Written Answers Nos. 37-44
37. Deputy Charlie McConalogue asked the Minister for Health the reason for the delay in publishing the report by the Independent Review Group on the location of the new National Children's Hospital; when this report will be published; and if he will make a statement on the matter. [40964/12]
Amharc ar fhreagraAs you will be aware, I established an independent Review Group to consider the implications of the decision of An Bórd Pleanála, received on 23 February 2012, to reject the planning application for the proposed construction of a national paediatric hospital on the site of the Mater Misericordiae Hospital. The aim of the Review was to consider all the possible options for the earliest possible delivery of a new children's hospital. In June, the Group presented its report, to which I am giving careful consideration and which I will be bringing to Government shortly. I intend to publish the Group's report when this process is complete.
38. Deputy Pádraig Mac Lochlainn asked the Minister for Health when the implementation Group on Universal Health Insurance will report; and if he will make a statement on the matter. [40992/12]
Amharc ar fhreagra67. Deputy Barry Cowen asked the Minister for Health when can we finally expect to see a White Paper on the introduction of universal health insurance; if he will provide any detail yet on the type of mode of universal health insurance that he intends to introduce; and if he will make a statement on the matter. [40973/12]
Amharc ar fhreagraI propose to take Questions Nos. 38 and 67 together.
The Government is committed to fundamental reform of healthcare in Ireland that will deliver a single tier health system, supported by universal health insurance (UHI), where access is based on need, not income. Every individual will have a choice of health insurer and will have equal access to a comprehensive range of curative services.
In February, I established an Implementation Group on Universal Health Insurance which will assist in developing detailed implementation plans for universal health insurance and driving implementation of various elements of the health reform programme.
The Group will also assist my Department in preparing a White Paper on Financing Universal Health Insurance. The White Paper will outline the estimated costs and financing mechanisms associated with the introduction of universal health insurance. Preparation of the White Paper is a complex process. It will involve significant financial modelling to support analysis of different design options and to estimate the cost of UHI. The White Paper will be published as early as possible within the Government's term of office.
In designing the model of care on which universal health insurance will be based, we must ensure that it meets the needs of the Irish system and that it achieves the best outcomes for patients. This requires that we carefully plan and sequence the reform programme and that we give detailed consideration to the most appropriate structures for delivery of different services.
It is also important that we look to other countries that have developed health insurance-based funding models and that we build on best international experience. This is reflected in the membership of the UHI Implementation Group. The UHI Implementation Group comprises a mix of those with executive responsibilities within our health services and external expertise, including international experts working with the World Health Organisation and the European Observatory on Health Systems and Policies. In addition, officials in my Department have been examining the experience of health reforms in a range of countries, including the Netherlands and Germany. This analysis is vital to enhancing our knowledge and informing policy. I would like to reiterate that, ultimately, this Government's reform proposals will be designed to meet the needs of the Irish system and ensure the best outcomes for Irish patients.
The reform programme is a complex and major undertaking that requires careful sequencing over a number of years. The Implementation Group will continue in existence throughout the health reform process and will oversee different elements of the reforms as they are being put in place. It is also intended that it will consult widely as part of the reform implementation process.
39. Deputy Billy Kelleher asked the Minister for Health the reason he has yet to begin negotiations with the IMO in relation to the roll out of free general practitioner care; when these negotiations are expected to begin; his views on whether promises made in relation to the roll out of free GP care are impossible until agreement is reached with GPs; and if he will make a statement on the matter. [40957/12]
Amharc ar fhreagraThe Programme for Government provides for significant strengthening of primary care services to deliver Universal GP Care with the removal of cost as a barrier to access for patients. Universal GP Care will be achieved on a phased basis. Primary legislation is required to give effect to this commitment. Legislation to allow the Minister for Health to make regulations to extend access to GP services without fees to persons with prescribed illnesses is currently being drafted by the Attorney General's office and will be published shortly. Implementation dates and application details will be announced in due course.
There have been preliminary discussions with the Irish Medical Organisation (IMO) to outline policy in this regard. I expect to engage in further discussions with GPs/IMO as soon as the legislation is published. At that stage, I will be in a better position to know what is possible or otherwise.
41. Deputy Pearse Doherty asked the Minister for Health noting that it is stated in his Department Strategy 2011-2014 that total expenditure for the public health service is being reduced by nearly €1.1 billion over the period 2011 to 2014 and that in excess of €2 billion will have to be taken out of the health budget over the same period to meet what was called unavoidable pressures and Government commitments, if he will explain the difference between the two figures; if he will estimate the level of the projected cut year on year for 2013 and 2014; and if he will make a statement on the matter. [40983/12]
Amharc ar fhreagra49. Deputy Bernard J. Durkan asked the Minister for Health if he is satisfied that he and his Department will be in a position to retain frontline services notwithstanding the requirements to make budgetary reductions in line with the agreement entered into by his predecessor in office; if he will outline the full extent of budgetary curtailments required under this heading by the end of the current year and thereafter in 2013; if he has managed to identify how best to manage such financial curtailments and at the same time keep in mind the necessity to provide core and frontline services throughout the country; and if he will make a statement on the matter. [40921/12]
Amharc ar fhreagraI propose to take Questions Nos. 41 and 49 together.
The Government has a significant fiscal deficit which needs to be closed. We are bound by our commitments to our international partners. They are our lenders of last resort. For now, we depend on them to enable us to pay our way. Our country has suffered the greatest economic crisis in living memory leading to a large fall in Exchequer revenues. Tax revenues fell from €47 billion in 2007 to €34 billion in 2011. However, we are rebuilding our revenue base - 2011 tax revenue was up €2 billion on 2010 - but we do not have the resources to fund all the services that we would like to provide.
It is in this context that expenditure plans for 2012 - 2014 were set in the Comprehensive Expenditure Report, published last December. The Health sector as with other sectors has incurred a reduction in the resources allocated to it. Further significant cost reduction/extraction is required in 2013 and 2014. This year, in accordance with the National Service Plan, the HSE had to plan for a reduction in expenditure of €750m in order to meet the targets set by Government as well as unavoidable pressures. In the Comprehensive Expenditure Report for 2012 the Government has indicated that further savings of €280m in line with Government targets in current health expenditure would be required over that period. However, additional savings will also be required to fund unavoidable pressures particularly in the area of community drugs schemes, additional superannuation costs and service pressures arising from demographic trends. Savings will also be required to provide for investment to meet commitments in the Programme for Government.
The savings being sought over the period are designed to reduce the cost base in the health service, particularly in the areas of drugs costs and procurement and also provide for a more efficient and equitable collection of income from the use of private beds in public hospitals. Initial indications are that between €750m and €900m will have to be taken out of the cost base of the health sector next year to meet the commitments I have outlined. Some savings will arise from the reduction in the numbers employed in the Health Services in line with the Government's policy in respect of employment in the public services generally. There are also some efficiencies being sought in the provision of services. The objective is to reduce costs while maintaining services to the greatest extent possible. It is acknowledged that the Programme poses serious challenges to the management of the health services in the coming years particularly in the context of the major reform programme being undertaken by the Government. However it is intended that through the achievement of greater efficiency in the delivery of services and the operation of the Croke Park agreement the savings can be achieved with the minimum impact on services.
My Department is working intensively with the HSE on proposals for submission to Government to address structural expenditure issues in the context of the 2013 Estimates. This includes reconfiguration of services, maximising the potential for flexibility under the Croke Park Agreement and curtailing expenditure in the Primary Care Reimbursement Service.
This is in line with the Programme for Government which is focussed on reforming the way health services are funded and delivered to achieve greater productivity and more cost effective services.
42. Deputy Dara Calleary asked the Minister for Health the steps he will take to tackle the problem of the illegal sale of prescription drugs across the country; and if he will make a statement on the matter. [29729/12]
Amharc ar fhreagraThe problem of the misuse of prescription drugs has been recognised at national, European and international levels. Through the framework of the National Drugs Strategy 2009-2016, the Department of Health is working in collaboration with the relevant statutory agencies to monitor the availability of controlled drugs, including prescription medicines, through illicit channels.
The enforcement of the law relating to the sale of drugs, including prescription drugs, continues to be a priority in the Government’s commitment to tackling the issue of drug misuse in this jurisdiction.
Under the Medicinal Products (Prescription and Control of Supply) Regulations, it is prohibited for a person to supply a prescription medicine except in accordance with a prescription, and the supply must be made from a registered pharmacy by or under the personal supervision of a registered pharmacist. A person who contravenes these Regulations is guilty of an offence. The Regulations also make it illegal for prescription medicines to be supplied by mail order. The definition of mail order includes reference to electronic custom solicitation and order for supply. This includes ordering prescription medicines through internet sites.
Furthermore, a person who has in his possession a prescription medicine containing a substance controlled under the Misuse of Drugs legislation for the purpose of selling or otherwise supplying it, is guilty of an offence under that legislation.
My Department is reviewing the Misuse of Drugs Regulations with a view to introducing additional controls on certain prescription drugs being traded illicitly, for example benzodiazepine medicines. These additional controls include introducing import and export controls as well as an offence of possession, thereby assisting the law enforcement roles of Customs and of the Garda Síochána.
My Department is consulting with key stakeholders in relation to the proposed amendments and it is anticipated that new legislation will be introduced by early 2013.
43. Deputy Peadar Tóibín asked the Minister for Health the current in-patient bed capacity in the North-East region; and if he will make a statement on the matter. [41006/12]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for direct reply.
44. Deputy Brendan Smith asked the Minister for Health if he will provide an update on discussions with the IPHA; the savings that are expected in relation to reducing the drugs bill as a result of these discussions; when he expects to see these savings take effect; and if he will make a statement on the matter. [40970/12]
Amharc ar fhreagra188. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the reason this State is the most expensive country in northern Europe to buy on-patent medicines; the efforts he is making to address the cost of on-patent medicines here; the progress made to date; the timeline and expected savings from same; and if he will make a statement on the matter. [41142/12]
Amharc ar fhreagra189. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the reason generic medicines often cost as much as 12 times more in this State than in Britain; the efforts he is making to address the cost of off-patent and generic medicines here; the progress made to date; the timeline and expected savings from same; and if he will make a statement on the matter. [41143/12]
Amharc ar fhreagraI propose to take Questions Nos. 44, 188 and 189 together.
The prices of medicines vary between countries for a number of reasons. These include different prices set by manufacturers, different wholesale and pharmacy mark-ups, different dispensing fees and different rates of VAT.
Negotiations are ongoing between officials of the Department/HSE and the two bodies that represent pharmaceutical manufacturers in Ireland regarding reductions in the price of medical products supplied under State Schemes. It is expected that these negotiations will conclude shortly and provide additional savings in the cost of medicines. In addition, the Health (Pricing and Supply of Medical Goods) Bill 2012will introduce a system of reference pricing and generic substitution for prescribed drugs and medicines. These reforms will promote price competition among suppliers and ensure that lower prices are paid for medicines resulting in savings for taxpayers and patients.
The Bill is a Government priority for this Oireachtas session.It completed its passage through the Seanad on Wednesday, the 19th of September, and will be discussed in the Dáil shortly.
