Written Answers Nos. 483-502
483. Deputy Finian McGrath asked the Minister for Health the position regarding the treatment of periods of cover for children and parents, where health insurance premiums are paid on their behalf by either their parents or another adult, including a spouse, if any penalties apply to dependants in the event of the policyholder passing away; and if he will make a statement on the matter. [13055/15]
Amharc ar fhreagraLifetime Community Rating (LCR) is being introduced to encourage people to take out health insurance at a younger age, thus helping to spread costs across the market and supporting affordable premiums for all. There is a nine month grace period, which expires on 30 April 2015, during which time as many people as want to can take out health insurance without incurring loadings. From 1 May 2015, late entry loadings will be applied to those who join the private health insurance market at age 35 or over, set at 2% per year for each year over the age of 34, up to a maximum loading of 70% at age 69 and over.
There are exemptions available for people who previously had health insurance but cancelled it. A credited period can apply for any periods of inpatient cover when a full adult premium is paid in respect of anyone, including spouses and dependant students. Therefore, where a person was named on a health insurance contract and the policyholder dies, all prior cover is recognised under LCR. Loadings can be avoided where the individual maintains their health insurance cover or has a break in cover of less than 13 weeks. There is a distinction between the treatment of the period of cover for adults and children, whereby the period of cover for children where child premium rates are paid is not taken into account for the purposes of LCR.
484. Deputy Tom Fleming asked the Minister for Health if he will pursue the widest and earliest possible implementation of effective vaccines against all strains of meningitis and septicaemia; and if he will make a statement on the matter. [13136/15]
Amharc ar fhreagraMeningococcal disease is a serious disease the incidence of which is falling in Ireland. Ireland’s introduction of Meningococcal C and Pneumococcal vaccine programmes have reduced the burden of these diseases and Meningococcal B vaccine is currently being used to control outbreaks of Meningococcal B disease.
The HSE National Immunisation Office (NIO) has responsibility for the operation of the primary childhood immunisation programme in Ireland. The NIO runs regular media campaigns highlighting the importance of immunisation and has a dedicated website (www.immunisation.ie) which provides information tailored for public and professionals. Information is also available to download.
There are a number of vaccines which protect against meningitis and those used in Ireland include:
- Hib - Hib is part of the combined 6 in 1 vaccine that protects against diptheria, tetanus, pertussis (whooping cough), polio and Hib. This vaccine is recommended for babies at 2, 4 and 6 months of age. A Hib booster is offered at 13 months of age;
- MenC -MenC is currently offered to babies at 4, 6 and 13 months of age;
- Pneumococcal (PCV) - Pneumococcal vaccine is offered to babies at 2, 6 and 12 months of age;
- Viral MMR – MMR prevents against some forms of viral meningitis. MMR is recommended at 12 months of age with a booster given in school between the ages of 4 and 5 years; and
- MenB vaccine is used in the control of clusters or outbreaks of Meningococcal B disease.
My Department continues to monitor the development of new vaccines and immunisation strategies in relation to this disease. It recently received a letter from the Chairman of National Immunisation Advisory Committee (NIAC) regarding the introduction of the Meningitis B vaccine into the Primary Childhood Immunisation Schedule. In this letter NIAC recommends the inclusion of Meningococcal B vaccine in the primary immunisation programme, if the vaccine can be made available at a cost-effective price. My Department is currently considering this recommendation.
The introduction of any new vaccine into the primary childhood immunisation schedule will be considered in the context of recommendations from NIAC, the outcome of cost- benefit analysis, the conclusions of the review of vaccination services currently being carried out, and resource availability.
485. Deputy Arthur Spring asked the Minister for Health if he will provide, in tabular form, the number of medical card reviews issued by the Health Service Executive to persons under 70 years of age for each month since January 2013 to date in 2015. [13154/15]
Amharc ar fhreagraThe 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.
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.
486. Deputy Arthur Spring asked the Minister for Health if he will provide, in tabular form, the number of medical card reviews issued by the Health Service Executive to persons over 70 years of age for each month since January 2013 to date in 2015. [13155/15]
Amharc ar fhreagraThe 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.
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.
487. Deputy James Bannon asked the Minister for Health when payment will be issued in respect of a person (details supplied) in County Longford; and if he will make a statement on the matter. [13157/15]
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.
488. Deputy Caoimhghín Ó Caoláin asked the Minister for Health when the consideration by the Health Service Executive of funding the medication Regorafenib Stivarga will conclude; and if he will make a statement on the matter. [13160/15]
Amharc ar fhreagraThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013.
The decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds by the HSE on the advice of the National Centre for Pharmacoeconomics. They are not political or Ministerial decisions.
The HSE received an application for the inclusion of Regorafenib in the GMS and community drugs schemes. The application is being considered in line with the procedures and timescales agreed by the Department of Health and the HSE with the Irish Pharmaceutical Healthcare Association for the assessment of new medicines.
In accordance with these procedures, the National Centre for Pharmacoeconomics conducted a pharmacoeconomic evaluation of Regorafenib. It is not possible to say at present when a decision on the funding of this medication will be made as the HSE is currently considering the results of the assessment by the National Centre for Pharmacoeconomics as well as the commercial negotiation that they have engaged in with the pharmaceutical company Bayer to seek to address some of the concerns raised in that assessment.
489. Deputy Michael McCarthy asked the Minister for Health if he will address a matter (details supplied) regarding respite care; and if he will make a statement on the matter. [13165/15]
Amharc ar fhreagraAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy. 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 the matter up with the HSE.
490. Deputy Billy Kelleher asked the Minister for Health if a conflict of interest arises in respect of the chief executive officers of hospital groups being appointed by the Health Service Executive to manage the resources, assets and staffing of hospital groups containing both Health Service Executive hospitals and non-Health Service Executive hospitals; and, if so, the measures being put in place to mitigate that conflict. [13173/15]
Amharc ar fhreagraThe HSE has a Governance Framework in place covering corporate, clinical and financial governance. The HSE Accountability Framework sets out the accountability of the Hospital Group CEOs to the National Director and the CEOs of Section 38 agencies to Hospital Group CEOs. Service Level Arrangements (SLAs) will continue to be the principal accountability agreement between the Hospital Group CEOs and the voluntary hospitals in the Group.
In relation to your query regarding any conflicts of interest, 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.
491. Deputy Billy Kelleher asked the Minister for Health the safeguards being put in place to maintain the autonomy of non-Health Service Executive hospitals within hospital groups; and the extent to which hospital group managers may interfere with that autonomy. [13174/15]
Amharc ar fhreagraHospital Groups have been established on an administrative basis, operating within the policy and accountability frameworks determined by the Department of Health and the HSE. As per the HSE Accountability Framework for 2015, Hospital Groups are responsible for performance, outcomes, operating within budget and employment limits, with the quality and safety of patients at the core of their business. Service Level Arrangements (SLAs) will continue to be the principal accountability agreement between the Hospital Group CEOs and the Section 38 voluntary hospitals in the Group. The SLAs include agreed specific service specifications and financial and quality schedules.
I believe that the exercise of the delegated authority to be provided to the Group CEOs and the provisions set out in the Service Level Agreements between the HSE and Section 38 agencies provide sufficient scope to integrate the voluntary hospitals into the Group while recognising the differing hospitals’ legal standing, roles and prescribed governance structures, in particular those with their own boards and separate legal entities.
The implementation of Hospital Groups will progress in a phased manner, which will provide for devolved decision-making, fostering flexibility, innovation and local responsiveness, while also adhering to prescribed national service objectives and standards. A key step in integrating all hospitals within the Group will be the development of Hospital Group Strategic Plans that demonstrate a co-ordinated approach to the planning and delivery of services within the Hospital Groups. The voluntary hospitals will be closely involved in the development of Strategic Plans for their Hospital Group.
My priority for 2015 is to get all the Hospital Groups up and running as single cohesive entities before then moving towards developing the appropriate underlying legislation as part of the wider structural reforms.
492. Deputy Billy Kelleher asked the Minister for Health if safeguards are being put in place to ensure that non-Health Service Executive hospitals are not competing for funding with a block of Health Service Executive hospitals within the groups in circumstances where the allocation of funding is controlled by a manager appointed by the Health Service Executive; and the powers the manager of a hospital group will have to withdraw resources, assets or staff from non-Health Service Executive hospitals within the group. [13175/15]
Amharc ar fhreagraHospital Groups have been established on an administrative basis, operating within the policy and accountability frameworks determined by the Department of Health and the HSE. As per the HSE Accountability Framework for 2015, Hospital Groups are responsible for performance, outcomes, operating within budget and employment limits, with the quality and safety of patients at the core of their business. Service Level Arrangements (SLAs) will continue to be the principal accountability agreement between the Hospital Group CEOs and the Section 38 voluntary hospitals in the Group. The SLAs include agreed specific service specifications and financial and quality schedules.
I believe that the exercise of the delegated authority to be provided to the Group CEOs and the provisions set out in the Service Level Agreements between the HSE and Section 38 agencies provide sufficient scope to integrate the voluntary hospitals into the Group while recognising the differing hospitals’ legal standing, roles and prescribed governance structures, in particular those with their own boards and separate legal entities.
The implementation of Hospital Groups will progress in a phased manner, which will provide for devolved decision-making, fostering flexibility, innovation and local responsiveness, while also adhering to prescribed national service objectives and standards. A key step in integrating all hospitals within the Group will be the development of Hospital Group Strategic Plans that demonstrate a co-ordinated approach to the planning and delivery of services within the Hospital Groups. The voluntary hospitals will be closely involved in the development of Strategic Plans for their Hospital Group.
My priority for 2015 is to get all the Hospital Groups up and running as single cohesive entities before then moving towards developing the appropriate underlying legislation as part of the wider structural reforms.
493. Deputy Seán Ó Fearghaíl asked the Minister for Health if he will expedite a surgical intervention in respect of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [13176/15]
Amharc ar fhreagraYou will appreciate that it is contrary to the Health Service Executive (Governance) Act 2013 for me to make a direction to the HSE or a hospital to benefit or prioritise any individual person or patient.
The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the Health Service Executive, sets out the processes that hospitals are to implement to manage waiting lists.
In relation to the particular query raised, 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.
494. Deputy Mary Lou McDonald asked the Minister for Health the supports available in respect of a person (details supplied) in Dublin 22 who suffers from epilepsy and requires a guide dog. [13198/15]
Amharc ar fhreagraAs the particular issue raised by the Deputy relates to an individual case, this is a service matter for the Health Service Executive. Accordingly, I have arranged for the question to be referred to the HSE for 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.
495. Deputy Michael Healy-Rae asked the Minister for Health the reason there are beds lying empty in Killarney Community Hospital and St. Columbanus home in County Kerry when, following treatment at Kerry General Hospital, persons urgently require access to beds before returning home; and if he will make a statement on the matter. [13204/15]
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.
496. Deputy Michael McCarthy asked the Minister for Health the drugs counselling services provided to persons under 18 years of age in Dundalk, County Louth; and if he will make a statement on the matter. [13207/15]
Amharc ar fhreagra497. Deputy Michael McCarthy asked the Minister for Health the drugs counselling programmes provided to persons under 18 years of age in Dundalk, County Louth; and if he will make a statement on the matter. [13208/15]
Amharc ar fhreagraI propose to take Questions Nos. 496 and 497 together.
As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
If the Deputy has not received a reply from the HSE within 15 working days he should contact my Private Office and they will follow up the matter with them.
498. Deputy James Bannon asked the Minister for Health the reason a person (details supplied) in County Longford has been denied a respite place at Charleville House in Tullamore, County Offaly; and if he will make a statement on the matter. [13216/15]
Amharc ar fhreagraAs the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy. 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 the matter up with the HSE.
499. Deputy Jerry Buttimer asked the Minister for Health in order to encourage persons with intellectual disabilities to take up opportunities of rehabilitative employment, if he will consider putting protections in place to ensure that such persons participating in employment will not be affected by additional payments, when it comes to accessing medical cards and other health services; and if he will make a statement on the matter. [13220/15]
Amharc ar fhreagraMany individuals with intellectual, physical or mental health disabilities gain full-time or part-time employment in the open labour market but may still receive health-funded supports on an intermittent or continuing basis, depending on their individual needs and abilities. The Health Service Executive (HSE) and voluntary disability agencies recognise the importance of employment to people with disabilities and are committed to supporting the participation of people with disabilities in the social and economic lives of their communities.
People with intellectual disabilities can avail of a range of community-based services and in many cases have priority in accessing these services. The relevant community services may include Public Health Nurses, Home Helps, Personal Assistance, Psychological Services, Speech and Language Therapy, Occupational Therapy, Social Work Services, Physiotherapy, Day Care, Respite Care and Medical/Surgical Aids and Appliances.
In general, community services for people with disabilities are accessed on the basis of need. However they may be subject to specific eligibility criteria, such as a holding a Medical Card or Long Term Illness card, although individuals who do not meet these criteria will be considered by the HSE on a case by case basis.
I appreciate the importance of the medical card to people with disabilities and the value that is placed on it by the person and their family. Under the relevant legislation, eligibility for a medical card is based primarily on residency and means and not on the basis of having a particular medical condition or disease. The Deputy will 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.
However, the Government recognises that the health service needs to be responsive to the circumstances of people with significant medical needs. Following publication of the two reports in November 2014, the Minister for Health and I announced a series of measures to enhance the operation of the medical card scheme and make it more sensitive to people’s needs, especially where serious illness is involved.
Where deemed appropriate in particular circumstances, the HSE may exercise discretion and grant a medical card even though an applicant's means exceed the prescribed threshold. Where a person does not qualify for a medical card, they may be provided with a GP Visit Card, appropriate therapy or other community supports or drugs.
500. Deputy Bernard J. Durkan asked the Minister for Health if much needed physiotherapy will be facilitated in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [13221/15]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for 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.
501. Deputy Robert Dowds asked the Minister for Health when the implementation of the national positive ageing strategy will commence; and when the consultation process will commence. [13225/15]
Amharc ar fhreagraThe 2011-2016 Programme for Government committed to completing and implementing the National Positive Ageing Strategy (NPAS) so that older people are recognised, supported and enabled to live independent full lives. In our statement of Health priorities for 2015, the Minister for Health and I have reiterated our commitment to implementing the Strategy.
The National Positive Ageing Strategy provides a vision for an age-friendly society and includes four National Goals and underpinning Objectives to provide direction on the issues that need to be addressed to promote positive ageing. As Minister of State with responsibility for older people, I am driving implementation at political level. The Strategy is a cross-Departmental one and my Department has an overall coordinating and collating role and a more direct role for the health-related objectives.
A key objective of this Strategy is to change the mindsets of decision makers across Government agencies and to raise the priority that is given to the concerns of older people. The first step in doing this is to establish a system of regular reporting on actions and initiatives that impact on older people, and these reports are regularly sought and collated by my Department. The fact that such reports are already and will continue to be required will in itself increase the focus that is given to older persons' issues, and these reports will be submitted for the consideration of the Cabinet Committee on Social Policy and Public Sector Reform chaired by An Taoiseach.
It is important to point out the many initiatives already in train which contribute to the Strategy's goals. For example, in the health sector, in the area of older people’s services and supports, the Review of the Nursing Homes Support Scheme will be completed shortly. The Single Assessment Tool, which will allow for a systematic assessment of need and allocation of services to older people, is being developed by the HSE; measures are being taken to ensure integrated care for older patients, and palliative care services are being improved. The Deputy will also be aware of the recent initiative which saw an additional € 25million provided to address the issue of delayed discharges in acute hospitals. The majority of these patients are older people, and these funds are being applied across both long term and short term residential services and at community level. As a result the waiting time for funding of approved patients under the Nursing Home Support scheme has fallen to eleven weeks now from fifteen weeks a short time ago.
A Healthy and Positive Ageing Initiative (HaPAI) has also been established to implement the research objective of the National Positive Ageing Strategy. It is a joint initiative between the Department of Health, the HSE’s Health and Wellbeing Programme and the Atlantic Philanthropies and will run from October 2014 to December 2017, with a commitment to Department of Health funding for a further two years. The Initiative will monitor changes in older people’s health and wellbeing linked to the Goals and Objectives of the Positive Ageing Strategy. This will be done primarily through the development of positive ageing indicators to be published every two years. The HSE will also develop a physical activity communications campaign under the Initiative.
502. Deputy Michael Healy-Rae asked the Minister for Health the position regarding the national dementia strategy (details supplied); if dementia will be recognised as a long-term illness with regard to obtaining a medical card and other entitlements; and if he will make a statement on the matter. [13238/15]
Amharc ar fhreagraIn accordance with the Health Act 1970 (as amended), the assessment for a medical card is determined primarily by reference to the means, including the income and expenditure, of the applicant and his or her partner and dependants and there is no entitlement to a medical card for a person with a particular illness or medical condition. The Deputy will 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.
However, the Government recognises that the health service needs to be responsive to the circumstances of people with significant medical needs. Following publication of the two reports, in November 2014, the Minister for Health and I announced a series of measures to enhance the operation of the medical card scheme and make it more sensitive to people’s needs, especially where serious illness is involved. Where deemed appropriate in particular circumstances, the HSE may exercise discretion and grant a medical card even though an applicant's means exceed the prescribed threshold. Where a person does not qualify for a medical card, they may be provided with a GP Visit Card, appropriate therapy or other community supports or drugs.
The medical card system is now operating in a more sensible and sensitive manner. The HSE is exercising greater discretion, as is evident in the increase in the number of discretionary medical cards in circulation - by over 55% from about 52,000 in mid-2014 to over 81,000 at the end of February this year.
The Irish National Dementia Strategy was published in December 2014 and the Government, together with the Atlantic Philanthropies foundation, pledged €27.5 million to change how the illness is treated and understood over the next four years. The primary focus of the Strategy is to enable people with dementia to live well in their own homes and communities for as long as possible, and it sets out ways of achieving this. It includes the provision of intensive home care packages, an information campaign and resources for GPs, who are most often the first port of call for people worried about dementia.
