Written Answers Nos. 1127-1143
1127. Deputy Richard Bruton asked the Minister for Health If she will outline the progress being made on a 2023 tender for home care services, and on the development of a statutory scheme for home care, which would bring equity and consistency into access; if she is aware of the frustration of some existing care providers on the continuous extension of the 2018 tender; and if he will make a statement on the matter. [27229/23]
View answerSince the Government gave its approval in April 2021 to start drafting legislation to establish a licensing framework for providers who operate in the home care sector. Primary Legislation is currently entering into final stages of the drafting process. It is intended to bring this legislation through the Houses of the Oireachtas at the earliest opportunity. This will ensure that all service users are provided with high quality home care which is currently unregulated in Ireland.
In order to help in drafting the legislation and regulations the Department completed a public consultation and a stakeholder consultation in 2022 to understand the core concerns of groups and people across the sector. A 6-week public consultation was completed in August 2022 and the analysis of the results by the IPH was published on 20th January 2023: www.gov.ie/en/publication/56ab1-draft-regulations-for-providers-of-home-support-services-an-overview-of-the-findings-of-the-department-of-healths-public-consultation/
The department has also been in consultation with HIQA, the HSE, legal consul, and representative groups to help improve the regulations further.
How home support will be funded in the future will be an essential factor of the new Statutory Scheme. With this in mind the Department is researching different funding models both internationally and here in Ireland. An internal consultation within the Department has been underway on a range of potential funding options. A targeted external consultation will also follow in 2023. The Economic and Social Research Institute (ESRI) also undertook a programme of work on behalf of the Department on the potential demand and cost of home support which culminated in two reports published in 2021 and 2022:
www.esri.ie/publications/demand-for-the-statutory-home-care-scheme
www.esri.ie/publications/home-support-services-in-ireland-exchequer-and-distributional-impacts-of-funding
A rapid response from the European Observatory on Health Systems was commissioned and published in March of this year. It is titled: “Improving Home Care Sustainability in Ireland. Are user charges a promising option?”
eurohealthobservatory.who.int/publications/i/improving-home-care-sustainability-in-ireland-are-user-charges-a-promising-option
This research will form an important part of the evidence base for the development of a sustainable funding model for home care services.
In 2022 a Pilot for testing of a reformed model of service for the delivery for home care became fully operational in 4 Community Healthcare Organisations (CHOs). Evaluation of the Pilot has been completed and a final report is expected in the coming months.
The national roll-out of interRAI as the new standard assessment tool for care-needs in the community is underway and the recruitment process for 128 interRAI Care Needs Facilitators commenced in late 2022.
The HSE is in the process of recruiting key posts to enable the establishment of a National Home Support Office. Funding is provided for 15 full time jobs, including 9 home support manager/coordinator posts. The Head of Service of the new National Home support Office has been appointed in November 2022, with the remaining posts to be filled as soon as possible this year.
To examine and address the significant workforce challenges in the home care and nursing home sectors in Ireland, Minister Butler established a cross-departmental Strategic Workforce Advisory Group (SWAG) in March 2022. The group was charged with identifying strategic workforce challenges in publicly and privately provided front-line carer roles in home support and nursing homes and with developing recommendations. Their report was published in October 2022 with 16 recommendations. Minister Butler has strongly endorsed the Advisory Group’s recommendations. They are being progressed through a dedicated implementation group. A detailed implementation plan will be published containing timelines and steps involved in delivering each of the recommendations in the coming months. The implementation group will meet quarterly, and the Department of Health will publish progress reports against this plan after these meetings take place.
Recommendation number 9 has been implemented. The statutory instrument authorising the issuance of 1,000 employment permits for home care workers was signed on 16 December 2022.
A link to the report is below.
www.gov.ie/en/publication/492bc-report-of-the-strategic-workforce-advisory-group-on-home-carers-and-nursing-home-health-care-assistants/
I have asked the HSE to reply further to the Deputy on Tender 2023.
1128. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [27233/23]
View answerI fully acknowledge the distress and inconvenience for patients and their families when elective procedures are cancelled, particularly for clinically urgent procedures. While every effort is made to avoid cancellation or postponement of planned procedures, the HSE has advised that planned procedures and operations can be postponed or cancelled for a variety of reasons including capacity issues due to increased scheduled and unscheduled care demand.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
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.
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.
1129. Deputy Robert Troy asked the Minister for Health if an appointment will be expedited for a person (details supplied). [27237/23]
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.
1130. Deputy Alan Dillon asked the Minister for Health in view of his Department's decision to fund the recruitment of an additional 3,500 skilled staff for the Enhanced Community Care Programme, 1,500 of whom are specialist staff to deliver urgently needed integrated care across community-hospital setting for older persons and chronic disease, if his attention has been drawn to the fact that it is impossible to deliver such services because of the refusal of his Department to provide the necessary funding for a fully functioning integrated electronic health record system (integrating hospital and community systems) and that the absence of such a system completely undermines the programme and poses a significant clinical risk to patient safety; and if he will make a statement on the matter. [27239/23]
View answerIn line with Sláintecare, the Enhanced Community Care (ECC) Programme’s objective is to deliver increased levels of health care with service delivery reoriented towards general practice, primary care and community-based services, and to implement an end-to-end care pathway that will care for people at home and over time prevent referrals and admissions to acute hospitals where it is safe and appropriate to do so and enable a “home first” approach.
Significant funding in recent years, including provision of €195million in Budget 2023 is enabling recruitment of an additional 3,500 staff to the ECC, with 2,641 WTE already recruited. 94 Community Healthcare Networks and 47 Community Specialist Teams for Older Persons, and for Chronic Disease Management are already operational, and providing integrated care services to clients across the country.
Reporting on ECC Programme Activity, Impacts and Outcomes across the system has commenced with performance targets set for each ECC team to the end of 2023 and throughout 2024. In the year to date there were 22,266 patient contacts by Community Specialist Teams for Older People, demonstrating the level of activity and care being provided in the community. Between January and April 2023, 167,494 patients were reviewed by their GP as part of the Chronic Disease Management Programme, with 28,362 patient contacts by Chronic Disease Community Specialist Teams from January to April inclusive.
There is no refusal by the Department to provide the necessary funding to support systems required to support the Enhanced Community Care Programme (ECC) programme. Whilst a ‘fully functioning electronic health record system’ is critical for supporting better, safer, more integrated care, such an undertaking is a long-term investment that will not address the needs of the ECC programme in the shorter term. For this reason, several options are being considered as to the type of digital solution that is most appropriate and that can be deployed in the shorter term, to ensure the work of the ECC teams is supported, is impactful for patients and that we can demonstrate the value of this investment.
1131. Deputy Pádraig O'Sullivan asked the Minister for Health further to Parliamentary Question No. 737 of 30 May 2023, the number of times the Chief Clinical Officer of the NCPE has briefed him since he took office in 2020; and if he will make a statement on the matter. [27244/23]
View answerThe National Centre for Pharmacoeconomics (NCPE) was established in 1998 with the aim of promoting expertise in Ireland for the advancement of the discipline of pharmacoeconomics through practice, research and education. The NCPE is an independent Health Technology Assessment (HTA) Agency responsible for evaluating drug treatments for use in the Irish healthcare setting.
The NCPE conducts the HTA of drugs for the health service in Ireland in collaboration with the Health Service Executive's Corporate Pharmaceutical Unit. They assess comparative clinical effectiveness and cost-effectiveness of drugs compared to current standard of care. The NCPE engages with stakeholders, including patients and clinicians, throughout the assessment process.
The Chief Clinical Officer referred to in Parliamentary Question No. 737 of 30 May 2023 is that of the Health Service Executive.
The NCPE responds to all requests from the Minister as and when required.
1132. Deputy Denis Naughten asked the Minister for Health the reason melatonin is not covered by the medical card or the drug payment scheme; the plans he has, if any, to review this; and if he will make a statement on the matter. [27251/23]
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.
1133. Deputy Robert Troy asked the Minister for Health if he will ensure a referral to the National Rehabilitation Hospital is expedited for a person (details supplied). [27255/23]
View answerAs this is a service matter, I have asked the Health Service Executive to reply to the Deputy directly, as soon as possible.
1134. Deputy Peter Burke asked the Minister for Health when the increase in the income limit thresholds for medical cards is due to come into effect. [27259/23]
View answerEligibility for a Medical Card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970 (as amended). The HSE assesses each medical card application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card. It is specific to the individual’s own financial circumstances.
Persons aged 69 and under are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. Certain expenses are also taken into account. Examples of allowable expenses include rent, mortgage, certain insurance costs, childcare, maintenance, nursing home net costs which help to increase the amount a person can earn and still qualify for a medical card. Detailed guidelines are available at: www2.hse.ie/services/schemes-allowances/medical-cards/applying/assessment/
Persons aged 70 or older are assessed under the over 70s medical card income thresholds which are based on gross income. It should be noted that in November 2020, the weekly gross medical card income thresholds for those aged 70 and over were increased to €550 per week for a single person and €1050 for a couple. This increase helps to ensure that a greater proportion of those aged 70 and over qualify for a medical card. However, it should be noted that those aged over 70 can also be assessed under the general means tested scheme where there are particularly high costs, e.g., medication, nursing home fees. Furthermore, the Deputy may be aware that, since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card.
I can assure the Deputy that, in order to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues, including the current medical card income thresholds, under review and any proposals are considered in the context of any potential broader implications for Government policy, the annual budgetary estimates process and legislative requirements arising.
1135. Deputy Cian O'Callaghan asked the Minister for Health if he will provide an update on the plans to address parking charges in hospitals, especially for those who attend hospital regularly due to ongoing treatment; and if he will make a statement on the matter. [27262/23]
View answerI am aware that hospitals that charge parking fees are very cognisant of the financial implications of parking costs for patients and their families, particularly for those with long-term illnesses.
Consequently, many hospitals have introduced a maximum daily fixed parking charge and reduced rate parking for long-term patients and visitors for whom the payment of the full rate would cause hardship.
The Programme for Government - Our Shared Future, makes a commitment to introduce a maximum daily car parking charge for patients and visitors at all public hospitals, where possible, and to introduce flexible passes in all public hospitals for patients and their families. This is a reflection of the Government’s appreciation of the financial challenge that can be faced by people in meeting these expenses, in particular where they are frequent users of hospital services. Accordingly, my Department and the HSE are currently examining the issue.
1136. Deputy Duncan Smith asked the Minister for Health if there have been any circumstances where the State has covered the cost or provided the direct funding for pectus carinatum bracing for an individual, through either the cross-Border Directive or on a discretionary basis to be carried out within another state; and if he will make a statement on the matter. [27269/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1137. Deputy Eoin Ó Broin asked the Minister for Health if stem cell-based therapies are available to people living with arthritis; and if not, if the HSE intends to progress to providing such treatments. [27270/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1138. Deputy Sean Sherlock asked the Minister for Health when a person (details supplied) in County Cork will receive an urgent physiotherapy appointment. [27291/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy as soon as possible.
1139. Deputy Mattie McGrath asked the Minister for Health the reason a day care centre in County Tipperary that is facing a staffing and funding crisis was refused additional Section 39 funding to help meet the costs of permanent staff; if this matter will be reviewed urgently as the centre is at risk of a reduction of hours of service; if an additional support worker will be funded to ensure continuity of service; and if he will make a statement on the matter. [27293/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1140. Deputy Denis Naughten asked the Minister for Health if he will fund a programme to expand the Sláintecare initiative in the West to employ a senior physiotherapist in each CHO area for people with multiple sclerosis and other neurological conditions; and if he will make a statement on the matter. [27326/23]
View answerThe Sláintecare Integration Fund formed part of the Sláintecare Action Plan 2019, which established the building blocks for a significant shift in the way in which health services are delivered in Ireland. Budget 2019 provided €20 million for the establishment of a ring-fenced Sláintecare Integration Fund or SIF, to support service delivery which focuses on prevention, community care and integration of care across all health and social care settings.
The SIF Round 1 supported 123 HSE and NGO sector projects, to test and evaluate innovative models of care providing a ‘proof of concept’ with a view to mainstreaming and scaling of successful projects through the annual budget estimates process.
The selection criteria for funding were:
• To encourage innovations in the shift of care to the community or provide hospital avoidance measures;
• To scale and share examples of best practice and processes for chronic disease management and care of older people;
• To promote the engagement and empowerment of citizens in the care of their own health.
Successful SIF projects were mainstreamed via NSP 2021 and 2022 at an estimated cost of €24 million.
The MS Ireland “Active Neuro” project was mainstreamed with ring-fenced funding allocated in Budget 2022 to the HSE to continue the project in 2022, and this has continued in 2023.
Any consideration for whether, and how best, to expand this service within the HSE, would be matter for the HSE to consider and to make a business case to the Department of Health, as part of the annual Estimates process in advance of the Budget later in the year.
1141. Deputy Patrick O'Donovan asked the Minister for Health when a community hospital, Newcastlewest, County Limerick (details supplied) will receive the requested letter from his Department or the HSE in response to their letter concerning an application for refund of unregistered VAT; and if he will make a statement on the matter. [27330/23]
View answerI would like to thank the Deputy for his query.
Officials in my Department have received the correspondence in question and have recently been in touch with the organisation about this request.
Should the Department receive confirmation from the HSE in support of this request, officials will engage directly with the organisation about the next steps in the process.
1142. Deputy Colm Burke asked the Minister for Health to confirm the reason that a person (details supplied) who has a diagnosis of paranoid schizoaffective disorder, dementia and several other physical health difficulties including a visual impairment, COPD, hypertension and arthritis and has been a patient of St. Vincent's Hospital, Fairview, Dublin, for the past two and a half years, has not had their funding request for placement with a nursing home approved, despite the person being assessed and approved for care in this facility, and the request for funding submitted to the HSE last year; when a decision will be made in respect of this case; and if he will make a statement on the matter. [27332/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1143. Deputy Niamh Smyth asked the Minister for Health the reason that a person (details supplied) has not received their diagnosis letter from a hospital; and if he will make a statement on the matter. [27333/23]
View answer1154. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) cannot get a letter from a doctor in Cavan General Hospital with their diagnosis to apply for assistance technology; and if he will make a statement on the matter. [27470/23]
View answerI propose to take Questions Nos. 1143 and 1154 together.
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
