Written Answers Nos. 622-636
622. Deputy Sorca Clarke asked the Minister for Health the estimated full-year cost of increasing dispensing fees of community pharmacies, to a flat fee model of care being reimbursed at €6.50 per medicine. [29178/23]
View answerThe regulations governing the pharmacy fee structure are set out in the Public Service Pay and Pensions Act 2017 (No. 34 of 2017) and in S.I. No. 639 of 2019, the Public Service Pay and Pensions Act 2017 (Payments to Community Pharmacy Contractors) Regulations 2019, which put the current fee structure in place, with effect from 1 January 2020.
Under Section 42(14) of the Public Service Pay and Pensions Act 2017 the current pharmacy fee structure must be reviewed every third year after 2020. My Department is currently carrying out a review and Department officials have arranged to meet with the Irish Pharmacy Union in that regard.
The full year cost of introducing a flat fee per item dispensed is determined by the number of persons with eligibility under the state schemes and the number of items dispensed under those schemes. These continue to rise year on year.
The estimated full-year additional cost of introducing a flat fee of €6.50 per item dispensed would be no less than €140m per annum. However, depending on activity under the schemes, it could cost up to €162m per annum.
623. Deputy Pádraig O'Sullivan asked the Minister for Health when he will publish the HSE Amyloidosis Working Group report, a new model of care and national guidelines, which was submitted in August 2020, approved in October 2022 and remains uncirculated; and if he will make a statement on the matter. [29179/23]
View answer624. Deputy Pádraig O'Sullivan asked the Minister for Health when he expects implementation of the guidelines set out in the HSE Amyloidosis Working Group report, a new model of care and national guidelines, which was submitted in August 2020, and approved in October 2022; and if he will make a statement on the matter. [29183/23]
View answerI propose to take Questions Nos. 623 and 624 together.
As the matter raised is a service delivery matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
625. Deputy John Brady asked the Minister for Health the number of people that are currently on the waiting list to attend a weight management clinic (details supplied) by CHO, in tabular form broken down by length of time 3, 6, 12, 18, 24 months and so on; and if he will make a statement on the matter. [29184/23]
View answerIn 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.
626. Deputy John Brady asked the Minister for Health how many people are currently attending a weight management clinic (details supplied); and if he will make a statement on the matter. [29185/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
627. Deputy John Brady asked the Minister for Health when the weight management new patient clinic will resume at a hospital (details supplied); how many dietitians there are at this clinic at present; and if he will make a statement on the matter. [29186/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
628. Deputy Patrick Costello asked the Minister for Health if he is in favour of a ban on all e-cigarette product flavours, barring tobacco flavour; and if he will make a statement on the matter. [29187/23]
View answerThe current legislative priority in this area is the Public Health (Tobacco Products and Nicotine Inhaling Products) Bill. The Bill will introduce a suite of measures which aim to reduce the appeal and availability of nicotine inhaling products such as electronic cigarettes to young people. In particular the Bill will prohibit the sale of these products to minors and introduce a requirement for a licence for their sale.
Further effective regulation of nicotine inhaling products is complex. Successful actions on public health issues such as smoking prevalence or alcohol consumption require multiple evidence-based interventions in order to affect usage. Each aspect of the product, including pricing, advertising, packaging and sale needs to be addressed in order to have a successful impact. There are a range of options for how best to regulate these products while taking into consideration their relative harm compared to combustible tobacco products. In addition, there is already significant regulation of these products at EU level and I am conscious that a proposal for a revised Tobacco Products Directive is expected in 2024.
In the context of all of these considerations, I have asked my officials to examine options for the development of further and comprehensive legislation on nicotine inhaling products which will include examining the restriction of flavours.
630. Deputy Michael Healy-Rae asked the Minister for Health if a long-term bed will be offered to a person (details supplied) in the Killarney or Kenmare area; and if he will make a statement on the matter. [29202/23]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
631. Deputy Maurice Quinlivan asked the Minister for Health about the case of a person (details supplied), who despite being a medical card holder has been charged for blood tests despite these being necessary as part of an investigation of medical symptoms; and if he will make a statement on the matter. [29203/23]
View answerUnder the terms of the current GMS contract, GPs are required to provide eligible patients with ''all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess". Persons who hold a medical card or a GP visit card are not subject to any co-payments or other charges in respect of such services including GP consultations.
The issue of GPs charging GMS patients for phlebotomy services (blood tests) is complex given the numerous reasons and circumstances under which blood tests are taken. Clinical determinations as to whether a blood test should taken to either assist in the diagnosis of illness or the treatment of a condition are made by the GP concerned. There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for such blood tests. In addition, blood tests undertaken in the context of services provided under the GP Chronic Disease Management programme are covered by the fees paid to GPs by the HSE for this care.
Where a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, or has been charged for a blood test provided under the Chronic Disease Management programme, then that patient should report the matter to their HSE Local Health Office. The local management, upon being notified of potential inappropriate charging of GMS patients, carry out an investigation into each complaint and will, where appropriate, arrange for a refund of charges incorrectly applied by the GP.
Fees charged by GPs outside the terms of the GMS contracts are a matter of private contract between the clinicians and their patients. The HSE does not have any role in relation to such fees.
632. Deputy Denis Naughten asked the Minister for Health how the number of primary care therapists eg physiotherapists, speech and language therapists, occupational therapists etc employed in each CHO area is determined; if population and/or numbers on waiting lists are taken into consideration; and if he will make a statement on the matter. [29207/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
634. Deputy Thomas Pringle asked the Minister for Health for an update plan for changes to the GP visit card eligibility (details supplied); and if he will make a statement on the matter. [29217/23]
View answer726. Deputy Peter Burke asked the Minister for Health if he will provide an update and dateline as to when the new GP only thresholds will be increased (details supplied). [29789/23]
View answerI propose to take Questions Nos. 634 and 726 together.
The Government is committed to the extension of GP visit card eligibility to those who earn the median household income or less, as announced in Budget 2023. Approximately 400,000 additional individuals are estimated to become eligible for a GP visit card under this expansion.
My Department and the HSE are engaged in intensive discussions with the IMO in relation to the concerns they have expressed around the roll-out of this increase in eligibility. These talks, which include engagement on the best use of the additional funding provided in Budget 2023 to support capacity in general practice, are currently ongoing. In the meantime, the necessary planning and administrative development work to provide for the expansion is well advanced in preparation for the commencement of the expansion.
Information in relation to the commencement of the expansion and further operational information will be provided when available.
Furthermore, it is intended to commence the expansion of GP care without charges to all children aged 6 and 7 as early as possible. My officials and the HSE have made preparations for this expansion and engagement is ongoing with the IMO in relation to the necessary fee structures for this service.
635. Deputy Jackie Cahill asked the Minister for Health why Tipperary University Hospital is being grouped with hospitals from Dublin and the South East as part of the realignment process, rather than with hospitals in Cork; if he will examine this matter and give it further consideration; and if he will make a statement on the matter. [29219/23]
View answerWith apologies for the delay in responding to the Deputy, the geographies for the six Health Regions were approved by Government Decision in 2019. A series of research, analysis, and consultation was undertaken by the Department of Health to support the identification of the optimal boundaries for the new regions. This included a review of approaches taken internationally and in previous reforms in Ireland, a public consultation process, and a detailed analysis of service usage patterns.
This analysis of service usage patterns across the country examined patient flows to establish the extent to which hospitals in a given location serve patients who live in that area. The regions were designed to be as self-contained as possible – this is critical in the move to a population-based planning and funding model. In the South Tipperary area, the analysis showed that the best alignment of patients to the hospitals they are most likely to attend was accomplished by including Tipperary University Hospital in Area C.
Another important consideration in any potential geography was ensuring minimum disruption to existing services. The majority of health and social care services are provided outside of hospitals and are delivered locally, closer to people’s homes. The nine CHOs have clearly identified catchment areas, whereas most Hospital Groups do not. Drawing boundaries to fit unclear hospital catchment areas would have proven disruptive. While considerable attention was paid to observing county boundaries where possible, certain necessary deviations from these (i.e. Dublin, Wicklow, and Tipperary) were done in favour of current boundaries associated with the delivery of community services. With regard to the area surrounding Tipperary University Hospital, the geography boundaries approved by Government respects the existing CHO 5 boundary, ensuring that all services in CHO 5 are delivered within the same region (which also includes Wexford, Carlow, Kilkenny, and Waterford), and ensuring there is minimum disruption to the delivery of those services.
At this time, Government does not plan to revise the geographies of the forthcoming Health Regions.
My officials have sought further information from the HSE regarding care pathways and their implications and we will revert as soon as is practical to the Deputy in writing.
636. Deputy Mary Lou McDonald asked the Minister for Health the current eye care services available to children aged eight years and over in CHO9. [29240/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
