Tom Fleming
Ceist:396. Deputy Tom Fleming asked the Minister for Health if he will review a fair deal appeal in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [10328/14]
Amharc ar fhreagraNursing Homes Support Scheme Appeals
Ceisteanna (396)
Freagraí scríofa
The Minister for Health has no role in reviewing appeals under the statutory Nursing Homes Support Scheme Act 2009. If a person is dissatisfied with the outcome of an appeal, they may appeal to the High Court against the decision on a point of law. Individuals may also take their case to the Office of the Ombudsman.
Departmental Correspondence
Ceisteanna (397)
Luke 'Ming' Flanagan
Ceist:397. Deputy Luke 'Ming' Flanagan asked the Minister for Health further to Parliamentary Questions Nos. 577, 578 and 580 of 17 December 2013, if he will explain the reason this Deputy has not yet received a reply from the Health Service Executive as per his answer; and if he will make a statement on the matter. [10330/14]
Amharc ar fhreagraFreagraí scríofa
As this is a service issue this question has been referred to the HSE for direct reply.
Health Services Reports
Ceisteanna (398)
Billy Kelleher
Ceist:398. Deputy Billy Kelleher asked the Minister for Health when he will publish the international evidence review on independent hospital trusts undertaken by the Health Research Board at his Department's request; and if he will make a statement on the matter. [10331/14]
Amharc ar fhreagraFreagraí scríofa
A literature review of Independent Hospital Trusts was requested from the Health Research Board by my Department in 2012, to inform policy development. It is regarded as best practice that academic articles and reviews undergo peer review prior to publication. The Health Research Board advised my Department that the peer review undertaken identified a requirement for some further work on this literature review. This is currently being progressed and the review will be published in due course.
Hospital Procedures
Ceisteanna (399)
Robert Troy
Ceist:399. Deputy Robert Troy asked the Minister for Health the reason a hip replacement has not been scheduled for a person (details supplied) in Cappagh given that the person was referred by their general practitioner over two years ago. [10360/14]
Amharc ar fhreagraFreagraí scríofa
In relation to the particular patient query raised by the Deputy, as this is a service matter, I have asked the Health Service Executive to respond to him directly.
Narcolepsy Issues
Ceisteanna (400, 401)
Jerry Buttimer
Ceist:400. Deputy Jerry Buttimer asked the Minister for Health the investigations undertaken by his Department and statutory agencies into the connection between the onset of narcolepsy and the swine flu vaccination; and if he will make a statement on the matter. [10386/14]
Amharc ar fhreagraJerry Buttimer
Ceist:401. Deputy Jerry Buttimer asked the Minister for Health the supports provided to persons who have been diagnosed with narcolepsy following receipt of the swine flu vaccination; and if he will make a statement on the matter. [10387/14]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 400 and 401 together.
In 2010 the Swedish and Finnish authorities reported an increased numbers of cases of Narcolepsy following the use of Pandemrix. Following reports to the Irish Medicines Board of narcolepsy cases among children and adolescents who were vaccinated with Pandemrix, a retrospective population based study was conducted and led by the Health Protection Surveillance Centre. The report of the National Narcolepsy Study Steering Committee was published on 19th April 2012 and is available on my Departments website (www.dohc.ie).
The HSE and the Department of Education and Skills continue to provide a range of services and supports to individuals diagnosed with narcolepsy following pandemic vaccination regardless of age, on an ex-gratia basis. These services and supports which are co-ordinated by the HSE National Advocacy Unit are intended to provide that individuals receive tailored assistance to address their specific requirements, where appropriate. It is acknowledged that treatment and individual medical needs may need to be reassessed over time to take account of changes in their condition or circumstances.
The ex-gratia health supports include clinical care pathways to ensure access to rapid diagnosis and treatment, multi-disciplinary assessments led by clinical experts, counselling services for both the individuals and their families, discretionary medical cards for those who have been diagnosed have been provided to allow unlimited access to GP care and any prescribed medication, ex-gratia reimbursement of vouched expenses incurred in the process of diagnosis and treatment, including travel expenses for attending medical appointments; physiotherapy, occupational therapy assessments, dental assessments and dietary services all on a needs basis. Regional co-ordinators have been appointed to assist individuals to provide advice, information and access to local services.
On the education side, the National Educational Psychological Services (NEPS) engaged with all of the schools being attended by children with narcolepsy to provide guidance and assistance on the condition and the supports available. These include special education home tuition, the provision of supplemental learning support/resource teaching support on a needs basis and the provision of Special Needs Assistants (SNA) support if required. Furthermore, reasonable accommodations, including special examination centres and rest breaks were provided for students who sat state exams in last June. Similar arrangements will be available on a needs basis to students sitting state exams in future years. The Department of Education and Skills issued circulars providing information to schools on the nature, likely symptoms, possible effect of the condition of narcolepsy on students and the supports available for students.
With regard to third level, students diagnosed with narcolepsy following pandemic vaccination can access the Disability Access Route to Education (DARE) scheme, which is a college/university scheme which offers enhanced access routes to third level education.
All health and educational services and supports will continue to be provided on an ex-gratia basis. Those services and supports will be reassessed on an ongoing basis to take account of the individual's condition and circumstances.
Medical Card Applications
Ceisteanna (402)
Finian McGrath
Ceist:402. Deputy Finian McGrath asked the Minister for Health the position regarding a medical card in respect of a person (details supplied) in Dublin 5. [10399/14]
Amharc ar fhreagraFreagraí scríofa
The 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.
Proposed Legislation
Ceisteanna (403)
Nicky McFadden
Ceist:403. Deputy Nicky McFadden asked the Minister for Health the reason for the proposed introduction of legislation to provide for an advance healthcare directive; the way the legislation will assist in developing patient-centred care at the end-of-life; when the legal framework is expected to be introduced; and if he will make a statement on the matter. [10402/14]
Amharc ar fhreagraFreagraí scríofa
An advance healthcare directive is a statement made by an individual with capacity setting out his/her will and preferences regarding treatment decisions that may arise in the future in the event that s/he lacks the capacity to provide consent to or to refuse those treatments. The advance healthcare directive has been recognised as an expression of an individual’s autonomy and as a useful tool in enabling the individual to maintain some level of control over medical treatment into the future, when he or she lacks the capacity to express autonomous preferences.
There is currently no specific legislation pertaining to advance healthcare directives in Ireland. The establishment of a statutory mechanism of advanced healthcare planning will bring clarity to individuals and their attending healthcare professionals regarding the individual’s will and preferences for future treatment. Given the increased focus on a more patient-centred model of healthcare, more and more people will wish to play an active role in their treatment decisions, even when they no longer retain capacity to do so. Advance healthcare directives are an important tool in this regard.
On Tuesday 4th February 2014, the Government approved the publication of the draft General Scheme of the advance healthcare directive provisions for the purposes of a public consultation. This consultation process is scheduled to conclude by Friday 7th March 2014. Following the consultation process the advance healthcare directive provisions are to be incorporated into the Assisted Decision-Making (Capacity) Bill at Committee Stage, in line with a Government decision from 2013. It is envisaged that the Bill will be brought to Committee Stage in the coming months.
Given the intersection between the aims of the capacity legislation and the role of advance healthcare directives, the Assisted Decision-Making (Capacity) Bill 2013 is considered to be the most appropriate vehicle for providing a legislative framework for advance healthcare directives. Incorporating provisions for advance healthcare directives into the capacity legislation represents an efficient and practical method of consolidating the law in this area.
Medical Card Applications
Ceisteanna (404)
Catherine Murphy
Ceist:404. Deputy Catherine Murphy asked the Minister for Health in situations where a medical card has been issued on medical hardship grounds and where it required the provision of evidence that was both costly and time consuming to gather, whether he will ask the PCRS to change its practice of disposing of the evidence where it has scheduled a review within a 12-month timeframe; if his attention has been drawn to the fact that much of the evidence, such as a diagnosis, will not alter, and that requiring the same evidence to be gathered again is placing additional, avoidable stress on applicants; if a limited review process might be considered as an alternative; and if he will make a statement on the matter. [10404/14]
Amharc ar fhreagraFreagraí scríofa
Eligibility for a medical card only exists for so long as a person continues to meet the criteria set out in the Health Act 1970, as amended. The legislation requires a person to notify the HSE of any change in their circumstances, such as income, expenditure, medical or social issues, which disentitles them to a medical card. In practice, very few people do so. As a result, the HSE has an obligation to take measures to ensure that the medical card register is as accurate as possible and that its voted budget is being spent appropriately in the medical card scheme.
All card holders, irrespective of the basis on which the card was awarded, may be subject to a periodic review of eligibility to determine continuing eligibility. Each person eligible to a medical or GP visit card receives a plastic card on which a "valid to" date is printed. This is the latest date that a review may be conducted in respect of that person. Notwithstanding the "valid to" date printed on the card, the HSE reserves the right to review eligibility at any time and to take appropriate action in circumstances where the cardholder no longer fulfils the criteria for eligibility under the medical card-GP visit card national assessment guidelines.
Persons who have been granted a medical card under the financial hardship provisions of the medical card scheme are required, when the subject of a review assessment, to submit all relevant and up-to-date details. This is necessary so that the HSE can make a correct determination of continuing eligibility. Where an applicant indicates on a review application that medical evidence has been previously submitted relating to a life-long medical condition, and this has been confirmed by the HSE, the HSE will not request further medical evidence in this regard. The applicant will, however, be required to submit all other information material to a review assessment.
Health Services Staff Remuneration
Ceisteanna (405)
Joan Collins
Ceist:405. Deputy Joan Collins asked the Minister for Health the annual wages of the chief executive officer of Cheeverstown as a section 38 voluntary service. [10426/14]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter it has been referred to the Health Service Executive for direct reply.
Health Services Reports
Ceisteanna (406)
Billy Kelleher
Ceist:406. Deputy Billy Kelleher asked the Minister for Health the reason the national treatment purchase fund December waiting lists report was not published as of 25 February 2013 in view of the fact that he previously indicated that the publication of such information occur simultaneously with the publication of Health Service Executive monthly reports, the December edition of which was published last week. [10434/14]
Amharc ar fhreagraFreagraí scríofa
In relation to the detailed information requested by the Deputy, as these are service matters, I have asked the Health Service Executive to respond to him directly.
Health Services Provision
Ceisteanna (407)
John McGuinness
Ceist:407. Deputy John McGuinness asked the Minister for Health if a dialysis machine will be provided in the home of a person (details supplied) in County Carlow; and if funding will be provided for this machine as soon as possible. [10449/14]
Amharc ar fhreagraFreagraí scríofa
As this is a service related matter, the HSE has been asked to investigate this case and respond to the Deputy as soon as possible.
Health Services Staff Recruitment
Ceisteanna (408)
Luke 'Ming' Flanagan
Ceist:408. Deputy Luke 'Ming' Flanagan asked the Minister for Health if paramedics will be recruited from 1 April 2014; if he will be lifting any recruitment embargo that is in place for paramedics; and if he will make a statement on the matter. [10486/14]
Amharc ar fhreagraFreagraí scríofa
The Government has decided that the numbers employed across the public service must be reduced in order to meet fiscal and budgetary targets. In order to mitigate the impact on frontline services of the reduction in employment numbers, the priority is to reform how health services are delivered in order to ensure a more productive and cost effective health system. The revised working arrangements provided for in the Haddington Road Agreement are a pivotal element in this regard.
Subject to approval by senior managers, arrangements are in place in the HSE to allow the recruitment of staff where it has been established that there is an urgent service requirement. In addition, the HSE continues to fill a significant number of development posts in line with service priorities identified by Government.
Speech and Language Therapy
Ceisteanna (409)
Charlie McConalogue
Ceist:409. Deputy Charlie McConalogue asked the Minister for Health if his Department applies different policy criteria to a child with autism requiring speech therapy services who is based in a mainstream school than to a child accessing the same service in a specialist autism unit; and if he will make a statement on the matter. [10490/14]
Amharc ar fhreagraFreagraí scríofa
Significant resources have been invested by the health sector in recent years in services for children with special needs, including those with autism. The Government is committed to the provision and development of services for these children, having regard to available resources.
The Health Service Executive’s National Review of Autism Services: Past, Present and Way Forward Report (2012) and its National Programme on Progressing Disability Services for Children and Young People (0-18 years) set out the overall policy context for the provision of autism services to children and young people. The objective of the Progressing Disability Services Programme is to achieve a national, unified approach to delivering disability health services. This Programme, when implemented, should mean greater equity in accessing services, based on need, clearer referral pathways to these services and improved collaboration between the relevant sectors. An additional €4m has been specifically allocated in 2014 to drive implementation of the Programme. This equates to approximately 80 therapy posts.
The specific issue of access by children with autism to speech and language therapy services is an operational matter for the HSE. Accordingly I have arranged for the question to be referred to the HSE for direct reply to the Deputy.
Medicinal Products Availability
Ceisteanna (410)
Luke 'Ming' Flanagan
Ceist:410. Deputy Luke 'Ming' Flanagan asked the Minister for Health the reason Staloral tablets, which have known health benefits for persons with severe allergies, are not available here but are available in the UK and throughout Europe; and if he will make a statement on the matter. [10501/14]
Amharc ar fhreagraFreagraí scríofa
As this is a service related matter, the HSE has been asked to examine the specific query raised by the Deputy and reply to him as soon as possible.
HIQA Issues
Ceisteanna (411)
Billy Kelleher
Ceist:411. Deputy Billy Kelleher asked the Minister for Health the specific issues that caused three members of the Health Information and Quality Authority board to resign from their positions earlier this month; when he was first advised of the likelihood of these resignations occurring; and if he will make a statement on the matter. [10512/14]
Amharc ar fhreagraFreagraí scríofa
During February, 2014 I received letters of resignation from 3 Board Members of the Health Information and Quality Authority. All three resigned in order to reduce the risk of any real, potential or perceived conflicts of interest arising from their membership of the Board of the Authority. I appreciate and understand the difficult decision that they have made which was taken in the best interests of the Authority.
General Practitioner Services
Ceisteanna (412, 413, 414)
Billy Kelleher
Ceist:412. Deputy Billy Kelleher asked the Minister for Health his views on a recent Irish Medical News survey of general practitioners which indicated that 90% of those surveyed do not believe that the Government was right to prioritise under sixes in the first phase of plans for universal GP care; that 97% of the GPs do not believe that general practice is adequately funded and resourced; that 96 % of the GPs do not believe that the Government will engage in a meaningful fashion on the clauses within the proposed new contract; and if he will make a statement on the matter. [10513/14]
Amharc ar fhreagraBilly Kelleher
Ceist:413. Deputy Billy Kelleher asked the Minister for Health his response to a recent Irish Medical News survey of general practitioners which indicated that four-fifths of GPs feel that the proposed new GP contract represents a conflict of interest for them in terms of their compliance with the medical practitioners act, professional competence and other laws governing GPs; and if he will make a statement on the matter. [10514/14]
Amharc ar fhreagraBilly Kelleher
Ceist:414. Deputy Billy Kelleher asked the Minister for Health if he or any of his Departments Ministers of State have personally written any part of the proposed new GP contract; and if he will make a statement on the matter. [10515/14]
Amharc ar fhreagraFreagraí scríofa
I propose to take Questions Nos. 412 to 414, inclusive, together.
The Government is committed to introducing, on a phased basis, a universal GP service without fees within its term of office, as set out in the Programme for Government and the Future Health strategy framework.
As announced in the Budget, it has been decided to commence the roll-out of a universal GP service by providing all children aged 5 and under with access to a GP service without fees. The decision to commence the roll-out with this age cohort is in accordance with the recommendation in Right from the Start, the Report of the Expert Advisory Group on the Early Years Strategy. Universal screening and surveillance services are already made available for children in this age cohort. Evidence suggests that a high-quality primary care system with universal access will achieve better outcomes for young children.
The implementation of this measure will require primary legislation. The necessary administrative arrangements will be made when the specifics of the legislation are known.
A public consultation process started on 31st January 2014 relating to the content and scope of a new GP contract to underpin the provision of GP care, free at the point of use, for all children aged under six years. I met with key stakeholders on 31st January - the Irish College of General Practitioners (ICGP), the Irish Medical Organisation (IMO) and the National Association of General Practitioners (NAGP) – to brief them on Government policy concerning the introduction of a universal GP service without fees and in particular, on the first phase concerning children under 6 years.
I wish to take this opportunity again to reiterate that the document which was put out for consultation is a draft . I am aware that GPs have raised a number of concerns, including the resourcing of general practice and the need for meaningful negotiation with the GP representative bodies.
General Practice is resourced through a range of payments to GPs under various contracts, including the General Medical Services (GMS) Scheme. In 2013, GMS fees and allowances paid to GPs totalled in the region of €453 million and GPs also generate funds through private practice. The Government is also providing new, additional funding of €37 million to meet the cost of providing GP care, free at the point of use, for all children aged under six years.
It is my intention to meet with the GP representative bodies in the coming weeks for detailed discussions on the scope and content of the draft contract. This will afford them the fullest opportunity to raise any and all issues which they may have regarding the draft contract, including concerns about their compliance with the Medical Practitioners Act, professional competence and other laws governing GPs. It will also enable them to make their own proposals as to how the draft contract may be improved. Consequently, I have no doubt that there will be changes to the text of the draft contract following the consultation process.
On 27th February 2014, I wrote to the IMO stating that the Department and the HSE are fully prepared to engage meaningfully with them and are prepared to negotiate with them on all aspects of the scope and content of the proposed contract. However, the ultimate setting of fees must remain a matter for the Minister for Health, though there will be an opportunity for their input on this aspect, and on the fee structure, which it is proposed to address by means of a separate consultation process. I have formally invited the IMO to meet with the Department and the HSE to commence this process during this week or on another mutually agreeable date if this week does not suit.
In relation to the Deputy’s question about ministerial involvement in the drafting of the contract, my ministerial colleagues in the Department of Health and I have not personally written any part of the draft contract; however, I as Minister of State for Primary Care have overseen the development of the draft contract.