Written Answers Nos. 154-173
154. Deputy Ruth Coppinger asked the Minister for Health when he expects the assisted human reproduction Bill to be published and brought before either House of the Oireachtas for a Second Stage debate. [44328/17]
Amharc ar fhreagraOn Tuesday 3 October 2017 the Government approved the drafting of a Bill on assisted human reproduction (AHR) and associated areas of research. Officials in my Department are engaging with the Office of the Attorney General in relation to the process of drafting this Bill.
In addition, in line with the Government's decision the General Scheme of the Assisted Human Reproduction Bill 2017 has also been referred to the Joint Committee on Health for review.
The introduction of legislation in relation to AHR and associated research is a priority for me, however, it is not possible at this time to give a definitive timeline for the completion of the Bill and its subsequent passage through the Houses of the Oireachtas.
155. Deputy Richard Boyd Barrett asked the Minister for Health the procedure a person should go through if they require surgery in another country; the way in which they receive a referral for the surgery; and if he will make a statement on the matter. [44347/17]
Amharc ar fhreagraThe Directive on Patients' Rights in Cross Border Healthcare provides rules for the reimbursements to patients of the cost of receiving treatment abroad, where the patient would be entitled to such treatment in their home Member State, and supplements the rights that patients already have at EU level. Public patients may access the healthcare they require in either the public or private healthcare system of another Member State under the Cross-Border Directive (CBD). Access to healthcare abroad is based on patients following public patient pathways, i.e. they must demonstrate they have followed the equivalent public patient pathways that a patient would follow if accessing public healthcare in Ireland. It is important to note that reimbursement is confined to the costs of the care itself and that the rates of reimbursement cannot exceed the cost of provision of the care if it were provided in the Irish public health service. Referral for care under the CBD may be made by a GP, a hospital consultant and certain other clinicians. The CBD excludes certain health services, e.g. services of public health, long term care, organ transplantation, etc. All persons on public waiting lists, other than for such exempt health services, are eligible for the Scheme.
The Health Service Executive operates the EU Directive on Patients’ Rights in Cross Border Healthcare in Ireland. In line with practice in other EU Member States, the HSE, through the National Contact Point (NCP) office, provides information for patients on the Cross-Border Directive on its website - www.hse.ie/eng/services/list/1/schemes/cbd/ - and also by phone, 056 778 4551. The principal function of the NCP (which is the mechanism specified under the Directive for the dissemination of information on the Directive by Member States) is to facilitate exchange of information for patients concerning their rights and entitlements relating to receiving healthcare in another Member State, in particular the terms and conditions for reimbursement of cost and the procedures for accessing and determining those entitlements.
156. Deputy Pearse Doherty asked the Minister for Health if medical card or general practitioner visit card holders are exempt from charges arising from blood tests performed at general practices; and if he will make a statement on the matter. [44348/17]
Amharc ar fhreagraThere is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for routine phlebotomy services provided by their GP, or the practice nurse on behalf of the GP, which are required to either assist in the diagnosis of illness or the treatment of a condition. The HSE has advised GPs that where a blood test forms part of the investigation or necessary treatment of a patient’s symptoms or conditions, this should be free of charge for patients who hold a medical card or GP visit card. Notwithstanding this, I am aware that in recent times some GPs have begun to charge GMS patients for phlebotomy services in some circumstances.
This is a matter of concern for me as it has long been the position of the Government and the Oireachtas that no user charges should apply to GP services provided to GMS and GP visit card patients. If a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient may make a complaint to the HSE Local Health Office, who will deal with the matter in accordance with the HSE's Complaints Policy.
In order to achieve clarity on this issue, I have asked that any difference of perspective in relation to the provision of phlebotomy services be addressed in the GP contractual review process, which is currently underway. The aim is to develop a contract which has a population health focus, providing in particular for health promotion and disease prevention and for the structured ongoing care of chronic conditions. I look forward to constructive and positive engagements with a view to achieving a satisfactory outcome.
157. Deputy Richard Boyd Barrett asked the Minister for Health if the regulations on health insurance require that a health insurance company here must take into account the number of years that a person returning here has had with an international health insurance company; and if he will make a statement on the matter. [44353/17]
Amharc ar fhreagraPeriods of cover on health insurance plans held outside the State are not taken into account for the purposes of waiting periods, as such plans do not comply with health insurance legislation or the key principles of community rating, open enrolment, lifetime cover and minimum benefit on which the Irish private health insurance regulatory system is based.
Community rating is a fundamental cornerstone of the Irish health insurance system and means that people who are old or sick do not have to pay more than the young and healthy. In other health insurance systems the level of risk that an individual presents directly affects the premium paid. Thus, different health insurance systems are not directly comparable or related, so periods of cover or time served as an insured person elsewhere are not interchangeable with the Irish regulatory system.
Any individual who takes out health insurance as a new entrant, whether resident here or returning from abroad, may have to serve waiting periods before they are fully covered (detailed in the table). The application of waiting periods helps support community rating and is an important tool for insurers to combat practices where someone could potentially take out a health insurance policy to avail of a particular treatment and then cancel the policy once treatment had been received, without either penalty or sustained contribution to the community-rated system.
New Customer Maximum Waiting Periods
|
Accident and Injuries |
Illnesses that commence after you join |
Illnesses that commence before you join |
Maternity related claims |
|
None |
26 weeks |
5 years |
52 weeks |
158. Deputy Jack Chambers asked the Minister for Health his plans to develop a general mix of a paediatrics allied health services, for example, general practitioner, occupational therapy, speech and language therapy, special needs assistant, physiotherapy and so on available in the same location within the community for parents, children and families in the Dublin 15 area in order that they do not have to travel long distances to access each individual service at separate locations; and if he will make a statement on the matter. [44354/17]
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.
159. Deputy John Brassil asked the Minister for Health further to Parliamentary Question No. 289 of 10 October 2017, when the additional trials will take place; the person or body that will conduct the trials; the steps that have been taken to commence the trial; and if he will make a statement on the matter. [44357/17]
Amharc ar fhreagraAs the HSE has responsibility for this matter, I have asked the HSE to respond directly to the Deputy on this issue.
160. Deputy Tony McLoughlin asked the Minister for Health the number of intestinal failure syndrome patients who are in the care of the HSE or who were in the care of the HSE at the end of 2016; his views on the incidence and prevalence of intestinal failure syndrome here compared with its incidence and prevalence in other countries in western Europe; his or the HSE's plans for the establishment of a specialist service here; if his Department or the HSE observes potential clinical or logistical and efficiency benefits that would be achieved for persons and for the HSE through the establishment of a tertiary referral centre for persons who develop severe intestinal failure and a single specialist unit to manage adult intestinal failure patients who receive out-of-hospital parenteral nutrition; and if he will make a statement on the matter. [44365/17]
Amharc ar fhreagraI am aware that a business case for the establishment of a dedicated centre for Intestinal Failure was prepared by St James’s Hospital. Any proposals for the funding for the centre for Intestinal failure in St. James's, including children with intestinal failure transitioning from the national paediatric unit at Our Lady's Children's Hospital Crumlin, will have to be considered as part of the Dublin Midland Hospital Group’s overall priorities and with regard to national priorities for service development in the context of resources available in 2018. In relation to the service issues raised, I have asked the HSE to respond to you directly.
161. Deputy John Brassil asked the Minister for Health the way in which a newly built mental health unit (details supplied) can now be found to have radon levels exceeding the recommended 200 becquerels per cubic metre; the amount by which the reading exceeded the limit; the measures that have been put in place to rectify the problem; the estimated extra cost of same; and if he will make a statement on the matter. [44371/17]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
162. Deputy Louise O'Reilly asked the Minister for Health the reason a person (details supplied) has been refused repayment for hospital services availed of in May and June 2017 in Northern Ireland under the cross-border directive. [44409/17]
Amharc ar fhreagraThe Health Service Executive operates the EU Directive on Patients’ Rights in Cross Border Healthcare in Ireland. In line with practice in other EU Member States, the HSE, through the National Contact Point (NCP) office, provides information for patients on the Cross-Border Directive on its website - www.hse.ie/eng/services/list/1/schemes/cbd/ - and also by phone, 056 778 4551. The principal function of the NCP (which is the mechanism specified under the Directive for the dissemination of information on the Directive by Member States) is to facilitate exchange of information for patients concerning their rights and entitlements relating to receiving healthcare in another Member State, in particular the terms and conditions for reimbursement of cost and the procedures for accessing and determining those entitlements.
The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.
163. Deputy Noel Rock asked the Minister for Health if funding for a continuing medical education tutor post for north County Dublin, which is currently vacant, will be approved in view of the fact that general practitioners in this catchment area are missing out on points needed to remain in an organisation (details supplied); and if he will make a statement on the matter. [44418/17]
Amharc ar fhreagraAll doctors on the Medical Council's register, including GPs, are required to maintain professional competence by enrolling in professional competence schemes and engaging in maintenance of professional competence activities in relation to their practice.
One of the methods used to fulfill part of the professional competence requirements for the Medical Council is small group learning, as seen in the GP Continuing Medical Education National Tutor Network. The HSE provides some support towards professional competence activities for GPs by funding the Tutor Network. These tutors provide teaching to GPs in active practice to keep them up to date with medical information in relation to general practice. In addition, the Irish College of General Practitioners provides elearning modules, courses, conferences and advice on achieving the professional competence requirements.
As the issue raised is a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
164. Deputy Clare Daly asked the Minister for Health the reason a person (details supplied) has been told that they will be waiting almost a year before treatment can be accessed in the Mater hospital after a referral from their company's doctor in respect of their chronic knee problems. [44429/17]
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.
165. Deputy Clare Daly asked the Minister for Health if he will meet with a person and a group (details supplied). [44435/17]
Amharc ar fhreagraThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. The Act does not give the Minister for Health any powers in this regard.
In relation to the access scheme for Respreeza, the operation of such schemes is at the discretion of manufacturers. As Minister for Health I have no role in the operation of these schemes. There is no provision in Irish legislation for the approval of compassionate use programmes for specific groups of patients with an unmet medical need.
On my request, the HSE has sought assurances from Beaumont hospital that appropriate care arrangements were in place in the event that the access programme is discontinued, and that appropriate ethical guidelines have been and continue to be followed in relation to all aspects of the clinical trial and access programme.
The HSE has informed my Department that they have received a letter from the company in relation to their Compassionate Access Programme and other issues. The HSE is carefully considering the communications and will be engaging further with the company in relation to the full details of their proposals.
I have asked the HSE to contact you directly to update you on this matter following the completion of this process.
166. Deputy Joan Collins asked the Minister for Health if he will address a matter concerning the case of a person (details supplied). [44463/17]
Amharc ar fhreagraMy Department has been informed by the HSE that the patient was seen in Tallaght Hospital on Tuesday 17 October 2017. This review would have provided the patient with an opportunity to discuss her clinical care with the relevant hospital staff.
167. Deputy Bernard J. Durkan asked the Minister for Health the extent to which women suffering breast cancer have ready access to a medical card and access to free prosthesis afterwards; and if he will make a statement on the matter. [44493/17]
Amharc ar fhreagraA key recommendation of the 2014 Report of the Expert Panel on Medical Need for Medical Card Eligibility was that a person’s means should remain the main qualifier for a medical card. The report also concluded that it is neither feasible nor desirable to list conditions in priority order for medical card eligibility. Therefore, medical card provision is solely based on financial assessment. Under the legislation, having a particular illness, in itself, does not establish eligibility for a medical card.
However, in the assessment of applications the HSE seeks, within the framework of the legislation, to exercise discretion. In that regard the HSE assesses the financial, social and medical circumstances of applicants who may be in excess of the income guidelines. This assessment informs the decisions taken by the HSE on whether to award a medical card on a discretionary basis.
Access to free prosthesis after cancer treatment is a service matter, therefore, I have asked the HSE to reply to the Deputy directly on this matter.
168. Deputy Clare Daly asked the Minister for Health the origins and genesis of the radiological study published by his Department in November 2016 in the Harding Clark report on the symphysiotomy payment scheme; and if this study was authorised and-or commissioned by his Department or his office. [44507/17]
Amharc ar fhreagra169. Deputy Clare Daly asked the Minister for Health if the radiological study published by his Department in November 2016 in the Harding Clark report on the symphysiotomy payment scheme was paid for by his Department; if so, the amount; if the study's principal author (details supplied) received payment from his Department for this purpose; if so, the amount; if the other ten doctors listed as co-authors of the study received payment for their work; and if so, the amount received by each. [44508/17]
Amharc ar fhreagra170. Deputy Clare Daly asked the Minister for Health the terms of reference of the radiological study published by his Department in November 2016 in the Harding Clark report on the symphysiotomy payment scheme; the process by which those terms of reference were drawn up; and the names of the persons involved in the process. [44509/17]
Amharc ar fhreagra171. Deputy Clare Daly asked the Minister for Health the patient demographics used to access the images of applicants to the symphysiotomy payment scheme from the national imaging archive further to the radiological study published by his Department in November 2016 in the Harding Clark report on the scheme; if the X-rays of all applicants to the scheme, including those whose applications failed, were accessed for the purposes of this research; if the data used to download these images included the applicants' names or other identifiers; and if so, the identifiers. [44510/17]
Amharc ar fhreagraI propose to take Questions Nos. 168 to 171, inclusive, together.
The Surgical Symphysiotomy Ex-gratia Payment Scheme, which was approved by Government, concluded with the publication of the Report of its independent Assessor, Judge Maureen Harding Clark, on 22 November 2016. Judge Clark's Report, included, as an appendix, a review undertaken by Professor Leo Lawler, Director of Radiology Services, consultant radiologist Mater Hospital and visiting Consultant to the Rotunda Hospital entitled "Symphysiotomy & Pubiotomy Review - a Imaging Perspectivs".
In order to undertake her role under her Terms of Reference in an informed manner, Judge Clark drew on the professional expertise of certain medical specialists in the areas of obstetrics, radiology, orthopaedic surgery and pelvic injury, urology and urogynaecology, who advised the Scheme throughout the process. Professor Lawler advised on radiology and Judge Clark notes in her report that he "attended for weekly meetings to advise and discuss". She noted that radiology could confirm that surgical intervention had occurred and it also provided evidence to permit a finding of significant disability.
While my Department arranged for payments to be made to the medical experts, it was done on the instruction of Judge Clark. As the office of the Judge was independent, my Department had no role in determining the terms of reference for any work undertaken by the experts or making any decisions regarding medical expertise or research that Judge Clark deemed necessary to undertake her role under the Terms of Reference for the Scheme. Invoice records show that Prof Lawler's services to Judge Clark included reviews of radiographs, CT scans or MRIs, case discussions, literature reviews, correspondence with hospitals and solicitors and preparation of a review of the Scheme. Documents released under FOI show that the cost of the review was in the region of €6,600. Professor Lawler names 11 doctors who were specialist registrars or radiology fellows who assisted him in his work, but no payments were made by my Department to these individuals.
I have no additional information other than what is provided by Professor Lawler in his Report regarding the demographics used, or the x-rays or imaging which were accessed for the purpose of his work. Judge Clark, however, was happy that the information merited inclusion in her independent report to me on the Symphysiotomy Payment Scheme.
172. Deputy Robert Troy asked the Minister for Health if an appointment for a person (details supplied) will be scheduled; and if he will make a statement on the matter. [44518/17]
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.
173. Deputy Pearse Doherty asked the Minister for Agriculture, Food and the Marine the reason for the delay in processing an application for the AEOS 2 plan by a person (details supplied) in County Donegal; and if he will make a statement on the matter. [44301/17]
Amharc ar fhreagraThe person named joined AEOS2 with a start date of 1 September 2011. The contract was due to run up to 31 December 2016.
An inspection was carried out on 11 May 2012. An issue arose in relation to water courses on the farm. The inspectors decision was to disallow the Alternative Water Source for Bovine action as no water courses, as defined in the AEOS specification, were found on the farm.
This finding was appealed to the Regional Inspector who informed the person named by letter dated 24 November 2015 that the original decision was upheld.
The person named then appealed that decision to the Agricultural Appeals Office which informed both the Appellant and the Department that the original decision was upheld by way of decision letter dated 1 June 2016.
The person named then made a complaint to the Ombudsman's Office regarding the decision. The Ombudsman's Office again upheld the decision of the Department and the Agricultural Appeals Office.
The person named was paid all due amounts for all years of the contract. The final, balancing, payment in respect of the 2016 scheme year issued on 21 December 2016.
