Written Answers Nos. 603 - 621
603. Deputy Patrick O'Donovan asked the Minister for Health when his Department will put in place a mechanism to allow for the roll-out of orthodontic therapists as part of the State's response to reduce waiting lists for orthodontic treatment for children in accordance with best international practice, if he has communicated his desire to see dental therapists in place to the Dental Council; and if he will make a statement on the matter. [40847/13]
Amharc ar fhreagraAn independent review of orthodontic services, commissioned by the HSE, is near completion. The outcome of this review 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. The HSE may also consider local initiatives which may involve the use of orthodontic therapists.
Dental therapists are independent practitioners. In other jurisdictions, they would typically work in remote and isolated areas where there may not be access to a dentist. They have a broad scope of practice which includes restorations, periodontal treatment, oral hygiene treatment and extractions of deciduous teeth. Such independent practice is not permitted under the terms of the Dentists Act 1985. Accordingly, the Dental Council has not created a scheme establishing dental therapists as a class of auxiliary dental worker. The Dentists Act 1985 is currently under review.
604. Deputy Jack Wall asked the Minister for Health the position regarding a medical card appeal in respect of a person; and if he will make a statement on the matter. [40849/13]
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.
605. Deputy Peadar Tóibín asked the Minister for Health the number of staff who are employed in each county as child care facilities inspectors; the number of new staff who have been employed in each county by the Health Service Executive as child care facilities' inspectors since the Prime Time Investigates exposé entitled A Breach of Trust in view of the fact that new legislation will strengthen regulations in this sector; and the number of new staff who will be employed to inspect these new regulations. [40931/13]
Amharc ar fhreagraThe Government has decided that the numbers employed across the public service must be reduced, in order to meet fiscal and budgetary targets. As a major employer, the health sector must make a significant contribution to this reduction. This policy requires that, by the end of 2013, the health service achieves a workforce of 98,938 wholetime equivalents, WTEs. The HSE may continue to recruit staff in exceptional circumstances, where it has been established that there is an urgent service requirement and that this can be accommodated within the budgetary constraints and overall employment ceiling. In relation to the specific issue, as this is a matter for the Department of Children and Youth Affairs, the Deputy should raise the matter with my colleague Deputy Frances Fitzgerald.
606. Deputy Sean Fleming asked the Minister for Health the total amount of capital spending incurred directly within his Department as a results of measures undertaken as part of the 2011 Jobs Initiative; and if he will make a statement on the matter. [40935/13]
Amharc ar fhreagraThere has been no capital spending incurred directly within my Department as a result of measures undertaken as part of the 2011 Jobs Initiative.
607. Deputy Willie Penrose asked the Minister for Health the steps he will take to ensure that no further cuts are proposed to the intellectual disability budget for 2014 as they have already incurred a 16% reduction in funding and there is no longer any further scope for savings from efficiencies that would not impact upon front-line services; and if he will make a statement on the matter. [40940/13]
Amharc ar fhreagraThe level of funding available for the health budget and the extent of the savings required in the health sector are being considered as part of the estimates and budgetary process for 2014 which is currently underway. Pending completion of the national estimates, budgetary and service planning process for 2014 it is not possible to predict the service levels to be provided next year for the disability sector.
608. Deputy Billy Kelleher asked the Minister for Health when moulded seating for a new wheelchair will be provided in respect of a person (details supplied) in County Cork who is severely disabled; and if he will make a statement on the matter. [40945/13]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
609. Deputy Billy Kelleher asked the Minister for Health when physiotherapy will be provided for a person (details supplied) in County Cork who is severely disabled; and if he will make a statement on the matter. [40946/13]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
610. Deputy Bernard J. Durkan asked the Minister for Health the progress made on the provision of a primary health care centre in Kilcock, County Kildare; the extent to which plans have been agreed; if agreement has been reached as to the full scale and extent of time scale involved; and if he will make a statement on the matter. [40965/13]
Amharc ar fhreagraThe Health Service Executive, HSE is working with the National Development Finance Agency, NDFA, to progress Primary Care Centre Public Private Partnership. The HSE has appointed design teams and technical advisors for the project. The HSE and NDFA have completed an indicative Public Sector Benchmark, PSB, which was presented to the Project Board for consideration of affordability in early September.
The NDFA as a centre of expertise will be responsible for the delivery of the Primary Care PPP programme on behalf of the HSE, including the management of the procurement phase and the provision of financial advice including a Value for Money assessment. It has been reviewing the processes involved in procurement of PPP projects with a view to streamlining the process and delivering projects more quickly. While it is not possible, at this time, to give start and completion dates for any of the individual 20 potential locations, the best estimate is that these primary care centres will be completed by late 2016.
611. Deputy Jerry Buttimer asked the Minister for Health the diagnosis and treatment facilities available for Lyme disease and if there are plans to expand these facilities; and if he will make a statement on the matter. [40985/13]
Amharc ar fhreagraSince September 2011, Lyme disease has been a notifiable disease under the Infectious Diseases Regulations. The standard approach to the treatment of Lyme Disease is to follow the guidance laid out in the Infectious Diseases Society of America guidelines on the clinical assessment, treatment and prevention of Lyme disease. This is accepted as being the most up to date synthesis of best available evidence on the clinical management of Lyme disease and treatment of Lyme Disease is based upon this guidance.
The acute tertiary hospitals in Ireland have the diagnostic and treatment facilities and personnel for the management of Lyme disease. In addition, a network of infectious disease specialists is available in all the major centres to provide consultative, expert advice in the management of Lyme borreliosis. I am advised by the Health Protection Surveillance Centre that there were eight cases of Lyme neuroborreliosis notified in 2012. Lyme neuroborreliosis is at the more severe end of the spectrum of Lyme borreliosis and as such it is possible that there may be more people with the milder form of the disease. Given the numbers of cases of Lyme borreliosis in Ireland, I am confident that the facilities available for the diagnosis and treatment of the condition are commensurate with the burden which the disease imposes.
612. Deputy Mary Mitchell O'Connor asked the Minister for Health if a defibrillator will be fitted in a station following a serious incident (details supplied) in County Dublin; and if he will make a statement on the matter. [40988/13]
Amharc ar fhreagraWhile it is accepted that defibrillators should be placed in facilities where the incidence of cardiac arrest is likely to be high, this requires further assessment from a cost-health benefit perspective and also that the first responder programme can be delivered in a safe and appropriate manner. For this reason, a health technology assessment is underway and this will guide how best to implement our first responder capacity including the requirement to provide defibrillators across many community settings. The Health Information and Quality Authority has agreed to undertake such an assessment. This will inform my subsequent decisions on the design and implementation of a national programme and the necessary legislation which my Department will draft.
The Second Stage of the Public Access to Defibrillators Bill, which sets out the requirement to provide defibrillators in a range of settings and for events which have a regular attendance in excess of 100 persons per day, was passed in the Seanad in June 2013. I have requested the Health Information and Quality Authority, HIQA, to undertake a health technology assessment, HTA, on the practical elements of the introduction of a public access defibrillation programme and Department of Health officials have met with HIQA to discuss the procedures around a HTA. The health technology assessment has now commenced and will be concluded in 2014.
613. Deputy Bernard J. Durkan asked the Minister for Health if and when consultation for urgent orthopaedic surgery will be arranged in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [41010/13]
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 asked the Health Service Executive, HSE, to investigate the situation and respond directly to the Deputy in this matter.
614. Deputy John McGuinness asked the Minister for Health the exact number of patients waiting on the bariatric surgery waiting list at St. Columcille's Hospital or St. Vincent's University Hospital, Dublin; the average waiting time for this type of surgery; the reason a person (details supplied) in County Kilkenny has been waiting 16 years; and if he will make a statement on the matter. [41027/13]
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 asked the HSE to investigate the situation and respond directly to the Deputy in this matter.
615. Deputy Michael McCarthy asked the Minister for Health if his attention has been drawn to the major collective effect of cuts to disability organisations (details supplied) in County Cork, which have experienced substantial budget cuts over the past six years; if he will acknowledge that there is a growing gap between the demand for services and the resources available to meet this demand; that further cuts will cause this gap to widen even further and threaten front-line services such as transport and respite supports, early intervention services and many more; if he will provide assurances that this sector will not be subject to further cuts in budget 2014; and if he will make a statement on the matter. [41036/13]
Amharc ar fhreagraThe level of funding available for the health budget and the extent of the savings required in the health sector are being considered as part of the estimates and budgetary process for 2014 which is currently under way. Pending completion of the national estimates, budgetary and service planning process for 2014 it is not possible to predict the service levels to be provided next year for the disability sector. In relation to the specific queries raised by the Deputy, the information requested is not available in my Department. However, I have asked the HSE to provide the information it has available directly to you in relation these matters.
616. Deputy Finian McGrath asked the Minister for Health the percentage of Government health levy that applies to all private health insurance policies; if this levy only applies to those paying private health insurance; and if he will make a statement on the matter. [41075/13]
Amharc ar fhreagraRisk equalisation is a mechanism designed to support the objective of a community rated private heath insurance market, whereby all customers pay the same amount for the same health insurance policy, irrespective of age, gender or health status. An effective and robust Risk Equalisation Scheme, RES, is required in order to protect affordability for those who need it most. The Health Insurance (Amendment) Act, 2012 introduced a new permanent RES for the private health insurance market, effective from 1 January, 2013. I assume that the Deputy is referring to the stamp duty applicable under RES 2013.
The Risk Equalisation Scheme provides that health insurers receive higher premiums in respect of insuring older people, but that older people receive RE credits equal to the amount of the additional premium, so that all people continue to pay the same amount for a given health insurance product. These credits are funded by a stamp duty payable by open market insurers in respect of each insured life covered. Each year, the Health Insurance Authority, HIA, prepares the Report of The Health Insurance Authority to the Minister for Health, in accordance with Section 7E (1)(b) of the Health Insurance Acts, 1994 – 2012. These reports set out the HIA’s evaluation and analysis of information returns supplied by insurers, together with its recommendations for Risk Equalisation Credits and associated Stamp Duty to apply for the following year. The most recent report was produced in November 2012 in advance of the introduction of the current permanent scheme.
The rates that apply are not percentage based. Instead a flat rate of €290 for lower cover or non-advanced plans and €350 for higher cover or advanced plans applies to all policies. It is important to note that the measures contained in the RES are designed to result in no overall increase of premiums paid in the market. Its purpose is to spread the risk more evenly between the healthy and the less healthy, as well as the old and the young and to target credits where they are needed most, i.e. to the older and less healthy members. It should also be noted that the levy is placed on private health insurance providers for each insured individual, and not on the customers themselves. Later this month, the HIA will submit its report to the Minister with recommendations in respect of revised Risk Equalisation Credits to apply from 1 January 2014.
617. Deputy Tom Fleming asked the Minister for Health the current waiting list and estimate of costs for medical and surgical appliances in County Kerry; if he will itemise the various categories and the approximate waiting time for the various items; and the total amount of funding available for 2013 for these appliances. [41092/13]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
618. Deputy Seán Kyne asked the Minister for Health if he will report on the progress on filling the diabetic nursing posts to serve the area under the remit of the Galway-Roscommon hospitals group, the establishment of which is vital for the introduction of insulin pump therapy, particularly for paediatric patients; and if he will make a statement on the matter. [41107/13]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
619. Deputy Seán Kyne asked the Minister for Health if, despite the opposition to such a measure which is driven by commercial interests and a complete unwillingness to accept the growing scientific and medical evidence which demonstrates that sugar, in various processed forms, is responsible for the substantial increase in obesity-related health problems, he is committed to introducing measures to encourage healthier eating and encourage business to reduce such harmful ingredients in products; and if he will make a statement on the matter. [41110/13]
Amharc ar fhreagraComprehensive, multi-level approaches are required to address the obesity epidemic. For this reason, I established a Special Action Group on Obesity, SAGO, with which I meet regularly to progress the obesity prevention agenda. SAGO is concentrating on a range of measures and initiatives to help reverse the growing prevalence of obesity in the Irish population. Revised Healthy Eating Guidelines were launched in 2012 which will help inform people about the food and drink choices required for a healthy lifestyle and set out in plain and simple language the food servings the Irish population need to consume to maintain health and well-being. A Health Impact Assessment on the health and economic aspects of introducing a sugar sweetened drinks tax was completed and presented to me. This year, SAGO established a sub-committee to investigate and develop a range of options to support healthy eating, including considerations on high fat, high salt and high sugar foods and drinks from the top shelf of the food pyramid. The report on measures recommended is at final draft stage and will be presented to me in the near future.
620. Deputy Denis Naughten asked the Minister for Health further to Parliamentary Question No. 906 of 11 June 2013, if he will provide an answer to the question; if he will make available the information provided to his Department by the Health Service Executive on 27 June; the reason for the delay in making this information available; and if he will make a statement on the matter. [41127/13]
Amharc ar fhreagraSnapshots of the level of prescribing of benzodiazepines and z-drugs were taken In November 2011, March 2012 and November 2012, and provided to all GMS GPs in February 2012, July 2012 and April 2013 respectively. Three pieces of information were provided to them: the prescribing frequency standardised for gender/panel profile of benzodiazepines and z-drugs; the number of patients who were presenting prescriptions for periods of more than 3, 6 and 12 months; and a pictorial representation of their individual prescribing against the national profile.
Where a GP asked for further information on receipt of details in February 2012, the HSE provided to that GP a “pharmacist reported” dispensing history over six months. Some 74 GPs were over two standard deviations from the mean. Separate communication was dispatched in May 2012 to four GPs who had not reverted previously to the HSE and who were over four standard deviations above the mean. In relation to the snapshot of March 2012 provided to all GMS GPs by letter in early July 2012, the HSE also wrote separately to 16 GPs whose prescribing rate was over 3 standard deviations from the mean enclosing the dispensing records for the four months up to the end of May 2012.
In its most recent communication to GPs in April 2013, the HSE drew attention of the GPs to the value of comparing the November 2012 and 2011 snapshots, anticipating that this would allow individual GPs to self-audit their practice effectively in the coming months and, where appropriate, make practise adjustments. The HSE also drew attention to the number of patients who were newly initiated and who should be closely monitored to avoid inadvertent dependence. The HSE is considering now whether it is appropriate to engage in more targeted “face to face intervention” and how such primary care intervention can be effectively introduced within the Medicines Management Programme
Since the initiative undertaken by the HSE, both the mean and standard deviation have reduced meaning that prescribers are coming increasingly in line with each other. While there is a small increase in the number of individual outliers, this is possibly because a reduced mean and standard deviation tend to highlight individual outliers. It is also important to note that some of these GPs have communicated to the HSE valid and reasonable rationales for their higher prescribing than their peers.
A comparison of the level of prescribing of benzodiazepines and z-drugs between November 2011 (when GPs were first written to) and November 2012 shows a reduction in items dispensed by community pharmacists of 1,427 items per quarter million patients, from 15,970 to 14,543 items. While it is important to remember that this is a quality prescribing initiative rather than a cost cutting measure, estimated savings per annum of €1.57 million were achieved.
621. Deputy Finian McGrath asked the Minister for Health if he will ensure that a person (details supplied) with a disability does not lose their transport service. [41221/13]
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.
