Hospital Appointment Status

<div class="sub-header">
<h3>Ceisteanna (183)</h3>
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<div class="question" id="pq_183">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/Dan-Neville.S.1989-10-01/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Dan-Neville.S.1989-10-01/image/thumb" alt="Dan Neville"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/Dan-Neville.S.1989-10-01/">Dan Neville</a>
</h4>
</div>
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<i>Roinn</i>
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<div class="content"><h4 class="from">Dan Neville</h4><span class="question-start">Ceist:</span>
<p id="para_2361" class="">183. <strong>Deputy Dan Neville</strong> asked the <strong>Minister for Health</strong> the position regarding a hospital appointment in respect of a person (details supplied) in County Limerick; and if he will make a statement on the matter. [21718/14]</p>
<a class="view-answer" href="#pq-answers-183">Amharc ar fhreagra</a></div>
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<div class="sub-header" id="pq-answers-183">
<h3>Freagraí scríofa (Ceist ar Health)</h3>
</div><div class="speech" id="spk_723">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/James-Reilly.D.2007-06-14/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/James-Reilly.D.2007-06-14/image/thumb" alt="James Reilly"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/James-Reilly.D.2007-06-14/">Minister for Health</a>
</h4>
</div>
<div class="text">
<div class="content"><div class="social-share"><a href="#" class="share-trigger" data-share-url="https://www.oireachtas.ie/ga/debates/question/2014-05-14/183/speech/723/" data-share-text="Hospital Appointment Status" title="Share speech #723 by Minister for Health"><i>Roinn</i></a></div>

<p id="para_2362" class="">The National Waiting List Management Policy, <em>A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2013,</em> 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.</p>
<p id="para_2363" class=""> In relation to the particular query raised by the Deputy, I have asked the HSE to respond directly to him on this matter.</p>
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Hospital Transfers

<div class="sub-header">
<h3>Ceisteanna (184)</h3>
</div>

<div class="question" id="pq_184">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/Robert-Troy.D.2011-03-09/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Robert-Troy.D.2011-03-09/image/thumb" alt="Robert Troy"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/Robert-Troy.D.2011-03-09/">Robert Troy</a>
</h4>
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<div class="content"><h4 class="from">Robert Troy</h4><span class="question-start">Ceist:</span>
<p id="para_2364" class="">184. <strong>Deputy Robert Troy</strong> asked the <strong>Minister for Health</strong> the position regarding a bed in a Dun Laoghaire hospital in respect of a person (details supplied) in County Westmeath. [21722/14]</p>
<a class="view-answer" href="#pq-answers-184">Amharc ar fhreagra</a></div>
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</div>
<div class="sub-header" id="pq-answers-184">
<h3>Freagraí scríofa (Ceist ar Health)</h3>
</div><div class="speech brief" id="spk_724">
<div class="c-avatar -debate -short">
<a class="c-avatar__img-link" href="/ga/members/member/Kathleen-Lynch.D.1994-11-10/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Kathleen-Lynch.D.1994-11-10/image/thumb" alt="Kathleen Lynch"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/Kathleen-Lynch.D.1994-11-10/">Minister of State at the Department of Health</a>
</h4>
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<div class="content"><div class="social-share"><a href="#" class="share-trigger" data-share-url="https://www.oireachtas.ie/ga/debates/question/2014-05-14/184/speech/724/" data-share-text="Hospital Transfers" title="Share speech #724 by Minister of State at the Department of Health"><i>Roinn</i></a></div>

<p id="para_2365" class="">As 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.</p>
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Hospital Appointment Status

<div class="sub-header">
<h3>Ceisteanna (185)</h3>
</div>

<div class="question" id="pq_185">
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<a class="c-avatar__img-link" href="/ga/members/member/Finian-McGrath.D.2002-06-06/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Finian-McGrath.D.2002-06-06/image/thumb" alt="Finian McGrath"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/Finian-McGrath.D.2002-06-06/">Finian McGrath</a>
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<div class="content"><h4 class="from">Finian McGrath</h4><span class="question-start">Ceist:</span>
<p id="para_2366" class="">185. <strong>Deputy Finian McGrath</strong> asked the <strong>Minister for Health</strong> the position regarding a hospital appointment in respect of a person (details supplied) in Dublin 5; and if he will make a statement on the matter. [21724/14]</p>
<a class="view-answer" href="#pq-answers-185">Amharc ar fhreagra</a></div>
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<div class="sub-header" id="pq-answers-185">
<h3>Freagraí scríofa (Ceist ar Health)</h3>
</div><div class="speech" id="spk_725">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/James-Reilly.D.2007-06-14/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/James-Reilly.D.2007-06-14/image/thumb" alt="James Reilly"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/James-Reilly.D.2007-06-14/">Minister for Health</a>
</h4>
</div>
<div class="text">
<div class="content"><div class="social-share"><a href="#" class="share-trigger" data-share-url="https://www.oireachtas.ie/ga/debates/question/2014-05-14/185/speech/725/" data-share-text="Hospital Appointment Status" title="Share speech #725 by Minister for Health"><i>Roinn</i></a></div>

<p id="para_2367" class="">With regard to specific complaints in relation to experiences of individuals in our hospitals, there is a formal complaints policy, entitled “<em>Your Service Your Say”,</em> details of which are on the HSE website, at http://www.hse.ie/eng/services/yourhealthservice/feedback/complaints/</p>
<p id="para_2368" class=""> In accordance with this procedure, a complaint must be made in the first instance to the hospital in which the incident causing the complaint occurred. </p>
<p id="para_2369" class=""> If an individual is not satisfied with the response from the hospital, a review can be sought from the HSE Director of Advocacy and the Ombudsman, whose details are set out below. </p>
<p id="para_2370" class=""> HSE Director of Advocacy</p>
<p id="para_2371" class=""> Oak House</p>
<p id="para_2372" class=""> Millennium Park</p>
<p id="para_2373" class=""> Naas</p>
<p id="para_2374" class=""> Co Kildare </p>
<p id="para_2375" class=""> Tel 1890 424 555</p>
<p id="para_2376" class=""> Office of the Ombudsman </p>
<p id="para_2377" class=""> 18, Lower Leeson Street</p>
<p id="para_2378" class=""> Dublin 2</p>
<p id="para_2379" class=""> Tel 1890 223 030</p>
<p id="para_2380" class="">Email: ombudsman@ombudsman.gov.ie
</p>
<p id="para_2381" class=""> I have asked the HSE to answer the specific queries the Deputy has raised and to reply to him directly.</p>
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Medical Card Reviews

<div class="sub-header">
<h3>Ceisteanna (186, 195, 196, 197)</h3>
</div>

<div class="question" id="pq_186">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/Michael-Healy-Rae.D.2011-03-09/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Michael-Healy-Rae.D.2011-03-09/image/thumb" alt="Michael Healy-Rae"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/Michael-Healy-Rae.D.2011-03-09/">Michael Healy-Rae</a>
</h4>
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<i>Roinn</i>
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<div class="content"><h4 class="from">Michael Healy-Rae</h4><span class="question-start">Ceist:</span>
<p id="para_2382" class="">186. <strong>Deputy Michael Healy-Rae</strong> asked the <strong>Minister for Health</strong> his views on the situation where persons with profound disabilities and serious illness have had their medical cards removed. [21730/14]</p>
<a class="view-answer" href="#pq-answers-186_195_196_197">Amharc ar fhreagra</a></div>
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<div class="question" id="pq_195">
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<a class="c-avatar__img-link" href="/ga/members/member/Bernard-Durkan.D.1981-06-30/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Bernard-Durkan.D.1981-06-30/image/thumb" alt="Bernard Durkan"/>
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<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/Bernard-Durkan.D.1981-06-30/">Bernard Durkan</a>
</h4>
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<div class="content"><h4 class="from">Bernard Durkan</h4><span class="question-start">Ceist:</span>
<p id="para_2383" class="">195. <strong>Deputy Bernard J. Durkan</strong> asked the <strong>Minister for Health</strong> the extent to which the review of eligibility for medical cards continues to be monitored with a view to alleviating hardship, stress and concerns for applicants; and if he will make a statement on the matter. [21773/14]</p>
<a class="view-answer" href="#pq-answers-186_195_196_197">Amharc ar fhreagra</a></div>
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<div class="question" id="pq_196">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/Bernard-Durkan.D.1981-06-30/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Bernard-Durkan.D.1981-06-30/image/thumb" alt="Bernard Durkan"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/Bernard-Durkan.D.1981-06-30/">Bernard Durkan</a>
</h4>
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<i>Roinn</i>
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<div class="content"><h4 class="from">Bernard Durkan</h4><span class="question-start">Ceist:</span>
<p id="para_2384" class="">196. <strong>Deputy Bernard J. Durkan</strong> asked the <strong>Minister for Health</strong> the measures he will put in place to ensure the minimisation of concerns arising from the review of eligibility for medical cards with particular reference to older persons and children and adults with special needs or particular medical conditions which might seriously impact on their quality of life and resources; and if he will make a statement on the matter. [21774/14]</p>
<a class="view-answer" href="#pq-answers-186_195_196_197">Amharc ar fhreagra</a></div>
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<div class="question" id="pq_197">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/Bernard-Durkan.D.1981-06-30/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Bernard-Durkan.D.1981-06-30/image/thumb" alt="Bernard Durkan"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/Bernard-Durkan.D.1981-06-30/">Bernard Durkan</a>
</h4>
</div>
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<div class="content"><h4 class="from">Bernard Durkan</h4><span class="question-start">Ceist:</span>
<p id="para_2385" class="">197. <strong>Deputy Bernard J. Durkan</strong> asked the <strong>Minister for Health</strong> the extent to which his attention has been drawn to the concern of persons affected by the review of eligibility of medical cards resulting in stress and trauma for families; if he will put in place provision to deal with this issue; and if he will make a statement on the matter. [21775/14]</p>
<a class="view-answer" href="#pq-answers-186_195_196_197">Amharc ar fhreagra</a></div>
</div>
</div>
<div class="sub-header" id="pq-answers-186_195_196_197">
<h3>Freagraí scríofa (Ceist ar Health)</h3>
</div><div class="speech" id="spk_726">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/Alex-White.S.2007-07-23/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Alex-White.S.2007-07-23/image/thumb" alt="Alex White"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/Alex-White.S.2007-07-23/">Minister of State at the Department of Health</a>
</h4>
</div>
<div class="text">
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<p id="para_2386" class="">I propose to take Questions Nos. 186, and 195 to 197, inclusive, together.</p>
<p id="para_2387" class=""> Under the Health Act, 1970, eligibility for a medical card is founded primarily on the undue financial hardship test and every application must be assessed on that basis. Under the legislation, determination of an individual’s eligibility for a medical card is the responsibility of the HSE. The 1970 Health Act obliges the HSE to assess whether a person is unable, without undue hardship, to arrange GP services for themselves and their family, having regard to their overall financial situation and reasonable expenditure. The legislation is clear that qualification for a medical card is means-tested. Medical cards are not awarded - nor have they ever been - on the basis of a particular illness or disease. Medical cards are issued 'automatically' - or irrespective of means - even if an applicant is suffering from a serious medical condition or a life long condition. </p>
<p id="para_2388" class=""> All medical card and GP visit card holders are subject to a periodic review of eligibility to determine continuing eligibility and the HSE has a very structured protocol in place for the review process and makes every effort to ensure on-going engagement with clients during this process. These reviews must be supported with a range of documentation and this requirement is clearly outlined on the application forms. As a result, where such supporting documentation is not supplied, or is incomplete, to enable the assessment of an application, in accordance with the National Assessment Guidelines, the HSE will issue correspondence to the applicant, specifying the additional information required to progress the assessment of their application. </p>
<p id="para_2389" class=""> 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. If the HSE is made aware that a person has a disability or special needs, assistance will be afforded to help that person complete the application and explain the support documentation they need to send, whether at application stage or at review stage. The local health office can be contacted on LoCall 1890 252 919 to request this assistance. </p>
<p id="para_2390" class=""> The HSE also makes every effort to provide a person with sufficient time to renew their eligibility. Each month, the HSE analyses the Medical Card Register to identify those medical/GP visit cards that are scheduled for review within three months. A review notification will indicate the card holder should complete a self-assessment or request the card holder to return evidence of household income, assessable outgoings and medical circumstances to enable a full review assessment be conducted by the HSE. The HSE has increased this notification time to four months in respect of those clients who were granted eligibility on the basis of discretion. This is to allow an additional month to ensure that all pertinent medical and other data is provided for inclusion in the assessment process. </p>
<p id="para_2391" class=""> A reminder letter is issued a month later if the requested review form details have not been returned at that point. If a person does not return the review form within the time specified, continuing eligibility cannot be confirmed and the medical card cannot be reissued. In these circumstances, or where the review process establishes that a person no longer holds eligibility, the eligibility ceases. </p>
<p id="para_2392" class=""> Persons are requested to return their completed review forms at least one month in advance of the due expiry date of their existing eligibility. This is to allow the HSE sufficient time to carry out the review and/or to get back to the individuals, if the application is incomplete or requires any further details to be furnished. </p>
<p id="para_2393" class=""> Where a review form is returned, but not fully completed by the expiry date, it is HSE policy to extend the eligibility of the client for a reasonable period of time until the review is carried out and a final decision made on the person's continuing eligibility, once there is appropriate communication from the client. Medical card holders who genuinely engage with the review of their medical card eligibility will not have their eligibility withdrawn before that review is complete. </p>
<p id="para_2394" class=""> Where an applicant indicates on their 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 up-to-date information material to a review assessment.</p>
<p id="para_2395" class=""> Eligibility for a medical card only exists for so long as a person continues to meet the criteria set out in the Health Act. 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. One recognised auditing practice, which the HSE now carries out, is to undertake random reviews. The selection criteria on which such random reviews occur varies from time to time. </p>
<p id="para_2396" class=""> Therefore, 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. The Deputies will be aware, each person who has eligibility to a medical card or a 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 take appropriate action in circumstances where the cardholder does not establish that he/she continues to fulfil the criteria for eligibility under the Medical Card / GP Visit Card National Assessment Guidelines.</p>
<p id="para_2397" class=""> A person’s GP is also kept informed of any review notifications of their patients. GPs are advised three months in advance of the review dates of their patients’ GP visit cards/medical cards and, subsequently, the following month and the month after that, if the patient has not returned the review form by that time. </p>
<p id="para_2398" class=""> GPs have full electronic visibility of the medical card panel of patients available to them and have the facility to electronically allow temporary extension of eligibility for expiring cards where a sensitive renewal is appropriate. The temporary extension may also be allowed where they are aware that a person is still availing of services but there may be something that prevents them from carrying out a standard review, e.g. a blind person with little family support. </p>
<p id="para_2399" class=""> Given that over 40% of the population, or about 2 million people, qualify for a medical card or GP visit card, the scale of the administration of the GMS scheme is significant. Over 700,000 individuals were assessed by the HSE in 2013. Well in excess of 95% of applications were processed within the target of 15 working days. I am satisfied that both applications and reviews are undertaken in a facilitative manner and that every support is afforded by the HSE.</p>
<p id="para_2400" class=""> The HSE is currently examining how individuals, who are not entitled to a medical card, could still receive services that meet their needs. This issue is being addressed in a manner that includes all of the services and supports provided by the HSE with as much flexibility as is available and at a local level. </p>
</div>
</div>
</div>

Hospital Appointment Status

<div class="sub-header">
<h3>Ceisteanna (187)</h3>
</div>

<div class="question" id="pq_187">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/John-McGuinness.D.1997-06-26/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/John-McGuinness.D.1997-06-26/image/thumb" alt="John McGuinness"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/John-McGuinness.D.1997-06-26/">John McGuinness</a>
</h4>
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<div class="content"><h4 class="from">John McGuinness</h4><span class="question-start">Ceist:</span>
<p id="para_2401" class="">187. <strong>Deputy John McGuinness</strong> asked the <strong>Minister for Health</strong> if an operation will be expedited in respect of a person (details supplied) in County Kilkenny. [21754/14]</p>
<a class="view-answer" href="#pq-answers-187">Amharc ar fhreagra</a></div>
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</div>
<div class="sub-header" id="pq-answers-187">
<h3>Freagraí scríofa (Ceist ar Health)</h3>
</div><div class="speech" id="spk_727">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/James-Reilly.D.2007-06-14/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/James-Reilly.D.2007-06-14/image/thumb" alt="James Reilly"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/James-Reilly.D.2007-06-14/">Minister for Health</a>
</h4>
</div>
<div class="text">
<div class="content"><div class="social-share"><a href="#" class="share-trigger" data-share-url="https://www.oireachtas.ie/ga/debates/question/2014-05-14/187/speech/727/" data-share-text="Hospital Appointment Status" title="Share speech #727 by Minister for Health"><i>Roinn</i></a></div>

<p id="para_2402" class="">The National Waiting List Management Policy, <em>A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2013,</em> 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.</p>
<p id="para_2403" class=""> In relation to the particular query raised by the Deputy, I have asked the HSE to respond directly to him on this matter.</p>
</div>
</div>
</div>

Nursing Home Services

<div class="sub-header">
<h3>Ceisteanna (188)</h3>
</div>

<div class="question" id="pq_188">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/Barry-Cowen.D.2011-03-09/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Barry-Cowen.D.2011-03-09/image/thumb" alt="Barry Cowen"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/Barry-Cowen.D.2011-03-09/">Barry Cowen</a>
</h4>
</div>
<div class="text">
<div class="social-share">
<a href="#" class="share-trigger" data-share-url="https://www.oireachtas.ie/ga/debates/question/2014-05-14/188/question/188/" data-share-text="Nursing Home Services" title="Share question #188 by Barry Cowen">
<i>Roinn</i>
</a>
</div>
<div class="content"><h4 class="from">Barry Cowen</h4><span class="question-start">Ceist:</span>
<p id="para_2404" class="">188. <strong>Deputy Barry Cowen</strong> asked the <strong>Minister for Health</strong> when a nursing home (details supplied) will receive accreditation to commence services; and if he will make a statement on the matter. [21756/14]</p>
<a class="view-answer" href="#pq-answers-188">Amharc ar fhreagra</a></div>
</div>
</div>
<div class="sub-header" id="pq-answers-188">
<h3>Freagraí scríofa (Ceist ar Health)</h3>
</div><div class="speech" id="spk_728">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/Kathleen-Lynch.D.1994-11-10/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Kathleen-Lynch.D.1994-11-10/image/thumb" alt="Kathleen Lynch"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/Kathleen-Lynch.D.1994-11-10/">Minister of State at the Department of Health</a>
</h4>
</div>
<div class="text">
<div class="content"><div class="social-share"><a href="#" class="share-trigger" data-share-url="https://www.oireachtas.ie/ga/debates/question/2014-05-14/188/speech/728/" data-share-text="Nursing Home Services" title="Share speech #728 by Minister of State at the Department of Health"><i>Roinn</i></a></div>

<p id="para_2405" class="">Under the Health Act, 2007 statutory responsibility is given to the Chief Inspector of Social Services in the Health Information and Quality Authority for registration and inspection of categories of designated centres, including nursing homes for older people. As the Chief Inspector is independent in the exercise of his statutory function it would be inappropriate to comment on any individual application for registration.</p>
</div>
</div>
</div>

Medical Qualifications

<div class="sub-header">
<h3>Ceisteanna (189, 192, 204)</h3>
</div>

<div class="question" id="pq_189">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/Bernard-Durkan.D.1981-06-30/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Bernard-Durkan.D.1981-06-30/image/thumb" alt="Bernard Durkan"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/Bernard-Durkan.D.1981-06-30/">Bernard Durkan</a>
</h4>
</div>
<div class="text">
<div class="social-share">
<a href="#" class="share-trigger" data-share-url="https://www.oireachtas.ie/ga/debates/question/2014-05-14/189/question/189/" data-share-text="Medical Qualifications" title="Share question #189 by Bernard Durkan">
<i>Roinn</i>
</a>
</div>
<div class="content"><h4 class="from">Bernard Durkan</h4><span class="question-start">Ceist:</span>
<p id="para_2406" class="">189. <strong>Deputy Bernard J. Durkan</strong> asked the <strong>Minister for Health</strong> the extent to which medical graduates tend to emigrate; the research available which might identify the reasons for seeking employment outside the jurisdiction; his proposals to address any issues arising; and if he will make a statement on the matter. [21767/14]</p>
<a class="view-answer" href="#pq-answers-189_192_204">Amharc ar fhreagra</a></div>
</div>
</div>
<div class="question" id="pq_192">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/Bernard-Durkan.D.1981-06-30/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Bernard-Durkan.D.1981-06-30/image/thumb" alt="Bernard Durkan"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/Bernard-Durkan.D.1981-06-30/">Bernard Durkan</a>
</h4>
</div>
<div class="text">
<div class="social-share">
<a href="#" class="share-trigger" data-share-url="https://www.oireachtas.ie/ga/debates/question/2014-05-14/189/question/192/" data-share-text="Medical Qualifications" title="Share question #192 by Bernard Durkan">
<i>Roinn</i>
</a>
</div>
<div class="content"><h4 class="from">Bernard Durkan</h4><span class="question-start">Ceist:</span>
<p id="para_2407" class="">192. <strong>Deputy Bernard J. Durkan</strong> asked the <strong>Minister for Health</strong> the extent to which qualified nurses have tended to emigrate over the past ten years to date; the primary reason for such emigration; the extent to which delivery of services in this jurisdiction is affected by such trends; and if he will make a statement on the matter. [21770/14]</p>
<a class="view-answer" href="#pq-answers-189_192_204">Amharc ar fhreagra</a></div>
</div>
</div>
<div class="question" id="pq_204">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/Bernard-Durkan.D.1981-06-30/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Bernard-Durkan.D.1981-06-30/image/thumb" alt="Bernard Durkan"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/Bernard-Durkan.D.1981-06-30/">Bernard Durkan</a>
</h4>
</div>
<div class="text">
<div class="social-share">
<a href="#" class="share-trigger" data-share-url="https://www.oireachtas.ie/ga/debates/question/2014-05-14/189/question/204/" data-share-text="Medical Qualifications" title="Share question #204 by Bernard Durkan">
<i>Roinn</i>
</a>
</div>
<div class="content"><h4 class="from">Bernard Durkan</h4><span class="question-start">Ceist:</span>
<p id="para_2408" class="">204. <strong>Deputy Bernard J. Durkan</strong> asked the <strong>Minister for Health</strong> the number of nursing and medical graduates required in the current year; the extent to which this can be met from numbers graduating; and if he will make a statement on the matter. [21782/14]</p>
<a class="view-answer" href="#pq-answers-189_192_204">Amharc ar fhreagra</a></div>
</div>
</div>
<div class="sub-header" id="pq-answers-189_192_204">
<h3>Freagraí scríofa (Ceist ar Health)</h3>
</div><div class="speech" id="spk_729">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/James-Reilly.D.2007-06-14/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/James-Reilly.D.2007-06-14/image/thumb" alt="James Reilly"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/James-Reilly.D.2007-06-14/">Minister for Health</a>
</h4>
</div>
<div class="text">
<div class="content"><div class="social-share"><a href="#" class="share-trigger" data-share-url="https://www.oireachtas.ie/ga/debates/question/2014-05-14/189/speech/729/" data-share-text="Medical Qualifications" title="Share speech #729 by Minister for Health"><i>Roinn</i></a></div>

<p id="para_2409" class="">I propose to take Questions Nos. 189, 192 and 204 together.</p>
<p id="para_2410" class=""> There is some evidence that medical graduates are tending to emigrate on completion of training here and, to a degree, at an earlier stage. The reasons encompass a range of factors including training, work environment, career opportunities, lifestyle and quality of life issues and remuneration. Last July I established a group under the chairmanship of Professor Brian MacCraith to carry out a strategic review of medical training and career structures. The Group is to make recommendations aimed at improving the retention of medical graduates in the public health system and planning for future service needs. It provided an Interim Report in December 2013 focused on training. Last month the Group submitted its second report to me dealing with medical career structures and pathways following completion of specialist training. The final report of the Group will deal with workforce planning and this is due to be submitted by the end of June 2014. The work of the Group is fundamental to ensuring that consultant positions in the public health service are attractive to medical graduates. I have also emphasised to the HSE the importance of addressing the working hours of NCHDs and moving as quickly as possible to compliance with the provisions of the European Working Time Directive.</p>
<p id="para_2411" class=""> A proportion of nurses have traditionally gone abroad following graduation. More recently, given the moratorium on recruitment, the numbers going abroad had increased. The Nurse Graduate Initiative was developed in order to achieve savings on agency costs and to provide an opportunity for a substantial number of recently-qualified nurses and midwives to work in Ireland for a two-year period. This Initiative gives recently graduated nurses the opportunity to gain valuable experience and additional skills at a time when job opportunities in the public service are limited, though nurses continue to be recruited to permanent posts where service demands require this. Nearly 500 nurses and midwives have commenced employment in recent months on the Initiative, with over 200 others currently going through the recruitment process.</p>
<p id="para_2412" class=""> With regard to the numbers of nursing graduates required, a workforce planning exercise carried out in 2013 to forecast future staffing requirements as part of the Review of the Undergraduate Nursing and Midwifery Degree Programmes has indicated that the overall number of trainee nurses and midwives currently undertaking the programmes, 1,570 places in total, is considered to be sufficient to meet demand. With regard to medicine, in 2006, the Fottrell Report recommended an annual intake of 725 students into Irish medical schools based on the projected medical manpower needs of the health service. This target number has now been reached and sufficient intern posts are available to enable each graduate to register with the Medical Council of Ireland.</p>
<p id="para_2413" class=""> The ability of the public service to attract and retain high quality frontline staff shapes the extent to which the HSE can maintain and develop the range of health services required.</p>
<p id="para_2414" class=""> Where frontline staffing shortages exist, the HSE makes alternative arrangements to ensure service provision, including recourse to agency and locum cover. However, it is preferable that sufficient numbers of doctors, nurses and NCHDs are recruited to permanent posts to support the most efficient and effective delivery of services.</p>
</div>
</div>
</div>

General Practitioner Services

<div class="sub-header">
<h3>Ceisteanna (190)</h3>
</div>

<div class="question" id="pq_190">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/Bernard-Durkan.D.1981-06-30/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Bernard-Durkan.D.1981-06-30/image/thumb" alt="Bernard Durkan"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/Bernard-Durkan.D.1981-06-30/">Bernard Durkan</a>
</h4>
</div>
<div class="text">
<div class="social-share">
<a href="#" class="share-trigger" data-share-url="https://www.oireachtas.ie/ga/debates/question/2014-05-14/190/question/190/" data-share-text="General Practitioner Services" title="Share question #190 by Bernard Durkan">
<i>Roinn</i>
</a>
</div>
<div class="content"><h4 class="from">Bernard Durkan</h4><span class="question-start">Ceist:</span>
<p id="para_2415" class="">190. <strong>Deputy Bernard J. Durkan</strong> asked the <strong>Minister for Health</strong> the total number of general practitioners currently practising throughout this jurisdiction; the extent to which this number has fluctuated in the past ten years; the extent to which demographic trends are affecting requirements in this area; and if he will make a statement on the matter. [21768/14]</p>
<a class="view-answer" href="#pq-answers-190">Amharc ar fhreagra</a></div>
</div>
</div>
<div class="sub-header" id="pq-answers-190">
<h3>Freagraí scríofa (Ceist ar Health)</h3>
</div><div class="speech" id="spk_730">
<div class="c-avatar -debate">
<a class="c-avatar__img-link" href="/ga/members/member/Alex-White.S.2007-07-23/">
<img class="c-avatar__img" src="https://data.oireachtas.ie/ie/oireachtas/member/id/Alex-White.S.2007-07-23/image/thumb" alt="Alex White"/>
</a>
<h4 class="c-avatar__name">
<a class="c-avatar__name-link" href="/ga/members/member/Alex-White.S.2007-07-23/">Minister of State at the Department of Health</a>
</h4>
</div>
<div class="text">
<div class="content"><div class="social-share"><a href="#" class="share-trigger" data-share-url="https://www.oireachtas.ie/ga/debates/question/2014-05-14/190/speech/730/" data-share-text="General Practitioner Services" title="Share speech #730 by Minister of State at the Department of Health"><i>Roinn</i></a></div>

<p id="para_2416" class="">On 30 April 2014, 2,892 medical practitioners held registration as trained Specialists in the specialty of General Practice on the Specialist Division of the Medical Council's Register of Medical Practitioners. Holding registration does not necessarily mean that the medical practitioner is in active practice in General Practice at this time. This compares with 2,840 on 31 December 2013; 2,731 on 31 December 2012; 2,562 on 31 December 2011; 2,270 on 31 December 2010; and 599 on 31 December 2004. </p>
<p id="para_2417" class=""> Prior to 16 March 2009, the Register of Medical Specialists (Medical Practitioners Act 1978) was a voluntary Register and only became a statutory Division of the Register on that date, following the commencement of Part 6 the Medical Practitioners Act 2007.</p>
<p id="para_2418" class=""> The following table shows the number of GPs who held a General Medical Services (GMS) contract over the period 2004 to date:</p>
<table>
<tr>
<td>
<p id="para_2419" class="">Date</p>
</td>
<td>
<p id="para_2420" class="">GMS Contract Holders</p>
</td>
</tr>
<tr>
<td>
<p id="para_2421" class=""> 30 April 2014</p>
</td>
<td>
<p id="para_2422" class="">2,416</p>
</td>
</tr>
<tr>
<td>
<p id="para_2423" class=""> 31 December 2013</p>
</td>
<td>
<p id="para_2424" class="">2,413</p>
</td>
</tr>
<tr>
<td>
<p id="para_2425" class=""> 31 December 2012</p>
</td>
<td>
<p id="para_2426" class="">2,353</p>
</td>
</tr>
<tr>
<td>
<p id="para_2427" class=""> 31 December 2011</p>
</td>
<td>
<p id="para_2428" class="">2,277</p>
</td>
</tr>
<tr>
<td>
<p id="para_2429" class=""> 31 December 2010</p>
</td>
<td>
<p id="para_2430" class="">2,258</p>
</td>
</tr>
<tr>
<td>
<p id="para_2431" class=""> 31 December 2009</p>
</td>
<td>
<p id="para_2432" class="">2,136</p>
</td>
</tr>
<tr>
<td>
<p id="para_2433" class=""> 31 December 2008</p>
</td>
<td>
<p id="para_2434" class="">2,098</p>
</td>
</tr>
<tr>
<td>
<p id="para_2435" class=""> 31 December 2007</p>
</td>
<td>
<p id="para_2436" class="">2,129</p>
</td>
</tr>
<tr>
<td>
<p id="para_2437" class=""> 31 December 2006</p>
</td>
<td>
<p id="para_2438" class="">2,095</p>
</td>
</tr>
<tr>
<td>
<p id="para_2439" class=""> 31 December 2005</p>
</td>
<td>
<p id="para_2440" class="">2,018</p>
</td>
</tr>
<tr>
<td>
<p id="para_2441" class=""> 31 December 2004</p>
</td>
<td>
<p id="para_2442" class="">1,984</p>
</td>
</tr>
</table>
<p id="para_2443" class="">On 30 April 2014, there were a further 475 GPs who were not contracted under the GMS scheme but who hold contracts with the HSE under other schemes, such as the Primary Childhood Immunisation Scheme, the Health (Amendment) Act 1996, Heartwatch and the Methadone Treatment Scheme.</p>
<p id="para_2444" class=""> There are currently 157 GP training places per year. The number of places increased from 120 in 2010.</p>
<p id="para_2445" class=""> In July last year, my colleague Dr James Reilly, Minister for Health, established a Working Group, chaired by Professor Brian MacCraith, President of DCU, to carry out a Strategic Review of Medical Training and Career Structure. The Working Group will examine and make high-level recommendations relating to training and career pathways for doctors with a view to improving graduate retention in the public health system, planning for future service needs, and realising maximum benefit from investment in medical education and training. Professor MacCraith has been asked to furnish the Group's final report by the end of June 2014.</p>
<p id="para_2446" class=""> The HSE is currently engaged in a medical workforce planning project, which will include a workforce plan for GPs. When this work has been completed, it will assist in identifying GP requirements.</p>
<p id="para_2447" class=""> The OECD Health Data 2013 shows the average number of General Practitioners (GPs) per 1,000 population across OECD countries in 2011 was approximately 0.70. It also shows that Ireland had approximately 0.72 GPs per 1,000 population in 2011. It should be noted that figures for some countries exclude trainees, while others (including Ireland) include all registered GPs.</p>
</div>
</div>
</div>