Written Answers Nos. 316-327
317. Deputy Claire Kerrane asked the Minister for Health the reason specialised lens, which are expensive to those with eye sight issues, are not covered under the medical card; and if he will make a statement on the matter. [49167/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
318. Deputy Claire Kerrane asked the Minister for Health how many dentists have signed back up to provide dental care for medical card holders in County Roscommon, County Galway, and in total across the State. [49168/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
319. Deputy Claire Kerrane asked the Minister for Health the number of dentists which left the dental treatment scheme, where they were providing dental care to medical card patients in counties Roscommon and Galway, in tabular form. [49169/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
320. Deputy Claire Kerrane asked the Minister for Health what plans he has to ensure that medical card holders can access dental care; and if he will make a statement on the matter. [49170/23]
View answerThe Dental Treatment Services Scheme (DTSS) provides dental care, free of charge, to medical card holders aged 16 and over. Since May 1st 2022, there has been additional prevention treatments included and a 40-60% increase in fees across most treatment items.
Fees paid to dentists for DTSS care are aligned with other European countries which provide comparable public dental care, noting that many European countries, especially in the southern and eastern regions, don’t have a scheme in place for adults which is free at point of access. From January to October this year, 142,450 additional treatments have been provided under the DTSS, with over 25,600 extra unique patients treated when compared with the same period last year.
The Government is committed to fundamentally reforming dental services, including the DTSS, through implementation of the National Oral Health Policy, Smile agus Sláinte . The Department is working closely with the HSE to ensure the establishment of focused structures to drive implementation of the Policy. The HSE has now appointed a Strategic Reform Lead to drive Policy implementation across the organisation and to move forward in 2024 with developing new services for both adults and children in line with the Policy. This will include work on planning new services for medical card holders.
While it will take a number of years to bring reform to complete fruition, there will be an early emphasis in implementation on addressing the current issues, including the reform of the provision of services for medical card holders.
321. Deputy Eoin Ó Broin asked the Minister for Health the number of public health nurse positions in each CHO area, including the number of vacant PHN positions in each CHO area and the specific geographic areas within each CHO that currently have no PHN in place, in tabular form; and what interim measures are in place to ensure universal access to public health nurse services. [49211/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
The Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
322. Deputy Joe Carey asked the Minister for Health if the medical centre in a location (details supplied), which is under the control of the HSE, is going to close in January 2024, if so, if the registered patients of the practice will be accommodated by other existing practices in the town; and if he will make a statement on the matter. [49212/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
323. Deputy Bernard J. Durkan asked the Minister for Health if a refusal for medical card can be reviewed and reversed in the case of a person (details supplied); and if he will make a statement on the matter. [49219/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
324. Deputy Bernard J. Durkan asked the Minister for Health the extent to which it is expected to improve the mental health facilities available in CHO7 in respect of each category of patient; and if he will make a statement on the matter. [49242/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.
325. Deputy Bernard J. Durkan asked the Minister for Health the extent to which persons in need of drug rehabilitation programmes have access to same, with a view to reducing their dependency on drugs; and if he will make a statement on the matter. [49243/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
326. Deputy Bernard J. Durkan asked the Minister for Health the extent to which plans are in hand to ensure an adequate GP service throughout County Kildare, given the number of GPs retiring and the existing and future demands; and if he will make a statement on the matter. [49244/23]
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 2,533 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.
For GMS patients unable to locate a GP themselves, the Health Service Executive may assign an eligible person to be included on a medical practitioner's GMS list, in accordance with the GMS contract.
The Government is aware of the workforce issues currently facing general practice, including the limited access to GP services in certain areas, and is working to ensure 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. In addition, the enhanced supports package for rural GP practices was increased by 10%.
The recent GP Agreement 2023 announced in July, which provides for the expansions of GP care without charges to those who earn up to the median household income and to children aged 6 & 7, includes additional capacity supports to enable the expansion and retention of staffing within general practice. It includes additional supports for GP Out of Hours services also.
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, improving access to GP services for patients throughout the country.
The number of doctors entering GP training has been increased in recent years, with 287 new entrants for this year and 350 places for new entrants planned for next year. Annual intake to the GP training scheme has been increased by over 80% since 2015. Furthermore, the joint HSE and ICGP programme underway to bring up to 100 non-EU GPs to Ireland in 2023 will help to quickly improve access to GP services, particularly in areas with limited access. It is planned to bring to Ireland up to 250 more non-EU GPs by the end of 2024.
Lastly, my Department and the HSE have commenced a Strategic Review of General Practice. The review, with input from key stakeholders, will examine the broad range of issues affecting general practice, including issues related to GP capacity, and will set out the measures necessary to deliver a more sustainable general practice into the future.
327. Deputy Bernard J. Durkan asked the Minister for Health the extent to which it is intended to ensure the availability of full medical cards for those with life changing or terminal conditions, given the degree to which such families are under stress; and if he will make a statement on the matter. [49245/23]
View answerMedical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold.
The issue of granting medical or GP visit cards based on having a particular disease or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.
The HSE also has a compassionate system in place for the efficient provision of medical cards in response to emergency situations i.e., where persons are in need of urgent ongoing medical care or when a patient is receiving end of life treatment. In these cases, a medical card is issued within 24 hours of receipt of the required patient details and completed medical report by a healthcare professional. In addition, since March 2021, persons who have been certified by their treating Consultant as having a prognosis of 24 months or less are now also awarded a medical card on an administrative basis. This measure delivered the Programme for Government commitment to extend eligibility for medical cards to persons with a terminal illness and work is continuing to develop a legislative framework to underpin this administrative scheme. Medical cards awarded on end of life grounds are never re-assessed by the HSE thereby providing reassurance and comfort to patients and their families.
Separately, I can advise the Deputy that, since 2015, medical cards are awarded without the need of a financial assessment to all children under 18 years of age with a diagnosis of cancer. Further information can be found on the HSE’s website at www.hse.ie/services/schemes-allowances/medical-cards/other-types-of-medical-card/emergency-medical-cards/.
I can assure the Deputy that, to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues under review and any changes are considered in the context of Government policy and other issues which may be relevant.
