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Tuesday, 26 Feb 2013

Written Answers Nos. 720-741

HSE Staffing

Ceisteanna (720)

Tom Fleming

Ceist:

720. Deputy Tom Fleming asked the Minister for Health if he will immediately lift the moratorium on staff recruitment in the Health Service Executive and appoint occupational therapists to address the waiting lists for occupational therapy intervention in County Kerry and the waiting list for paediatric occupational therapy in the County Kerry; if he will address these waiting lists that are most unreasonable; and if he will make a statement on the matter. [10244/13]

Amharc ar fhreagra

Freagraí scríofa

The Government has decided that the numbers employed across the public service must be reduced in order to meet its fiscal and budgetary targets. The health sector must make its contribution to that reduction. However, the HSE can make staff appointments once it remains within its overall employment ceiling and has the financial resources to do so. As the recruitment of occupational therapists is a matter for the HSE in the first instance, the Deputy's enquiry has been referred to the Executive for direct reply.

Hospital Trusts

Ceisteanna (721)

Thomas P. Broughan

Ceist:

721. Deputy Thomas P. Broughan asked the Minister for Health if he will ensure that existing links between the Rotunda and the Mater hospitals, Dublin, are maintained under the project in view of the fact that the Mater Hospital is the Rotunda Hospital's nearest adult acute hospital and long time clinical partner and it is an extremely convenient location if the Rotunda Hospital needs to transfer any high-risk adult patients for specialist care; his views on whether the best fit for patient outcomes would be for the Rotunda Hospital to relocate with the Mater Hospital and continue to provide assistance and care to the north east region; and if he will make a statement on the matter. [10255/13]

Amharc ar fhreagra

Freagraí scríofa

A key stepping stone to the introduction of Universal Health Insurance will be to develop independent not-for-profit hospital trusts in which all hospitals will function as part of an integrated group. As a first step on that journey, hospitals will be aligned within groups on an administrative basis. The rationale behind the establishment of hospital groups and trusts is to support increased operational autonomy and accountability for hospital services in a way that will drive the service reforms and provide the maximum possible benefit to patients.

It is well recognised that the Rotunda Hospital provides leadership in maternity services obstetrics, midwifery, neonatology and gynaecology services to all of north Dublin and the northeast. Strong clinical links with the Mater Misericordiae University Hospital, including joint consultant appointments, are a fundamental support to the work of the Rotunda, and this will continue in any configuration in which the Rotunda is required to operate. It is neither intended nor anticipated that the Rotunda will be constrained by being positioned within a particular group. As well as its long standing links with the Mater, which can and should be retained, it would also be appropriate for the Rotunda to establish links with other hospitals to meet its future aspirations for sub-specialty development and to expand and consolidate the links which currently exist.

The KPMG Independent Review of Maternity and Gynaecology Services in Greater Dublin, which was completed in 2008, noted that Dublin’s model of stand alone maternity hospitals is not the norm internationally and recommended that the Dublin maternity hospitals should be co-located with adult acute services and that one of the three new Dublin maternity facilities should be built on the site of the new national paediatric hospital. The intention has been that the National Maternity Hospital should be relocated to St Vincent's, the Coombe to Tallaght and the Rotunda to the Mater, and the maternity hospitals have been working with the relevant adult sites to progress this. There will be early discussions with the maternity hospitals regarding their maternity /adult co-location plans in the context of the Government decision to build the new children’s hospital on the St James’s campus. Notwithstanding this, I am committed to the intent of the report - that the Dublin maternity hospitals be located alongside adult acute services - while also bearing in mind the need to plan for the provision of tri-located paediatric, adult and maternity services, as is the intention in relation to the new children's hospital.

Orthodontic Service Waiting Lists

Ceisteanna (722)

Tom Fleming

Ceist:

722. Deputy Tom Fleming asked the Minister for Health the number of persons awaiting orthodontic treatment in County Kerry; the length of time they are waiting; the progress that has been made to reduce the waiting lists in County Kerry; and if he will make a statement on the matter. [10256/13]

Amharc ar fhreagra

Freagraí scríofa

The HSE provides orthodontic treatment to patients based on their level of clinical need. An individual's access to orthodontic treatment is determined against a set of clinical guidelines and priority is given to patients with greatest needs. The HSE has been asked to examine the specific query raised by the Deputy and to reply to him as soon as possible.

HSE Staffing

Ceisteanna (723, 724)

James Bannon

Ceist:

723. Deputy James Bannon asked the Minister for Health when it is proposed to replace the retiring doctor in Milltownpass, County Westmeath in view of the fact that this health provision is essential to the area as the Health Service Executive do not own a health centre to provide such a service; and if he will make a statement on the matter. [10265/13]

Amharc ar fhreagra

James Bannon

Ceist:

724. Deputy James Bannon asked the Minister for Health if he will provide details of the number of applicants for the post of general practitioner in Milltownpass, County Westmeath under the GMS system, advertising for which has been facilitated by the Health Service Executive in December 2012 and January, 2013, without a successful candidate being identified; and if he will make a statement on the matter. [10266/13]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 723 and 724 together.

As the Deputy's question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.

Nursing Homes Support Scheme Applications

Ceisteanna (725)

James Bannon

Ceist:

725. Deputy James Bannon asked the Minister for Health when a person (details supplied) in County Longford will be issued with a grant in respect of nursing home support respite under the fair deal scheme; and if he will make a statement on the matter. [10268/13]

Amharc ar fhreagra

Freagraí scríofa

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

Medical Card Applications

Ceisteanna (726)

James Bannon

Ceist:

726. Deputy James Bannon asked the Minister for Health when a person (details supplied) in County Longford will be issued with their full medical card; and if he will make a statement on the matter. [10269/13]

Amharc ar fhreagra

Freagraí scríofa

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Hospital Services

Ceisteanna (727)

James Bannon

Ceist:

727. Deputy James Bannon asked the Minister for Health if he will provide the numbers of podiatrist posts linked to the Midlands Regional Hospital diabetes service and his plans to extend the service to Longford to enhance the care of local diabetes patients and improve their quality of life; and if he will make a statement on the matter. [10272/13]

Amharc ar fhreagra

Freagraí scríofa

The HSE National Clinical Programme for Diabetes - which includes the care of children and adolescents with diabetes - was established within the Clinical Strategy and Programmes Directorate. The purpose of the Programme is to define the way diabetic Clinical Services should be delivered, resourced and measured; and a clinician has been appointed to lead on the development of the programme. One of the objectives of the National Diabetes Programme is to develop a footcare screening and treatment service to prevent foot ulceration and subsequent lower limb amputation. In relation to the specific queries raised by the Deputy, I have asked the Health Service Executive to respond directly to the Deputy in this matter.

Medical Card Applications

Ceisteanna (728)

Patrick Nulty

Ceist:

728. Deputy Patrick Nulty asked the Minister for Health if a medical card application will be granted on exceptional medical grounds in respect of a person (details supplied) in Dublin 15; and if he will make a statement on the matter. [10276/13]

Amharc ar fhreagra

Freagraí scríofa

The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Long-Term Illness Scheme Expenditure

Ceisteanna (729, 730, 731)

Gerald Nash

Ceist:

729. Deputy Gerald Nash asked the Minister for Health if he will provide in tabular form the total cost of the long term illness scheme for the years 2009 to 2012 inclusive; and the cost per patient availing of this scheme. [10279/13]

Amharc ar fhreagra

Gerald Nash

Ceist:

730. Deputy Gerald Nash asked the Minister for Health if he will provide in tabular form the administration costs of the long term illness scheme for the years 2009 to 2012 inclusive. [10280/13]

Amharc ar fhreagra

Gerald Nash

Ceist:

731. Deputy Gerald Nash asked the Minister for Health if he has given consideration to abolishing the long term illness scheme and giving any patient with a defined long term illness a medical card, in view of the fact that patients on the long term illness scheme already have their medication paid for and will, under the Programme for Government be in receipt of general practitioner cards; and if he will make a statement on the matter. [10281/13]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 729 to 731, inclusive, together.

The information requested in relation to the Long Term Illness (LTI) scheme, for the years 2009 to 2011, is set out in the following table:

2011

2010

2009

Cost of the LTI scheme

€118.1m

€126.92m

€139.76m

Number of claimants

59,274

67,492

65,731

Cost per claimant

€1,992

€1,881

€2,126

The figures for 2012 are not yet available.

In general, administration costs of the Primary Care Reimbursement Service (PCRS) represent less than 1% of the payments expenditure associated with all the PCRS schemes.Under the provisions of the Health Act 1970, eligibility for health services in Ireland is based primarily on residency and means.There are currently two categories of eligibility for all persons ordinarily resident in Ireland i.e. full eligibility (medical card) and limited eligibility (all others).Full eligibility is determined mainly by reference to income limits and is granted to persons who, in the opinion of the Health Service Executive, are unable to provide general practitioner, medical and surgical services to themselves and their dependents without undue hardship. There is no automatic entitlement to a medical card for persons with any specific illness.

There is a provision for discretion to grant a card in cases of "undue hardship" where the income guidelines are exceeded. The HSE set up a clinical panel to assist in the processing of applications for discretionary medical cards where there are difficult personal circumstances. There is an emergency process for a person who is terminally ill, or in urgent need of medical attention and cannot afford to pay for it, that provides a card within 24 hours while the normal application process is completed. Once a letter from the patient's GP or consultant is received stating that the person is terminally ill and the required personal details are provided, an emergency card is issued to that person for a six-month period. The Programme for Government commits to reforming the current public health system by introducing Universal Health Insurance with equal access to care for all. As part of this, the Government is committed to introducing, on a phased basis, GP care without fees within its first term of office. Primary legislation is required to give effect to Government commitment to introduce a universal GP service without fees.

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 Office of the Attorney General and the Department and it will be published shortly. Implementation dates and application details will be announced in due course. There are no plans to abolish the LTI scheme and give medical cards to patients with defined long term illnesses.

Medical Card Reviews

Ceisteanna (732)

Gerald Nash

Ceist:

732. Deputy Gerald Nash asked the Minister for Health if he will provide in tabular form the total cost of assessing persons for eligibility for medical cards for the years 2009 to 2012, inclusive. [10282/13]

Amharc ar fhreagra

Freagraí scríofa

The information sought by the Deputy is not readily available. However, I have asked the Health Service Executive to supply this information to me and I will forward it to the Deputy as soon as possible.

Nursing Homes Support Scheme Eligibility

Ceisteanna (733)

Gerald Nash

Ceist:

733. Deputy Gerald Nash asked the Minister for Health if he will provide in tabular form the total cost of assessing persons for eligibility for the fair deal scheme for the years 2009 to 2012 inclusive. [10283/13]

Amharc ar fhreagra

Freagraí scríofa

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

Medical Card Eligibility

Ceisteanna (734)

Gerald Nash

Ceist:

734. Deputy Gerald Nash asked the Minister for Health the links that are in place between the Health Service Executive and the Department of Social Protection and the Revenue to assist with means testing in determining persons eligibility when applying for medical cards or fair deal. [10284/13]

Amharc ar fhreagra

Freagraí scríofa

Legislation is currently being drafted by the Office of the Attorney General and the Department which will provide a legal basis for the exchange of personal data between the HSE and the Revenue Commissioners and the Department of Social Protection which will enhance the ability of the HSE to verify and audit the accuracy of eligibility status on the national medical card database.

The HSE has some links with the Department of Social Protection to assist with means testing in determining eligibility for the Fair Deal scheme. In a number of Nursing Homes Support offices, the HSE has access to the Department of Social Protection's IT system -which provide details of applicant's means. Information is shared in accordance with data protection legislation and social welfare legislation.

In regard to the HSE links with the Revenue Commissioners, there are no direct links between Revenue and the HSE to assist with means testing in determining a person's eligibility when applying for financial support under the Fair Deal Scheme.

Medical Card Eligibility

Ceisteanna (735)

Gerald Nash

Ceist:

735. Deputy Gerald Nash asked the Minister for Health if he will give consideration to the idea of transferring responsibility for assessing eligibility for medical cards and the fair deal scheme to the Department of Social Protection on the basis that it could potentially eliminate the duplication of functions between Departments and agencies; and if he will make a statement on the matter. [10285/13]

Amharc ar fhreagra

Freagraí scríofa

Under the Health Act 1970, determination of eligibility for a medical card is the responsibility of the Health Service Executive. There are no proposals to alter this process under consideration by the Government. The Nursing Home Support Schemes Act 2009 governs assessment under the Fair Deal Scheme and likewise there are no proposals to alter this process under consideration.

Question No. 736 answered with Question No. 626.
Question No. 737 answered with Question No. 692.
Question No. 738 answered with Question No. 678.

HIQA Investigations

Ceisteanna (739)

Seamus Healy

Ceist:

739. Deputy Seamus Healy asked the Minister for Health when he intends to introduce legislation to enable the Health Information and Quality Authority to inspect and investigate any problems, should they exist, in sheltered homes for the elderly; and if he will make a statement on the matter. [10318/13]

Amharc ar fhreagra

Freagraí scríofa

At this time there are no plans to extend the remit of HIQA to sheltered housing for the disabled and the elderly.

Medicinal Products Licensing

Ceisteanna (740)

Micheál Martin

Ceist:

740. Deputy Micheál Martin asked the Minister for Health further to Parliamentary Questions No. 476 of 11 December 2012 and No. 220 of 13 February 2013, the reason the Health Service Executive is not providing the information sought in these questions in view of the fact that the company (details supplied) on whose behalf the questions were tabled is not in litigation with the HSE; if the litigation referred to by the HSE was ongoing in December 2012 when Parliamentary Question No. 476 of 11 December 2012 was tabled; the timeframe the litigation referred to has been going on; the reason litigation is relevant to the HSE making a decision as to the company's 14 applications given that when the applications were made no mention was made of any litigation; and if he will make a statement on the matter. [10326/13]

Amharc ar fhreagra

Freagraí scríofa

As I indicated in my reply on 13 February, the company referred to by the Deputy is one of a number of companies engaged in the parallel importation of drugs and medicines into the State. The HSE has been seeking reductions in the price of the products involved.

The litigation referred to in my previous reply was ongoing in December last, the Notice of Motion having been issued on 8 March 2012. The HSE is unable to comment further in light of the fact that a threat of Judicial Review proceedings has been made by the company in respect of its 14 applications by way of solicitors' letters to the HSE issued in 2012 and 2013.

General Practitioner Services

Ceisteanna (741)

Dara Calleary

Ceist:

741. Deputy Dara Calleary asked the Minister for Health further to Parliamentary Question No. 1 of 14 February 2013, if he will clarify what he means where he points out that legislation to extend access to general practitioner services without fees to persons with prescribed illnesses and it will be published shortly; the expected date for publication of same; and if he will make a statement on the matter. [10358/13]

Amharc ar fhreagra

Freagraí scríofa

The Government's Programme for Government committed it to major reforms of the manner in which health services are delivered. As part of the reform programme, Universal Primary Care is to be introduced on a phased basis during its term of office. Primary legislation is being prepared to give effect to this commitment. The wording of this legislation, which will 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 Office of the Attorney General and the Department. As the legislation is still being drafted, I am not in a position to give a definite date for its publication. Details of an implementation timeframe, illnesses to be covered etc and application details will be announced in due course.

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