Written Answers Nos. 156 - 163
156. Deputy Bernard J. Durkan asked the Minister for Health the degree to which his initiative to alleviate overcrowding at accident and emergency units is expected to have an early and positive impact; and if he will make a statement on the matter. [15137/15]
Amharc ar fhreagraED overcrowding is a key issue for me and for the Government. I acknowledge the consistent staff effort to provide safe, quality care in very challenging circumstances, but I acknowledge equally the difficulties experienced by patients and their families.
Nationally the Government provided additional funding of €3 million in 2014 and €25 million in early 2015 to tackle Delayed Discharges and ED Overcrowding. On 2 April, I announced further funding of €74m. As a result, 746 Applicants have been or are in the process of being notified of funding approval under the Nursing Home Support Scheme and waiting times for placement are reducing.
As well as additional funding, I pursued the establishment of the ED Taskforce to determine time-defined actions to optimise existing hospital and community capacity, develop internal capability and improve processes, leadership, governance, planning and oversight.
In respect of specific anticipated service impacts, 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.
157. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the number of acute general hospital beds available throughout the public health sector has fluctuated in each of the past ten years to date; if augmentation is warranted; and if so, to what extent; and if he will make a statement on the matter. [15139/15]
Amharc ar fhreagraThe Government approach to addressing the perceived acute bed shortage is to reduce over-reliance on the acute sector and to develop care in more appropriate community and day care based settings which is more consistent with best practice in Ireland and internationally and capable of providing better care and results. 'Future Health' commits to a move away from the current hospital-centric model of care towards a new model of integrated care which treats patients at the lowest level of complexity that is safe, timely, efficient, and as close to home as possible. This will help to reduce costs, improve access and move from the existing emphasis on episodic reactive care towards preventative, planned and well co-ordinated care. This is particularly important for the growing numbers of people with chronic conditions and those with two or more diseases and disorders.
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.
158. Deputy Bernard J. Durkan asked the Minister for Health the position regarding the provision of the proposed new children's hospital, with particular reference to the need to ensure an early starting date; and if he will make a statement on the matter. [15140/15]
Amharc ar fhreagraThe National Paediatric Hospital Development Board is the statutory body responsible for planning, designing, building and equipping the new children's hospital. The new hospital will be co-located with St James's Hospital, and ultimately tri-located with a maternity hospital to be developed on campus. In addition to the main hospital, the project includes two satellite centres at the campuses of Tallaght and Connolly Hospitals.
A design team is now working on detailed design development with planning submission scheduled for June 2015. Subject to planning, work is scheduled to commence at the main site at St. James's, and at satellite centre sites at Connolly and Tallaght, in January 2016. Transition of services to the new hospital is expected to begin in April 2019, and to the satellite centres in 2017.
159. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he can improve and reduce the extent of the waiting lists for various hospital appointments and procedures; the degree to which an evaluation has been made with a view to identifying the causes for delays; and if he will make a statement on the matter. [15141/15]
Amharc ar fhreagraImproving waiting lists for scheduled care is a key priority for Government. Taking into account current pressures on acute hospital services, I have put in place a target that by mid-year nobody will wait more than 18 months for in-patient and day case treatment or an out-patient appointment; by year-end, that target will be revised to a wait time of no more than 15 months.
The HSE is currently working on an implementation plan to achieve these targets, and I have asked them to respond to you directly in this regard.
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.
160. Deputy Bernard J. Durkan asked the Minister for Health the extent to which his Department continues to monitor the costs of private health insurance; if community rating processes are being observed by all insurers, without exception; if indications to the contrary have been observed; and if he will make a statement on the matter. [15142/15]
Amharc ar fhreagraThe Health Insurance Authority is a statutory regulator of the private health insurance market. In exercise of its functions, the independent regulator monitors the health insurance market including compliance by the health insurers with the legislative rules and regulations governing the market, particularly in relation to community rating. In doing so, the Authority ensures that the market is regulated appropriately and that insurers are discouraged from engaging in practices, or offering health insurance contracts, which undermine community rating or the principal objective of the Health Insurance Acts.
With regard to the specific issue of costs, I introduced a suite of measures to address rising health insurance premiums and stabilise the private health insurance market in the interests of consumers. These include a reduction in the Risk Equalisation Stamp Duty Levy, special lower premiums for young adults, the introduction of Lifetime Community Rating, and a reduction in the Health Insurance Authority Levy. The package also includes key recommendations set out in the two Pat McLoughlin reports on Private Health Insurance costs, and builds on Budget 2015 which included a freeze on hospital bed charges and no decrease in the relievable amount on health insurance premiums for tax relief purposes.
Taken together, these measures are intended to create a sustainable market where health insurance is as affordable for as many people as possible and to create the best possible environment within which more people, particularly young people, will want to obtain and retain private health insurance, thereby reducing the necessity for premium inflation across the market.
161. Deputy Bernard J. Durkan asked the Minister for Health the extent to which children seeking orthodontic treatment can expect to have treatment within a reasonable time; the expected waiting time for patients in category one, two and three; and if he will make a statement on the matter. [15143/15]
Amharc ar fhreagraThe HSE provides orthodontic treatment to those who have been assessed and referred for treatment before their 16th birthday. It should be noted that the nature of orthodontic care means that immediate treatment is not always desirable. It is estimated that in up to 5% of cases it is necessary to wait for further growth to take place before treatment commences. Patients are assessed by the HSE Orthodontic Service under the modified Index of Treatment Need. Patients with the greatest level of need, i.e. Grade 5 or some with a Grade 4 are provided with treatment by the HSE.
The HSE has established a pilot scheme in Dublin North East which will involve the use of orthodontic therapists in the treatment of a number of eligible children. Consideration will be given to expanding this Scheme to other HSE areas in the future. In addition to the services provided by HSE staff, orthodontic treatment for certain categories of misalignment will be provided by a panel of independent practitioners under contract to the HSE over the next three years. A national procurement process is being finalised. This initiative will especially focus on those waiting for 4 years or longer. It is expected that this initiative will commence later this year and will have a positive impact on waiting times.
162. Deputy Bernard J. Durkan asked the Minister for Health the extent to which cost comparisons continue to be made between public and private sector hospitals in respect of various procedures; and if he will make a statement on the matter. [15144/15]
Amharc ar fhreagraCost data in relation to public hospitals are collected by the hospitals and collated centrally by the Healthcare Pricing Office (HPO). These data are used by the HPO to set prices for the Activity Based Funding (ABF) system which is in the process of being implemented in public hospitals.
ABF represents a major change in the way hospitals are funded and will result in a new level of focus on hospital costs. The new funding model involves moving away from inefficient block grant budgets to a new system where hospitals are paid for the actual level of activity undertaken. Under ABF, the prices to be paid to hospitals will be set by reference to the average cost of treatment across all public hospitals. By setting prices based on average costs, hospitals will be incentivised to better understand their cost-base and improve efficiency.
Patient Level Costing and Business Intelligence systems are also being rolled out across the hospital system to support implementation of ABF. The introduction of these systems will allow hospitals to interrogate their cost data in greater detail than was possible in the past and will also allow hospitals to compare their costs with peer hospitals. This will facilitate greater engagement by doctors with their own data, support improvements in the quality of patient care and help to drive efficiency.
Data relating to the cost of private hospitals are not collected or verified by my Department or the HSE/HPO. As such, cost comparisons between the public and private hospital sectors cannot be made.
163. Deputy Bernard J. Durkan asked the Minister for Health the position regarding the provision of free general practitioner services for children under six years of age and people over 70 years of age; and if he will make a statement on the matter. [15145/15]
Amharc ar fhreagraThe Government is committed to introducing a universal GP service without fees on a phased basis. The first phase will be for all children aged under 6 years. This service will commence during the summer. In parallel with this, the second phase will extend universal GP care without fees to all persons aged 70 years and over, subject to the passing of the necessary legislation. These measures represent a major step on the way to universal health care. By this summer, approximately 800,000 people in Ireland will benefit from universal access to GP services.
Agreement has been reached between the Department of Health, the HSE and the Irish Medical Organisation on terms for the delivery of GP care without fees for all children aged under 6. This agreement represents the first step in the phased introduction of a universal GP service without fees. Under the new arrangements, an additional 270,000 children under 6 will benefit from GP care free at the point of service. This service will commence during the summer. This will be preceded by a public information campaign and simple on-line arrangements for parents or guardians to register their children for the service.
All children under 6 will benefit from the new enhanced service under the proposed GP contract. This will involve age-based preventive checks focused on health and well-being and the prevention of disease. These assessments will be carried out when a child is aged 2 and again at age 5. The contract will also cover an agreed cycle of care for children diagnosed with asthma, under which GPs will carry out an annual review of each child where the doctor has diagnosed asthma.
In parallel with this, GP care without fees will be extended to all persons aged 70 years and over, subject to the passing of the necessary legislation. The Health (General Practitioner Service) Bill 2015, which was published on 25 March 2015, will provide the statutory basis for the over-70s universal GP service. This service will benefit about 36,000 people and will be provided under the existing GMS contract.
