Michael Healy-Rae
Ceist:571. Deputy Michael Healy-Rae asked the Minister for Health if he will address a matter (details supplied) regarding private health insurance; and if he will make a statement on the matter. [12433/18]
Amharc ar fhreagraHealth Insurance Cover
Ceisteanna (571)
Freagraí scríofa
Our health insurance system is voluntary and community rated. Lifetime Community Rating (LCR) was introduced in May 2015 to encourage people to join the private health insurance market at an earlier age and thus avoid late entry loadings of 2% per annum which may apply at age 35 and older. There was a grace period available up until introduction, during which time health insurance could be purchased (at any age) without incurring loadings. The application of loadings is mandatory and applies to the premium of anyone aged 35 and over taking out health insurance for the first time.
It should be noted that following a review of the system of Lifetime Community Ratings in 2017 by the Health Insurance Authority, amendments have been made to refine the system, including the fact that any loadings that are incurred are now applied for ten years (previously, loadings applied for life).
It is also important to note that the purchase of private health insurance is optional and that people who do not take out health insurance continue to have the same entitlement to services in the public hospital system.
HSE Complaints Procedures
Ceisteanna (572)
Michael McGrath
Ceist:572. Deputy Michael McGrath asked the Minister for Health the status of a complaint by a person (details supplied) submitted to the HSE in March 2017. [12437/18]
Amharc ar fhreagraFreagraí scríofa
The 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.
Hospital Appointments Status
Ceisteanna (573)
Michael Healy-Rae
Ceist:573. Deputy Michael Healy-Rae asked the Minister for Health the status of a hospital appointment for a child (details supplied); and if he will make a statement on the matter. [12442/18]
Amharc ar fhreagraFreagraí scríofa
Under 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 HSE, 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 the Deputy directly.
Disability Support Services
Ceisteanna (574)
Clare Daly
Ceist:574. Deputy Clare Daly asked the Minister for Health the steps he will take to address deficiencies in view of a HSE memo (details supplied) highlighting deficiencies in service provision for school leavers and those persons leaving rehabilitative training, RT, programmes who will require a HSE-funded day service commencing in September 2018 [12443/18]
Amharc ar fhreagraFreagraí scríofa
The 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.
Local Drugs Task Forces
Ceisteanna (575)
John Curran
Ceist:575. Deputy John Curran asked the Minister for Health the way in which he expects local drug task forces to meet the commitment made in the Programme for Partnership Government to extend the services of local and regional drug and alcohol task forces if funding to local drug task forces remains at 2014 levels; and if he will make a statement on the matter. [12457/18]
Amharc ar fhreagraFreagraí scríofa
Drug and Alcohol Task Forces play a key role in assessing the extent and nature of the drug problem in their areas and in coordinating action at local level, so that there is a targeted response to the problem of substance misuse in local communities. Every effort has been made to protect the budgets of Drug and Alcohol Task Forces in recent years. In excess of €27.6m has been allocated to Task Forces by the HSE and the Department of Health for community-based drugs initiatives this year. This level of funding is consistent with the amounts provided in 2014, 2015, 2016 and 2017.
In recognition of the key role Drug and Alcohol Task Forces play in providing a targeted response to the drug problem in local communities, I will shortly be announcing details of new funding initiatives to strengthen the capacity of Task Forces to support the implementation of Reducing Harm, Supporting Recovery during 2018.
In addition the Department of Health is developing a new programme to promote community awareness of alcohol related harm. An additional €0.25m is being made available by the Department in 2018 to fund Phase 1 of the scheme. It is anticipated that the scheme will commence in the last quarter of 2018 and will be developed over the coming months in association with the Health and Wellbeing Unit in the Department.
Work Placement Programmes
Ceisteanna (576)
Margaret Murphy O'Mahony
Ceist:576. Deputy Margaret Murphy O'Mahony asked the Minister for Health the plans in place to provide work placements for psychotherapy students in the HSE in line with other health care students; and if he will make a statement on the matter. [12477/18]
Amharc ar fhreagraFreagraí scríofa
I have asked the HSE to respond to the Deputy directly on this matter.
Health and Social Care Professionals
Ceisteanna (577)
Margaret Murphy O'Mahony
Ceist:577. Deputy Margaret Murphy O'Mahony asked the Minister for Health the plans in place to recognise a grade for psychotherapists (details supplied); and if he will make a statement on the matter. [12478/18]
Amharc ar fhreagraFreagraí scríofa
My Department is seeking clarification from the Deputy in relation to this question.
Health and Social Care Professionals Regulation
Ceisteanna (578)
Margaret Murphy O'Mahony
Ceist:578. Deputy Margaret Murphy O'Mahony asked the Minister for Health his plans to introduce regulation of counsellors and psychotherapists under the Health and Social Care Professionals Act 2005; and if he will make a statement on the matter. [12479/18]
Amharc ar fhreagraFreagraí scríofa
Counsellors and psychotherapists are not currently designated under the Health and Social Care Professionals Act 2005. The Minister for Health may designate health or social care professions not currently designated if he or she considers that it is in the public interest to do so and if the specified criteria have been met. Following a public consultation, I decided to proceed with the designation of two distinct professions under the Act, that of counsellor and that of psychotherapist. Each will have its own register under one registration board. This decision was communicated to the Health and Social Care Professionals Council (CORU), the relevant professional bodies, and all the respondents to the public consultation process.
The draft Regulations to designate the professions of counsellor and psychotherapist under the Health and Social Care Professionals Act 2005 and to establish a registration board for the professions have, in accordance with the provisions of the Act, been laid before each House of the Oireachtas. Resolutions approving the drafts have been submitted to each House and these will be considered by both Houses next week. The Joint Committee on Health met on 7 March to discuss the resolutions; no objections to the proposed regulations were raised at that time.
Subject to the approval by the Houses of these regulations, the next step will be the appointment of the 13 members of the registration board following the submission of suitable candidates for my consideration by the Public Appointments Service. I hope that the registration board will be in a position later this year to begin the task of drafting the various by-laws to allow it to establish its registers.
Disability Support Services Funding
Ceisteanna (579)
Ruth Coppinger
Ceist:579. Deputy Ruth Coppinger asked the Minister for Health his plans to increase resources to the Health Service Executive in north Dublin city and county assessment of needs section to resolve the long waiting times; and if he will make a statement on the matter. [12486/18]
Amharc ar fhreagraFreagraí scríofa
It is recognised that early intervention services and services for school-aged children with disabilities need to be improved and organised more effectively and this process is well under way. One of the key priorities for the HSE is to improve waiting times for therapy services by implementing a revised model of care for children’s Speech and Language Therapy services and Psychology services and develop new models for Physiotherapy and Occupational Therapy services. The HSE has established a Service Improvement Initiative to include Occupational Therapy services, with a particular focus on waiting times for access.
The HSE is currently engaged in a reconfiguration of existing therapy resources to geographic based teams for children (0-18 years). The objective of the new model of assessment and intervention is to provide one clear referral pathway for all children (0-18s), irrespective of their disability, where they live or the school they attend.
Evidence to date from areas where this has been rolled out shows that implementation of this programme will have a positive impact on waiting lists both for assessments and therapies. Some HSE Areas have already reconfigured into interdisciplinary Children’s Disability Network Teams (a total of 56 networks of the 129 network teams required are in place) whilst others are developing their reconfiguration and implementation plan.
The HSE has also recognises that a lack of standardisation and clarity has contributed to significant delays in the Assessment of Need process. In addition, the Assessment of Need has resulted in resources being targeted almost exclusively towards assessment with some children receiving very limited intervention.
A revised Standard Operating Procedure for Assessment of Need has been developed to ensure that there is a standardised approach to assessment across all areas. This procedure will be implemented from 1 April 2018. The procedure addresses the issue of eligibility for Assessment of Need and aligns this with the National Policy on Access to Services for Children & Young People with Disability & Developmental Delay.
The implementation of the Standard Operating Procedure for Assessment of Need is intended to support children with disabilities to access timely assessment and appropriate intervention.
At a national level, €8 million in additional funding was invested in 2014 and 2015 to fund 200 additional posts to support the implementation of the Progressing Disabilities programme.
A further €4 million in additional funding was provided for 75 therapy posts in 2016.
Budget 2018 funding will facilitate the recruitment of additional occupational therapy posts to address waiting lists and enable patients to have earlier access to assessment and treatment.
It is expected that this re-configuration of services along with other measures outlined will have a significant impact on the HSE’s ability to meet the needs of children and young people in a more efficient, effective and equitable manner. In particular, it will facilitate their ability to comply with the statutory time-frames set out in the Disability Act and the accompanying regulations.
Dental Services
Ceisteanna (580)
Marcella Corcoran Kennedy
Ceist:580. Deputy Marcella Corcoran Kennedy asked the Minister for Health if his attention has been drawn to the fact that a person (details supplied) has been told that they will now have to pay for a child's dental work; and if he will make a statement on the matter. [12494/18]
Amharc ar fhreagraFreagraí scríofa
As this is a service matter it has been referred to the HSE for direct reply to the Deputy.
Health Services Provision
Ceisteanna (581)
Thomas P. Broughan
Ceist:581. Deputy Thomas P. Broughan asked the Minister for Health the way in which his Department is monitoring adherence to the guidelines by an organisation (details supplied) for transgender healthcare; the reason psychiatric diagnosis is conducted as opposed to psychosocial assessment in accordance with the guidelines; and if he will make a statement on the matter. [12499/18]
Amharc ar fhreagraFreagraí scríofa
Transgender-specific guidelines have been developed by the World Professional Association for Transgender Health (WPATH) and the Endocrine Society. These guidelines were devised by experts in transgender healthcare, along with members of the International Transgender, Transsexual and LGBT community.
International best practice for transgender children, adolescents and adults involves a comprehensive multi disciplinary psychosocial assessment by a multi disciplinary team and shared decision making in the best interests of the individual. Both WPATH and the Endocrine Society Guidelines 2017 specify the assessment must be carried out by a mental health professional (s) with experience in transgender health care and possess specific skills.
The emerging evidence on good outcomes following medical and/or surgical transitioning is based on use of multi-disciplinary psychosocial assessment, fulfillment of criteria for hormones and ongoing psychological support throughout the process. It is important that psychological support is available to individuals before, during and after transitioning. Informed consent is essential, whereby benefits and risks of hormone treatment and surgery are discussed with individuals seeking these interventions to try and prevent negative outcomes. Although regret rates are low, it can happen and can also lead to high levels of psychological distress.
The model of care provides the framework for the development of National Gender Clinics and MDTs for children and adults, funded by the Acute Hospitals and Mental Health Divisions of the HSE. Recruitment will commence to develop these national teams in 2018. It is envisaged that these National Teams will be in place in 2018, pending successful recruitment campaigns.
Health Services Provision
Ceisteanna (582)
Thomas P. Broughan
Ceist:582. Deputy Thomas P. Broughan asked the Minister for Health the reason all general practitioners trained in administering hormone replacement therapy, HRT, are not working in transgender healthcare; the number of general practitioners that are providing healthcare to trans persons; and if he will make a statement on the matter. [12500/18]
Amharc ar fhreagraFreagraí scríofa
A proposed model of care for transgender children, adolescents and adults has been developed by the HSE Quality Improvement Division. 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 queries, I have asked the HSE to respond to you directly.
Questions Nos. 583 and 584 answered with Question No. 517.
Hospital Waiting Lists
Ceisteanna (585)
Thomas P. Broughan
Ceist:585. Deputy Thomas P. Broughan asked the Minister for Health the steps he has taken to expedite hospital treatment for persons waiting longer than 12 months; the waiting targets for key procedures with long wait times; and if he will make a statement on the matter. [12505/18]
Amharc ar fhreagraFreagraí scríofa
Last October’s Budget announced a total 2018 allocation of €55m for the National Treatment Purchase Fund (NTPF) for 2018 which more than doubles its 2017 total allocation which was €20m. This significant increase in funding reflects the fact that reducing waiting times for patients is one of this Government's key priorities.
The Department of Health, the HSE and the NTPF are finalising an Inpatient/Daycase Action Plan 2018 which will set out ambitious targets for both the HSE and NTPF to reduce the overall number of patients waiting for treatment.
The 2018 Inpatient/Day Case Action Plan will see the NTPF and HSE working closely together to enable the provision of treatment patients across a range of specialties and procedures and will focus on long-waiting patients and overall waiting list numbers. The NTPF will work with both public and private hospitals in order to provide access for patients to treatment.
Hospital Waiting Lists
Ceisteanna (586)
Thomas P. Broughan
Ceist:586. Deputy Thomas P. Broughan asked the Minister for Health his views on the fact that the Euro Health Consumer Index 2017 has reported that Irish persons' waiting times for hospital treatment are the worst in Europe; and if he will make a statement on the matter. [12506/18]
Amharc ar fhreagraFreagraí scríofa
The Euro Health Consumer Index 2017 report has highlighted areas that our health service are focused on improving. Reducing waiting times for the longest waiting patients is one of this Government's key priorities. Waiting times are often unacceptably long and I am conscious of the burden that this places on patients and their families.
Budget 2018 allocated a total of €55m for the National Treatment Purchase Fund (NTPF), more than doubling the 2017 allocation of €20m. The HSE and the NTPF are currently finalising 2018 Waiting List Action Plans for 2018, with a specific focus on reducing the number of patients waiting the longest for inpatient and daycase procedures.
Waiting List Figures for the end of February, published by the NTPF on 14 March, show that 72% of Inpatient Day Case patients and 61% of outpatients are waiting 9 months or less.
At the end of February 2018, there were 79,039 patients in total waiting for an inpatient or day case procedure, this is a reduction of 1,165 patients waiting compared to the end of January 2018 and a reduction of 7,075 when compared to the numbers waiting at the end of July 2017.
This is against a background of increasing demands on our Acute Hospitals, which, since 2000 are carrying out four times more procedures for patients aged 65 and over and twice as many in the under 65 age group.
More broadly, a number of system-wide improvements to Waiting List Management are being undertaken to reform and improve how our health service manages hospital waiting lists. These initiatives seek to drive sustainable, multi-faceted and innovative approaches in waiting list management.
Nursing Staff Provision
Ceisteanna (587)
John Brassil
Ceist:587. Deputy John Brassil asked the Minister for Health his plans to ensure his Department makes adequate funding available to the HSE to provide a replacement public health nurse (details supplied); and if he will make a statement on the matter. [12515/18]
Amharc ar fhreagraFreagraí scríofa
As this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.