Written Answers Nos 158-164
158. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the total of the revenue stream to public hospitals from private health insurance sources; and if he will make a statement on the matter. [9519/15]
Amharc ar fhreagraYour question has been referred to the Health Service Executive for direct reply as it is the statutory body with responsibility for delivering health and personal social services. If you have not received a reply from the HSE within 15 working days please contact my Private Office who will follow up on the matter.
159. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the total spent by the public on private health insurance, by provider; and if he will make a statement on the matter. [9520/15]
Amharc ar fhreagraThe latest available figure from the Health Insurance Authority (HIA) shows the total health insurance premiums paid in 2013, gross of tax relief, amounted to €2,378 million. This is "premium income paid" data that has been calculated by the HIA from quarterly returns provided by health insurers.
The following is a breakdown by the different health insurance businesses in the State (except Restricted Membership Undertakings) of their "earned premium income", which has been extracted from financial accounts information that has been separately provided to the HIA by the health insurers. It should be noted that "premium income paid" and "earned premium income" are related but not identical accounting calculations of premium income in insurance businesses.
The latest HIA data is for 2013, as follows:
|
€ millions |
Aviva Health - €m |
Elips (Laya) - €m |
Great Lakes (Glohealth) - €m |
Quinn - €m |
VHI - €m |
|
Earned premiums before reinsurance and age related tax credit |
333.8 |
412.2 |
34.5 |
10.6 |
1,469.4 |
The figures may differ from published accounts, which may have been finalised on a different date and may include business other than private health insurance business, which my Department does not collate, as the companies concerned are commercial entities.
160. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide details of the current reviews of disability services; and if he will make a statement on the matter. [9521/15]
Amharc ar fhreagraI understand that the Deputy is referring to the Value for Money and Policy Review of Disability Services (VFM Review) and the reconfiguration of services for children and young people with disabilities aged 0 to 18 years, under the National Progressing Disability Services for Children and Young People Programme.
This is a time of change in the delivery of disability services in this country, and a major transformation programme is underway. The implementation of the VFM Review is a multi-year project which will result in very significant changes to the way in which services and supports for people with disabilities are delivered. The Health Service Executive (HSE) is responsible for delivering the recommendations contained in the VFM Review and has given the implementation of these recommendations top priority in the National Service Plan for 2015, with actions and targets outlined in the Social Care Operational Plan for 2015.
The Working Groups established to support the implementation of the reform process are continuing their work on a range of inter-connected and challenging projects, including work on the development of the guidelines for evaluation of demonstration projects and the production of a policy appraisal project plan. The Working Groups are also making progress on implementing recommendations on reform of adult day services, de-institutionalisation and 0-18s therapy services.
The VFM Review envisaged that the transformation process would be guided by demonstration projects, developed as proof of concept, and run in parallel with current services, following which their suitability for wider application would be evaluated. The HSE and disability agencies are already working on demonstration projects aimed at giving service users greater choice and control and testing how aspects of the new policy will work in practice. Taking into account the number and diversity of demonstration projects underway, an extensive evaluation process will be initiated by one of the Working Groups and this will guide the final shape of the disability services reform programme.
In relation to disability services for children and young people aged 0 to 18 years, the HSE is currently engaged in a reconfiguration of therapy resources into multi-disciplinary geographic based teams for children and young people, as part of the National Progressing Disability Services for Children and Young People Programme. As mentioned above, implementation of this reconfiguration is being overseen and monitored under the VFM process. The aim of the Programme is to achieve a national, unified approach to delivering disability health services so that there is a clear pathway to services for all children, regardless of where they live, what school they go to or the nature of their disability.
The Programme is organised at national, regional and local level and includes representatives from the health and education sectors, non-statutory service providers and parents. An additional €4 million has been specifically allocated in 2014 for implementation, which equates to approximately 80 therapy posts. Further investment of €4 million will be made in 2015 (equating to €6 million in a full year).
161. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if he will provide the details of the various current hospital charges per person in the public system; the overall amount generated by such charges in each of the past three years; and if he will make a statement on the matter. [9522/15]
Amharc ar fhreagraThe Health Service Executive has been asked to examine the matter of income generated by hospital charges and to reply to the Deputy as soon as possible. If the Deputy has not received a reply from the HSE within 15 working days, please contact my Private Office who will follow up the matter with them. The hospital charges that currently apply are as follows.
The Health (Out-Patient Charges) Regulations 2013 provides for a €100 charge for out-patient services provided at an emergency department, an accident and emergency department, a casualty department, a minor injury unit, an urgent care centre, a local injury unit or any other facility providing similar services, subject to certain exemptions. In addition, under the Health Services (Out-Patient) Regulations 1993, the HSE may levy a charge on private patients for the use of an MRI machine in a public hospital.
Under the Health (In-Patient Charges) Regulations 1987 (as amended) public in-patients in public hospitals are liable to a €75 per day charge subject to a maximum of €750 in any 12 consecutive months, subject to certain exemptions. Under the Health (Amendment) Act 2013 private in-patients in public hospitals are subject to charges that range from €329 to €1,000 per day. The charge levied depends on whether accommodation is provided in a single or multiple occupancy room and if overnight accommodation is provided.
As required by the Health (Amendment) Act 1986, where a hospital is informed that the patient, their personal representative or a dependent is pursuing a Road Traffic Accident (RTA) claim, billing data is generated on the local billing system. Invoices can be raised for an RTA related in-patient or out-patient charge depending on the services provided at the hospital.
The Health (Charges for In-Patient Services) Regulations 2005-2011 provide that, subject to certain exemptions, charges apply to the maintenance element of "long-stay" in-patient services (excluding acute in-patient services or services supported under the Nursing Homes Support Scheme) provided in hospitals or other specified settings by or on behalf of the HSE for over 30 days within a rolling 12 month period. Charges apply to those with full or limited eligibility and may not exceed 80% of the weekly non-contributory State pension. The Regulations provide for sliding scales of charges based on income, with the current maximum being €175 per week where 24-hour nursing care is provided or €130 per week where 24-hour nursing care is not provided. The charges may be waived or reduced where necessary to avoid financial hardship, having regard to each individual's financial circumstances (including whether he or she has dependants).
162. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if bulk buying by joint contract on an international basis with either the National Health Service in the North and in Britain or the EU has been examined for the procurement of medications and medical equipment; and if he will make a statement on the matter. [9523/15]
Amharc ar fhreagraMost drugs, medicines and consumable appliances which are paid for by the HSE are supplied to patients through over 1,800 community pharmacies who, in turn, purchase them from wholesalers or, to a lesser extent, directly from drug manufacturers.
The current pharmacy based model results in over 70 million items being dispensed annually through local pharmacies across the State, including low population centres in rural areas. It enables pharmacies to receive deliveries each day from multiple wholesalers ensuring that all patients have continued access to essential medicines without delay. Under this model, as the drugs are purchased by individual pharmacies with no direct input by the HSE, there is no scope for the type of central procurement arrangement envisaged by the Deputy.
Establishing an alternative centralised distribution centre capable of distributing 70 million items across the State would be extremely difficult to achieve and would absorb any potential savings available to the HSE from directly purchasing medicines.
There is, however, a Joint Procurement Agreement for medical countermeasures in place at an EU level which enables countries, including Ireland, to procure pandemic vaccines and other medical countermeasures on a group rather than individual basis.
163. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if there has been a roadmap of elimination of hospital charges planned alongside the introduction of universal health insurance; and if he will make a statement on the matter. [9524/15]
Amharc ar fhreagraThe question of whether there will be hospital charges under a future system of universal healthcare remains to be determined. The White Paper on Universal Health Insurance, published on 2 April 2014, stipulates that the State will determine the standard UHI package, including the minimum and maximum out of pocket payments which may be applied as part of the package.
Co-payments for certain services are often a feature of health insurance systems in other countries. Indeed, some level of co-payments could assist in reducing the cost of insurance plans under a future system of UHI. However, there would have to be careful consideration of any proposed co-payments to ensure that they would not become a barrier to accessing the health services which citizens need and to which they are entitled.
164. Deputy Caoimhghín Ó Caoláin asked the Minister for Health if consultant contracts will be revisited before the roll-out of universal health insurance; and if he will make a statement on the matter. [9525/15]
Amharc ar fhreagraOver 70% of consultants in the public health service hold contracts that allow them engage in private practice, subject to specified limits, in addition to meeting a public commitment. Engagement with the consultants representative bodies will therefore be required before the roll out of Universal Health Insurance.
