Written Answers Nos. 388-410
388. Deputy Clare Daly asked the Minister for Health his views on the cuts to vital services for children diagnosed with autism in counties Galway and Roscommon where 2.5 staff currently serve two counties and therefore children cannot access vital services such as speech and language therapy and occupational therapy, his proposals regarding same; and if he will make a statement on the matter. [44786/15]
Amharc ar fhreagraThe particular issue raised by the Deputy 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.
389. Deputy Clare Daly asked the Minister for Health if early intervention teams are discharging children as young as three years of age to the autism spectrum disorder team, even though early intervention is meant to be up until the child is six years of age; and if he will make a statement on the matter. [44787/15]
Amharc ar fhreagraThe particular issue raised by the Deputy 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.
390. Deputy Robert Troy asked the Minister for Health if he will expedite a consultant appointment for a person (details supplied). [44789/15]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, 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.
391. Deputy Pearse Doherty asked the Minister for Health his views that current rates of payment and premiums for student nurses for intellectual disability, as per the Haddington Road agreement, are a contributing factor to the difficulties faced by the health services in retaining and recruiting graduates; his plans to revise these rates; the efforts made to accommodate the schedules of students who hold positions in part-time employment outside the parameters of their studies and placements; and if he will make a statement on the matter. [44838/15]
Amharc ar fhreagraPursuant to a "Chairman's Note" to the Lansdowne Road Agreement, the Department of Health and the HSE are to consider the issues of pay for student nurses during the fourth year 36 week placement with the nursing unions. This matter is the subject of direct engagement between my Department, the HSE and the nursing unions at present.
Student nurses participate in the 4th year rostered clinical placement as part of their degree programme and are paid in accordance with the trainee rates specified in the National Minimum Wage Acts for the duration of the placement. At present they are paid €6.49 per hour for the first 12 weeks of the placement, €6.92 for the second 12 weeks and €7.79 for the third 12 weeks. This equates to approximately 53% of the 1st point of the staff nurse scale. Mental health student nurses are paid 2.3% more, reflecting existing relativities between general and psychiatric staff nurse pay scales. When undertaking the placement, the students are not qualified nurses and require supervision. This is reflected in the 2:1 replacement ratio for student nurses replacing staff nurses.
The current rates of pay will be increased from the 1 January 2016, pro rata to the increase in the minimum wage for trainees announced in Budget 2016 and provided for in the National Minimum Wage Order 2015 (S.I. No. 442 of 2015).
392. Deputy Finian McGrath asked the Minister for Health his views on correspondence regarding essential equipment for a person (details supplied) in Dublin 5; and if he will make a statement on the matter. [44839/15]
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.
393. Deputy Finian McGrath asked the Minister for Health his views on correspondence regarding the case of a person (details supplied) with the later stages of dementia and Alzheimer's; the current procedures that are in operation for this person and others with a similar condition; and if he will make a statement on the matter. [44842/15]
Amharc ar fhreagraAs this is a service issue this question has been referred to the HSE for direct reply. If you have not received a reply within the next 15 working days, please contact my Private Office and they will follow up the matter with them.
394. Deputy Finian McGrath asked the Minister for Health his views on correspondence regarding the available services for adults with an intellectual disability; why a person (details supplied) who will become an adult in 2016 will no longer be entitled to the current disability services; and if he will make a statement on the matter. [44843/15]
Amharc ar fhreagraThe Disability Manager for this area is Ms Gillian Farrelly who can be contacted at the HSE offices, Fujitsu House, Unit 100, 4th Floor, Lakeshore Drive, Airside Business Park, Swords, Co. Dublin, telephone 01-8953727.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the 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.
395. Deputy Dessie Ellis asked the Minister for Health to justify the exorbitant costs paid to private nursing homes and the measures that are put in place to prevent private nursing homes from adding extra costs that are driving the families of those in care into poverty (details supplied). [44846/15]
Amharc ar fhreagraThe legislation underpinning the Nursing Homes Support Scheme requires each private nursing home to negotiate and agree a price for long-term residential care services with the National Treatment Purchase Fund (NTPF) should they wish to be an approved nursing home for the purposes of the Scheme. The NTPF is independent in the performance of this function and, in carrying it out, must ensure value for money for both the individual and the State. It negotiates with each nursing home individually and may examine the records and accounts of nursing homes as part of the process. This is to ensure that the State obtains the best value for each individual in a nursing home and to comply with competition law.
In negotiating with nursing homes, the NTPF has regard to:
- costs reasonably and prudently incurred by the nursing home and evidence of value for money;
- price(s) previously charged;
- local market price; and
- budgetary constraints and the obligation on the State to use available resources in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the public.
The Scheme covers the cost of the standard components of residential care, which are:
- nursing and personal care appropriate to the level of care needs of the person;
- bed and board;
- basic aids and appliances necessary to assist a person with the activities of daily living; and
- laundry service.
It is not permissible for any facility to levy additional charges in respect of the above. Part 8 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009 stipulates that the registered provider of the nursing home must agree a contract with each resident within one month of their admission. This contract must include details of the services to be provided to that resident and the fees to be charged. Residents should not be charged fees which are not set out in the contract. The HSE is not a party to such contracts which are concluded between each resident and their nursing home.
A person's eligibility for other schemes, such as the Medical Card Scheme or the Drugs Payment Scheme, is unaffected by participation in the Nursing Homes Support Scheme or residence in a nursing home. Incontinence wear, where required, is provided free of charge by the HSE to all Nursing Homes Support Scheme residents that possess a Medical Card.
396. Deputy Pearse Doherty asked the Minister for Health the number of general practitioners in receipt of the rural practice allowance and the cost of this, by county, for each of the years 2010 to date in tabular form; and if he will make a statement on the matter. [44851/15]
Amharc ar fhreagra397. Deputy Pearse Doherty asked the Minister for Health the number of general practitioners who have had their rural practice allowance withdrawn, by county, for each of the years 2010 to date, in tabular form; why a decision was made to withdraw this payment; and if he will make a statement on the matter. [44852/15]
Amharc ar fhreagraI propose to take Questions Nos. 396 and 397 together.
As these are service matters, they have 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.
398. Deputy Richard Boyd Barrett asked the Minister for Health further to Parliamentary Question No. 138 of 7 October 2015, why the Health Service Executive has decided to wind down the oasis project at Mounttown Community Facility; why this long-standing community project was not deemed appropriate to deal with drug and alcohol addiction for local young persons; how extensive was the consultation in making this decision, if oasis project workers or service users were involved in this process; and if he will make a statement on the matter. [44854/15]
Amharc ar fhreagra399. Deputy Richard Boyd Barrett asked the Minister for Health further to Parliamentary Question No. 138 of 7 October 2015, if community facility board members were involved in making the decision to wind down the oasis project at Mounttown Community Facility; the specific differences between the new project and the oasis project; the model of service provision the new project is based upon; and if he will make a statement on the matter. [44855/15]
Amharc ar fhreagra400. Deputy Richard Boyd Barrett asked the Minister for Health further to Parliamentary Question No. 138 of 7 October 2015, who the new provider agency is for the new project replacing the oasis project; if, during the tendering process to find a provider agency, there was advertising in local, national and European journals; and if he will make a statement on the matter. [44856/15]
Amharc ar fhreagraI propose to take Questions Nos. 398 to 400, inclusive, together.
As these are service matters, they have 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.
401. Deputy Terence Flanagan asked the Minister for Health his plans to improve the disclosure of hospital and HSE reporting on tragic incidents in the maternity services, to make them fully open to public scrutiny; and if he will make a statement on the matter. [44870/15]
Amharc ar fhreagraAs I have previously indicated the safety of service users is of paramount importance and steps need to be taken to anticipate and avoid things going wrong and to reduce the impact if they do. All employees including medical staff are required to disclose and report incidents in line with the HSE's Safety Incident Management Policy. Creating a culture of open disclosure and learning from the things that go wrong is the bedrock of making systems safer. Open Disclosure is defined as 'an open consistent approach to communicating with patients and their families when things go wrong in healthcare. This includes expressing regret for what has happened, keeping the patient informed, providing feedback on investigations and the steps taken to prevent a recurrence of the adverse event'.
I recently announced that the Government has given its approval to the drafting of provisions to support open disclosure of patient safety incidents. This will be included in the Department of Justice and Equality’s draft Bill on Periodic Payment Orders which is well advanced. The legislation is part of a broader package of reforms aimed at improving the experience of those who are affected by adverse events.
This legislation builds on the joint development by the HSE and State Claims Agency of the National Policy on Open Disclosure (2013). The HSE is progressing the implementation of the Policy across all health and social care services. We all know that when error or harm is experienced by a patient, the trust and confidence of that patient and their family are compromised. That is why honest, open disclosure and communication, which demonstrate empathy and sensitivity, are so essential. The intent of this legislation is to provide certain legal protections for healthcare staff for open disclosure, which is undertaken in good faith and in compliance with national standards. This will give further support to those staff in their communications with patients and family members if an adverse event occurs. The Ethical Code of Practice set out by the Medical Council also makes clear the responsibilities of doctors in relation to open disclosure.
Open disclosure is now HSE policy and therefore any unjustified breach of the policy (as with any HSE policy) will be managed in line with the HSE disciplinary procedures. Where potential deviations have been identified the Healthcare records must be reviewed to ascertain any documentation in relation to communication with the patient about the adverse event and to establish if any rationale for non-disclosure has been documented. Where there is no evidence that open disclosure has occurred the incident must be reviewed with the staff involved in the event. The patient must be informed of the event and the impact of the event explained and acknowledged. The patient should also be informed of the initial failure to disclose and an appropriate acknowledgement, explanation and apology provided.
From a patient safety perspective the key focus of open disclosure is on learning so that systems and processes can be improved in order to reduce potential future harms to patients. If a person is not satisfied that a health professional or administrator has fulfilled their obligations regarding open disclosure then that person has recourse to the HSE's complaints procedures. It is also open to a person to raise a complaint with the appropriate professional regulatory body or with the Ombudsman.
402. Deputy Brendan Griffin asked the Minister for Health if a nurse will be appointed to a school (details supplied) in County Kerry; and if he will make a statement on the matter. [44871/15]
Amharc ar fhreagraThe particular issue raised by the Deputy 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.
403. Deputy Finian McGrath asked the Minister for Health his views on correspondence (details supplied) concerning the available services for adults with an intellectual disability, why a current service provider who will become an adult in 2016 will no longer be entitled to these services in 2016; and if he will make a statement on the matter. [44908/15]
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.
404. Deputy Denis Naughten asked the Minister for Health when a person (details supplied) in County Roscommon will be permanently placed on a general practitioner list why this has not been done to date; if it is acceptable that this patient is passed from general practitioner to general practitioner on a frequent basis how this provides for continuity of care; and if he will make a statement on the matter. [44911/15]
Amharc ar fhreagraAs this is a service issue, 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 the Executive.
405. Deputy Michael Healy-Rae asked the Minister for Health his views on correspondence (details supplied) regarding the parents of children in receipt of the domiciliary care allowance; his plans to address the concerns raised; and if he will make a statement on the matter. [44916/15]
Amharc ar fhreagra486. Deputy Terence Flanagan asked the Minister for Health if he will introduce medical cards for all children in receipt of a domiciliary care allowance (details supplied); and if he will make a statement on the matter. [45452/15]
Amharc ar fhreagraI propose to take Questions Nos. 405 and 486 together.
Under the provisions of the Health Acts, medical cards are provided to persons who are, in the opinion of the HSE, unable without undue hardship to arrange GP services for themselves and their dependants. In the assessment process, the HSE can take into account medical costs incurred by an individual or a family. 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 Domiciliary Care Allowance (DCA) payment is made by the Minister for Social Protection to carers in respect of a child at home under 16 years of age with a severe disability, where it has been determined that the child requires ongoing care and attention, substantially over and above the care and attention usually required by a child of the same age. Eligibility for the DCA is not based primarily on the medical or psychological condition, but on the resulting lack of function of body or mind necessitating the degree of extra care and attention required. As such it is not possible to say if a particular child or any particular medical condition or disability will qualify for a payment under the DCA scheme.
The Deputy will be aware that the report of the Expert Panel on Medical Need for Medical Card Eligibility, known as the Keane Report, recommended that a person’s means should remain the main qualifier for a medical card and that it was not feasible, desirable, nor ethically justifiable to list medical conditions for medical card eligibility. Nonetheless, it is clear that there are people – including children - with medical needs and it is important that they should be able to access necessary assistance in a straight forward manner.
Consequently, the Clinical Advisory Group on medical card eligibility was established by the HSE to develop a framework for assessment and measurement of the burden of disease and appropriate operational guidelines for the medical card scheme. However, the Clinical Advisory Group has not recommended that children in receipt of the Domiciliary Care Allowance should automatically qualify for a medical card. In advance of the Group completing its work, there are no proposals to issue automatic medical cards to one particular group.
The Government is committed to making the medical card system as responsive as possible to the circumstances of people with significant medical needs. As a result of a range of improvements, the HSE is exercising greater discretion. Consequently, the number of discretionary medical cards has increased by about 84% - from about 52,000 in mid-2014 to nearly 96,000 at the beginning of November this year.
Ultimately, the proper way to address this issue is to develop a system of universal health care, which is at the centre of Government health policy. Otherwise, whenever there are qualifying rules, there will always be a person who is above the means test, does not have the selected disease, or is not in receipt of the specific social welfare payment.
406. Deputy Mary Lou McDonald asked the Minister for Health the reason for the lengthy delay in a person (details supplied) in Dublin 22 receiving an appointment at Our Lady's Children's Hospital in Crumlin for emergency surgery; and when a date for the surgery will be provided. [44918/15]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
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.
407. Deputy John McGuinness asked the Minister for Health if clients of St. Patrick's on the Kells Road in County Kilkenny whose financial affairs are being managed by the company will be allowed to change this arrangement by having the financial accounts managed by the client and family members concerned only; and if he will make a statement on the matter. [44924/15]
Amharc ar fhreagra409. Deputy John McGuinness asked the Minister for Health if he or the Health Service Executive will continue all of the services at St. Patrick's on the Kells Road in County Kilkennyl; if the executive and St. Patrick's have met those concerned to explain what is happening relative to St. Patrick's; if a grant system will be put in place for parents who require respite hours to allow the parents to access the services privately; if Suicide or Survive, SOS, or the executive will provide a long-term plan for respite; and if he will make a statement on the matter. [44926/15]
Amharc ar fhreagraI propose to take Questions Nos. 407 and 409 together.
As the Deputy's questions relate to service matters, I have arranged for the questions 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.
408. Deputy John McGuinness asked the Minister for Health the process available through his Department or the Health Service Executive for individuals who are dissatisfied with the outcome of a hearing conducted by the Irish Medical Organisation; if there is an independent review of appeals process available; and if he will make a statement on the matter. [44925/15]
Amharc ar fhreagraThe Irish Medical Organisation (IMO) is a registered trade union. Hearings conducted by the IMO are not within the remit of the Minister for Health.
410. Deputy John McGuinness asked the Minister for Health the changes being made to home help hours in the Callan area of County Kilkenny; if this pilot project has been agreed with all those concerned including those who work for the Health Services Executive and the union; if the change in the work practice will result in more hours being available to those in need; and if an assessment will be undertaken with the staff to determine if the pilot project is acceptable. [44927/15]
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.
