Written Answers Nos. 261-272
261. Deputy Bernard J. Durkan asked the Minister for Health the extent to which his Department has access to information regarding the cost to persons of drugs across the European Union with a view to ensuring equal access for persons here; and if he will make a statement on the matter. [21083/17]
Amharc ar fhreagraThe HSE have statutory responsibility for pricing and reimbursement of medicines under the community drug schemes.
In line with Part 4 of the Health (Pricing and Supply of Medical Goods) Act 2013 the HSE publish and maintain a reimbursement list. This list specifies the ingredient price for each drug. In setting this price or reviewing the price of a reimbursed drug, the HSE shall take into account among other factors, the equivalent reference price of an item in all other member states where the item is marketed and the terms of any agreement in place with industry representative bodies.
The HSE use Euripid and other data sources to inform their decisions regarding the reimbursement list. The Euripid project, which was established in 2010, seeks to be a European wide collaboration of the national competent authorities for pricing and reimbursement to make prices of reimbursable pharmaceuticals more transparent via an on-line accessible, comprehensive, reliable, continuously maintained and easy-to-use database.
263. Deputy Bernard J. Durkan asked the Minister for Health the number of persons currently on waiting lists for all orthopaedic and cardiac procedures; if the factors contributing to the waiting lists have been identified; and if he will make a statement on the matter. [21085/17]
Amharc ar fhreagraI acknowledge that waiting times are often unacceptably long and am conscious of the impact of this on people’s lives.
It is important to note that a combination of a growing and ageing population has led to an increase in demand for acute hospital services in recent years. Our hospitals are now carrying out four-times more procedures in patients aged 65 years and over, and twice as many in the under 65 age group since 2000. Last year alone there was a 4% increase in inpatient and day-case activity over 2015, and in 2016 almost 1.69 million patients received inpatient or daycase treatment in our hospitals, an increase of almost 40,000 on the previous year.
Reducing waiting times for the longest waiting patients is one of this Government's key priorities. Consequently, Budget 2017 allocated €20 million to the NTPF, rising to €55 million in 2018. In order to reduce the numbers of long-waiting patients, I asked the HSE to develop Waiting List Action Plans for 2017 in the areas of Inpatient/Daycase, Scoliosis and Outpatient Services. These plans have now been finalised and will be communicated shortly.
The NTPF publishes waiting list data by speciality, hospital and hospital group each month including data for orthopaedics and cardiology. This data can be viewed on its website at NTPF.ie.
264. Deputy Bernard J. Durkan asked the Minister for Health the number of step-down or nursing home standard beds currently available throughout the public and private sectors; the degree to which augmentation is required in either category; and if he will make a statement on the matter. [21086/17]
Amharc ar fhreagraResidential care in Ireland is provided through a mix of public, voluntary and private provision. It is worth highlighting that the net budget for long-term residential care in 2017 is €940m and the Nursing Homes Support Scheme will support 23,603 clients by the end of the year.
The Health Information and Quality Authority is the independent authority established under the Health Act 2007 to drive continuous improvement and to monitor safety and quality in Ireland’s health and personal social care services. Since 2009 all nursing homes - public, voluntary and private have been registered and inspected by HIQA. At the end of 2016 there were 30,396 beds registered with HIQA.
Public Nursing Units are an essential part of our national nursing home infrastructure. They provide 5,000 long stay residential care beds. They also provide about 2,000 short stay community public beds nationally providing combination of ‘step up/step down’ care, intermediate care, rehabilitation and respite care. To allow flexibility, these are interchangeable in their use depending on demand.
Many public units are housed in buildings that are less than ideal in the modern context, but notwithstanding this, the standard of care delivered to residents is generally of a very high standard. It is important therefore that we consolidate our existing stock and this is the aim of the 5 year Capital programme for Community Nursing Units which was announced last year. This provides the framework to allow for an enhanced programme to replace, upgrade and refurbish these care facilities which will consolidate our existing public stock and is expected to provide about 250 additional beds.
With regard to private facilities, in Budget 2016 the Minister for Finance announced changes to the Employment and Investment Incentive Scheme to allow for investment in the expansion, management and operation of nursing homes. The inclusion of nursing home expansion works in the Scheme was influenced by an analysis submitted by the Department of Health on measures, including tax measures, to support targeted development in nursing homes and primary care centres.
I would like to reiterate that it is Government policy that long-term nursing home care should be a last resort and we want to develop home and community care services to provide a more viable alternative to nursing home care for a greater number of people. In that context, I am prioritising the development of a regulatory and funding model for home care services. I have committed to launching a public consultation at the end of May which will allow all those with an interest to express their views and ideas, including older people themselves, their families, and healthcare workers.
265. Deputy Bernard J. Durkan asked the Minister for Health the position regarding the new general practitioner contract; and if he will make a statement on the matter. [21087/17]
Amharc ar fhreagraThe development of primary care is central to the Government's objective to deliver a high-quality, integrated and cost effective health service. The Programme for Government commits to a decisive shift within the health service towards primary care in order to deliver better care close to home in communities across the country. The development of a new, modernised contract for the provision of general practitioner services will be a key element in facilitating this process.
Previous engagements have resulted in a number of service developments including the introduction of a Diabetes Cycle of Care for adult GMS patients with Type 2 Diabetes, an enhanced support framework for rural GPs, and a revised list of special items of service under the contract to encourage the provision of more services in the primary care setting. These measures, combined with the under-6s and over-70s universal GP care initiatives, have increased the financial support for general practice.
The next phase of discussions on a new GP contract is under way and engagement with GP representative bodies began in January. As with any negotiation-type process, and given the range and complexity of the issues to be discussed, the engagement may take some time. While I am of course anxious to see good progress made, it is not my intention to set a deadline for completion of discussions. I look forward to positive and constructive engagements with GP representatives in the months ahead.
266. Deputy Bernard J. Durkan asked the Minister for Health his preferred options for the respective roles of the public and private sectors in the delivery of health services throughout the country in the future; and if he will make a statement on the matter. [21088/17]
Amharc ar fhreagraAs the Deputy will be aware, I had the opportunity to outline my views recently to the all-party Oireachtas Committee on the Future of Healthcare regarding the future direction of the health service and a number of key priorities that I believe should underpin that future direction, including this issue around the respective roles of the public and private sectors in the delivery of health services. As I expect to receive the final report and recommendations of the Committee later this month, I intend to await the outcome before moving ahead with any further detailed considerations on this issues.
267. Deputy Bernard J. Durkan asked the Minister for Health his plans to ensure early access to assessment for persons with special needs; and if he will make a statement on the matter. [21089/17]
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.
268. Deputy Bernard J. Durkan asked the Minister for Health his plans to improve access to quality services for persons with mental health problems comparable to best international practice; and if he will make a statement on the matter. [21090/17]
Amharc ar fhreagraThis Government is focused on the continual improvement of our mental health services. It is important that any such improvements are evidence-based and informed by national and international research. This can be seen in our national strategy to reduce suicide, Connecting for Life, which builds on previous work and contributes key elements to moving forward. It is based on extensive consultation, a global knowledge base and defined commitments across government departments and key statutory and non-statutory agencies in Ireland.
'A Vision for Change', the policy framework for our mental health services, came to the end of its 10-year term in 2016 and preparations for a review and updating of policy have been underway since early last year. In September 2016, an external evidence and expert review was commissioned from WRC Consultants as the first step in determining the parameters of a revision of A Vision for Change.
This review was completed on 17 February 2017, and will provide evidence to determine the policy direction for a revision of A Vision for Change, both in terms of international best practice and the experience of implementing A Vision for Change. The review is currently being assessed by the Department of Health.
In line with a commitment given to Dáil Éireann on 6 October 2016, an Oversight Group will be established within three months of the review being finalised to oversee the development of a new policy for mental health based on the outcome of the Expert Review. Terms of Reference for this Group are being finalised. The policy review process will also involve consultation with key stakeholders.
Improvements continue to be made across key areas of mental health service provision. A central commitment in the Programme for Partnership Government relates to the provision of 24/7 mental health services. I am presently considering HSE proposals for an implementation plan for the provision of a 7-day service response across all HSE mental health service areas, which should be produced in the coming weeks. Substantial funding has also been provided in 2017 for Mental Health capital projects, most notably to commence the construction of the new forensic hospital at Portrane this year to replace the Central Mental Hospital, Dundrum.
269. Deputy Bernard J. Durkan asked the Minister for Health the number of medical cards currently in circulation; the extent to which numbers have fluctuated in recent years; and if he will make a statement on the matter. [21091/17]
Amharc ar fhreagra270. Deputy Bernard J. Durkan asked the Minister for Health if the processing of medical card applications can be expedited; and if he will make a statement on the matter. [21092/17]
Amharc ar fhreagraI propose to take Questions Nos. 269 and 270 together.
The Health Service Executive (HSE) operates the General Medical Services scheme which includes medical cards and GP visit cards, under the Health Act 1970, as amended.
In relation to the processing of medical card applications as at week ending 1 April 2017 (latest figures available), 99.67% of medical card applications received by the Primary Care Reimbursement Services were processed within a 15 day timeframe.
The following table indicates the number of medical cards as at 1 January for the past 5 years:
|
Date |
Number of medical cards |
|
1 January 2017 |
1,669,721 |
|
1 January 2016 |
1,734,853 |
|
1 January 2015 |
1,768,700 |
|
1 January 2014 |
1,849,380 |
|
1 January 2013 |
1,853,877 |
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 worth noting that the HSE is the established 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 was issued to Oireachtas members.
271. Deputy Bernard J. Durkan asked the Minister for Health the steps he will take to alleviate the problem of overcrowding at general hospitals throughout the country; and if he will make a statement on the matter. [21093/17]
Amharc ar fhreagraSince the start of 2017 there have been approximately 6.3% less patients waiting on trolleys nationally compared to the same period last year.
In September the HSE launched its ‘Winter Initiative Plan 2016-2017’ which provided €40 million of additional funding for winter preparedness. This Initiative was developed to manage the expected winter surge in demand for hospital care in an integrated way across Primary, Acute and Social Care. This Initiative concluded in March.
A range of practical measures to address ED overcrowding were implemented, including 90 additional beds, aids and appliances for over 4,450 patients, around 1,000 extra homecare packages and 615 additional transitional care bed approvals.
During the Winter Initiative, delayed discharges reduced from 638 in September 2016 to a low of 434 at the end of December and were maintained below 500 from mid-December through to end February. This had a positive impact on ED overcrowding and trolley numbers, in freeing up beds for use by patients awaiting admission to hospital.
I can assure the Deputy that there continues to be a very strong focus on reducing ED overcrowding. My Department and the HSE are currently engaged in a process to commence winter planning for next year and to achieve an improvement trajectory in ED performance.
The HSE's Special Delivery Unit continues to work closely with hospitals to identify improvements that can be made to support patient flow, reduce trolley numbers and improve patients' ED experience
272. Deputy Róisín Shortall asked the Minister for Health if additional resources will be provided to the maxillofacial department in St. James's Hospital, Dublin 8 in order to allow persons (details supplied) to be seen and to receive treatment within a reasonable timeframe; and if he is satisfied with the operation of this department. [21098/17]
Amharc ar fhreagraIn relation to the query raised by the Deputy, as this is service issue, I have the HSE to respond to you directly.
