is available in the public health service in Ireland, but received in another EU\EEA Member State. The patient may access the overseas service in either the public or private health sector of the other Member State they choose to receive the service in. The patient pays for the treatment and claims reimbursement from the HSE at the cost of that treatment in Ireland or the cost of it abroad, whichever is the lesser.
Referral for care under the CBD may be made by a GP, a hospital consultant and certain other clinicians. The HSE through the National Contact Point (NCP) provides information for patients on the operation of the CBD.
The patient should contact the HSE TAS/CBD office for advice on making an application for treatment abroad under the most appropriate scheme. They can be contacted in writing at HSE TAS/CBD Office, St Canices, Laken, Dublin Road, Kilkenny, R95 P231 or by phone on 056 778 4551. Information is also available on the HSE's TAS and CBD websites.
