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Tuesday, 18 Sep 2012

Written Answers Nos. 1513-1525

Disease Classification

Ceisteanna (1513)

Pat Deering

Ceist:

1513. Deputy Pat Deering asked the Minister for Health the reason Declaration 69/2008 of the European Parliament calling for the European Union to recognise Fibromyalgia has not been adopted here. [37051/12]

Amharc ar fhreagra

Freagraí scríofa

Fibromyalgia is a distinct condition under the international classification of diseases which is the international standard by which diseases are classified and is accepted by Ireland and is endorsed by the World Health Organisation. Ireland’s recognition of fibromyalgia as a distinct condition is in compliance with the European Parliament declaration 69/2008 on fibromyalgia which called on the European Union to recognise fibromyalgia as a disease.

Ambulance Service Provision

Ceisteanna (1514, 1539)

Luke 'Ming' Flanagan

Ceist:

1514. Deputy Luke 'Ming' Flanagan asked the Minister for Health the reason the new air ambulance is to be located at Baldonnel Aerodrome, Dublin, rather than at Athlone which is geographically closer to the centre of Ireland; and if he will make a statement on the matter. [37053/12]

Amharc ar fhreagra

Billy Kelleher

Ceist:

1539. Deputy Billy Kelleher asked the Minister for Health when he expects the air ambulance service to be fully operational; and if he will make a statement on the matter. [37079/12]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 1514 and 1539 together.

The Emergency Aeromedical Service (EAS) pilot scheme, which supports the work of the emergency ambulance service, commenced on 4th June 2012 and currently operates from Custume Barracks, Athlone.

National Carers Strategy Status

Ceisteanna (1515)

Terence Flanagan

Ceist:

1515. Deputy Terence Flanagan asked the Minister for Health the action plan that has been put in place regarding the implementation of the carer's strategy; and if he will make a statement on the matter. [37054/12]

Amharc ar fhreagra

Freagraí scríofa

The National Carers’ Strategy, which was published in July, sets the strategic direction for future policies, services and supports provided by Government Departments and agencies for carers. It sets out a Vision to work towards and an ambitious set of National Goals and Objectives to guide policy development and service delivery to ensure that carers feel valued and supported to manage their caring responsibilities with confidence and are empowered to have a life of their own outside of caring. The Strategy also contains a Roadmap for Implementation, which outlines the Actions that will be taken to deliver on the Goals and Objectives of the Strategy. The Roadmap also outlines the timelines and the Department with responsibility for their implementation.

Each Department will produce an annual report on progress, which will be published on their website. A progress report on the overall implementation of the Strategy will be produced on a periodic basis over the lifetime of the Strategy and presented to the Cabinet Committee on Social Policy. Currently, each Department is in the process of appointing a senior official to take responsibility for their Department’s actions and for the provision of up-dates for the Cabinet Committee.

Long-Term Illness Scheme Applications

Ceisteanna (1516)

Tom Fleming

Ceist:

1516. Deputy Tom Fleming asked the Minister for Health if he will include Behcet's Syndrome on the list of long-term illnesses. [37056/12]

Amharc ar fhreagra

Freagraí scríofa

There are no plans to extend the list of conditions covered by the Long Term Illness Scheme. Under the Drug Payment Scheme, no individual or family pays more than €132 per calendar month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals incurring ongoing expenditure on medicines. In addition, people who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. In the assessment process, the Health Service Executive can take into account medical costs incurred by an individual or a family. Those who are not eligible for a medical card may still be able to avail of a GP visit card, which covers the cost of general practice consultation.

Tax Reliefs Application

Ceisteanna (1517)

Brendan Griffin

Ceist:

1517. Deputy Brendan Griffin asked the Minister for Health when a claim for medical expenses will be granted to a person (details supplied) in County Kerry; and if he will make a statement on the matter. [37057/12]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.

Health Services Expenditure

Ceisteanna (1518)

Michael Healy-Rae

Ceist:

1518. Deputy Michael Healy-Rae asked the Minister for Health the total cost of patient transport in the Health Service Executive; and if he will make a statement on the matter. [37058/12]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, it has been referred to the Health Service Executive for direct reply.

Health Services Provision

Ceisteanna (1519)

Michael Healy-Rae

Ceist:

1519. Deputy Michael Healy-Rae asked the Minister for Health if he will consider transferring responsibility for the provision of hospital patient transport to the providers of the rural transport programme, as this might result in considerable savings in the sector; and if he will make a statement on the matter. [37059/12]

Amharc ar fhreagra

Freagraí scríofa

The cost of non-emergency patient transport, in particular for outpatient (OPD) appointments, has been escalating in recent years and non-essential provision has been identified as an area suitable for budgetary control. Accordingly, criteria have been restricted considerably in recent times and a uniform approach is being rolled out across the health regions.

In general, patients are expected to make their own way to and from hospital and OPD appointments, using private or scheduled public transport. The exceptions are for dialysis, cancer (radiotherapy and chemotherapy) and post-operative transplant patients. In these cases, the patient's appointment or treatment should be directly related to the condition. Transport may also be provided where, in the clinician's view, the patient would be unable to make the journey without clinical assistance or where the patient must be transported on a stretcher. I am satisfied that significant savings will arise from the uniform national application of the criteria for non-emergency and non-stretcher based patient transport.

Question No. 1520 answered with Question No. 1497.

Health Insurance Prices

Ceisteanna (1521)

Michael Healy-Rae

Ceist:

1521. Deputy Michael Healy-Rae asked the Minister for Health If he will respond to correspondence regarding private health insurance (details supplied). [37061/12]

Amharc ar fhreagra

Freagraí scríofa

I am concerned private health insurance is becoming increasingly harder to afford, particularly for older people. I am strongly committed to protecting the principle of Community Rating in the private health insurance market. Community Rating means that the level of risk that a particular consumer poses to an insurer does not directly affect the premium paid. It also means that premiums for younger or healthier lives are typically higher that their expected claims would require, whereas for older or less healthy lives, premiums are typically lower than the expected claims would require. It is also useful to note that older people who have been paying health insurance premiums for many years will have supported the older generation when they were younger and could reasonably expect to benefit in a similar way as they themselves now become older. The Health Insurance Authority (HIA) is the independent regulator of the private health insurance market in Ireland and provides information to consumers regarding their rights and health insurance plans and benefits. The HIA's website is www.hia.ie and has a very useful plan comparison tool which may assist in finding the most suitable and competitive health insurance plan to meet one's needs.

Community Rating needs a robust system of risk equalisation. The Interim Scheme of Age-Related Tax Credits and Community Rating Levy was introduced in 2009 in order to provide direct support to community rating. It achieves this by way of mechanism which provides for a cost subsidy from the young to the old.

The Interim Scheme provides that health insurers receive higher premiums in respect of insuring older people but that older people (in six age bands ranging from 60-64 yrs to 85 yrs+) receive an age-related tax credit equal to the amount of the additional premium so that all people continue to pay the same net amount for a given health insurance product. The tax credit is provided as a tax relief at source, that is, the cost of the policy is reduced by the amount of the age-related tax credit. The Scheme is funded by an annual levy on health insurers based on the number of lives insured by them. The Scheme is designed to be Exchequer neutral, neither a cost nor a benefit to the State. It is a matter for the insurance companies as to the extent, if any, they pass the levy on their clients.

In order to keep down the cost of health insurance for older people, I was pleased to increase significantly the age-related income tax credit for insured persons aged 60 years and over from 1 January 2012. Without this support health insurers would have had an even stronger financial incentive to 'segment' the market by offering policies targeted at young people to the disadvantage of older customers.

It must be stressed that the measures taken are designed to result in no overall increase of premiums in the market and to spread the risk more evenly between the healthy and the less healthy, the old and the young. The increased levy is balanced by a corresponding increase in tax credits for older people to that the system is Exchequer neutral.

The Programme for Government contains a commitment to put a permanent scheme of risk equalisation in place. This is a key requirement for the existing private health insurance market and also in the context of plans to introduce Universal Health Insurance from 2016. In December 2011, the Government agreed to introduce a new Risk Equalisation Scheme (RES) with effect from 1 January 2013 which will replace the present Interim Scheme of Age-Related Tax Credits and Community Rating Levy. The new scheme will allow for a greater number of risk factors than the Interim Scheme, including a measure of health status. The legislation is currently being drafted and a Bill will be published in the next few weeks.

The new RES will be operated prospectively by the Health Insurance Authority (HIA), with funds collected via a stamp duty by the Revenue Commissioners. In terms of financial arrangements, the main difference between this and the current Interim Scheme is that risk equalisation payments will be disbursed by the HIA rather than by the Revenue Commissioners. The rates will be set each year by an Act of the Oireachtas.

Medicinal Products Supply

Ceisteanna (1522)

Michael Healy-Rae

Ceist:

1522. Deputy Michael Healy-Rae asked the Minister for Health his views on a matter (details supplied); and if he will make a statement on the matter. [37062/12]

Amharc ar fhreagra

Freagraí scríofa

Roaccutane (active substance, isotretinoin) is authorised for treating severe forms of acne which have been resistant to other standard therapies. It should only be prescribed by or under the supervision of doctors with expertise in using the product and with a full understanding of the risks of therapy and the monitoring requirements.

Under European and Irish legislation, all medicinal products must be authorised nationally or through common EU assessment procedures before being marketed. A determination on an application for authorisation of a medicine is based on a rigorous scientific assessment of the application against legal and regulatory requirements. Roaccutane has been closely monitored at national and EU level since it was first authorised. It was most recently reviewed at EU level in April 2011 when further warnings regarding skin reactions were added to the product information for patients and their doctors. The risk of depression associated with use of isotretinoin was also reviewed at that time. However, the existing comprehensive information on the risk of depression associated with isotretinoin and the monitoring requirements provided on the product information were considered sufficient.

The inclusion of new and updated warnings in the product information to support the safe and appropriate use of a medicine, is based on the evaluation of cumulative safety data and experience with use of the product, including reports of side effects occurring in patients. The information for patients and for their doctors includes detailed advice on the risks associated with use of Roaccutane and recommendations to minimise their occurrence. The package leaflet advises patients to tell their doctor if they have ever had any mental illness (including depression, suicidal behaviour or psychosis), or if they take medicines for any of these conditions. It also advises them to contact their doctor straight away if they have signs of any of these problems.

The information for doctors lists potential psychiatric disorders. It emphasises that particular care needs to be taken in relation to patients with a history of depression and that all patients should be monitored for signs of depression during their treatment with the product and referred for appropriate treatment if necessary. The benefits of treatment are considered to outweigh the risks when the product is used in accordance with the product information.

Proposed Legislation

Ceisteanna (1523)

Billy Kelleher

Ceist:

1523. Deputy Billy Kelleher asked the Minister for Health when the Health and Social Care Professionals (Amendment) Bill will be published; and if he will make a statement on the matter. [37063/12]

Amharc ar fhreagra

Freagraí scríofa

I wish to inform the Deputy that the Health and Social Care Professionals (Amendment ) Bill 2012 was published on 7th August last. The purpose of the Bill is to amend the Health and Social Care Professionals Act 2005 to

(i) remove difficulties in relation to the effective operation of the Health and Social Care Professionals Council, in particular to urgently provide for the Minister to continue to appoint professional representatives to the Council from the designated professions under the Health and Social Care Professionals Act 2005, whose term of office expired in March 2011, and

(ii) implement Directive 2005/36/EC on the recognition of professional qualifications in respect of the professions designated under the 2005 Act and provide a legal base for the assessment of qualifications which are outside the scope of the Directive.

These amendments are technical in nature and simply facilitate the more effective operation of the Act. It is hoped to have the Bill enacted during the current Dáil session.

Proposed Legislation

Ceisteanna (1524)

Billy Kelleher

Ceist:

1524. Deputy Billy Kelleher asked the Minister for Health when the Health Service Executive (Governance) Bill will be published; when new directors will be appointed; if the roles will be advertised; the salary scales of new appointees; and if he will make a statement on the matter. [37064/12]

Amharc ar fhreagra

Freagraí scríofa

The Health Service Executive (Governance) Bill 2012 was published on 19 July 2012. The Bill provides for the abolition of the HSE Board and the establishment of a Directorate, headed by a Director General, to be the new governing body for the HSE in place of the Board. Under the Bill, the Directorate will be chaired by a Director General and will be made up of a minimum of three and a maximum of seven members. Members will be appointed from National Director post holders.

In tandem with the proposed new governance structures, new administrative structures will be put in place within the HSE to reflect the need for a greater operational management focus on the delivery of key services and greater transparency about funding, service delivery and accountability. Work is being undertaken at present to prepare the necessary detailed job specifications for the planned director posts. It is envisaged that these posts will be filled on an accelerated basis in accordance with the Public Service Management (Recruitment and Appointments) Act 2004. The terms and conditions for these positions will be in accordance with Government policy and will be subject to the approval of the Minister for Public Expenditure and Reform.

Accident and Emergency Departments Waiting Times

Ceisteanna (1525)

Billy Kelleher

Ceist:

1525. Deputy Billy Kelleher asked the Minister for Health if he will provide, in tabular form, the median average wait in each hospital accident and emergency department; the number in each waiting more than 24 hours to be admitted; the number waiting more than 12 hours; and if he will make a statement on the matter. [37065/12]

Amharc ar fhreagra

Freagraí scríofa

I have asked the Health Service Executive for a report on the issue raised by the Deputy. I will revert to the Deputy on the matter as soon as possible.

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