Written Answers Nos. 702-714
702. Deputy Pearse Doherty asked the Minister for Health if a reassessment of value of property is required under the fair deal scheme when the family home is sold and a new property is purchased by a spouse or partner of the applicant; and if he will make a statement on the matter. [25874/23]
View answerThe Nursing Home Support Scheme (NHSS), commonly referred to as 'Fair Deal', is a system of financial support for people who require long-term residential care. The primary legislation underpinning the NHSS is the Nursing Homes Support Scheme Act 2009. Participants in the NHSS contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone, and that people are cared for in the most appropriate settings.Participants within the NHSS contribute up to 80% of their income (40% if part of a couple) and 7.5% per annum of the value of their assets (3.75% if part of a couple). The first €36,000 (€72,000 if part of a couple) is excluded from assessment. The value of a person's principal residence is only assessed for contributions for their first three years on the scheme.
The applicant’s contribution to the cost of their care is calculated based on the financial assessment of their assets on the date they apply to the Nursing Homes Support Scheme.
Assets assessed include cash assets as well as non-cash assets such as the principal private residence, other property and land, including farmland.
For the purposes of financial assessment, income includes:
•Earnings, including income from farming or business activities
•Pension income
•Social welfare benefits/allowances
•Rental income
•Income from holding an office or directorship
•Income from fees, commissions, dividends or interest
•Any income which you have deprived yourself of in the five years prior to applicationTransferred assets are considered to be assessable under the scheme. Under the Nursing Home Support Scheme Act, which underpins the scheme, a transferred asset is defined as an asset that has been transferred at any time in the period of 5 years prior to the date on which an application for State support is first made by or on behalf of that person.An applicant or their representative can request another financial review 12 months after the first assessment or 12 months after the most recent review. The HSE may review a financial assessment at any stage.If there is a change in circumstances, for example the sale of an asset such as the principal private residence, the applicant, their spouse/partner or their personal representative has 10 days to notify their local Nursing Home Support Office (NHSO). Failure to notify the local NHSO within the specified timeframe may incur a fine. A list of other events that can be considered a change in circumstances can be found on the HSE website at: www2.hse.ie/services/schemes-allowances/fair-deal-scheme/if-your-circumstances-change/ Proceeds of Sale: Nursing home residents may also benefit from the sale of the principal private residence.The Nursing Homes Support Scheme (Amendment) Act 2021, which was signed into law on 22 July 2021, and commenced on 20 October, introduces further safeguards in the NHSS to further protect the viability and sustainability of family farms and businesses. It also includes an amendment in relation to applying the 3-year cap to the proceeds of sale of a house while a resident is in long-term care. This addresses the first relevant commitment in the Housing for All Strategy (action 19.7). Within the NHSS, the asset value of a resident's home, known in the Scheme as the "principal residence", is assessed for 3 years, with 7.5% of its value going towards the cost of care (3.75% in the case of a couple). After a person has been in care for 3 years , the value of this property is no longer assessed. In practice, this generally reduces the nursing home fees of those maintaining their home, from year four onwards. The 2021 Act now extends the 3-year cap to cover the proceeds of sale, so that a person will be able to sell their home without incurring additional fees from their fourth year in long-term residential care onwards. This applies even if the home is sold before 3 years in care; the proceeds of sale will be assessed up to the 3-year point, but excluded from assessment after that. Further details can be found here: www2.hse.ie/services/fair-deal-scheme/the-3-year-cap.htmlAn applicant may also appeal a decision made on an application under the Nursing Homes Support Scheme – ‘Fair Deal scheme’, they have no later than 40 working days after notice of the decision was given. This is a statutory requirement under the Nursing Homes Support Scheme Act 2009 (as amended). Appeals can be made against decisions of the Executive (HSE) through the National Appeals Process. Details for the Appeals services and the process can be found on the HSE's website by following this link: www.hse.ie/eng/about/who/appeals-service
In the situation described by the deputy, it is advisable that the person contacts their local Nursing Home Support Office. A list of local NHSO contacts is available at: www2.hse.ie/services/schemes-allowances/fair-deal-scheme/contact/
703. Deputy Róisín Shortall asked the Minister for Health if his attention has been drawn to a proposal from an organisation (details supplied) for a new model of GP service for disadvantaged urban areas which are currently poorly served with GP services; if he is aware that this model operates successfully out of Summerhill primary care centre; if he will give positive consideration to supporting a proposal for a similar model in the Finglas west and south area, a large area which currently has no GP service; if he will undertake to meet with the principals of this organisation in order to progress the matter; and if he will make a statement on the matter. [25875/23]
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. Where a vacancy arises in a practice with a GMS contract, the HSE becomes actively involved in the recruitment process to find a replacement GP. As of this month, there are 30 GMS vacancies, approximately 1 percent of the total number of panels, there are no vacancies in Finglas.
The Government has taken a number of steps to increase the number of GPs practicing in the State and thereby increase access to GP services.
Investment in GP services has been increased significantly under the 2019 GP Agreement which now provides for an additional €211.6m in annual expenditure for general practice. The Agreement, amongst other things, increased the fees for participating GPs and improved GMS GP maternity and paternity leave arrangements, to improve the attractiveness of working in general practice in Ireland.
The number of doctors entering GP training has been increased approximately ten percent year on year from 2019, rising from 193 in 2019 to 258 in 2022, and a further large increase to 285 is planned for this year. Working with the ICGP, it is aimed to have 350 training places available for new entrants per year by 2026. 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.
In addition, the HSE is currently working with the ICGP on a programme to bring 100 non-EU GPs to Ireland in 2023 to help improve access to GP services, particularly in areas with limited access. These new additional posts will work in general practice for a 2-year period following which they will be able to take up a GMS contract. The programme commenced with 25 posts having started in January and is progressing to meet the target of 100 additional non-EU GP placements by year end.
I recently published the Terms of Reference for the Strategic review of General Practice which will commence shortly and is to 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 capacity, such as the provision of services in areas where service delivery is challenging and the support model necessary to underpin the provision of sustainable GP services. Having examined these issues, a report will set out the measures necessary to deliver a better general practice.
704. Deputy Richard Boyd Barrett asked the Minister for Health how a non-national physiotherapist (details supplied) can meet work placement requirements enforced by CORU for physiotherapy practice in Ireland, given that they applied to numerous hospitals across Ireland, but due to various reasons such as a shortage of senior staff, specific university affiliations and staff shortages following the Covid-19 pandemic, they have not been able to find the required support; and if he will make a statement on the matter. [25876/23]
View answerOfficials in my Department have been in contact with CORU on this matter and CORU have informed them that it is currently working with public health agencies to establish pathways for applicants to undertake adaptation periods. This project is in its early stages but guidance will be updated on CORU's website in due course. This initiative will be of benefit to applicants required to undertake an adaptation period when launched.
I understand that the recognition team in CORU have been in contact with this particular applicant and have provided support documentation in relation to undertaking an adaptation period as required.
705. Deputy Peadar Tóibín asked the Minister for Health the number of adverse incidents that were recorded in the health service in total in 2022, and for each of the previous four years; the number of adverse incidents that were recorded in each hospital group in the same timeframe; the number of adverse incidents that were recorded in each hospital; the number of adverse incidents that were recorded in each CAMHS region; if he will detail the nature of all of the aforementioned adverse incidents; the number of health service-related claims that have been lodged with the State Claims Agency for each of the past five years; and the amount in compensation that has been paid out by the State as a result of claims lodged against the health service. [25891/23]
View answerThe information requested by the Deputy relating to the recording of adverse incidents has been referred to the HSE for direct reply to the Deputy.
The State Claims Agency (SCA) has a statutory remit to manage personal injury claims on behalf of Delegated State Authorities including the Health Service Executive.
The State Claims Agency has provided me with the information set out below regarding the number of health service-related claims that have been lodged with the State Claims Agency for each of the past five years and the amount in compensation that has been paid out by the State as a result of claims lodged against the health service. I have been informed by the SCA that this information has been extracted from the National Incident Management System (NIMS).
The report below provides information on claims and damages for the General Indemnity Scheme and the Clinical Indemnity Scheme, in respect of Healthcare i.e. all Health Service Executive and Voluntary Healthcare locations on NIMS. Private Healthcare locations are excluded from this report.
Paid damages, relates to payments made in each of the specified years, and therefore may relate to claims received in the years prior to 2018.
Claims Received
Table 1 below shows all Healthcare claims received between 2018 and 2022.
|
2018 |
2019 |
2020 |
2021 |
2022 |
Total |
|
|
Claims Received |
2,080 |
2,226 |
2,039 |
1,835 |
1,858 |
10,038 |
Table 1: The number of Healthcare claims received 2018 – 2022 as of 30/04/2023.
Paid Damages
Table 2 shows all damages payments made on healthcare claims between 2018 and 2022.
|
2018 |
2019 |
2020 |
2021 |
2022 |
Total |
|
|
Paid Damages |
€229,831,286 |
€279,518,656 |
€274,882,433 |
€345,710,567 |
€351,810,953 |
€1,481,753,895 |
Table 2 : The amount paid in damages between 2018 and 2022 for Healthcare claims as of 30/04/2023.
Criteria used
• Location at Level 1: Healthcare.
• This report is correct as of 30/04/2023.
Claims Received
• Claim Create Date: 2018 – 2022.
• Coverage excludes PDR.
Compensation Paid
• Transaction Report Date: 2018 – 2022.
• Transaction Payment Type: Damages.
Definitions:
National Incident Management System (NIMS):
Incidents (which include claims) are reported using the “National Incident Management System”, hosted by the State Claims Agency (SCA). An incident can be a harmful Incident (Adverse Event), no harm incident, near miss, dangerous occurrence (reportable circumstance) or complaint.
Claim Create Date:
Official date that the claim was created on NIMS. If a record is first logged to the system as a claim, the "Claim Create Date" and "Create Date" will be the same, however, if a record was once an incident and subsequently transitioned into a claim, the "Claim Create Date" will differ from the "Create Date", with the "Create Date" representing the date the incident was first recorded, and the "Claim Create Date" representing the date the record transitioned to a Claim.
Transaction Reporting Date:
This refers to the date that payments were issued. These payments include damages, legal fees and other expert fees.
Claim:
A claim refers to notification of intention to seek compensation for personal injury and/or property damage where it is alleged the State was negligent. The application may be in the form of a letter of claim, an InjuriesBoard.ie application, or a written/oral request.
Damages:
Damages payments include special and general damages payments.
706. Deputy Sean Sherlock asked the Minister for Health when a person (details supplied) in County Cork, who has been on a waiting list for plastic surgery since 2019, will be allocated an appointment for re-assessment pre-operation given the time lapse. [25914/23]
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.
707. Deputy Paul Kehoe asked the Minister for Health the reason elderly persons in County Wexford who do not have a full medical card are refused access to public health nurse services; if this decision can be reversed; and if he will make a statement on the matter. [25915/23]
View answerEligibility for all health services including nursing services is outlined in The Health Act 1970. The Act provides for two categories of eligibility for persons ordinarily resident in the country, i.e. full eligibility (medical card holders) and limited eligibility (all others).
In relation to eligibility for the Public Health Nursing (PHN) service, the Act provides for free care at the point of delivery for home nursing services to persons who have full eligibility (i.e. medical card holders). Non-Medical Card holders do not have automatic entitlement to access all services provided by PHNs. In certain circumstances consideration may be given to referrals received in relation to non-Medical Card patients dependent upon both clinical need and the availability of resources.As this question includes elements of service provision in relation to the current service delivery in County Wexford, I have asked the Health Service Executive (HSE), to provide a response to the Deputy as soon as possible.
708. Deputy Paul Kehoe asked the Minister for Health if he will confirm the counties that do not provide a person without a full medical card access to public health nurse services; and if he will make a statement on the matter. [25916/23]
View answerEligibility for all health services including nursing services is outlined in The Health Act 1970. The Act provides for two categories of eligibility for persons ordinarily resident in the country, i.e. full eligibility (medical card holders) and limited eligibility (all others).
In relation to eligibility for the Public Health Nursing (PHN) service, the Act provides for free care at the point of delivery for home nursing services to persons who have full eligibility (i.e. medical card holders). Non-Medical Card holders do not have automatic entitlement to access all services provided by PHNs. In certain circumstances consideration may be given to referrals received in relation to non-Medical Card patients dependent upon both clinical need and the availability of resources.As this question includes elements of service provision in relation to the current service delivery in specific counties, I have asked the Health Service Executive (HSE), to provide a response to the Deputy as soon as possible.
709. Deputy Peadar Tóibín asked the Minister for Health if he will provide a breakdown for each of the past five years, per emergency department nationally, of the number of times people were billed for attending an emergency department without having been seen by any medical or healthcare practitioner or having received any medical care or treatment, in tabular form. [25930/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
710. Deputy Joe McHugh asked the Minister for Health if he will provide an update on plans being considered to ensure the continuation of adult diabetes care and services at Letterkenny University Hospital, following the resignation of consultant endocrinologists at LUH (details supplied); and if he will make a statement on the matter. [25946/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
711. Deputy Eoin Ó Broin asked the Minister for Health further to Parliamentary Question No. 265 of 11 May 2023, if the HSE has initiated a recruitment process to staff the primary care centre at Boot Road, Clondalkin. [25956/23]
View answerAs the Health Service Executive (HSE) holds responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have asked the HSE to respond directly to the Deputy as soon as possible.
712. Deputy Carol Nolan asked the Minister for Health if his Department assists with, or makes a financial contribution to, the sourcing or provision of childcare or crèche facilities for the children of staff members of any grade or position; if so, the names of the providers; the costs incurred for the period 2020 to date in 2023; the number of staff who have availed of such assistance over this timeframe; and if he will make a statement on the matter. [25975/23]
View answerMy Department does not assist with nor make a financial contribution to the sourcing or provision of childcare or crèche facilities for the children of staff members.
713. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) cannot get their appointment in Merlin Park Hospital; and if he will make a statement on the matter. [25989/23]
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.
