Written Answers Nos. 1299-1316
1299. Deputy Eric Byrne asked the Minister for Health the appropriate legal minimum ratio of nursing staff to patients in nursing homes; the minimum standard of care as set by his Department in nursing homes; if any consideration is being given to a continuity of care; and if he will make a statement on the matter. [36996/13]
Amharc ar fhreagraThe Health Act, 2007 introduced a significant change to how residential care settings for older people are inspected and registered. Since July, 2009 the Health Information and Quality Authority (HIQA) is the statutory independent body responsible for the registration and inspection of all residential care services for older people. This responsibility is underpinned by a comprehensive regulatory framework comprising of the Health Act 2007, the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009, as amended, the Health Act 2007 (Registration of Designated Centres for Older People) Regulations 2009 and the National Quality Standards for Residential Care Settings for Older People in Ireland.
All nursing homes, public and private are subject to the same core standards and regulations in relation to quality and safety in order to ensure the well-being of their residents. In the context of continuity of care the regulations require that an individual care plan must be developed and agreed with each resident and this plan must be kept under review as required by their changing needs or circumstances.
The staffing requirement of each nursing home is dependent on its configuration, occupancy and the dependency levels of its residents. It is a matter for HIQA's Chief Inspector of Social Services to determine, for each nursing home, whether the staffing level and mix is appropriate.
1300. Deputy Michael Healy-Rae asked the Minister for Health the position regarding surgery in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [37010/13]
Amharc ar fhreagraThe National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2013, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to this particular query raised by the Deputy, I have been informed by the HSE that they replied to the Deputy on the 25th June in relation to this matter. However, I have asked the Health Service Executive to respond again to the Deputy in this matter.
1301. Deputy James Bannon asked the Minister for Health the reason for the increase in the number of medical card refusals particularly in cases where applicants are seriously ill; the reason mortgages/home loans and so on are now not being taken into account when assessing applications; and if he will make a statement on the matter. [37012/13]
Amharc ar fhreagraUnder the provisions of the Health Act 1970, medical cards are provided to persons who are, in the opinion of the Health Service Executive (HSE) unable without undue hardship to arrange GP services for themselves and their dependants. Assessment for a medical card is determined primarily by reference to the means, including the income and reasonable expenditure, of the applicant and his or her partner and dependants.
There is also provision for discretion by the HSE to grant a card in cases of "undue hardship" where the income guidelines are exceeded. Such cases are decided by a qualified Medical Officer. Medical expenses are taken into account when assessing an application on hardship grounds.
The HSE has produced national assessment guidelines to provide a clear framework to assist in the making of reasonable, consistent and equitable decisions when assessing an applicant for the General Medical Services scheme. These guidelines are publicly available and can be downloaded from the HSE's medical card website.
Budget 2013 announced that the rules on a person's expenses that are taken into account in calculating their net income for medical card purposes would be tightened.
Changes recently introduced by the Health Service Executive from April 2013 onwards mean that payments on a home improvement loan and a €50 per week allowance for a car are excluded from the standard means test assessment.
For clarity, the exclusion from travel to work costs relates to removing the weekly amount of €50 allowed to cover standing charges, such as depreciation or other running costs, used when considering travel to work costs as an outgoing where public transport is not available or suitable and a car is required. This means that the HSE will continue to consider the standard mileage costs or public transport costs when assessing eligibility.
The Deputy may be aware that there are a broad range of allowable expenses under the means test assessment for medical cards that have not been affected by these changes.
I would like to assure the Deputy that the changes were identified with a view to mitigating the impact on the assessment process, while also yielding savings. In so doing, the new assessment arrangements continue to fully take account of a person's mortgage or rental expenses. In addition, other allowable expenses were protected Budget 2013. And finally, the need to reduce the income limits for medical cards was avoided.
1302. Deputy Seán Crowe asked the Minister for Health if his attention has been drawn to of the case of a person (details supplied) in Dublin 24 who has transferred from Tallaght hospital to a private nursing home without the knowledge or permission of their family and if he will investigate this case [37037/13]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply.
1303. Deputy Bernard J. Durkan asked the Minister for Health if and when a medical card application will issue in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [37042/13]
Amharc ar fhreagraThe Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible. The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has issued to Oireachtas members.
1304. Deputy Clare Daly asked the Minister for Health the steps he will take to ensure that children suffering from arthritis and rheumatological illnesses are dealt with in view of the waiting lists that in some cases can be up to eighteen months [37062/13]
Amharc ar fhreagraImproving access to day, inpatient and outpatient services is a key priority for the Government. Immediately following my appointment, I established the Special Delivery Unit (SDU), the aim of which is to unblock access to acute services by improving the flow of patients through the system. For this year, the target maximum waiting times as set out in the HSE Service Plan are eight months for adults awaiting an inpatient or daycase procedure, 20 weeks for children awaiting an inpatient or daycase procedure, 13 weeks for routine GI endoscopy and 12 months for a first-time outpatient appointment. The Special Delivery Unit, together with the National Treatment Purchase Fund, is working closely with hospitals towards achievement of these maximum waiting times across all specialties; this involves analysing performance, agreeing action plans and extra support as necessary, and ensuring hospital capacity is being optimised.
1305. Deputy Tom Fleming asked the Minister for Health the number of applicants on the waiting list for wheelchairs in County Kerry; the length of time they are waiting; the action he will take to address these waiting lists; and if he will make a statement on the matter. [37071/13]
Amharc ar fhreagraAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
1306. Deputy Andrew Doyle asked the Minister for Health if he will provide an update on the paediatric rheumatology service for children in Irish hospitals; if he will outline on each date when current and previous consultants have been appointed to the service over the past seven years; if he will outline appointments during that time who are no longer in the hospitals; the expected waiting times; and if he will make a statement on the matter. [37072/13]
Amharc ar fhreagra1325. Deputy Joe Higgins asked the Minister for Health if he will provide information on the waiting times for paediatric rheumatology services and if he will confirm his plans to provide more full time staff to this service to cater fully for the needs of patients [37253/13]
Amharc ar fhreagraI propose to take Questions Nos. 1306 and 1325 together.
As these are service matters, I have asked the HSE to reply directly to the Deputy in relation to these issues.
1307. Deputy Bernard J. Durkan asked the Minister for Health his future plans to regulate the use of sunbeds with particular reference to the need for regulation in respect of minors and in addition to the failure of safe regulation in recent years; and if he will make a statement on the matter. [37077/13]
Amharc ar fhreagraThe Public Health (Sunbeds) Bill has now been drafted. Under the Draft Bill, I propose to make it an offence to sell or hire a sunbed to a person under 18 years of age or allow such a person to use a sunbed on a sunbed premises. Breaches of this core provision will result in prosecution and very significant penalties will be available to the courts in cases of non-compliance.
The Draft Bill provides for a prohibition on sunbed businesses from permitting persons under 18 years of age from purchasing or hiring a sunbed or using a sunbed on a sunbed premises. Other key provisions included in the Bill:-
(i) a prohibition on the unsupervised use of sunbeds in a sunbed premises;
(ii) an exemption for medical purposes;
(iii) control on the remote sale or hire of sunbeds (internet transactions);
(iv) sunbed operators, sellers and hirers will be required to notify the HSE;
(v) a requirement that sunbed operators provide training for staff;
(vi) an enforcement regime and the imposition of penalties for non-compliance;
(vii) an obligation on all sunbed operators to provide protective eyewear to users;
(viii) a requirement that warning signs be displayed in all sunbed premises;
(ix) a prohibition on certain promotional marketing practices;
(x) a requirement on operators to ensure that sunbed users are made fully aware of the potential dangers of sunbed use; and a related provision whereby sunbed users are required to sign to confirm that they have been made so aware.
I am delighted to be in a position to confirm that the drafting of the Bill has been completed and that the Bill has been notified to the EU Commission under the EU Transparency Directive - a process that will take a minimum of 3 months to complete. Following completion of the Commission's process, the Bill will be published and initiated in the Oireachtas.
1308. Deputy Bernard J. Durkan asked the Minister for Health the procedure to be followed in order to obtain a primary medical certificate in respect of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [37080/13]
Amharc ar fhreagraThe Revenue Commissioners' operate a Disabled Drivers and Disabled Passengers Scheme whereby a person with a disability or a family member can qualify for tax relief linked to the purchase of vehicles, providing the person with a disability is the holder of a Primary Medical Certificate. As applications for Primary Medical Certificates are processed by the Health Service Executive (HSE) through local offices, I have arranged for the question to be referred to the HSE for direct reply to the Deputy.
1309. Deputy Michael Healy-Rae asked the Minister for Health with regard to the €100 emergency department charges, if he will confirm the number of charges not actually paid because they are sent to persons who were initially exempt from the charge in the first instance; his views on whether there be a major re-think of the whole system of charging; and if he will make a statement on the matter. [37098/13]
Amharc ar fhreagraThe 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.
1310. Deputy Seán Ó Fearghaíl asked the Minister for Health if he will consider a matter (details supplied) regarding rheumatology services; and if he will make a statement on the matter. [37100/13]
Amharc ar fhreagraMy Department has contacted Our Lady’s Children’s Hospital, Crumlin and Temple Street Children’s University Hospital concerning your question and has been provided with the following information regarding the services provided by the two hospitals:
Children’s University Hospital, Temple Street has a general paediatrician with a special interest in rheumatology, who is on maternity leave at present. The two rheumatologists at Our Lady’s Children’s Hospital, Crumlin are covering the hospital’s outpatient department clinics in the spirit of cross hospital support. If a child needs joint injections, they will be done in Our Lady’s Children’s Hospital, Crumlin but there has been no requirement to date. With regard to waiting list numbers, I am advised that Temple Street has 33 patients on its outpatient waiting list, with three new patients being seen per week at the Rheumatology Clinic, and four follow-up patients. A patient visit includes review with the multidisciplinary team i.e. consultant, physiotherapist and clinical nurse specialist. Links are also made with the dietetic and social work service as required.
With regard to Our Lady’s Children’s Hospital, Crumlin, both rheumatology consultant posts at Crumlin are general paediatricians with a special interest in rheumatology. The Clinical Director, Director of Operations, Chair of Medical Board and the two consultants have recently met with a view to reducing waiting times for rheumatology patients through a number of potential initiatives including, for example, a pilot project to utilise additional specialised physiotherapy resources. In addition two new consultant appointments taking up positions at the end of the year will also help with this service.
1311. Deputy Ann Phelan asked the Minister for Health his views on the matter of general practitioners plans to charge medical card holders for previously free warfarin blood tests; if his attention has been drawn to the fact that warfarin is a vital weapon in the fight against the blood clotting (details supplied); and if he will make a statement on the matter. [37101/13]
Amharc ar fhreagraThe current General Medical Services (GMS) GP Capitation Contract was introduced in 1989 and is based on a diagnosis and treatment model. Under the GMS contract, GPs receive a range of fees and allowances, including an annual capitation payment in respect of each medical card and GP visit card patient on their GMS list.
Section 11 of the current contract states as follows:
“The medical practitioner shall provide for eligible persons, on behalf of the relevant Health Board, all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess. This will include such preventive and developmental services as are currently provided or may be developed in the new style of practice which this agreement facilitates, some of which services may be included on the list of special items of service for which specific payments shall be made.”
The monitoring and appropriate care of patients receiving anti-coagulation therapy with Warfarin comes within the scope of competence of general practice. Warfarin testing is also available free of charge in hospitals.
Warfarin testing is carried out by some general practitioners as a matter of course in their practices and I welcome this. This provides their patients with an option of receiving this service locally in a primary care setting rather than attending an acute hospital for the service.
The Programme for Government provides for the introduction of a new GMS GP contract with an increased emphasis on the management of chronic conditions, such as diabetes and cardiovascular conditions. It is envisaged that the new contract, when finalised, will focus on prevention and will include a requirement for GPs to provide care as part of integrated multidisciplinary Primary Care Teams.
Officials in my Department are in consultation with the HSE with a view to drawing up a new contract. The appropriate arrangements in relation to anti-coagulation therapy will be considered as part of the new contract.
1312. Deputy Bernard J. Durkan asked the Minister for Health if and when recommended occupational therapy will be offered in the case of a child (details supplied) in County Kildare who has been discharged from both the Child and Adolescent Mental Helath Services and the Community Occupational Therapy Paediatric Services despite clear recommendations that such therapy is necessary for a child of their circumstances, if either CAMHS or Community Occupational Therapy Paediatric Services will take responsibility for the necessary treatment; and if he will make a statement on the matter. [37112/13]
Amharc ar fhreagraThe particular issue raised by the Deputy is a service matter for the Health Service Executive. Accordingly I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
1313. Deputy Michael Healy-Rae asked the Minister for Health the position regarding a fair deal nursing home support scheme in respect of a person (dtails supplied); and if he will make a statement on the matter. [37126/13]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply.
1314. Deputy Michael Healy-Rae asked the Minister for Health if he will put funding in place to ensure that persons will not have to wait an inordinate length of time for orthodontic treatment (details supplied); and if he will make a statement on the matter. [37179/13]
Amharc ar fhreagraThe HSE has commissioned an independent review of orthodontic services. The outcome of this review, which is near completion, will give guidance as to what changes will be desirable to provide the best possible model of care delivery, given the current resources available and future demand for services.
1315. Deputy Finian McGrath asked the Minister for Health when the opt out policy on kidney and heart donors will come into effect. [37199/13]
Amharc ar fhreagraThe Government proposes to introduce an opt-out system of consent for organ donation. Consent will be deemed unless the person has, while alive, registered his/her wish not to become an organ donor after death. However, it is proposed that, even though consent is deemed, the next of kin will in practice always be consulted prior to removing any organ. If the next of kin objects to the organ donation, the donation will not proceed. This is known as a “soft” opt-out system.
My Department is currently undertaking a public consultation on the practical aspects of introducing an opt-out system of consent for organ donation and interested parties have been invited to submit their views by September 20th. Following the receipt of submissions and the distillation of the views received, my Department plans to host a focused workshop on the findings of the consultation. It is envisaged that the workshop will inform the next steps in the legislative process.
1316. Deputy Finian McGrath asked the Minister for Health the position regarding funding for a home care package in respect of a person (details supplied) in Dublin 5. [37201/13]
Amharc ar fhreagraAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
