Written Answers Nos. 241-51
241. Deputy John Brassil asked the Minister for Health the provisions in place via the National Treatment Purchase Fund, NTPF, in regard to providing orthodontic treatment for children waiting more than 18 months for orthodontic treatment; and if he will make a statement on the matter. [12391/17]
Amharc ar fhreagraIt is not envisaged that the Waiting List initiatives due to be implemented by the NTPF and the HSE under its Waiting List Action Plans will include orthodontic care.
The Programme for a Partnership Government contains a commitment to providing timely access to orthodontic care. In order to address the waiting times being experienced by people who have been referred for orthodontic assessment or treatment, the HSE has commenced an initiative which involves the procurement of orthodontic services in primary care from a number of private service providers. Priority is being accorded to cases of a routine orthodontic nature who have been waiting longest to be seen. Up to the end of February 2017, 2,350 patients have been contacted and 1,431 have accepted transfer from HSE to a private orthodontic provider. Complex cases are not part of the HSE waiting list initiative and will be treated by the HSE orthodontic service.
The HSE is also working to adapt skill-mix to assist in providing more timely access for patients. This involves using orthodontic therapists working under the supervision of specialist orthodontists. Two orthodontic therapists are in place, with a further two are in training and the HSE plan to extend this initiative.
The national approach to future oral health service provision, including orthodontics, will be informed by the National Oral Health Policy which is currently being developed by my Department. The target-date for completion of this policy is late 2017.
242. Deputy John Brassil asked the Minister for Health if he will allow persons accessing ophthalmology services, specifically cataract treatment, via Kerry University Hospital currently facing lengthy waiting times to access the National Treatment Purchase Fund, NTPF, via the Bon Secours Hospital, Tralee; and if he will make a statement on the matter. [12393/17]
Amharc ar fhreagraIn relation to this particular query raised, as this is a service matter, I have asked the HSE to respond to you directly.
243. Deputy Alan Kelly asked the Minister for Health his views on the intention of the HSE to immediately cut funding to section 39 organisations providing vital social care services, due to their being unable to sign service level agreements by virtue of not being fully funded to meet the pay restoration requirements now falling due under the Lansdowne Road agreement. [12395/17]
Amharc ar fhreagraI have asked the HSE to respond to the Deputy directly on this matter.
244. Deputy Bernard J. Durkan asked the Minister for Health the extent to which assessments are readily available for children with special needs with particular reference to conditions requiring early diagnosis; and if he will make a statement on the matter. [12406/17]
Amharc ar fhreagraThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As 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.
245. Deputy Bernard J. Durkan asked the Minister for Health the extent to which speech and language therapy is available to all children with such a requirement here; and if he will make a statement on the matter. [12407/17]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
246. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the mental health needs of children and adults continue to be monitored and met here; and if he will make a statement on the matter. [12408/17]
Amharc ar fhreagraBudget 2017 provided for an additional €35 million for services to be initiated in 2017. Key priorities to be addressed in the HSE 2017 Service Plan include youth mental health, further improvement to child & adolescent (CAMHS) and adult services, older people's services and further enhanced out-of-hours response for those in need of urgent services. Recognising the time lag in new staff taking up posts and the completion of preparations for the introduction of these services, it is estimated that the revenue spend in 2017 associated with this increased allocation will be some €15 million. There will also be a further additional spend of €9.5 million in mental health associated with increased pay rates, bringing the total HSE funding for mental health in 2017 to €853 million.
The HSE Service Plan 2017 will also progress enhanced service user and carer engagement, ongoing implementation of the suicide reduction strategy Connecting For Life, improved early intervention for youth mental health, including embedding Jigsaw sites and development of primary-care based therapeutic responses. There will also be increased services to meet the needs of those with severe and enduring mental illness with complex presentations, improved specialist clinical responses through clinical programmes, improved regulatory compliance and incident management. The HSE continues to strengthen governance arrangements to improve performance and effective use of human, financial and infrastructural resources.
Activity data in relation to agreed priorities and targets for mental health is published in monthly Performance Reports, available on the HSE website. I , and my Departmental officials, will continue to closely monitor these HSE reports. In addition, I am regularly briefed by the HSE Mental Health Directorate on all aspects of progressing the mental health care programme, given the challenge it faces to meet the requirements of increasing demand overall on such services.
247. Deputy Bernard J. Durkan asked the Minister for Health the extent to which adequate long-term care continues to be provided for in the public sector having particular regard to the need to retain adequate accommodation thereby alleviating the burden on acute hospitals already affected by bed shortages; and if he will make a statement on the matter. [12409/17]
Amharc ar fhreagraThe Nursing Homes Support Scheme (NHSS) is a system of financial support for those in need of long-term nursing home care. Participants contribute to the cost of their care according to their income and assets while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings. Funding for the Scheme in 2017 is €940 million. This represents an increase of €18.5 million on 2016 expenditure, and will enable an additional 500 people to be supported in 2017, increasing the numbers supported under the Scheme to just over 23,600 by the end of the year.
As the Deputy may be aware , the HSE launched the ‘Winter Initiative Plan 2016-2017’ in September 2016 which provided €40 million of additional funding for winter preparedness and to assist hospitals to deal with increased demand. A key focus of the Winter Initiative is to improve access for hospitals to social care and community measures to discharge patients, when deemed clinically appropriate, to return home or to a more appropriate community setting. Since the start of the Winter Initiative delayed discharges have reduced nationally from 638 to 517, freeing up hospitals beds to alleviate ED pressures.
In addition the Winter Initiative was cognisant of the need to support increased bed capacity within the system and as such 90 additional beds have been opened at the following hospitals: Galway University Hospital, the Mater Hospital, Beaumont Hospital, the Regional Midland Hospital Tullamore, the Regional Midland Hospital Mullingar and the Mercy Hospital in Cork.
My Department has also commenced a bed capacity review in line with the Programme for Government commitment. The intention is that this review will be broader than previous exercises that focused solely on acute bed capacity. While the exact parameters of the review are still subject to considerations, I expect that it will seek to take into account, to some degree, other factors which affect hospital capacity.
248. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he expects to be in a position to utilise the benefit of the single EU market to facilitate the negotiation of an affordable price for specific new drugs; and if he will make a statement on the matter. [12410/17]
Amharc ar fhreagraEach EU member state is responsible for the procurement of medicinal products. However, our membership of the single market offers an opportunity for international cooperation with other member countries to reduce the cost of new drugs.
In June 2016, the Employment, Social Policy, Health and Consumer Affairs Council adopted conclusions on strengthening the balance in the pharmaceutical systems in the EU and its member states. Those conclusions invited member states to explore opportunities for cooperation on pricing and reimbursement of medicines and to identify areas for cooperation which could contribute to affordability and better access to medicines. I have indicated my support for these measures and I welcome the opportunity for member states to cooperate by sharing information, so that we can achieve affordable and sustainable access to medicines.
I and my officials have been actively engaged with our international colleagues on the issue of drug pricing. I used the opportunity at the second Round Table meeting for European Health Ministers and heads of Europe-based pharmaceutical companies in Portugal last December, and the recent OECD meeting in January, to engage with Ministers from other countries on how to address the challenge of securing access to new medicines for citizens at an affordable price.
249. Deputy Bernard J. Durkan asked the Minister for Health the number of children listed for orthodontic treatment in categories A, B and C; the number of children currently in the course of receiving such treatment; and if he will make a statement on the matter. [12411/17]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for reply to the Deputy.
250. Deputy Bernard J. Durkan asked the Minister for Health the extent to which it might be possible to streamline and expedite the process of medical card applications; and if he will make a statement on the matter. [12412/17]
Amharc ar fhreagra253. Deputy Bernard J. Durkan asked the Minister for Health the extent to which procedures are in place to ensure that persons that do not qualify for medical cards on income grounds might be re-evaluated and their eligibility suitably weighted to take account of a particular illness, terminal or otherwise, which might require extraordinary care, cost, attention and stress to the particular families; and if he will make a statement on the matter. [12415/17]
Amharc ar fhreagraI propose to take Questions Nos. 250 and 253 together.
Under the Health Act, 1970, 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 and every application must be assessed on that basis. In accordance with the Act, 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. Where deemed appropriate in particular circumstances, the HSE may exercise discretion and grant a medical card even though an applicant exceeds the income guidelines but where they may face difficult financial circumstances, such as extra costs arising from illness.
Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information and documentation to fully take account of all the relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses. As at week ending 3rd February 2017, 99% of medical card applications received by the Primary Care Reimbursement Services were processed within a 15 day timeframe.
All applications or reviews concerning medical and GP visit cards must be supported with a range of documentation, as outlined on the application forms. Where such supporting documentation is not supplied or is incomplete, to enable the assessment of the application, in accordance with the National Assessment Guidelines, the HSE will issue correspondence to the applicant specifying the additional information required to progress the assessment of their application. Clearly the processing time for incomplete applications is dependent on the furnishing of the required documentation by the applicant.
It is important that people with medical needs and it is important that they should be able to access necessary assistance in a straight forward manner. It is clear greater discretion is being exercised by the HSE because the number of discretionary medical cards in circulation has increased from about 52,000 in mid-2014 to over 117,854 as of 1st February this year. This followed the measures announced by my predecessor Minister Varadkar, when the "Keane" Report of the Expert Panel on Medical Need for Medical Card Eligibility was published. The "Keane" Report found that it is not feasible, desirable or ethically justifiable to list medical conditions for medical card eligibility. On foot of the publication of the report, the HSE established a Clinical Advisory Group to develop clinical oversight and guidance for the operation of a more compassionate and trusted medical card system. Its establishment followed the completion of the work of the Expert Panel on Medical Need for Medical Card Eligibility and demonstrates the HSE's commitment to the development of a medical system which is responsive and considerate of an applicant's particular circumstances.
The HSE has a system in place for the provision of medical cards in response to an emergency situation for persons with a serious medical condition in need of urgent or on-going medical care that they cannot afford and persons in palliative care, who are terminally ill. With the exception of terminally ill patients, all medical cards, granted on an emergency basis, are issued on the basis that the patient is eligible for a medical card on the basis of means or undue hardship, and will follow up with a full application within a number of weeks of receiving the medical card eligibility. These cards are issued within 24 hours of receipt of the required patient details and a letter which confirms the medical condition from a doctor or consultant. For terminally ill persons, no means test applies.
