Written Answers Nos. 1641-1655
1641. Deputy Alan Farrell asked the Minister for Health to provide an update on work being done by his Department to develop career development pathways for GPs; and if he will make a statement on the matter. [17575/23]
View answerGPs are private practitioners, most of whom hold a GMS contract with the HSE for the provision of GP services without charge to medical card and GP visit card holders. Our model of general practice is based on private practice, which allows GPs to develop their practices and sub-specialisations in line with the particular needs of their patients and their own career ambitions.
The responsibility for GP training transferred from the HSE to the Irish College of General Practitioners (ICGP) in 2021. The number of doctors entering GP training has increased approximately ten percent year on year from 2019, rising from 193 in 2019 to 258 in 2022, and a further large increase is planned for this year. It is aimed to have 350 training places available for new entrants per year by 2026.
The ICGP education programme also provides a wide range of continuous medical education for trained GPs and professional development opportunities to allow GPs to meet the relevant Medical Council requirements to maintain professional competence. Further training is available in clinical areas such as dermatology, older person care and women's health and also in areas of practice management.
Under the GMS scheme, a number of practice supports are provided for, including staff supports and supports for rural practices and practices in deprived urban areas. Contributions are also made to eligible GMS GPs towards locum expenses for leave taking purposes including study leave.
I recently published the Terms of Reference for a Strategic review of General Practice which is to commence shortly and will be completed this year. The review, with input from key stakeholders, will examine the broad range of issues affecting general practice, including issues related to GP training, and will set out the measures necessary to deliver a more sustainable general practice.
1642. Deputy Alan Farrell asked the Minister for Health the efforts his Department is making to boost the number of GPs in rural areas; and if he will make a statement on the matter. [17576/23]
View answerGPs are self-employed practitioners and therefore may establish practices at a place of their own choosing. There is no prescribed ratio of GPs to patients and the State does not regulate the number of GPs that can set up in a town or community.
Under the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. Currently there are 2,539 GPs contracted to provide services under the GMS Scheme.
The Government is aware of the workforce issues currently facing general practice and is working to ensure patients across the country continue to have access to GP services and that general practice is sustainable in all areas into the future.
Under the 2019 GP Agreement additional annual expenditure provided for general practice has been increased now by €211.6m. This provides for significant increases in capitation fees for participating GMS GPs, and new fees and subsidies for additional services. Improvements to GP’s maternity and paternity leave arrangements and a support for GPs in disadvantaged urban areas, have also been provided for.
An enhanced supports package for rural GP practices was introduced previously to support rural GPs, these supports have been increased by 10% under the 2019 GP Agreement. In addition, practices in receipt of rural practice supports attract the maximum allowable rates for practice staff support subsidies and locum contributions for leave taking. Specific fees are also in place for dispensing doctors (who operate in rural areas), these have been increased by 28% under the Agreement.
The number of doctors entering GP training has increased approximately ten percent year on year from 2019, rising from 193 in 2019 to 258 in 2022, and a further large increase is planned for this year. Following the transfer of responsibility for GP training from the HSE to the Irish College of General Practitioners (ICGP), it is aimed to have 350 training places available for new entrants per year by 2026.
These measures will make general practice in Ireland a more attractive career choice and will see an increase in the number of GPs working in the State.
Furthermore, I recently published the Terms of Reference for a Strategic review of General Practice which is to commence shortly and will be completed this year. The review, with input from key stakeholders, will examine the broad range of issues affecting general practice in general and in rural areas specifically, and will set out the measures necessary to deliver a better general practice.
1643. Deputy Alan Farrell asked the Minister for Health the efforts being made to reduce the administrative burden on GPs; and if he will make a statement on the matter. [17577/23]
View answerGPs are private practitioners, and while most hold a GMS contract with the HSE for the provision of GP services without charge to medical card and GP visit card holders.
Under the GMS scheme, GPs are paid a subsidy towards the cost of employing a practice nurse and/or a practice secretary, the latter would commonly perform a range of administrative duties. The rate payable depends on the GP's GMS panel size and the level of experience of the nurse or secretary. A practice manager subsidy is also available.
In addition, as provided for in Budget 2023, a significant package of additional practice supports is being prepared in the context of the expansion of eligibility for GP care without charges to people who earn the median household income or less.
As part of its commitment to GP practice, the HSE continue to invest in the development of many new features within GP practice management systems in an effort to expand their capabilities, improve patient care and facilitate a reduction in administrative overheads for busy GP practices.
Practice systems have been continuously developed to support the chronic disease management (CDM) programme and digitally enable the submission of both the data required to manage the CDM programme and the data required for reimbursement; a single submission now covers both.
Through a combination of technology and regulatory changes, the pandemic saw the rapid deployment of new facilities to support electronic transfer of prescriptions via Healthmail, access to teleconsultations, the introduction of electronic referrals for patients that required Covid testing and system enhancements to support GP practices administration of Covid vaccinations, digitally enabling the reimbursement of GPs as an integral part of the data submission for the vaccination. This capability was subsequently extended to support the administration of flu vaccines last winter, eliminating much of the administration overhead associated with the older, paper based process.
In recent years we have also seen the introduction of electronic sick certs in lieu of the older, paper based forms, again in an effort to streamline processes and leverage digital to reduce administrative overhead.
Whilst the impact of these initiatives in some cases pushed back the delivery of other ICT related initiatives, as described under the 2019 GP Agreement, the planned development of other eHealth initiatives, such as a full electronic prescribing, the national summary and shared care record programmes, we anticipate will also help improve care and reduce the administration burden on GP practices.
1644. Deputy Alan Farrell asked the Minister for Health if he will comment on the work his Department is undertaking to increase the number of intern doctors selecting general practice; and if he will make a statement on the matter. [17578/23]
View answerThe Government is aware of the workforce issues currently facing general practice and in particular the need to increase the number of GPs practising across the country to ensure patients continue to have access to GP services.
A number of measures have been taken to make general practice in Ireland a more attractive career choice for doctors, and the positive impact of these measures is being seen in the increased number of doctors both applying for and undertaking GP training.
Under the 2019 GP Agreement additional annual expenditure provided for general practice has been increased now by €211.6m. This provides for significant increases in capitation fees for participating GMS GPs, and new fees and subsidies for additional services. Improvements to GP’s maternity and paternity leave arrangements and a support for GPs in disadvantaged urban areas have been provided for, and the supports for rural GP practices have also been increased.
The number of doctors entering GP training has increased approximately ten percent year on year from 2019, rising from 193 in 2019 to 258 in 2022, and a further large increase is planned for this year. Following the transfer of responsibility for GP training from the HSE to the Irish College of General Practitioners (ICGP), it is aimed to have 350 training places available for new entrants per year by 2026.
In addition, the number of applications from doctors to undertake GP training has also increased year on year from 2019, with 446 applications received in 2019 rising to a record 968 applications received this year.
Furthermore, I recently published the Terms of Reference for a Strategic review of General Practice which is to commence shortly and will be completed this year. The review, with input from key stakeholders, will examine the broad range of issues affecting general practice, and will set out the measures necessary to deliver a more sustainable general practice. GP training and the need to ensure an adequate supply of general practitioners to meet the changing needs of the population is one of the key issues to be examined under the review.
1645. Deputy Michael Lowry asked the Minister for Health the reasons a person (details supplied), who had received septorhinoplasty ENT treatment through the National Treatment Purchase Fund, has been denied additional treatment through the NTPF despite a senior consultant ENT confirming that this person requires additional ENT specialist treatment; and if he will make a statement on the matter. [17584/23]
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.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1646. Deputy Matt Shanahan asked the Minister for Health his views on a matter concerning bed capacity at University Hospital Waterford (details supplied); and if he will make a statement on the matter. [17593/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1647. Deputy Matt Shanahan asked the Minister for Health his views on a matter concerning cardiology services at University Hospital Waterford (details supplied); and if he will make a statement on the matter. [17594/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1648. Deputy Matt Shanahan asked the Minister for Health his views on a matter concerning a laboratory at University Hospital Waterford (details supplied); and if he will make a statement on the matter. [17595/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1649. Deputy Martin Browne asked the Minister for Health the average ambulance response times in Tipperary per quarter over the past five years, in tabular form. [17596/23]
View answer1650. Deputy Martin Browne asked the Minister for Health if he is aware of a recent case where an ambulance had to come from outside Tipperary as there were none available in the county; and if his Department plans to increase the number of ambulances in Tipperary. [17597/23]
View answerI propose to take Questions Nos. 1649 and 1650 together.
As these are service matters I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
1651. Deputy Louise O'Reilly asked the Minister for Health when a retired healthcare worker (details supplied) will receive their pension increment. [17599/23]
View answerAs this is an administrative matter for the Health Service Executive, the HSE has been requested to respond directly to the Deputy.
1652. Deputy Michael Creed asked the Minister for Health the plans, if any, he has to review the qualifying criteria for benefit under the long-term illness scheme; if he believes it appropriate that persons suffering with ADHD should have their circumstances covered under the benefits of the long-term illness scheme; and if he will make a statement on the matter. [17600/23]
View answerThe Long-Term Illness (LTI) scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 illnesses covered by the scheme.
These 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.
Statutory Instrument No. 277 of 1971, put a limitation on Section 59(3) of the Health Act 1970, in respect of the provision of medicines to those suffering from mental illness:
"Arrangements for the supply of drugs and medicines to persons suffering from mental illness in pursuance of section 59 (3) of the Act shall be made only in respect of persons under the age of 16 years."
Persons suffering with ADHD are eligible for the LTI scheme under the category of "mental illness" and currently this limitation on age applies to them. My Department is currently examining all of the issues around the scope of the Scheme, including this issue.
However, it is also important to remember that the LTI scheme exists within a wider eligibility framework.
This Government has put a significant focus on improving access to and the affordability of healthcare services, advancing substantial policy, legislation and investment to deliver expanded eligibility.
In 2022, a range of measures were delivered including the abolition of public inpatient charges for children, reductions in the Drug Payment Scheme threshold to €80 per month, and the introduction of free contraception for women aged 17-25.
The significant investment in Budget 2023 will facilitate better access to affordable, high-quality healthcare for people at a time when the cost-of-living crisis is impacting on everyone.
In 2023 this will mean:
• an expansion of GP care without charges to people earning no more than the median household income
• all public in-patient hospital charges will be abolished
• an extension of free contraception to 26-year-old women since 1 Jan 2023, and further extension to 27-30 years old women from 1 September 2023.
These measures continue to create a health and social care service that offers affordable access to quality healthcare.
In addition, people who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card.
In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Medical card eligibility is primarily based on an assessment of means and is not granted on the basis of any particular condition.
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
Under the Drug Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines.
The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
1653. Deputy Pádraig O'Sullivan asked the Minister for Health the number of permanent multi-annual funded residential beds for respite in CHO4; what plans, if any, there are for expansion; and if he will make a statement on the matter. [17612/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly as soon as possible.
1654. Deputy Pádraig O'Sullivan asked the Minister for Health if he plans to expand the provision of funding for the Freestyle Libre Flash Glucose Monitoring System to persons with diabetes over 21 years of age; and if he will make a statement on the matter. [17613/23]
View answerThe Health Service Executive (HSE) has statutory responsibility for pricing and reimbursement decisions under the community schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. Therefore, this matter has been referred to the HSE for attention and direct reply to the Deputy.
1655. Deputy Imelda Munster asked the Minister for Health if he will provide a progress update with regard to the development of the Newgrange Hospice in Drogheda; if a suitable site has been located and a commencement date set; and if he will make a statement on the matter. [17617/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
