Written Answers Nos. 574-594
574. Deputy Róisín Shortall asked the Minister for Children and Youth Affairs the number and location of all child detention places; the average monthly occupancy rates in each case; the number of occasion over the past two years when no place was available for a minor referred by the Courts; and if she will make a statement on the matter. [50860/13]
Amharc ar fhreagraThere are currently 3 children detention schools in the State: Trinity House, Oberstown Boys and Oberstown Girls schools. All are located on the same campus at Oberstown, near Lusk, Co. Dublin. These schools currently accommodate girls under 18 years of age and boys under 17 whose detention is ordered by the Courts on remand or on conviction for criminal offences.
The current legal detention capacity on the Oberstown campus comprises 24 male detention places in Trinity House School, 8 female detention places in Oberstown Girls School, and 22 male detention places in Oberstown Boys School. In the latter case, this was increased from 20 detention places with effect from 1 October 2013. However, only 16 of the certified 24 male places in Trinity House School are currently available. The Irish Youth Justice Service, which is based in my Department, is currently in discussions with management, staff and unions on the Oberstown campus on initiatives to reconfigure the detention places and staff resources, in order to address the increased demand for male detention places from the courts.
There were a small number of places available at most times in all 3 children detention schools in the period November 2011-February 2013. However, since March 2013, the occupancy of Trinity House School and Oberstown Boys School has been at maximum on most occasions, due to the high level of demand from the courts for male detention places. This has meant that any places that become available have been reallocated within a short period of time. Based on daily occupancy reports from the Irish Youth Justice Service in the period 1 March - 25 November 2013, it is estimated that there were 108 days where there was a male detention place available in either Trinity House School or Oberstown Boys School. On most other days, both sites were at maximum occupancy and no further places were available. This estimate excludes weekends and public holidays. In the case of Oberstown Girls School, there have been no issues relating to a shortage of female detention places in the past 2 years.
There is daily coordination between the 24 hour on - call bed management service operated by the Irish Youth Justice Service for the Oberstown campus, the Probation Service, an Garda Síochána and the Courts. Updated information is available at any time on the occupancy level in Oberstown. There are long standing arrangements whereby the other stakeholders involved cooperate with this system and enquiries received may relate to either the general availability of detention places or the availability of a place for a particular young person. It is also important to note that while both Trinity House School and Oberstown Boys School are operating at maximum capacity on most occasions at present, there is still a service being provided for a significant number of young people in contact with the criminal justice system. There were 23 boys in detention on committal orders on 1st March 2013 and there were 12 boys on remand orders on the same date. I am advised that in the period 1 March - 25 November 2013, there were a total of 88 boys remanded in custody and 29 boys committed to a period of detention to either Trinity House School or Oberstown Boys School.
In terms of the overall capacity of the Oberstown site, I have recently confirmed that a main contractor and a number of sub-contractors have now been appointed to the Oberstown development project and construction of the new facilities started on site on 23 September 2013. On 14 October 2013 I officially launched the construction project with the event taking place on the campus in Oberstown.
The timeline for the project will see the first three new residential units available in the third quarter of 2014, which will be used to facilitate the transfer of responsibility for 17 year old boys from adult prison facilities (currently St. Patrick's Institution) to the Oberstown campus and will deliver on the Government's commitment to end the practice of detaining children in St. Patrick's Institution. An additional three residential units, to be delivered in 2015, will be used to replace existing accommodation on the Oberstown campus which has reached the end of its useful life. The development will also provide associated education, recreation, security and other ancillary facilities and will result in all detention services for children being delivered in a single location, maximising the scope for ensuring best practice standards using the children detention school model and for operational efficiency. The project is due to be fully complete by the third quarter of 2015.
575. Deputy Arthur Spring asked the Minister for Health if an applicant for the over-70s medical card who is a PAYE employee is permitted a reduction in the means test for travel-to-work costs incurred by that applicant; and if he will make a statement on the matter. [50158/13]
Amharc ar fhreagraAssessment for eligibility for an over -70s medical /GP visit card is based on gross income only. The general Medical Card/GP Visit scheme assesses medical card/GP visit card eligibility based on an applicant(s) net assessable household income less assessable outgoing expenses. The general scheme is not age dependant and is open to persons of all ages ordinarily resident in the state. The medical card/GP visit card qualifying income limits under the general scheme are lower than those under the over-70s scheme.
Under the general scheme of assessment, outgoings in relation to travel costs to and from work are allowable expenses. The full cost of public transport is allowed for travel to and from work. Where public transport is not available or suitable and, if a car is required, reasonable travel costs to cover mileage are allowed. Full details can be found in the HSE's Medical Card/G.P. Visit Card National Assessment Guidelines
576. Deputy Mary Lou McDonald asked the Minister for Health if his attention has been drawn to allegations of abuse while a patient was in a hospital (details supplied) in Dublin 7; and the action he will take regarding same. [50191/13]
Amharc ar fhreagraThe Minister for Health received representations from a public representative earlier this year on behalf of the named individual. However, as there was insufficient information in the correspondence to allow the Department or the HSE to follow-up on the complaint, the public representative was requested to arrange with the individual for the provision of additional information into the nature of the specific complaint, with dates locations etc. To date, a reply has not been received.
577. Deputy Seán Crowe asked the Minister for Health if his attention has been drawn to the major epidemic of opiate drugs being taken in midland towns, namely Athy, County Kildare; and his plans to open a new drug treatment clinic, including methadone treatment, in County Kildare. [50586/13]
Amharc ar fhreagraThe HSE provides opioid substitution (mainly methadone) in a number of treatment settings to meet the needs of individual drug users. These settings include:
- primary care through GPs and community pharmacies;
- treatment centres where opioid substitution treatment is dispensed on site; and
- residential rehabilitation facilities.
Currently there are two Level II Community GPs and 6 Level I Community GPs in Kildare who provide treatment to a total of 105 patents. There are 25 people on a waiting list for treatment in Kildare and the GP coordinator meets with local GPs regularly with a view of arranging treatment. The HSE Addiction Service has three counsellors for Kildare who provide services in Kildare Town, Kilcullen, Athy, Newbridge, Maynooth, Celbridge, Leixlip and Kilcock. These services can be accessed by persons from outside of these locations.
In addition to the above, the HSE provide Outreach Services, which include a harm reduction and needle exchange programme in Newbridge and a mobile Outreach Service in Naas. In response to the demand for treatment in Kildare, the HSE Addiction Service Dublin Mid Leinster is in the early stages of developing a plan to provide treatment services from a central location in 2014. This centre will provide a range of services by a multidisciplinary team.
578. Deputy Ciarán Lynch asked the Minister for Health the value of services provided to the public by his Department and entities reporting to his Department where a payment is accepted by debit or credit card; the percentage of additional charge that is applied to such transactions under the merchant agreement; the total value of the additional charge in respect of debit and credit cards in 2012; if any portion of the additional charge accrued to his Department; and if he will make a statement on the matter. [50136/13]
Amharc ar fhreagraPayments to my Department are made by cheque, postal order or electronic funds transfer to the Department's bank account at the Central Bank. The Department does not have a merchant account. The information requested by the Deputy in relation to agencies operating under the aegis of this Department is being collated and will be forwarded to the Deputy when it is finalised.
579. Deputy Michael McCarthy asked the Minister for Health the amount allocated to a school (details supplied) in County Louth for physical, occupational and speech therapy for 2009, 2010, 2011, 2012 and to date in 2013; and if he will make a statement on the matter. [50164/13]
Amharc ar fhreagraThe school referred to by the Deputy is a special national school operated by the St. John of God North East Services under the Department of Education and Skills. The provision of health related supports to the school 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.
580. Deputy Terence Flanagan asked the Minister for Health if he will provide details of the proposed primary care centre for Coolock/Darndale; the proposed details of the project, location, and budget; when it will be completed; and if he will make a statement on the matter. [50168/13]
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 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.
The HSE and NDFA have completed an indicative Public Sector Benchmark (PSB) for the overall project. Considerable work on the project has been completed by the HSE and its appointed design teams and technical advisors. The HSE has submitted a planning application for this location. It is expected that the NDFA will proceed to market with the PPP projects very shortly.
581. Deputy Michael Healy-Rae asked the Minister for Health the reason for higher costs here, even for Irish manufactured drugs, compared to other countries [50177/13]
Amharc ar fhreagraThe prices of drugs vary between countries for a number of reasons, including different prices set by manufacturers, different wholesale and pharmacy mark-ups, different dispensing fees and different rates of VAT. The State has introduced a series of reforms in recent years to reduce pharmaceutical prices and expenditure. These have resulted in reductions in the price of thousands of medicines. Price reductions of the order of 30% per item reimbursed have been achieved between 2009 and 2013; the average cost per items reimbursed is now running at 2001/2002 levels.
A major new deal on the cost of drugs in the State was concluded with the Irish Pharmaceutical Healthcare Association (IPHA) in October 2012. It will deliver a number of important benefits, including
- significant reductions for patients in the cost of drugs,
- a lowering of the drugs bill to the State,
- timely access for patients to new cutting-edge drugs for certain conditions, and
- reducing the cost base of the health system into the future.
The IPHA agreement provides that prices are referenced to the currency adjusted average price to wholesaler in the nine EU member states. The prices of a range of medicines were reduced on 1 January 2013 in accordance with the agreement. The gross savings arising from this deal will be in excess of €400 million over 3 years. €210 million from the gross savings will be available to fund new drugs.
A new agreement was also reached with the Association of Pharmaceutical Manufacturers in Ireland (APMI), which represents the generic drugs industry. Since 1 November 2012, the HSE only reimburses generic products which are priced at 50% or less of the initial price of an originator medicine. This represents a significant structural change in generic drug pricing and should lead to an increase in the generic prescribing rate. It is estimated that the combined gross savings from the IPHA and APMI deals will be in excess of €120 million in 2013 with an additional €28 million saved in 2014.
The Health (Pricing and Supply of Medical Goods) Act 2013, which came into operation on the 24th of June, introduces a system of generic substitution and reference pricing. This legislation will promote price competition among suppliers and ensure that lower prices are paid for these medicines resulting in further savings for both taxpayers and patients. It is estimated that this system will yield €50 million in savings in 2014. Under the Act, the Irish Medicines Board (IMB) is responsible for the assessment for interchangeability of medicines. Generic substitution will be introduced incrementally with the IMB prioritising those medicines which will achieve the greatest savings for patients and the State. The Board is in the process of reviewing an initial 20 active substances, which equates to approximately 1,500 individual medicines. They include statins, proton pump inhibitors, angiotensin-converting-enzyme (ACE) inhibitors and angiotensin II receptor blockers.
The first List of Interchangeable Medicines, containing groups of atorvastatin products, was published by the IMB on the 7th August. The IMB is updating the List of Interchangeable Medicines on an ongoing basis and it expects to complete the assessment of the top 20 priority medicines by mid- 2014. The process will then continue until all relevant medicinal products on the reimbursable list have been assessed. Once a List of Interchangeable Medicines is published by the IMB a two stage price reduction process gets underway. First, under the terms of the 2012 APMI Agreement, the price of all relevant products fall by 20%, e.g. atorvastatin prices were reduced from 1st September. Secondly, the legislation provides that the HSE may set a reference price for groups of interchangeable products published on the List of Interchangeable Products with a view to introducing further significant price cuts. Taking both price reductions into account, atorvastatin prices are down 70% since the introduction of generic substitution.
Reference pricing involves the setting of a common reimbursement price, or reference price, for a group of interchangeable medicines. It means that one reference price is set for each group or list of interchangeable medicines, and this is the price that the HSE will reimburse to pharmacies for all medicines in the group, regardless of the individual medicine’s prices. The first reference price for atorvastatin products was implemented on 1 November 2013. Reference prices will ensure that generic prices in Ireland will fall towards European norms.
582. Deputy Gerald Nash asked the Minister for Health if he will provide an explanation for the large variance between emergency caesarean rates on Mondays and Wednesdays, compared to Saturdays as reflected in an ESRI report 2011; the course of action the Health Service Executive is taking to address the growing rates of caesarean sections which stood at 50% in some maternity units during the summer months of 2013 in the case of first-time mothers; and if he will make a statement on the matter. [50194/13]
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.
583. Deputy Willie O'Dea asked the Minister for Health the position regarding moneys paid to general practitioner, GP, practices in the midlands and the south on the programme known as Heartwatch for 2011, 2012 and to date in 2013; the reason these moneys are still being paid in view of the fact there is a nationally-agreed model of care; and if he will make a statement on the matter. [50198/13]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for a direct reply to the Deputy.
584. Deputy Eoghan Murphy asked the Minister for Health if the chief executive officers of individual hospitals or areas of the health service are responsible for their performance regarding budgeting and so on; and if so to whom are they responsible. [50200/13]
Amharc ar fhreagraEach agency under the aegis of the Department of Health has set out the respective roles of its Accounting Officer and Chief Executive Officer. For bodies which have a Board, the Board is responsible for the body’s system of internal controls, including financial, operational and compliance controls and risk management. The Chief Executive Officer is answerable to the Board. Each State body has a properly constituted internal audit function or should engage appropriate external expertise in this regard and should operate within the provisions set out in the Department of Finance’s “Code of Practice for the Governance of State Bodies”. In relation to the specific arrangements in relation to hospitals and agencies for which the HSE is responsible I have forwarded the question to the HSE for direct reply to the Deputy.
585. Deputy Dara Calleary asked the Minister for Health the number of persons waiting for an orthodontic appointment in County Donegal in tabular form for 0-3 months, 3-6 months, 6-9 months, 9-12 months, over 12 months; and if he will make a statement on the matter. [50201/13]
Amharc ar fhreagraThe HSE provides orthodontic treatment to those who have been assessed and referred for treatment before their 16th birthday. Orthodontic referrals are generally received via the Public Dental Service school screening programme. At the time of assessment those with urgent clinical need are prioritised. It should be noted that the nature of orthodontic care means that immediate treatment is not always desirable. It is estimated that in up to 5% of cases it is necessary to wait for further growth to take place before treatment commences. Information on waiting times is collated by the HSE by region and for the intervals as shown below only. County Donegal is part of the HSE West region. The most recent information relates to the third quarter of 2013.
|
Waiting times HSE West |
1 - 6 months |
7 - 12 months |
13 - 24 months |
2 - 3 years |
Over 4 years |
TOTAL |
|
Patients waiting for assessment |
362 |
301 |
- |
- |
- |
663 |
|
Patients waiting for treatment to commence |
566 |
1135 |
1165 |
1200 |
61 |
4,127 |
586. Deputy Dara Calleary asked the Minister for Health the number of discretional medical cards removed from persons on a county basis in 2010, 2011 and 2012 and to date in 2013; and if he will make a statement on the matter. [50202/13]
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.
587. Deputy Bernard J. Durkan asked the Minister for Health if and when an appointment will be arranged with an ear specialist in respect of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [50207/13]
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.
588. Deputy Billy Kelleher asked the Minister for Health if the reported €150 million Exchequer investment in VHI will be found from the 2013 health budget or will have to be added to the 2014 budget; and if he will make a statement on the matter. [50231/13]
Amharc ar fhreagraIn order to comply with the European Court of Justice Judgement of September 2011, the Government agreed to take all necessary steps to bring VHI to the point of authorisation, but it has made no commitment to date to capitalise the company. It is premature to speculate on the amount of capital, if any, that might be required by the VHI. It is currently preparing an application to the Central Bank of Ireland (CBI) for authorisation. The CBI will determine the level of any capital requirement as part of its assessment of VHI’s financial position and readiness for authorisation.
If Exchequer assistance is required, a separate Government Decision will be taken at the appropriate time. Subject to Government approval, any capital injection would be expected to be in the form of a repayable loan at market interest rates and would come from general Exchequer funding, not from the health budget. Any such capitalisation would also require the approval of the European Commission under State Aid rules. I will be bringing proposals to Government very shortly regarding the VHI and authorisation and will also continue to engage with the EU Commission on the matter.
589. Deputy Billy Kelleher asked the Minister for Health if the 2012 VHI annual report has been published; and if he will make a statement on the matter. [50232/13]
Amharc ar fhreagra592. Deputy Billy Kelleher asked the Minister for Health if the VHI 2012 annual report and accounts have been published; if he has received same; the relevant rules regarding their publication following his receipt of same; the timeframe for their being laid before the Houses of the Oireachtas; and if he will make a statement on the matter. [50242/13]
Amharc ar fhreagraI propose to take Questions Nos. 589 and 592 together.
In accordance with the VHI Acts, the VHI is required to submit its Annual Report and Accounts to the Minister, and I as Minister am required to lay the Annual Report and Accounts before the Oireachtas; the relevant legislation does not make provision for a specific time frame for so laying the Annual Report and Accounts. The VHI's 2012 Annual Report and Accounts have been submitted and I have now made arrangements for them to be laid before the Houses of the Oireachtas.
590. Deputy Tom Fleming asked the Minister for Health the position regarding cataract treatment in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [50234/13]
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 Health Service Executive, sets out the processes that hospitals are to implement to manage waiting lists. In relation to the particular query raised by the Deputy, I have asked the HSE to respond directly to the Deputy in this matter.
591. Deputy Jerry Buttimer asked the Minister for Health the organ donation policy in respect of gay men; if this policy differs from other jurisdictions; and if he will make a statement on the matter. [50235/13]
Amharc ar fhreagra665. Deputy Seán Kyne asked the Minister for Health if, in the context of the proposed move to opt-out organ donation system, all citizens will be able to donate irrespective of the current restrictions regarding blood donation. [50858/13]
Amharc ar fhreagraI propose to take Questions Nos. 591 and 665 together.
EU Directive 2012/53/EU requires Member States of take all necessary measures to safeguard the recipients of organs. This was transposed by the European Union (Quality and Safety of Human Organs Intended for Transplantation) Regulations, S.I. No. 325 of 2012. The Regulations apply to donation, procurement, testing, characterisation, transport and transplantation of organs. They set out a clear legal framework for the application of quality and safety standards for human organs intended for transplantation. The Regulations, however, do not specify who should or should not be donors, but state that selection assessments carried out pursuant to the regulations may provide for the exclusion of persons whose donation could present unacceptable health risks.
For transplantation to proceed safely, all potential donors are risk assessed, in line with international practice, in order to prevent inadvertent transmission of infection. All potential donors, or, in the case of deceased donors, their next of kin, must answer a range of questions prior to the organ donation process proceeding. These include questions in relation to certain risk behaviours. A decision on whether someone who is gay may become a donor is not based on sexual orientation. However, it is known that there is an increased level of HIV infection rates among MSM in Ireland and this could influence decisions on organ donation. While testing for HIV is sensitive and effective, there remains a period between infection and detection for which allowance has to be made in deciding on acceptability for organ donation.
593. Deputy Lucinda Creighton asked the Minister for Health if he will consider conducting and independent inquiry into a matter (details supplied); and if he will make a statement on the matter. [50250/13]
Amharc ar fhreagraI would like in the first instance to offer my sympathies to the family involved in this very unfortunate case. I am advised that previous communications earlier this year to my Department from the family in question sought a Coroner's Inquest into this sad death. The decision to hold an Inquest is a matter for the Coroner. The Coroner is entirely independent in his functions under the Coroner's Act 1962 and the family were advised of the position. I have referred this case to the HSE and asked them for a report on the matter. I will revert further to the Deputy in this regard.
594. Deputy Robert Troy asked the Minister for Health the reason a person (details supplied) in County Longford has had their operation for a hip replacement at MRH Tullamore postponed on three separate occasions; and if he will make a statement on the matter. [50256/13]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to respond directly to the Deputy.
