Hospitals Policy

Ceisteanna (129)

Fiona O'Loughlin

Ceist:

129. Deputy Fiona O'Loughlin asked the Minister for Health if a consultation process has commenced relating to the Midland Regional Hospital, Portlaoise as previously indicated; and if he will make a statement on the matter. [18139/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I am committed to securing and further developing the role of the Midland Regional Hospital Portlaoise as a constituent hospital within the Dublin Midlands Hospital Group. Since 2014, the focus has been on supporting the hospital to develop and enhance management capability, implementing changes required to address clinical service deficiencies, and incorporating the hospital into the governance structures within the Dublin Midlands Hospital Group.

Significant work has been undertaken to strengthen and stabilise current arrangements for services at the hospital to ensure that services that are not sustainable are discontinued and those that are, are safety assured and adequately resourced. Funding has increased by 35% relative to the 2012 budget and staffing levels have risen by 29% from the 2014 base.

Governance and management arrangements in Portlaoise Hospital have been strengthened, additional clinical staff has been appointed and staff training, hospital culture and communications have improved.

As outlined at a meeting with Laois Oireachtas members, no decision has been made yet on the draft Action Plan for Portlaoise Hospital and the consultation process involving local clinicians and the community is currently under consideration by my Department.

Medicinal Products Reimbursement

Ceisteanna (130)

Mary Butler

Ceist:

130. Deputy Mary Butler asked the Minister for Health his plans to ensure the same number of persons with type 1 diabetes will be seen as per current standards, guidelines and wait times for individual reimbursement support with regard to the FreeStyle Libre blood glucose management system in view of the workload that will be incurred by the endocrinologist consultants; and if he will make a statement on the matter. [18155/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

Hospital Appointments Administration

Ceisteanna (131)

Mary Butler

Ceist:

131. Deputy Mary Butler asked the Minister for Health the minimum and maximum waiting times for adults and children with type 1 diabetes to see a consultant for follow-up or review consultation by CHO in tabular form; and if he will make a statement on the matter. [18156/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Departmental Expenditure

Ceisteanna (132, 140)

Timmy Dooley

Ceist:

132. Deputy Timmy Dooley asked the Minister for Health the amount his Department has spent on social media training and consultancy in each of the years 2011 to 2016. [18167/18]

Amharc ar fhreagra

Timmy Dooley

Ceist:

140. Deputy Timmy Dooley asked the Minister for Health if training has been delivered in his Department on the use of social media; the frequency and cost of this training; and if he will make a statement on the matter. [18203/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 132 and 140 together.

The Department of Health spent a total of €2329.85 on social media training (including staff attendance at seminars) in the years 2011 to 2018 (as per the following table), with zero spend on social media consultancy.

Year

Spend on social media training  

2011

€1040.00

2012

€0.00

2013

€1050.00

2014

€239.85

2015

€0.00

2016

€0.00

2017

€0.00

2018

€0.00

Mental Health Services Provision

Ceisteanna (133)

Pat Buckley

Ceist:

133. Deputy Pat Buckley asked the Minister for Health the status of the ten new beds that were to be opened in the Central Mental Hospital; and if he will make a statement on the matter. [18175/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Mental Health Services Provision

Ceisteanna (134)

Pat Buckley

Ceist:

134. Deputy Pat Buckley asked the Minister for Health the status of the opening of Portrane mental health facility; and if he will make a statement on the matter. [18176/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Mental Health Services Data

Ceisteanna (135)

Pat Buckley

Ceist:

135. Deputy Pat Buckley asked the Minister for Health the number waiting in the prison system and in approved centres for admittance to the Central Mental Hospital in tabular form; and if he will make a statement on the matter. [18177/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Mental Health Services Data

Ceisteanna (136)

Pat Buckley

Ceist:

136. Deputy Pat Buckley asked the Minister for Health the medium and long-term residential rehabilitation beds that are provided for by CHO area; and if he will make a statement on the matter. [18178/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Nursing Homes Support Scheme Data

Ceisteanna (137)

Noel Grealish

Ceist:

137. Deputy Noel Grealish asked the Minister for Health the number of persons in nursing homes under the fair deal scheme who have a family home registered in their name which is included as part of the assessment for the scheme; the number of these houses that still have a spouse or family member residing in the property; the number of these family homes that are rented and generating an income; the number of these houses that are vacant; and if he will make a statement on the matter. [18179/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Disability Services Provision

Ceisteanna (138)

Kevin O'Keeffe

Ceist:

138. Deputy Kevin O'Keeffe asked the Minister for Health if a person (details supplied) will be assisted in transferring to a specific unit which would be more suitable for the person. [18189/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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 an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Hospital Waiting Lists

Question No. 140 answered with Question No. 132.

Ceisteanna (139)

Tom Neville

Ceist:

139. Deputy Tom Neville asked the Minister for Health his views on a matter in the case of a person (details supplied); and if he will make a statement on the matter. [18192/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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.

Question No. 140 answered with Question No. 132.

Health Services Staff

Ceisteanna (141)

Joan Burton

Ceist:

141. Deputy Joan Burton asked the Minister for Health if his attention has been drawn to the fact that World Health Organisation guidelines state that Ireland should have six full-time rheumatology consultants; the steps he is taking to implement the WHO guidelines; and if he will make a statement on the matter. [18222/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I have asked the HSE to respond to you directly on this matter.

Hospital Waiting Lists

Ceisteanna (142)

Brendan Howlin

Ceist:

142. Deputy Brendan Howlin asked the Minister for Health when a person (details supplied) will receive an appointment; and if he will make a statement on the matter. [18223/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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.

Hospital Waiting Lists

Ceisteanna (143)

Pearse Doherty

Ceist:

143. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) in County Donegal will receive an appointment to attend Letterkenny University Hospital; and if he will make a statement on the matter. [18224/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

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.

General Practitioner Contracts

Ceisteanna (144, 145)

Barry Cowen

Ceist:

144. Deputy Barry Cowen asked the Minister for Health the FEMPI cuts that were made to general practitioners pay since 2008; the estimated full-year cost of reversing each of these cuts; and if he will make a statement on the matter. [18225/18]

Amharc ar fhreagra

Barry Cowen

Ceist:

145. Deputy Barry Cowen asked the Minister for Health if he has consulted the Minister for Public Expenditure and Reform about the cost implications of reversing FEMPI cuts for general practitioners; and if he will make a statement on the matter. [18226/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 144 and 145 together.

Under the General Medical Services (GMS) contract, GPs are reimbursed for a range of services they provide to medical card and GP visit card holders. GPs are remunerated for these services primarily on a capitation basis, with a range of additional support payments and fees for specific items of service. GPs are also remunerated for services they provide on behalf of the HSE under other public health schemes, such as the Maternity and Infant Care Scheme, Primary Childhood Immunisation Scheme, etc.

The Financial Emergency Measures in the Public Interest (FEMPI) Act 2009 imposed a range of adjustments to health contractor payments. These included different levels of reductions to various GP fees and allowances and the elimination of certain payments resulting in savings of approximately €120 million per annum.

Despite reductions to the payment rates of health contractors made under FEMPI legislation, the total fees paid to GPs under the GMS scheme have increased during this period from just over €472 million in 2009 to approximately €518 million in 2016. This increase in fees is largely due to significant developments and investment in GP services introduced in recent years, with more services being made available to our citizens and additional financial support provided by the HSE.

Following the publication of the Public Service Pay and Pensions Bill late last year, along with my colleague the Minister for Public Expenditure and Reform, I made it clear that Government is committed to engaging with health contractors on the revision of fees as provided for under this legislation.

In this context the Government is committed to engaging with the representatives of general practitioners on the development of a package of measures and reforms to modernise the current GMS Contract. The primary focus of this engagement will be on a package of measures and reforms which, if agreed, will result in an expansion in the scope of the service provided by GPs to holders of medical cards and GP visit cards.

I have engaged with my colleague, the Minister for Public Expenditure and Reform about the future resourcing of general practice. My officials are working with counterparts in the Department of Public Expenditure and Reform and the HSE to ensure that the engagement process with GP representatives, which is due to start in coming weeks, is fully focused on the priorities of the Government’s health reform agenda and measures which will contribute to addressing the strategic challenges facing the service. If the talks process is successful and agreement can be reached on reforms that will benefit both patients and GPs, there is potential for State expenditure on GP services to increase in the coming years.

Details of the adjustments to GP payments under FEMPI are set out as follows.

SI 262 of 2009 applied an 8% reduction to the range of GP fees and allowances payable under the GMS Scheme, the Maternity and Infant Care Scheme and the (Health Amendment) Act 1996.

SI 638 of 2010 applied reductions to a range of GP fees and allowances payable under the GMS Scheme, the Maternity and Infant Care Scheme, the Health (Amendment) Act 1996 and the HeartWatch Programme, which equated to an approximate overall reduction of 9% to payments under these schemes.

- A 50% reduction was applied to the capitation fee in respect of patients aged 70 years or more who reside in a private nursing home (approved by the HSE) for continuous periods in excess of 5 weeks.

- The “distance from the GP’s surgery” was removed as a factor in calculating capitation fees, which were standardised at the 0-3 miles rate within the various age and gender categories.

-The “distance from the GP’s surgery” was removed as a factor in calculating out-of-hours fees and new rates applied.

- The “distance from the GP’s surgery” was removed as a factor in calculating Special Type Consultation (STC) fees in respect of temporary residents, EEA visitors and consultations where a GP sees another GP’s patient in an emergency and a 5% reduction was applied to STC fees.

- The Fund for the Development of General Practice (introduced in 1993) was abolished.

- A 5% reduction was applied to payments in respect of the practice secretary/nurse/manager subsidy.

- An 8% reduction was applied to other payments, including special items of service; leave cover; locum expenses under the fee per item contract; dispensing fees; rural practice allowance; and payments under the Health (Amendment) Act 1996.

- An 8% reduction was applied to fees under the Maternity & Infant Care Scheme.

- A 15% reduction was applied to fees under HeartWatch scheme.

SI 556 of 2011 reduced the administration fees payable to GPs for childhood immunisations under the Primary Childhood Immunisation Scheme by 7.5%, and the fees for administration for influenza and pneumococcal immunisations under the GMS scheme by 33%.

In 2013, an overall reduction of 7.5% was applied to a range of GP fees and allowance. SI 278 of 2013 reduced the fee payable to GPs for administering the influenza vaccination to the same rate as the fee payable to pharmacists for administering the same vaccination. SI 277 of 2013 introduced the following measures:

- Elimination of the special fee payable in respect of discretionary medical cards.

- A reduction of 3.1% in respect of the following fees:

- Capitation Fees

- Supplementary Out-of-Hours Fees

- Asylum Seekers / Non EU Nationals.

- A reduction of 1% in respect of the practice nurse/secretary/manager subsidy.

- A reduction of 7.5% in respect of the following payments under the GMS scheme:

- Out-of-Hours fees,

- Special Type Consultations (STCs),

- Special Items of Services (excluding immunisations),

- Rural Practice Allowance,

- Dispensing Fees,

- Second Medical Opinion,

- Leave cover.

- A reduction of 7.5% in respect of the following payments paid to GPs under the General Medical Services (GMS) 1972 Fee-per-Item Contract:

- Fee-per-Item Consultation Fees

- Homes for the Aged Consultations

- Rural Practice Allowance,

- Locum Expenses & Practice Expenses,

- Special Items of Service.

- A reduction of 7.5% in respect of the following payments:

- Health Amendment Act 1996 (Hepatitis C patients),

- Maternity & Infant Care Scheme,

- HeartWatch Programme.

General Practitioner Data

Ceisteanna (146)

Barry Cowen

Ceist:

146. Deputy Barry Cowen asked the Minister for Health the number of general practitioners receiving funding from the State; the number that is required; and if he will make a statement on the matter. [18227/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

General Practitioners are private contractors. There is no prescribed ratio of GPs to patients and the State does not regulate the number of General Practitioners that can set up in a town or community.

Under the provisions of the Health (Provision of General Practitioner) Act 2012, a GP can enter into a state contract to provide GP services provided he/she is on the Medical Council's Specialist Register in  General Practice, irrespective of the number of GPs that are already established in an area.

As at 1 of April 2018, there are 2,485 GPs contracted by the HSE to provide services under the GMS scheme. A further 419 GPs who do not hold GMS contracts are contracted by the HSE to provide services under the Primary Childhood Immunisation Scheme, the Health(Amendment) Act 1996, Heartwatch, the Methadone Treatment Scheme and the National Cancer Screening Service.

It should be noted that as at 1 March 2018 there were only 23 GMS panels that do not have a permanent GP in place – a vacancy rate of less than 1%.

The Health Service Capacity Review estimates a requirement of 4,970 GPs by 2031 which is an increase of 1,400 or 39% based on no changes to eligibility and current patterns of activity.

I would like to assure the Deputy of the Government's commitment to the continued development of GP capacity to ensure that patients across the country continue to have access to GP services and that general practice is sustainable in all areas into the future. I want to ensure that existing GP services are retained and that general practice remains an attractive career option for newly-qualified GPs.

Efforts undertaken in recent years to increase the number of practising GPs include changes to the entry provisions to the GMS scheme to accommodate more flexible/shared GMS/GP contracts, and to the retirement provisions for GPs under the GMS scheme, allowing GPs to hold GMS contracts until their 72nd birthday, as well as the introduction of an enhanced supports package for rural GP practices. Separately, the State is seeking to train more GPs to provide GP services to the population. In 2009, there were 120 GP training places and in 2018 we expect to fill 194 training places, an increase of over 60% over this nine year period.  The Government is committed to further increasing this number to 259 places annually in future years.

Assisted Human Reproduction

Ceisteanna (147, 148, 151, 152)

Alan Kelly

Ceist:

147. Deputy Alan Kelly asked the Minister for Health when plans to subsidise or assist couples with the cost of IVF will be published and introduced; and if he will make a statement on the matter. [18228/18]

Amharc ar fhreagra

Alan Kelly

Ceist:

148. Deputy Alan Kelly asked the Minister for Health the projected costs in 2019 of the introduction of free IVF treatment as committed to in October 2017; and the estimated number of couples who would be provided with access in 2019 and in each of the following five years [18229/18]

Amharc ar fhreagra

Alan Kelly

Ceist:

151. Deputy Alan Kelly asked the Minister for Health the supports that are provided to couples who require assistance in funding IVF and other fertility treatments; and if he will make a statement on the matter. [18232/18]

Amharc ar fhreagra

Alan Kelly

Ceist:

152. Deputy Alan Kelly asked the Minister for Health further to previous parliamentary replies, if he reverted to Government at the end of 2017 as committed to with proposals for a potential model of public funding for assisted human reproduction treatment; and if he will make a statement on the matter. [18233/18]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

I propose to take Questions Nos. 147, 148, 151 and 152 together.

The Government approved the drafting of a Bill on assisted human reproduction (AHR) and associated areas of research in October last year. In order to support the commencement of the legislation, officials in my Department will work during 2018 with the HSE to develop a model of care for infertility to ensure the provision of safe, effective and accessible services through the public health system as part of the full range of services available in obstetrics and gynaecology.

Part of this work includes identifying policy options for a potential public funding model for AHR treatment. Once I have had the opportunity to consider these policy options I will bring a Memorandum to Government for a model of public funding for AHR treatment for the Government's consideration and decision.

It should be noted that any funding model that may ultimately be introduced would need to operate within the broader regulatory framework set out in the AHR Bill and a model of care for infertility.

While IVF treatment is not currently provided by the Irish public health service, there is some support available in that patients who access IVF treatment privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme. In addition, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Scheme administered by the HSE. Medicines covered by the High Tech Scheme must be prescribed by a consultant/specialist and approved by the HSE ‘High Tech Liaison Officers’. The cost of the medicines is then covered, as appropriate, under the Medical Card or Drugs Payment Scheme. In addition to these schemes, there is a limited specialist AHR service available through the HSE, which provides funding for fertility preservation for cancer patients whose treatment is likely to impact on their future fertility.