Written Answers Nos. 1800-1819
1800. Deputy Róisín Shortall asked the Minister for Health the progress on his discussions with the Department of Housing, Planning and Local Government and local authorities on plans to provide State-funded retirement villages; and if he will make a statement on the matter. [34919/18]
Amharc ar fhreagraMy Department, in conjunction with the Department of Housing, Planning and Local Government (DHPLG), is currently exploring policy options including supporting housing/housing with care so that older people have a wider range of housing options and choices available to them. A cross Department/Agency steering group chaired by the DHPLG and comprising the Department of Health, the Health Service Executive, the Housing Agency and other key stakeholders was established in 2017 to consider the issues and provide guidance on drafting a joint policy statement on housing options for older people. The draft statement is currently being finalised.
This will be a first step in the broader process of seeking to ensure that older people are provided with appropriate accommodation options that are suited to their needs. The policy statement will set out a framework by which the Government can facilitate housing, including housing with care, for older people having regard to current demographics and looking at best practice models. The aim is to ensure that people can grow old and live in a community of their choosing, with dignity and independence.
In November I intend to host a joint expert conference on housing for older people, together with the Minister of State with responsibility for Housing and Urban Renewal. The conference will identify and discuss a range of issues including opportunities, barriers and enablers to guide future development of housing and support needs for older people.
1801. Deputy Dessie Ellis asked the Minister for Health the number of children between 12 and 16 years of age who have had eye care provided by the HSE reduced or stopped; the reason for their treatment being reduced or stopped; the number of children in this cohort who previously received vouchers for the purchase of new glasses and will no longer receive such vouchers; and if he will make a statement on the matter. [34922/18]
Amharc ar fhreagraAs this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.
1802. Deputy John Brassil asked the Minister for Health if an MRI appointment for a person (details supplied) will be expedited; and if he will make a statement on the matter. [34997/18]
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 National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since 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.
1803. Deputy Richard Boyd Barrett asked the Minister for Health the full-year cost of reversing all the cuts to dental care introduced since 2007; and if he will make a statement on the matter. [35005/18]
Amharc ar fhreagraThe Dental Treatment Services Scheme (DTSS) provides dental treatments to medical card holders. In 2010 the range of treatments provided under the Scheme was reduced in order to cap expenditure at the 2008 level of €63 million. Expenditure on the DTSS in 2017 was €63.3 million. The cost of restoring treatments which had been provided before 2010 would depend on a number of factors, including the underlying oral health of the population and the likely level of take-up of such services. The HSE continues to monitor the operation of the DTSS to ensure the most beneficial, effective and efficient use of available resources.
1804. Deputy Richard Boyd Barrett asked the Minister for Health the estimated full-year cost of introducing home care as a demand-led service; and if he will make a statement on the matter. [35006/18]
Amharc ar fhreagraIn advancement of the Government’s commitment to promote community-care so that people can continue to live independently in their own homes for as long as possible, the Department of Health is currently engaged in the development of a new, stand-alone statutory scheme and system of regulation for home-care services.
The new home-care scheme will introduce clear rules in relation to the services for which individuals are eligible and in relation to service-allocation. It will therefore be an important step in ensuring that the system operates in a consistent and fair manner and will help to improve access to home-care services on an affordable and sustainable basis.
The development of a statutory scheme and system of regulation for home-care services is a complex undertaking. The publication of a Health Review Board Report in 2017 on the review of the home-care systems in place in four European countries and the publication of a report on the public consultation on homecare on 26th June 2018 commissioned by the Department of Health, represent important milestones in the process of developing the new scheme. However, a significant amount of additional work remains to be carried out before final decisions are taken on the form of the home-care scheme and system of regulation. This is required if the reforms are to be successful, affordable and sustainable. The Department will continue to prioritise its work in developing the new scheme and every effort will be made to progress this matter as quickly as possible. However a realistic timeframe for the establishment of the new scheme on a statutory basis is 2–3 years.
While the new home-care scheme is under development, the Department of Health and Health Service Executive are continuing efforts to improve existing home-care services. In 2018 the HSE brought the funding for home help and Home Care Packages together into a single home support service for older people. As well as simplifying the application-process for home-care, the new service will be more responsive to service-users' changing needs. More broadly the HSE will continue to encourage local integration of services and to build appropriate care-pathways, in particular for people with complex needs. A consumer-directed approach to home-support provision will be introduced, giving service-users greater choice in relation to when they receive services and their selection of a service-provider. This enhancement of current service-provision is being supported by increased investment in home-care services. In line with the commitment in A Programme for a Partnership Government (2016) to increase funding for home-care annually, home support services received particular priority in Budget 2018, with an additional €18.25m allocated bringing the total home support allocation for 2018 to almost €417 million which includes funding for intensive home care packages. The HSE 2018 National Service Plan provides for over 17 million home support hours to be delivered to 50,500 people at any time and 235 Intensive Home Care Packages for people with more complex needs delivering approximately 360,000 hours in the full year. A further 156,000 hours, relating to adverse weather funding, will be provided this year.
In relation to the request for an estimated full year cost I have asked the HSE to correspond directly with the Deputy to advise on the cost of servicing the current wait list for Home Help and Home Care Packages under the rules of the current scheme and of introducing home care as a demand led service.
1805. Deputy Richard Boyd Barrett asked the Minister for Health the full-year cost of abolishing inpatient and emergency department charges for public patients; and if he will make a statement on the matter. [35007/18]
Amharc ar fhreagraIn 2017, €27 million was raised through the statutory in-patient charge, and a further €17m was raised through the out-patient charge in the Acute Hospitals.
A further €12m was raised in the community sector in in-patient charges.
In 2018 the HSE estimates that €23 million will be raised through the statutory in-patient charge, and a further €16m through the out-patient charge in Acute Hospitals.
A further €15m is estimated to be raised in the community sector.
Therefore it would cost approximately €54m to abolish these charges.
1806. Deputy Richard Boyd Barrett asked the Minister for Health the full-year cost of providing universal free general practitioner care for all; and if he will make a statement on the matter. [35021/18]
Amharc ar fhreagra1844. Deputy Brendan Howlin asked the Minister for Health the estimated cost of extending free general practitioner care to all children aged 18 years of age and under; and if he will make a statement on the matter. [35257/18]
Amharc ar fhreagraI propose to take Questions Nos. 1806 and 1844 together.
GMS contractors receive a range of capitation rates, fee per service payments and practice supports. It is not possible to definitively calculate the cost of extending universal GP access given the wide range of payments and variables that have to be accounted for.
Such a calculation would require a complex and detailed modelling exercise to account for a range of demographic changes, future projections of service demands and variation in the number of GPs and the allowances that could be paid.
The cost of GP visit and medical cards varies significantly with the age of the cardholder. The table below outlines the current indicative annual cost for GP visit card eligibility and medical card eligibility, by age group.
|
Age Group |
IIIndicative Annual Cost per Card |
|
|
GP Visit Card |
Medical Card |
|
|
0 – 4 Yrs |
€242 |
€385 |
|
5 – 15 Yrs |
€165 |
€234 |
|
16 - 44 Yrs |
€150 |
€642 |
|
45 – 64 Yrs |
€221 |
€1,243 |
|
65 – 69 Yrs |
€249 |
€1,629 |
|
Aged 70 and over |
€498 |
€2,125 |
Note: Indicative costings compiled by the HSE Primary Care Reimbursement Service, based on claims for the 12 month period to March 2018.
The extension of free GP care to all children under 18 not currently covered by a medical card or GP visit card would encompass a further 510,000 people approximately. Extension of free GP care to all citizens who do not currently hold a medical card or GP visit card would encompass a further 2.7 million people approximately.
The Report of the Committee on the Future of Healthcare which was published in May 2017 recommended the phased introduction of universal GP care over the next five years through increased income thresholds. A Sláintecare Implementation Strategy has been developed in response to the Sláintecare report and was recently approved by Government. I expect to publish this implementation strategy in the coming weeks. The implementation strategy will set out a programme of health reform for the coming years, addressing this and other recommendations in the Sláintecare report.
1807. Deputy Richard Boyd Barrett asked the Minister for Health the full-year cost of increasing the mental health budget to the levels in the United Kingdom; and if he will make a statement on the matter. [35022/18]
Amharc ar fhreagraThe HSE Mental Health Budget has been increased by over €200 million from 2012, to €911 million today. This represents roughly 6% of the overall health spend. The percentage varies depending on which elements of overall health expenditure are taken into account, as well as what elements of healthcare are included within the mental health allocation (e.g. relevant parts of the social care allocation, or of dementia care services).
It should be noted that this figure does not include mental health activity which takes place in other Departments such as the Department of Education and Skills, or the Department of Justice and Equality. In addition, this figure does not capture expenditure by other units within the Department of Health which also provide mental health services or support, or the varying counselling and psychology services provided in primary care. This includes, for example, €2 million for specific services to enhance responses to those who are homeless and mentally ill under the ‘Drugs Policy and Social Inclusion’ unit.
Noting the above, it is not possible for me to make a accurate comparison to the United Kingdom mental health budget. I would also point out that I am more focused on how we do what we do within available budgets as increasing budgets alone will not improve mental health services for the user. I would welcome considered proposals from any deputy that can be evaluated against the available mental health budget that is increasing year-on-year, and the predicted improved outcomes for the service user.
A Vision for Change, our national mental health policy which was published in 2006 and whose ten-year term came to an end in 2016, proposed a target of 8% for mental health spending from the overall health allocation. Other commentators have suggested higher figures. There has been a significant increase in the overall gross non-capital mental health budget funding over 2012-2018. This is against a background of resource limitations and of competing demands generally for the Exchequer, including the wider health sector. A comparative positioning of Ireland internationally suggests that the percentage resource allocation today is around the median level across EU countries.
I will continue to keep the matter raised by the Deputy under review, in light of Programme for Government commitments and evolving funding and service priorities overall.
1808. Deputy Richard Boyd Barrett asked the Minister for Health the amount it will cost to maintain the current levels of service provision across the health service in 2019 in view of demographic changes and inflation. [35046/18]
Amharc ar fhreagra1837. Deputy Brendan Howlin asked the Minister for Health the programmes and initiatives or hiring of staff to which the additional €123 million allocated to his Department in 2019 to meet demographic costs will be allocated; and if he will make a statement on the matter. [35250/18]
Amharc ar fhreagraI propose to take Questions Nos. 1808 and 1837 together.
My Department is engaging in ongoing dialogue with the Department of Public Expenditure and Reform and the Health Service Executive in relation to the 2019 Estimates.
These discussions are still progressing and until they are concluded it would not be appropriate for me to comment on this matter.
1809. Deputy Richard Boyd Barrett asked the Minister for Health the full-year cost of implementing all the measures recommended in the Sláintecare report. [35047/18]
Amharc ar fhreagraThe Sláintecare report was produced by the all-party Oireachtas Committee on the Future of Healthcare, which was established to devise cross party agreement on a single long term vision for health care and direction of health policy in Ireland.
The Committee estimated that the full year cost (by year 10 of a 10 year programme) of implementing all the measures recommended in the report is €2.836 billion. In addition, the Committee recommended that transitional funding of €3 billion over a six year period would also be required to deliver the Committee’s proposals. The Committee acknowledge in the report that these costings are only indicative.
The actual cost of implementing Sláintecare will depend on the prioritisation, sequencing and timing of actions. External factors such as general and medical inflation and changes in demand for services will also influence the cost of implementation.
The Government remains committed to improving our health services and putting in place a programme of reform to achieve the vision set out in the Sláintecare report. A Sláintecare Implementation Strategy was approved by Government last week and I expect to publish it in the coming weeks. In addition, a Sláintecare Programme Office is being established to drive forward this programme of reform. I look forward to continuing to work with members of the Oireachtas and with stakeholders in advancing this important agenda.
1812. Deputy Richard Boyd Barrett asked the Minister for Health the full year cost of adding 1,000 acute beds to the hospital network [35050/18]
Amharc ar fhreagraAs this is a service matter, I have the Health Service Executive to respond to you directly as soon as possible.
1813. Deputy Richard Boyd Barrett asked the Minister for Health the full-year cost of hiring 4,000 new nurses on the pre-2011 rate of pay. [35051/18]
Amharc ar fhreagraI have asked the HSE to respond to you directly on this matter.
1814. Deputy Richard Boyd Barrett asked the Minister for Health the full-year cost of hiring 500 consultants. [35052/18]
Amharc ar fhreagraI have asked the HSE to respond to you directly on this matter.
1815. Deputy Seán Crowe asked the Minister for Health if his attention has been drawn to the fact there is a shovel-ready site on the footprint of Tallaght Hospital ready to deliver extra hospital beds in view of the ongoing difficulties being experienced by patients in emergency department units across the State; and his plans to fast-track funding for this project. [35072/18]
Amharc ar fhreagraIn the light of the conclusions of the Health Service Capacity Review that the system will need nearly 2,600 additional acute hospital beds by 2031, I asked my Department to work with the HSE to identify the location and mix of beds across the hospital system which can be opened and staffed this year and into 2019 in order to improve preparedness for Winter 2018/2019 and alleviate hospital congestion.
As part of this process, I can confirm that the HSE has submitted a 2018 capacity proposal to my Department, as part of a broader three year unscheduled care capacity plan, to increase capacity nationally which includes a proposal from Dublin Midlands Hospital Group in relation to Tallaght Hospital.
My Department is currently assessing the HSE proposal and any decisions in relation to individual proposals at hospital level will be made as part of the broader capacity plan.
1816. Deputy Niamh Smyth asked the Minister for Health the number of vacancies (details supplied) unfilled or filled on a temporary basis in Cavan and Monaghan hospitals; and the details of each. [35080/18]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible.
1817. Deputy Gerry Adams asked the Minister for Health the position regarding the HSE commitment to deliver a new primary care centre in Dundalk that will accommodate the needs of local community mental health services; the action that has been undertaken to advance this delivery; and if he will make a statement on the matter. [35082/18]
Amharc ar fhreagraAs the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
1818. Deputy Gerry Adams asked the Minister for Health the CAMHS services available to families in Dundalk; the number of young persons awaiting CAMHS services in the Dundalk area; and the length of time they have been waiting to access the services. [35083/18]
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.
1819. Deputy Gerry Adams asked the Minister for Health the action that has been taken to identify and develop community mental health services in Dundalk. [35084/18]
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.
