Written Answers Nos. 35-40
35. Deputy Seamus Healy asked the Minister for Health in view of the recent statements by four large Dublin hospitals regarding the adequacy of budgets and the safety of service and statements by senior health officials that the 2014 health budget represents a €1 billion cut, his views on the adequacy and safety of the health service; and if he will make a statement on the matter. [48059/13]
Amharc ar fhreagraThe issues raised by the hospitals will be considered in the context of the HSE Service Plan for 2014. I wrote to the HSE last Thursday 31 October to confirm that the Executive has until 15 November to submit its Service Plan. In that letter, I also conveyed to the Executive that my overriding priority is patient safety, with the next priority being to treat patients in as timely a fashion as possible. Clearly 2014 will be a very challenging year for the health services. In meeting this challenge, the goal, wherever possible, is to cut the cost of services rather than the level or quality of the services delivered, and to accelerate the pace of reform. The reform programme for hospitals, as set out in Future Health, aims to deliver more responsive and equitable access to services for all patients; to organise public hospitals into more efficient and accountable hospital groups, which can deliver better patient care for less cost; and to ensure that smaller hospitals continue to play a key role.
It can be difficult to achieve the necessary reform while hospitals exist in isolation from one another. The formation of Hospital Groups, which I announced last May, will allow each Group to manage their own affairs and operate with maximum autonomy. It will also ensure that the treatment required by patients is received at the most appropriate level in the most appropriate and safest setting. I have now appointed Chairs to all seven Hospital Groups, the process of recruitment of CEOs has commenced and the process of establishing a Strategic Advisory Group to oversee the reorganisation of services by Hospital Groups is underway. The overall aim is to provide efficient and effective care, as close to the patient’s home as possible, with a view to improved health outcomes and satisfaction for patients.
36. Deputy Joe McHugh asked the Minister for Health the actions he has taken to ensure that services at Letterkenny General Hospital will be restored following last summer's flash flooding; and if he will make a statement on the matter. [47942/13]
Amharc ar fhreagraOn Friday 26 July 2013, 40% of the floor space and 70% of the functional capacity of Letterkenny General Hospital was lost. With the rapid activation of the Hospital's Major Emergency Plan, patients and staff were safely evacuated, arrangements made with other hospitals and the NAS to ensure that appropriate treatment would remain available to patients and a massive clean-up operation was commenced within hours. I am particularly grateful to the Western Trust of Northern Ireland, to Altnagelvin, Enniskillen, Sligo and Galway hospitals for their assistance and to the staff of Letterkenny General Hospital who were willingly redeployed to some of these locations to assist with patient care.
A key factor in re-establishing services was the replacement of radiology services, through the provision of a mobile CT and modular digital radiology facilities in the carpark, the outsourcing of MRI and the restoration of ultrasound capability. Modular units were also sourced for the reprovision of ED services and a phased re-opening commenced 3 weeks after the flood.
Works on Gynaecology ambulatory care were commenced within weeks and are now complete; this service has been re-commissioned. A building has been identified in the town centre for the provision of outpatient clinics; it is currently being fitted out. Work on the hospital Pharmacy has commenced and is due for completion in February 2014. Contractors have been on site from 11 November to work on the Emergency Department and Acute Medical Assessment Unit and these are to be completed in March 2014. A Multipurpose Radiology Interventional Suite, which will have greater functionality than the previous radiology facility at the hospital, has been approved by the national capital steering group and is at design stage. Project teams have also been established for services in those areas which were significantly impacted by the flooding, such as CCU, Cardiac investigations, medical records, laboratories, mortuary and staff facilities.
37. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will carry out an immediate review of the adequacy of ambulance cover in the north east region and across the State in view of the recent incident when a stroke victim in Navan, County Meath, had to wait 40 minutes for an ambulance and a similar recent incident in County Cavan; and if he will make a statement on the matter. [48065/13]
Amharc ar fhreagraIn relation to the specific query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.
38. Deputy Denis Naughten asked the Minister for Health his plans to improve ambulance coverage and response times throughout County Roscommon and east Galway; and if he will make a statement on the matter. [47946/13]
Amharc ar fhreagraIn relation to the specific query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.
39. Deputy Noel Harrington asked the Minister for Health if he will request the civil registration service section of the Health Service Executive to notify the medical card section of the HSE of all deaths registered with them; if this requires legislation to be passed; and if he will make a statement on the matter. [47948/13]
Amharc ar fhreagraThe HSE already has a system in place with regard to notifications of the death of medical card holders.
In 2012, the HSE introduced data sharing with the Death Events Publication Service (DEPS) operated by the General Register Office (GRO). Death events notifications (DEPS) are received by the HSE from the GRO on a weekly basis and loaded to the PCRS payment systems. Medical card eligibility is removed immediately and payments to the GP are ceased immediately.
40. Deputy Billy Kelleher asked the Minister for Health the measures he will put in place to support the health insurance market; and if he will make a statement on the matter. [48048/13]
Amharc ar fhreagraMy Department oversees the maintenance of a competitive and sustainable private health insurance market, under the provisions of the Health Insurance Acts 1994 to 2012, and monitors developments on an ongoing basis, to ensure that the market is regulated appropriately in the transition to a market-based Universal Health Insurance system. There are a number of separate measures currently underway to ensure sustainability of the market, which include cost control initiatives, revised Risk Equalisation Credits to protect community-rated health insurance for all and the ongoing consideration of appropriate regulatory measures necessary to support the market.
With regard to health insurance costs, 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. I want all insurers to address the base cost of their claims and to see all procedures provided in an appropriate, safe, healthcare setting. Work on this review process is progressing well and I expect to receive an initial report from the Chair very shortly.
I am committed to progressively increasing the extent to which risk equalisation compensates for the costs of insuring older customers. A permanent Risk Equalisation Scheme (RES) was introduced with effect from 1 January, 2013. Prior to the introduction of the permanent RES, an Interim Scheme of Age-Related Tax Credits and Community Rating Levy had been in operation from 2009 to 2012. Yesterday I received Government approval to the immediate publication of the Health Insurance (Amendment) Bill 2013, which sets out revised risk equalisation credits and the corresponding stamp duties that will apply under the Risk Equalisation Scheme from 1 March 2014. Different risk equalisation credits will apply to 'advanced' and 'non-advanced' health insurance policies. There will be no change to the stamp duty payable on lower cost 'non-advanced' health insurance, which will help to ensure that the option of lower cost health insurance remains available. The stamp duty for health insurance products providing 'advanced' cover will increase from €350 to €399 per adult and from €120 to €135 per child. This will help direct support, in the form of higher risk equalisation credits, where it is needed most and will subsidise health insurance for the most vulnerable patients. Under the Health Insurance Acts, I set the rates for risk equalisation credits and the Minister for Finance sets the rate of stamp duty require to fund those credits.
The decreasing membership of the health insurance market, in addition to the adoption of industry-wide strategies, represents a significant challenge to the long term continuation of community rating and sustainability of the market. In particular, the proliferation of plans available on the market and the increasing segmentation of the market due to strategies adopted by the commercial providers is of growing concern to me. I am open to considering any practical measures or initiatives which help to maintain affordability, and provide greater clarity, for consumers seeking to purchase health insurance. I intend to address this further in the New Year in order to simplify things for the consumer and will consider the regulatory measures necessary to ensure a smooth transition from the current system of a voluntary private health insurance market to a Universal Health Insurance system.
