Written Answers Nos. 397-411
397. Deputy Mary Mitchell O'Connor asked the Minister for Health the reason there are still cases of persons, and especially young children, being refused discretionary medical cards, despite being extremely ill and in view of the Health Service Executive stating in November 2014, that the process would be enhanced to make it more sensitive to people’s needs; and if he will make a statement on the matter. [3785/15]
Amharc ar fhreagraAs the Deputy will be aware, eligibility for medical cards is set out in the Health Act 1970 (as amended). The Act provides that persons, unable without undue hardship having regard to their overall financial situation to arrange GP services for themselves and family, qualify for a medical card. The Deputy will also be aware of the publication of the Report of the Expert Panel on Medical Need for Medical Card Eligibility and the Medical Card Process Review in November 2014. A key recommendation of the Expert Panel was that a person’s means should remain the main qualifier for a medical card.
The HSE has discretion, exercised in accordance with the legislation, to grant a medical card where a person's income exceeds the income guidelines. The HSE is obliged to operate within the legal parameters as set out in the Health Act, while also responding to the variety of circumstances and complexities faced by individuals who apply for a medical card.
In the light of the conclusions of the two reports a range of actions have been identified to improve the operation of the medical card system, particularly for people with significant medical needs. The HSE has appointed a senior manager to lead the reform of the systems for handling medical card application and reviews. Under one of the actions, the HSE is taking steps to establish a clinical advisory group to develop a methodology and guidance for the assessment of applications involving significant medical conditions so as to take account of the burden involved and the needs arising from the condition and to ensure that appropriate services are provided to people who need them. The HSE is also putting arrangements in place for a more integrated and sensitive processing of medical card applications involving significant medical conditions to ensure greater interaction between the central office regarding the assessment of a person’s eligibility and the local health office regarding the person’s medical condition and the services that they may require. Consequently, the number of medical cards issued, where the HSE has exercised discretion, has increased from approximately 50,300 at the start of 2014 to approximately 76,700 at the start of 2015.
The Minister and I have also asked the HSE to examine, with the Department of Health, the best way to meet the needs of people with significant medical conditions who need the support of the public health system. This work includes considering the best way to make medical aids and appliances available to persons who do not hold a medical card, the provision of services to children with severe disabilities, and to enable people with particular needs to have these met on an individual basis rather than awarding a medical card to all family members.
398. Deputy Eoghan Murphy asked the Minister for Health his views on implementing recommendations (details supplied) regarding residential care. [3798/15]
Amharc ar fhreagraLike others, I was shocked and distressed by the revelations of extremely poor and unacceptable standards of care and mistreatment of vulnerable adults in Áras Attracta. Every person who uses our disability services is entitled to expect and receive supports of the highest standard and to live in an atmosphere of safety and care.
The safeguarding and protection of vulnerable people in the care of the health service is of paramount importance and the Director General of the HSE has written to all staff instructing them to take personal responsibility for ensuring that individuals supported by the HSE in any setting are treated with dignity and respect.
In December 2014 the HSE initiated both an expert investigation chaired by Mr Christy Lynch, and an independently chaired review of services at this facility led by Dr Kevin McCoy.
Mr Lynch’s investigation team is working independently of the HSE and its findings will be a precursor to any disciplinary process consideration at which the HSE will undertake. Mr Lynch is both nationally and internationally recognised as a champion for people with a disability and a leader in the implementation of innovative supports. His independence in relation to this issue should not be questioned, as his proven track record in fighting for people with a disability speaks for itself.
Dr McCoy is undertaking an Assurance Review of the services at Áras Attracta and the final report will include an individual plan for improvement in each bungalow within the complex. The review will identify system wide learning involving engagement with relevant expertise as well as input from staff.
A Garda investigation into allegations of abuse at the centre is ongoing and the Garda had requested that a stay be placed on HSE investigations until such time as the Garda investigation is completed. However, the HSE has informed me that gardaí have now cleared the way for the investigation to commence. Following the lift of a Garda stay, I have asked the HSE to keep me informed of progress.
On 16 December 2014, the Director General of the HSE announced the appointment of Ms Leigh Gath as Confidential Recipient in respect of complaints or disclosures of abuse of vulnerable persons in receipt of HSE funded services. Ms Gath has been a fearless advocate and a champion for people with a disability for many years and will, no doubt, provide a strong and independent voice in her role. I am informed by the HSE that Ms Gath took up her duties with effect from Monday 22 December 2014
In line with Government policy, disability providers are delivering an increasing proportion of services and supports which are individualised and person-centred and the HSE is actively working with disability providers towards the migration of more services in 2015 to this person-centred supports model.
Further work is necessary before decisions can be taken on the form or forms which individualised budgeting will take, but the essence of it will be that the individual is given more choice and control over how the money allocated to meet their needs is utilised.
In the meantime there are demonstration projects underway which are looking at all aspects of providing more person-centred and accountable supports for people with disabilities and these projects are providing a valuable insight into the issues arising.
The other points made in the details attached by the Deputy touch on the responsibilities of a number of my colleagues as well as myself, and I will make sure that my colleagues are made aware of these.
I can assure the Deputy that my Department will monitor progress on the initiatives and processes commissioned by the HSE in relation to Áras Attracta, to ensure that the learning from this incident is promulgated throughout our health system.
399. Deputy Clare Daly asked the Minister for Health his plans to include private nursing home care agencies under the remit of the Health Information and Quality Authority, or any other regulatory bodies, in view of the absence of any effective remedy for persons who currently have complaints. [3802/15]
Amharc ar fhreagraThe Health Information and Quality Authority is the independent authority established under the Health Act 2007 to drive continuous improvement and to monitor safety and quality in Ireland’s health and personal social care services.
Since 2009 all nursing homes - public, voluntary and private - have been registered and inspected by HIQA. During the course of this Government HIQA’s function has been extended to residential services for those with disabilities and child protection services.
As regulator, HIQA’s remit operates at the level of facilities rather than that of individual complaints, but the requirements at facility level impact very directly on how individual cases are dealt with.
All nursing homes are required to have an accessible and effective complaints procedure, including an appeals process. They must investigate all complaints promptly, and following investigation put in place any measures required for improvement. Records of complaints made are required to be kept. These are available for inspection, thus enabling the HIQA inspector to determine whether the complaints system is sufficiently robust.
HIQA takes into account and uses all information received to inform and plan its regulatory activity, and information on individual cases can provide useful pointers in this context. HIQA’s programme of both scheduled and unannounced inspections helps to ensure that standards are maintained and where issues of non-compliance arise, that these are addressed and rectified. If a nursing home is found not to be in compliance with the Regulations it may either fail to achieve or lose its registration status. HIQA also has wide discretion in deciding whether to impose conditions of registration on nursing homes.
My Department, in consultation with both HIQA and the service providers, is working on an ongoing basis to improve and update the requirements that apply to nursing home care. Any request from HIQA for an extension of their remit on the lines suggested by the Deputy will be carefully considered.
400. Deputy Róisín Shortall asked the Minister for Health the reason he is not implementing the full recommendations (details supplied) of Judge Quirke's report in respect of the Magdalen scheme as originally promised; and if he will make a statement on the matter. [3815/15]
Amharc ar fhreagraIn his report, Judge Quirke was of the opinion that Magdalen women should be provided with access to a comprehensive suite of health services. He specified GP services, prescribed drugs, medicines, aids and appliances, dental, ophthalmic, aural, home support, home nursing, counselling, chiropody and physiotherapy services and formed the opinion that the health provisions should operate in a manner similar to the scheme made available to certain persons under the Health (Amendment) Act 1996.
Judge Quirke’s recommendation that the women should have access to the range of services under the Health (Amendment) Act 1996 is being given effect in the Redress for Women Resident in Certain Institutions Bill 2014.
401. Deputy Derek Nolan asked the Minister for Health if he will provide an update on the findings of the interdepartmental group on the mobility allowance and motorised transport grant; the timeframe in place for this group's recommendations; if those persons who had their allowance cut in 2013 will now have the opportunity to reapply for it; and if he will make a statement on the matter. [3817/15]
Amharc ar fhreagraThe Inter-Departmental Group considered matters such as eligibility criteria and administrative arrangements for individual payments to people with severe disabilities who require additional income to address the cost of their mobility needs. The Government decided that the preparatory work required for a new travel subsidy scheme should be progressed by the Minister for Health. Work is ongoing on the policy proposals to be brought to Government for the drafting of primary legislation for a new scheme. Once policy proposals have been finalised and approved by Government, the time frame for the introduction of a new scheme will become clearer.
Pending decisions on a new scheme, monthly payments will continue to be made by the Health Service Executive to 4,700 people who were in receipt of the Mobility Allowance at the time that the scheme closed. The Motorised Transport Grant is closed.
402. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if patients are tested for MRSA as a matter of routine when admitted to Mayo General Hospital; the number of patients tested positively for MRSA on admission to Mayo General Hospital in 2013 and 2014; the number of patients being discharged from Mayo General Hospital in 2013 and 2014 who tested positive for MRSA; the number of patients in this hospital that have had complications related to MRSA infection; and if he will make a statement on the matter. [3823/15]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive (HSE) for attention and direct reply to the Deputy.
If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.
403. Deputy Denis Naughten asked the Minister for Health if he will provide the interface which has been developed by the National Ambulance Service, the command and control centre and the community first responders; the number of CFR groups and persons that are currently hooked up to the new system; and if he will make a statement on the matter. [3854/15]
Amharc ar fhreagraLast Thursday 21 January I was delighted to be able to launch the CFR Network. It is rare that pre hospital care in Ireland is recognised for the hard work that goes into it. So it was great to be part of such a positive development.
However as this is a service matter, I have asked the HSE to respond to you directly. If you have not received a reply from the HSE within 15 working days please contact my Private Office and my officials will follow the matter up.
405. Deputy Pat Deering asked the Minister for Health when a person (details supplied) in County Carlow will have a fair deal scheme application approved. [3867/15]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.
406. Deputy Pat Deering asked the Minister for Health when a person (details supplied) in County Carlow will have a fair deal application approved. [3868/15]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.
408. Deputy Michael Healy-Rae asked the Minister for Health when additional beds will open in Dingle Community Hospital, County Kerry; and if he will make a statement on the matter. [3880/15]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply. If you have not received a reply from the HSE within 15 working days please contact my Private Office and they will follow up the matter with them.
409. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question No. 468 of 20 January 2015, if he will specify the incident which is under investigation which led to the decision to suspend the indemnity of a person (details supplied). [3889/15]
Amharc ar fhreagraI wish to thank the Deputy for the question raised.
As there are 2 investigations ongoing into this case, I am not in a position to discuss service delivery issues at this time. It is expected that the investigations will be completed at the end of the first quarter and further disclosure may then be available.
410. Deputy Finian McGrath asked the Minister for Health the position regarding respite care in respect of persons (details supplied) in Dublin 3; and if he will make a statement on the matter. [3894/15]
Amharc ar fhreagraThe vision for the Health Service Executive's Disability Services Programme is to contribute to the realisation of a society where people with disabilities are supported, as far as possible, to participate to their full potential in economic and social life, and have access to a range of quality personal social supports and services including respite care to enhance their quality of life.
In relation to the specific query raised by the Deputy, as this is a service issue, it has been referred to the HSE for direct reply. If the Deputy has not received a reply from the HSE within 15 working days, he can contact my Private Office and they will follow up the matter with the HSE.
411. Deputy Finian McGrath asked the Minister for Health the reason Prader-Willi syndrome which is a severe condition that affects approximately 200 adults and children here is not provided the appropriate funding and services to support parents and family such as the case of family (details supplied) in Dublin 9; and if he will make a statement on the matter. [3895/15]
Amharc ar fhreagraThe Government is fully committed to ensuring the on-going delivery of vital services and supports to people with disabilities within available resources.
The Health Service Executive's (HSE's) 2015 National Service Plan, including its disability services programme for children and adults with disabilities is detailed in the HSE's 2015 Operational Plan.
In relation to the specific query raised by the Deputy, as this is a service issue, it has been referred to the HSE for direct reply. If the Deputy has not received a reply from the HSE within 15 working days, he can contact my Private Office and they will follow up the matter with the HSE.
