Written Answers Nos. 1549-1566
1549. Deputy Billy Kelleher asked the Minister for Health when cancer patients can expect to be able to receive ipilimumab; the reasons for the further delay in its provision; and if he will make a statement on the matter. [37089/12]
Amharc ar fhreagraFrom 3 May, 2012 Ipilimumab has been available to all eligible patients with progressive melanoma treated in public hospitals. There have been no reported delays in relation to its provision.
The Director of the HSE's National Cancer Control Programme (NCCP) is aware that some private insurers were in ongoing negotiations with the manufacturers to agree reimbursement of Ipilimumab for patients treated in private hospitals. As the NCCP does not have responsibility for patients treated in private hospitals any query in relation to the provision of this drug, in the private hospital setting, should be addressed directly with the manufacturers.
1550. Deputy Billy Kelleher asked the Minister for Health when cancer patients may expect to be able to receive Gilenya; the reasons for the further delay in its provision; and if he will make a statement on the matter. [37090/12]
Amharc ar fhreagraGilenya, which is used for the treament of Multiple Sclerosis, has been reimbursed on the High Tech Scheme since 1 July 2012. There is no restriction on the reimbursement of High Tech prescriptions for Gilenya which are written by Neurologists.
1553. Deputy Billy Kelleher asked the Minister for Health the total spend on taxis in the Health Service Executive and the National Treatment Purchase Fund in each of the years 2008 to 2011; the total spend to date in 2012; the projected spend in 2012; and if he will make a statement on the matter. [37093/12]
Amharc ar fhreagraThe total spend on taxis for the National Treatment Purchase Fund (NTPF) is set out in the table below.
|
Year |
Spend |
|
2008 |
€2,554.14 |
|
2009 |
€661.98 |
|
2010 |
€1,560.91 |
|
2011 |
€987.51 |
|
2012 year to date |
€742.12 |
|
2012 total year forecast |
€1000,00 |
The spend for the Health Service Executive is a service matter, and has been referred to the Health Service Executive for direct reply.
1554. Deputy Billy Kelleher asked the Minister for Health if he will provide, in tabular form, a breakdown by hospital of bed closures, theatre closures and ward closures this year; and if he will make a statement on the matter. [37094/12]
Amharc ar fhreagra1559. Deputy Billy Kelleher asked the Minister for Health the total number of closed operating theatres in public hospitals around the country; if he will provide a breakdown of the hospitals affected; the number of theatres closed in each hospital; the length of time each theatre has been closed; and if he will make a statement on the matter. [37099/12]
Amharc ar fhreagra1562. Deputy Billy Kelleher asked the Minister for Health if he intends reopening closed beds following recent figures which show waiting lists have increased by 24% over the past year; and the number of closed beds he intends reopening; and if he will make a statement on the matter. [37102/12]
Amharc ar fhreagraI propose to take Questions Nos. 1554, 1559 and 1562 together.
As these are service matters, they have been referred to the Health Service Executive for direct reply.
1556. Deputy Billy Kelleher asked the Minister for Health the resource implications, in terms of staff, funding, and ancillary support, of implementing the recommendations of the Tallaght hospital report in full nationwide; his plans to do so; and if he will make a statement on the matter. [37096/12]
Amharc ar fhreagraAs this is a service matter, it has been referred to the HSE for direct reply.
1557. Deputy Billy Kelleher asked the Minister for Health if he has met with the Health Service Executive, the INMO, the IMO, the INO and other organisations regarding the implications of the Tallaght hospital report; the nature of the discussions; if any decisions were made arising from the discussions; and if he will make a statement on the matter. [37097/12]
Amharc ar fhreagraI have set up an expert group to oversee the implementation, by the HSE, of the recommendations of the Tallaght Report. This group has met a number of agencies on my behalf, and will continue to do so as appropriate. The group will report in due course.
1558. Deputy Billy Kelleher asked the Minister for Health the actual amount of additional revenue generated by increasing charges on private patients in public hospitals; the amount projected in budget 2012; and if he will make a statement on the matter. [37098/12]
Amharc ar fhreagra1593. Deputy Billy Kelleher asked the Minister for Health the charges set by him in respect of inpatient and outpatient hospital care and for visiting an accident and emergency department; if these charges have changed since February 2011; if these charges will change in 2012; the revenue accruing from such charges in 2011; the anticipated income in 2012; and if he will make a statement on the matter. [37133/12]
Amharc ar fhreagra1595. Deputy Billy Kelleher asked the Minister for Health the rate of hospital charges - inpatient, outpatient and accident and emergency; the categories of patient required to pay hospital charges; the changes in charges which took place in 2012; and if he will make a statement on the matter. [37135/12]
Amharc ar fhreagra1596. Deputy Billy Kelleher asked the Minister for Health the anticipated income from statutory inpatient, outpatient and accident and emergency charges in 2011 and 2012, in tabular form; and if he will make a statement on the matter. [37136/12]
Amharc ar fhreagraI propose to take Questions Nos. 1558, 1593, 1595 and 1596 together.
The current statutory public in-patient charge is €75 per day, subject to a maximum of €750 in any period of 12 consecutive months.The statutory in-patient charge also applies to day cases. A number of categories of individuals are exempt from the above charge, including those with full eligibility.
Maintenance charges for private in-patient services in respect of private, semi-private and day-care accommodation in categories 1 and 2 public hospitals were increased with effect from 1 January 2012. The new rates are set out below. There were no changes in respect of category 3 hospitals. It is anticipated that the increased charges will yield additional revenue in the region of €18 million in 2012.
|
- |
Hospital Category |
Private Accommodation |
Semi-Private Accommodation |
Day-care |
|
1 |
HSE Regional Hospitals, Voluntary & Joint Board Teaching Hospitals |
€1,046 |
€933 |
€753 |
|
2 |
HSE County Hospitals Voluntary Non-Teaching Hospitals |
€819 |
€730 |
€586 |
|
3 |
HSE District Hospitals |
€260 |
€222 |
€193 |
The private in-patient daily charge of €75, subject to a maximum payment of €750 in any period of 12 consecutive months, remained unchanged for 2012. These maintenance and daily charges are applicable to all private in-patients without exception. The A&E charge is provided for by the Health (Out-Patient Charges) Regulations 1994 (as amended). The charge is currently €100.The charge applies to persons attending Accident and Emergency and Casualty Departments subject to exemptions set out in these regulations, including medical card holders and those who have a letter of referral from a registered medical practitioner.
Private patients are liable to a charge for the use of MRI scans in a public hospital, currently set at a maximum of €400.
The Health Service Executive has indicated the anticipated income from hospital charges in 2012 as follows:
|
2011 Actual €m |
2012 Estimate €m |
|
|
Private Accommodation charges |
464.2 |
488.2 |
|
Inpatient levy |
48.6 |
54.3 |
|
Emergency Dept |
16.4 |
16.5 |
The 2012 estimate of income is based on the extrapolation of the July 2012 year-to-date amounts.
Charges are kept under review in the context of the budgetary process but no decision has been taken to make any changes.
1560. Deputy Billy Kelleher asked the Minister for Health if he will outline in full what he hopes to achieve from the current discussions with the consultant groups and how this will differ to what was already agreed in the Croke Park agreement in 2010 and also as part of the 2008 consultant contract; and if he will make a statement on the matter. [37100/12]
Amharc ar fhreagra1561. Deputy Billy Kelleher asked the Minister for Health if he is committed to ensuring that consultants are rostered for a seven-day week as opposed to a five-day week; and if he will make a statement on the matter. [37101/12]
Amharc ar fhreagra1592. Deputy Billy Kelleher asked the Minister for Health if reductions in fees paid to hospital consultants have been accounted for in his budget estimates; the level by which they will be reduced; and if he will make a statement on the matter. [37132/12]
Amharc ar fhreagraI propose to take Questions Nos. 1560, 1561 and 1592 together.
Following a request on 13 September by senior health service management on behalf of the Government, intensive discussions between health service employers and the two consultant representative bodies commenced immediately at the Labour Relations Commission. These dealt with a range of matters, including measures to ensure that the relevant parts of the Health Sectoral Agreement within the Public Service Agreement 2010-2014 can be given effect. These discussions concluded on 17 September.
The outcome of this engagement is that the following proposals have been agreed between the parties: Consultants will be available for rostering for any five days out of seven as opposed to weekdays as at present; There can be rostering of consultants where required on 16/7 (8 a.m. to midnight) or 24/7 basis in services where this is required (primarily Emergency Depts., obstetrics, anaesthetics); Clinical Directors will have strengthened management role and all consultants will be subject to Clinical Director’s authority, e.g. re work schedules, performance, annual leave, cross-cover arrangements and compliance with rules on private practice; Consultants’ work location can to be changed to facilitate the most appropriate organisation of hospital services; There will be cooperation with a range of measures to support improved Community and Mental Health services; Consultants commit to expeditious processing and signing of claims for submission to private health insurers; There will be more cost-effective arrangements for funding of continuing medical education.
Separately, Government will apply a 30% reduction in salary for future consultant appointees and implement the Government “pay cap” so that salaries for future academic consultants will not exceed €200,000 p.a. Current consultants’ pay is protected under the Croke Park Agreement.
Two matters, viz management proposals to reduce the “rest day” arrangements that currently apply and the elimination of the fee to consultant psychiatrists for giving a second opinion under the Mental Health Act 2001 will be referred to the Labour Court, in line with the procedures provided for in the Public Service Agreement. The issue of “historic rest days” will be referred to the Labour Court in line with normal procedures.
1563. Deputy Billy Kelleher asked the Minister for Health if his Department has carried out any research or intends to carry out any research into the impact of increased numbers of patients presenting themselves in public hospitals as a result of private patients giving up their private health insurance; and if he will make a statement on the matter. [37103/12]
Amharc ar fhreagraAs I have previously advised the Deputy, my Department has no plans to carry out research into the impact of patients presenting in public hospitals who previously held private health insurance. In respect of access to public hospitals, the work of the Special Delivery Unit is focussed on improving waiting times for access to both scheduled and unscheduled treatments and to maximise the capacity of existing facilities to manage patient flow.
While there has been a decrease in the numbers with private health insurance, by 38,913 this year, it is important to note that the decline in private health insurance coverage is modest to date, at less than 1.8% of the overall market in 2012. This leaves some 2.123 million, or 46.3% of the population, covered by private health insurance. Even in the current difficult financial climate, the vast majority of consumers with private health insurance are retaining some level of health insurance cover. In this context, I would strongly advise consumers to shop around for the health insurance plan that best suits their needs. Consumers have a legal right to switch between or within insurers to get better value and to reduce their premium costs. All customers should carefully consider the full range of plans and levels of cover available within the market, so that their own needs are fully met. Where customers wish to switch products, the relevant health insurance legislation ensures that switching is as easy and seamless as possible for customers.
In addition to the choices available to consumers in the health insurance market, the Government's clear objective is for the health insurance market to remain as competitive and affordable as possible, as we move towards a new system of Universal Health Insurance.
1564. Deputy Billy Kelleher asked the Minister for Health if he will detail, in tabular form, the number of staff in receipt of top-up pay in excess of €10,000, €50,000, €100,000, and €200,000 per hospital; the average amounts of payments; the basis for the payments; and if he will make a statement on the matter. [37104/12]
Amharc ar fhreagraIt is essential that organisations funded by the HSE to provide services on its behalf comply in full with Government policy on public service pay.
Following publication of the recent HIQA report on Tallaght Hospital, which identified the issue of additional payments being made to a small number of executives, the Secretary General of my Department wrote to the then CEO of the HSE, asking him to inform him of the measures he proposed to take to ensure that such practices are not extant in other hospitals funded by the HSE. The HSE is at present undertaking a detailed review of the remuneration arrangements for senior staff in all organisations funded under section 38 of the Health Act 2004. When this has been completed, a report on the matter will be considered by the Board of the HSE in the first instance.
1565. Deputy Billy Kelleher asked the Minister for Health the composition and all changes to the interim Health Service Executive board since April 2011; the roles of those on the board within the Department of Health or HSE; the corporate governance structure currently in place; when he expects HSE governance legislation to be passed; when he expects a new board to be in place; and if he will make a statement on the matter. [37105/12]
Amharc ar fhreagraThe interim HSE Board, which I established in May 2011, was designed to facilitate greater coordination and integration between the senior management teams in my Department and the HSE. The interim Board has provided a basis on which to make early progress on the health reform agenda, facilitating a greater unity of purpose. It also streamlines reporting relationships to ensure that decisions are implemented quickly and as a result, better services are delivered for patients with greater emphasis on service delivery.
The Health Service Executive (Governance) Bill 2012 was published last July. The Bill provides for the abolition of the Board of the HSE under the Health Act 2004 and the putting in place of a new governance structure. The Board will be replaced by a Directorate, headed by a Director General and with strengthened accountability arrangements for the HSE. Table 1 below sets out the current composition of the interim Board, the roles of those on the Board within the Department and the HSE and all changes since it was established.
Table 1: Membership and Term of Office of Interim HSE Board as at 18 September 2012
|
Member Name of Board |
Term of Office |
|
Dr. Ambrose McLoughlin (Chair), Secretary General, Department of Health - Dr. McLoughlin filled the vacancy occasioned by the resignation of Mr. Michael Scanlan, former Secretary General of the Department of Health, on 25 April 2012. - Mr. Scanlan had served as Chairman from 1January 2012. He had replaced Dr. Frank Dolphin who resigned as Chairman on 31 December 2011. Prior to his appointment as Chair, Mr. Scanlan served as an ordinary Board member from 20 May 2011 to 31 December 2011. |
26/04/2012 – 14/08/2015 |
|
Mr. Tony O’Brien, Deputy CEO and Director General Designate, HSE. - Mr. O'Brien filled the vacancy occasioned by the resignation of Mr. Cathal Magee as Chief Executive Officer, HSE on 20 August 2012. Mr. O’Brien was appointed Deputy CEO, HSE on 20 August 2012. |
Contiguous with term of office as Deputy CEO. |
|
Dr. Tony Holohan, Chief Medical Officer, Department of Health. |
20/05/2011 – 07/02/2015 |
|
Mr. Paul Barron, Assistant Secretary, Primary Care & Eligibility, Department of Health. |
20/05/2011 – 07/02/2015 |
|
Ms. Bairbre Nic Aongusa, Assistant Secretary, Finance, Information, EU/International, Research, Department of Health. |
20/05/2011 – 07/02/2015 |
|
Ms. Frances Spillane, Assistant Secretary, National HR, Department of Health. - Ms. Spillane filled the vacancy occasioned by Mr. Michael Scanlan’s appointment as Chairperson 1 January 2012. |
09/03/2012 – 07/02/2015 |
|
Mr. Jim Breslin, Secretary General, Department of Children and Youth Affairs - Mr. Breslin filled the vacancy occasioned by Mr. Pat Farrell’s resignation on 19 May 2011. |
09/03/2012 – 31/12/2012 |
|
Dr. Barry White, HSE National Director, Clinical Strategy & Programmes. |
20/05/2011 – 31/12/2012 |
|
Dr. Philip Crowley, HSE National Director, Quality, Risk & Clinical Care. |
20/05/2011 – 31/12/2012 |
|
Ms. Laverne McGuinness, HSE National Director, Integrated Services-Performance & Financial Management. |
20/05/2011 – 31/12/2012 |
|
Mr. Brian Gilroy, formerly HSE National Director, Integrated Services-Reconfiguration. - [Note: Mr. Gilroy is no longer employed by the HSE but has agreed to remain as a Board member pro tem]. |
20/05/2011 – 31/12/2012 |
|
Vacancy occasioned by Mr. Tony O'Brien's appointment as Deputy CEO, HSE. - Mr. O’Brien had previously filled the Board vacancy occasioned by Dr. Martin Connor’s resignation on 8 March 2012. Dr Connor had been appointed to the Board on 6 June 2011. |
Term ends 07/02/2015 |
1566. Deputy Billy Kelleher asked the Minister for Health if he will provide, in tabular form, the number of customers who have left the private health insurance market by county; the average change in premiums over the past year and since budget 2012; the maximum increase in premiums over those time periods; and if he will make a statement on the matter. [37106/12]
Amharc ar fhreagraThe Health Insurance Authority (HIA) is the statutory regulator of the private health insurance market in Ireland and provides information to consumers regarding their rights and health insurance plans and benefits. As previously outlined to the Deputy in June, the HIA does not compile figures by county on the number of customers who have left the private health insurance market. In relation to the average change in premiums, the HIA has estimated that the average premium increase per customer is 10 per cent, when comparing the second quarter of 2011 to the second quarter of 2012. The HIA points out that any figures calculated for time periods of less than one year (for example, since Budget 2012) would be distorted, as this is the time of the year that insurers normally apply price changes.
While there has been a decrease in the numbers with private health insurance, by 38,913 persons this year, it is important to note that the decline in private health insurance coverage is modest to date, at less than 1.8% of the overall market in 2012. is leaves some 2.123 million, or 46.3% of the population, covered by private health insurance. Even in the current difficult financial climate, the vast majority of consumers with private health insurance are retaining some level of health insurance cover.
I would strongly advise consumers to shop around for the health insurance plan that best suits their needs. Consumers have a legal right to switch between or within insurers to get better value and to reduce their premium costs. All customers should carefully consider the full range of plans and levels of cover available within the market, so that their own needs are fully met. Where customers wish to switch products, the relevant health insurance legislation ensures that switching is as easy and seamless as possible for customers. In addition to the choices available to consumers in the health insurance market, the Government's clear objective is for the health insurance market to remain as competitive and affordable as possible, as we move towards a new system of Universal Health Insurance.
