Written Answers Nos. 128-133
128. Deputy Dara Calleary asked the Minister for Health his key priorities in the forthcoming capital review; the projects submitted for priority inclusion in the review; the status of negotiations with the Department of Public Expenditure and Reform on the review; and if he will make a statement on the matter. [2292/18]
Amharc ar fhreagraThe Mid Term review of the Capital Plan was published by the Minister for Public Expenditure and Reform on 13th September 2017.
Health capital funding was outlined in the recently published Public Service Estimates for 2018 and the HSE is currently developing its Capital Plan for 2018-2021.
The Government is preparing a new National Development Plan for the period 2018-2027, which is expected to be published alongside and in support of the forthcoming new National Planning Framework, to sustain national economic and social progress over the long term. As the Deputy knows, my priority is increasing capacity to improve access and I will shortly bring the capacity report to Government to feed into this process.
129. Deputy Róisín Shortall asked the Minister for Health the HSE's policy on medical card holders over 70 years of age who have been bereaved where the resulting change in circumstances means they no longer qualify for a medical card in their own right; if special allowances made in terms of income are taken into consideration in view of the particular circumstances; and if he will make a statement on the matter. [2299/18]
Amharc ar fhreagraThe HSE Medical Card/GP Visit Card National Assessment Guidelines for People aged 70 years and Over obliges that in the event of the death of a person covered who attains the over 70 medical card, the surviving spouse/ partner who is over the age of 70 years will retain the medical card for a period of three years providing that the death occurred on or after January 2009, that the surviving spouse/ partner was aged 70 or over at the time of death and that he or she remains within the relevant income limits for a couple that are relevant to the period when the applicant is being assessed. At the expiry of the three year period, he or she will be assessed under the single persons’ income limits.
If the surviving spouse or partner is under 70 years he or she will be assessed in accordance with the General Medical Card/GP visit card scheme using the appropriate income limits.
130. Deputy Róisín Shortall asked the Minister for Health if his attention has been drawn to the long waiting times faced by transgender persons to access public endocrinology services here; the steps he will take to address these waiting lists; and if he will make a statement on the matter. [2300/18]
Amharc ar fhreagraThe NTPF publishes the Inpatient and Outpatient waiting list figures by specialty and hospital each month. This information is available on NTPF.ie. The most recent figures published by the NTPF for December 2017 indicates that there is a total of 41 people on the Inpatient/Daycase waiting list for Endocrinology and a total of 9,043 people on the Outpatient waiting list for Endocrinology. The Deputy may wish to note that this data is extracted from the overall waiting list figures which does not differentiate transgender patients from other patients on the waiting list.
Reducing waiting times for the longest waiting patients is one of this Government's key priorities. Consequently, Budget 2018 allocated €55 million for the National Treatment Purchase Fund in 2018. This significant increase in funding more than doubles their 2017 total allocation which was €20m.
The HSE and NTPF are working together to develop coherent and synergistic Waiting List Action Plans in 2018 with the objective of arranging the provision of treatment for patients across a range of inpatient/daycase and outpatient specialties and procedures. These initiatives will continue to focus on long-waiting patients and overall waiting list numbers.
The existing care pathway in Ireland generally begins with an approach by an individual to their GP. The GP may refer the person to the local Community Mental Health Team for support and a diagnosis of Gender Dysphoria by psychiatrist or a clinical psychologist. A thorough assessment is a pre-requisite to commencing hormone suppressants in Ireland, in line with international best practice. This is to ensure that the correct path is being taken for the individual and to ensure co-morbid issues are identified and addressed.
131. Deputy Róisín Shortall asked the Minister for Health his views on whether it is appropriate to require transgender persons to seek a psychiatric diagnosis of gender dysphoria before they can seek endocrinology services; and if he will make a statement on the matter. [2301/18]
Amharc ar fhreagra132. Deputy Fergus O'Dowd asked the Minister for Health if a reply will issue to a query from a person (details supplied) on transgender health care needs; and if he will make a statement on the matter. [2302/18]
Amharc ar fhreagraI propose to take Questions Nos. 131 and 132 together.
The prevalence of transgender people in Ireland is difficult to estimate as there is no official collection of this data. The HSE, however, points to two significant sources in this respect.
The UK based Gender Identity Research and Education Society (GIRES) have estimated that 1% of individuals may experience some degree of gender variance or non-conformity and approximately 0.2% may undergo transition.
In a recent study, researchers from the Department of Endocrinology in St. Columcille’s Hospital (SCH), Loughlinstown, Dublin reviewed the medical records of 218 patients and estimated prevalence of gender dysphoria at one in 10,154 male-to-female and one to 27,668 female-to-male individuals in the Irish population. These figures, however, only include individuals seeking medical services from that hospital and exclude those who are seeking treatment elsewhere or who do not medically transition.
A proposed model of care for transgender children, adolescents and adults was submitted by the HSE Quality Improvement Division to the HSE Divisions of Primary Care, Mental Health and Acute Hospital programme for consideration in January 2017. The model was developed in consultation with key treating clinicians, planners, policy makers, advocates and service users. The model outlines key services required to ensure the needs of the transgender population including children and adolescents are addressed. It details current service provision and emerging service demand in relation to adults and separately in relation to children and adolescents. It draws on evidence based international best practice and aims to build on services which already exist and develop services where deficits prevail.
A number of initiatives are supported through the Social Inclusion Services including the development of the Gender Identity Skills Training Programme for Clinicians and professionals who work with children and young persons under the age of 18 years who are experiencing gender identity related issues to include General Practitioners, CAMHS Teams, Psychologists.
In response to your query, I have asked the HSE to respond to you directly.
133. Deputy Catherine Murphy asked the Minister for Health further to Parliamentary Question No. 143 of 8 November 2017, if the resources that are required have been identified in each hospital that does not have an early discharge team; his plans to recruit to fill these positions and establish teams; if locations have been identified to add extra teams in locations that already have teams; and if he will make a statement on the matter. [2303/18]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to you directly.
