Written Answers Nos. 1136-1155
1136. Deputy Terence Flanagan asked the Minister for Health the measures his Department is taking to help solve the suicide epidemic here particularly among young persons; and if he will make a statement on the matter. [46344/13]
Amharc ar fhreagraDealing with the current high levels of suicide and deliberate self harm is a priority for this Government. Reach Out our National Strategy for Action on Suicide Prevention makes a number of recommendations in relation to fast track referrals to community-based mental health services, effective response to deliberate self-harm, training, reducing stigma and promoting positive mental health, initiatives aimed at helping young men and research.
Consequently, the HSE's National Office for Suicide Prevention (NOSP) has developed a range of initiatives to support people who are suicidal and also supporting their families, friends and peers in recognising and responding appropriately to signs of emotional distress and suicidal thoughts.
Since 2011, funding for the NOSP has increased significantly from €4 million in 2011 to €7.9 million in 2013. This increase in funding along with the additional investment in mental health has led to work being progressed on almost every recommendation in Reach Out including the following actions:
- Supporting over 40 individual organisations and programmes both internal and external to the HSE. This increase in funding has focused on resourcing front line services for persons who are in emotional distress, who have engaged in self harm or who have been bereaved through suicide. Many of these services are being delivered by the Non-Governmental Organisation sector with direct funding from the NOSP, including Pieta House, Samaritans, Console etc.
- Working to build the capacity of frontline services providers and communities to respond to suicide through the delivery of a number of suicide prevention training programmes; to date over 42,000 participants have completed the ASSIT and safeTALK programmes. In addition, the NOSP has invested significantly in the development of Dialectical Behavioural Therapy (DBT) services across community mental health teams.
- The NOSP resourced the Irish College of General Practitioners to implement a training programme on suicide prevention for GPs and general practice staff. International evidence highlights GP training in depression and the management of suicidal behaviour as critical to reducing suicide rates.
- The development of the National Clinical Care Programme for Self Harm in Emergency Departments and the SCAN (Suicide Crisis Assessment Nurse) service.
- The delivery of two effective social marketing campaigns on mental health that have changed public attitudes and behaviours related to help seeking and mental health. The NOSP is also working to develop a new national communication strategy for suicide prevention.
- The NOSP is currently working with the Irish Association of Suicidology and other partners to develop national standards for service providers that will improve the quality and safety of funded services.
- The NOSP in partnership with the Department of Education and Skills developed the Well-Being in Post Primary Schools Guidelines for Mental Health Promotion and Suicide Prevention. These guidelines have been distributed to schools and health services on a nationwide basis.
- The HSE is implementing the Counselling in Primary Care programme. This national service was launched in 2013 and is delivering counselling to medical card holders at a primary care level.
The NOSP has been reviewing its current activities to make the most of our available resources, including looking at best practice internationally to inform evidence-based policy decisions. The review will result in a new Framework which will build on work already undertaken under Reach Out. Its aim will be to support population health approaches and interventions that will assist in reducing the loss of life through suicide. This renewed focus will provide for improved coordination and integration of services to ensure that pathways of care for persons at risk of suicide or in suicidal crisis can be accessible, acceptable and available.
1137. Deputy Billy Kelleher asked the Minister for Health if he will ensure that the recommended and approved wheelchair is provided in respect of a person (details supplied) in County Dublin without further delay; and if he will make a statement on the matter. [46355/13]
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.
1138. Deputy Tom Fleming asked the Minister for Health if he will consider extending the number of hospitals offering exercise rehabilitation as per proposal by chronic obstructive pulmonary disease Ireland as patients with serious lung conditions would benefit greatly from supervised exercise in our hospitals; if he will take into consideration that 440,000 patients have this lung condition and the very real difference supervised exercise will have on their health and well-being; and if he will make a statement on the matter. [46362/13]
Amharc ar fhreagraThe exercise programme referred to forms part of a structured Pulmonary Rehabilitation programme. The HSE COPD Clinical Care Programme published a Model of Care for Pulmonary Rehabilitation services in 2010. Health policy in Ireland is committed to service reform that is moving service provision away from the current hospital centric model of care towards a new model of integrated care which treats people at the lowest level of complexity and is as close to home as possible. Depending on their disease trajectory most patients are suitable to avail of community services at some stage in their illness, and therefore pulmonary rehabilitation is being provided by community as well as acute services. In order to improve access to pulmonary rehabilitation programmes the HSE has in recent years included targets in its service plans for both settings.
In 2012 the annual target was for 25 % of centres, regardless of the setting (acute hospitals and community areas combined), to have access to pulmonary rehabilitation. It was reported in June of that year that 56% of centres provided a service.
In 2013 the target was changed from combined to individual services; 25 acute hospitals and 20 local health areas were required to provide access. Recent reports indicate that currently 25 acute hospitals and 15 local health areas are providing access.
For 2014 an increased target of 28 hospitals and 25 local health areas has been proposed.
1139. Deputy Michael McGrath asked the Minister for Health if he will provide information regarding public hospital waiting lists for surgery (details supplied). [46363/13]
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 to investigate the situation and respond directly to the Deputy in this matter.
1140. Deputy Michael McGrath asked the Minister for Health if he will provide information regarding public hospital waiting lists (details supplied). [46364/13]
Amharc ar fhreagraFor 2013, a maximum waiting time target of 12 months has been set for a first time consultant-led outpatient appointment and this is reflected in the HSE Service Plan. The SDU and the NTPF are working closely with hospitals towards achievement of the maximum waiting time.
Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she would be in the best position to take the matter up with the consultant and hospital involved. In relation to the specific hospital appointment query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.
1141. Deputy Noel Grealish asked the Minister for Health the reason a general practitioner prescribes medication that is eltroxin or lipitor which only comes in certain strengths, for example 20mg, 40mg, 60mg and 80mg, but a doctor prescribes a dosage of 30mg, which requires a person to purchase two packets; pharmacies are charging for two items under the prescription; his plans to address this situation; and if he will make a statement on the matter. [46367/13]
Amharc ar fhreagra1162. Deputy Éamon Ó Cuív asked the Minister for Health if his attention has been drawn to the fact that where a prescription for one medication requires two tablets of different dosage these different dosage tablets are being considered as separate items for the purpose of the prescription charge for medical card holders; and if he will make a statement on the matter. [46552/13]
Amharc ar fhreagraI propose to take Questions Nos. 1141 and 1162 together.
Currently, medical card holders are required to pay a €1.50 charge per item for medicines and other prescription items supplied to them by community pharmacists, subject to a cap of €19.50 per month for each person or family. Prescription charges do not apply to children in the care of the HSE or to methadone supplied to patients participating in the Methadone Treatment Scheme.
Where a drug or medicine is required to be dispensed in different strengths and different containers, a prescription charge applies to each item.
1142. Deputy Noel Grealish asked the Minister for Health the amount of money owed to his Department by other EU Countries under the European Health Insurance Card Scheme; the efforts being taken to recoup the money; the amount of money owed by his Department to other countries under the scheme; and if he will make a statement on the matter. [46368/13]
Amharc ar fhreagraThe amount owed by Ireland to other States arising from treatments received by persons holding Irish issued European Health Insurance Cards (EHIC) is in the region of €17 million. Ireland has had waiver agreements with a number of member states whereby such costs were mutually waived. Many of these agreements have been terminated in recent years. In view of this and of the increased numbers availing of services since the EU was expanded the HSE is currently working on systems to capture EHIC costs so as to enable it to commence the issuing of claims for reimbursement of costs to the relevant competent states in the near future.
I would like to add that Ireland's primary interaction has been, and continues to be, with the United Kingdom with whom it operates a bilateral healthcare reimbursement agreement, covering such persons as temporary visitors between the two countries (EHIC), pensioners of one country and their dependants residing in the other country, and the dependant families of persons employed in the other country. Under the terms of the agreement net liability between the two countries is calculated on a lump sum basis rather than an individual basis. The amount received by Ireland from the United Kingdom in respect of reimbursement of healthcare costs provided under the relevant EU Regulations was €220 million in 2012.
1143. Deputy Patrick O'Donovan asked the Minister for Health if drugs and other medical supplies, provided on prescription to medical card holders are at an agreed cost between the Health Service Executive and the manufacturers or suppliers; if the same agreements in price exist under the supply of medications for the drug payment scheme; and if he will make a statement on the matter. [46382/13]
Amharc ar fhreagraThe prices paid by the HSE for products included on the list of reimburseable items apply to both the General Medical Services Scheme and the Drugs Payment Scheme.
1145. Deputy Tom Fleming asked the Minister for Health if he will expedite a medical card review and issue a full medical card in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [46388/13]
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.
1146. Deputy Tom Fleming asked the Minister for Health if he will intervene and examine a medical card appeal in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [46393/13]
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.
1147. Deputy Bernard J. Durkan asked the Minister for Health the progress to date in determination of appeal for medical card in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [46399/13]
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.
1148. Deputy Sean Fleming asked the Minister for Health when dental checks will be carried out for children in a school (details supplied) in County Laois; if students in third class will be covered by the check; and if he will make a statement on the matter. [46400/13]
Amharc ar fhreagraThe HSE is responsible for providing dental care to schoolchildren. The matter has, therefore, been referred to the HSE for attention and direct reply to the Deputy.
1149. Deputy Aodhán Ó Ríordáin asked the Minister for Health if he will provide in tabular form, the numbers of doctors employed in each hospital nationally; if he well provide this figure broken down by grade; and if he will make a statement on the matter. [46403/13]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply.
1150. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will reverse the proposed cuts to local drugs task forces; if he will detail the approach which will be taken when allocating the budget for 2014 for local drugs task forces; if due consideration will be applied to case load-client numbers; the budget which will be allocated to the Finglas-Cabra drugs task force for 2014; and if he will make a statement on the matter. [46424/13]
Amharc ar fhreagra1175. Deputy Dessie Ellis asked the Minister for Health the way he intends to distribute cuts to local drug task forces. [46664/13]
Amharc ar fhreagra1225. Deputy Dessie Ellis asked the Minister for Health if his attention has been drawn to the fact that the Finglas-Cabra Drug Task Force is the lowest funded of all the LDTF's in the Dublin region; the devastating effects that further cuts will have on its ability to continue delivering services; and if he will make a statement on the matter. [46868/13]
Amharc ar fhreagraI propose to take Questions Nos. 1150, 1175 and 1225 together.
In line with the National Drugs Strategy, the Government is committed to continuing support for initiatives to tackle the drug problem. No decisions have been taken yet in relation to the allocations to Drugs Task Forces for 2014. In line with previous years, funding will be focused on areas where there is the highest concentration of drugs activity. It is anticipated that Drugs Task Forces will be informed of their allocations later in the year.
1151. Deputy Maureen O'Sullivan asked the Minister for Health if he will list all the non-core payments of middle and senior management staff (non-medical) in the Health Service Executive in 2012, non-core meaning overtime, bonuses, including sponsored trips, hospitality events, benefits-in-kind or any other payments not defined as basic; and if he will make a statement on the matter. [46426/13]
Amharc ar fhreagraThe Health Sector Consolidated Salary Scales, which are prepared and issued by my Department, set out the rates of pay and allowances for staff in the public health service. These scales were revised in July 2013 to take account of the reductions provided for under the Financial Emergency Measures in the Public Interest Act 2013. Public service pay policy requires that the salary scales must be strictly adhered to and no employee should receive remuneration in the nature of pay and allowances of an amount greater than the amount prescribed. The remuneration arrangements for health service personnel are subject to approval by the Minister for Health, with the consent of the Minister for Public Expenditure and Reform.
In accordance with Section 25(3) of the Health Act 2004, the HSE has prepared a Code of Standards and Behaviour which applies to all employees and which, in line with normal public service practice, includes appropriate provisions regarding the receipt of gifts or benefits from third parties.
I have asked the HSE to respond directly to the Deputy with the more detailed information requested.
1153. Deputy Mattie McGrath asked the Minister for Health if his attention has been drawn to the fact that it is taking almost two months for the medical card office to complete a review of a decision; if his attention has been further drawn to the difficulties that this is causing persons with medical needs; the efforts he has made to address these waiting times; if he will ensure that a satisfactory turnaround time is adhered to by the medical card office; and if he will make a statement on the matter. [46457/13]
Amharc ar fhreagraThe HSE Primary Care Reimbursement Service has, in the period since the centralisation of medical card processing, (1 July 2011 - to-date) received a total of 1,111,023 medical card/GP visit card applications. This total includes both new applications and renewal applications. In this period, 1,049,388 applications have been processed and decisions issued to the applicants concerned. This figure represents an overall 98.52% completion rate for the total number of applications received. Of the applications processed, 90.81% of these applications were processed within 15 days of the application having been received by the HSE.
A total of 34,065 review notifications were issued by the HSE in the month ending 30 September 2013. There are currently 16,483 returned applications (as at 01/11/2013) in process. Persons will continue to have eligibility extended pending the outcome of the review assessment, as will their dependants, if applicable, provided:
- they have returned the review form within the time specified, and
- they are engaging with the HSE in enabling their review assessment to complete.
If a person is a new applicant presenting with an urgent medical need or an urgent medical need in respect of their dependant(s), the HSE will facilitate a prioritised assessment of eligibility, once the applicant has provided all the necessary information.
Again, the HSE is currently operating at a 90.81% completion rate achieved within 15 days of applications being received to the HSE. Applications that remain in process outside of this period of time are facilitated so that eligibility is either retained or assessment prioritised without delay to the applicant who is engaging with the process.
1154. Deputy Billy Kelleher asked the Minister for Health if people over 70 years are being requested as part of the medical card review process to place a valuation on their family home; the reason this is relevant; if this change will apply to every review and not just the over-70s; and if he will make a statement on the matter. [46460/13]
Amharc ar fhreagraFor the purposes of assessing income for an over-70s medical card, income from property (whether a family home, a holiday home or any other property) will only be included if the property is generating a rental income. The income to be assessed will be the actual rental income less any cost necessarily incurred associated with the rental of the property and such costs may include insurance premium, mortgage repayments, maintenance, etc.
Under the standard means assessment medical card, income from property is taken as the gross income received less any cost necessarily incurred associated with the property and such cost may include insurance premiums, mortgage repayments, maintenance etc.
Where land/buildings (other than the family home that is being lived in) are not being used but are capable of being leased or sold, then the following options can be applied to determine income for medical card/GP visit card eligibility assessment purposes, with the more beneficial option applying to the applicant:
- Notional assessment of the rental/lease “going rate” for the area.
- Assessment of capital value worked out on the basis of the formula set out in the Medical Card/GP Visit Card National Assessment Guidelines.
In cases where the latter option is applied, the applicant will be requested to provide a valuation for the property concerned. The valuation provided will then be subject to the formula to determine the amount to be taken into account as weekly income from this source for medical card/GP visit card eligibility assessment purposes.
1155. Deputy Lucinda Creighton asked the Minister for Health if he will provide further details on the figures regarding the health insurance tax relief changes impact that he referred to at the Health Committee meeting on 17 of October 2013 in response to questioning from this Deputy; if he favours a reversal of the Department for Finance's restriction on tax relief for health insurance; if the decision by the Department for Finance to restrict the tax relief on health insurance could lead to more persons forgoing their health insurance; if the changes to tax relief for health insurance will damage his efforts to encourage persons to take up private health insurance and introduce universal health insurance; and if he will make a statement on the matter. [46466/13]
Amharc ar fhreagraIn Budget 2014, the Minister for Finance announced a cap on tax relief on premia for private health insurance, whereby tax relief for medical insurance premiums will be restricted to the first €1,000 per adult and the first €500 per child insured. Any portion of premium paid in excess of these ceilings will no longer qualify for tax relief. The tax relief at source provided to policy holders has been a significant subsidy to the actual cost of premiums charged by health insurers. I am pleased that the Minister for Finance did not remove tax relief in its entirety and has still allowed 20% tax relief on polices up to €1000 gross for adults and €500 for children.
It is also important to note that the measure is projected to save the Exchequer €94m in 2014 and €127m in a full year. Pricing of insurance premiums is a matter for insurers. In terms of potential increases in premia that might arise from this measure, it is up to each insurer to contain its own costs and to compete actively on the basis of price.
With regard to health insurance costs generally, I have consistently emphasised the vital need to address the rising cost of private health insurance and the necessity for all private health insurers to address their cost base aggressively. Last year, I established the Consultative Forum on Health Insurance to generate ideas to address health insurance costs. In June of this year, I appointed an independent Chairperson, Mr. Pat McLoughlin, who will work with my Department and the insurers on a review process to give effect to real cost reductions in the private health insurance market. Work on this review process is progressing well and I expect to receive an initial report from the Chair very shortly.
I will continue to focus strongly on addressing costs in the private health insurance market, to keep insurance as affordable as possible for people who wish to avail of private health insurance. 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.
