Written Answers Nos. 292-309
292. Deputy Clare Daly asked the Minister for Health further to Parliamentary Question Nos. 156 to 158, inclusive, of 26 September 2018, if Defence Forces medical officers are excluded from the legal obligation to obtain prior consent from their patients prior to a medical investigation, examination or treatment; and if he will make a statement on the matter. [40893/18]
Amharc ar fhreagraDefence Forces medical officers who are medical practitioners must hold full registration with the Medical Council and are therefore not exempt from the Medical Council's Guide to Professional Conduct and Ethics. This states at section 9.2 "You must make sure that patients have given their consent before you provide any medical investigation, examination or treatment. Consent is required by law and is an essential part of respect for patients’ autonomy. Patients have the right to decide what happens to their own body."
293. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) is waiting so long for an appointment in the Mater Misericordiae University Hospital; and if he will make a statement on the matter. [40895/18]
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.
294. Deputy Robert Troy asked the Minister for Health the reason persons on the public waiting list here are being excluded from the cross-border scheme due to the fact an element of their income is an English pension (details supplied). [40918/18]
Amharc ar fhreagraUnder the Cross Border Directive it is a person's Member State of affiliation which is responsible for the reimbursing of treatment accessed and not the Member State in which they reside.
A person's Member State of affiliation is the State in which the person is, or has been, an insured person within the meaning of Article 2 of EU Regulation 883/2004. A person who has worked and paid their social insurance contributions in one Member State may choose to live in another Member State. However, the State to which they are affiliated remains responsible for reimbursing them for the purposes of the Cross Border Directive. Thus if a person is in receipt of a contributory pension, however small, from another Member State, it is that State and not Ireland which is responsible for reimbursing a person under the terms of the Cross Border Directive.
As the particular details of any case to which the Deputy is referring is a service matter, this question has also been referred to the Health Service Executive for attention and direct reply to the Deputy.
295. Deputy Robert Troy asked the Minister for Health the reason administrative staff are changing the code of procedures carried out under the cross-border scheme which is resulting in patients only recovering a percentage of the money they paid (details supplied); and if he will make a statement on the matter. [40919/18]
Amharc ar fhreagraUnder the Cross Border Directive (CBD) public patients in Ireland can seek to be referred to another EU/EEA country for a treatment that is available in Ireland. The patient pays for the treatment and claims reimbursement from the HSE at the cost of that treatment in Ireland or the cost of it abroad, whichever is the lesser.
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 the provision of the care if it were provided in the Irish public health service.
The HSE has an obligation to check and verify the details of any payments it makes including applications for reimbursement under the Directive. In carrying out due diligence on applications for reimbursement under the Directive the HSE may examine the details of the treatment received to ensure that the treatment claimed for, and the clinical details of the treatment supplied on the application, are consistent with the procedure code which has been supplied. If there is a discrepancy the HSE will query the details in the application and this may lead to an adjustment of the reimbursement based the details of the treatment received.
296. Deputy Clare Daly asked the Minister for Health the full year cost of recruiting an extra 70 mental health intellectual disability posts for children. [40926/18]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive to respond directly with the Deputy as soon as possible.
297. Deputy Bríd Smith asked the Minister for Health further to Parliamentary Question Nos. 165, 166 and 171 of 26 September 2018, if he will answer the specific questions (details supplied) contained in the original questions which to date his reply did not answer. [40928/18]
Amharc ar fhreagraAs outlined in previous Parliamentary Questions to the Deputy, screening tests are a balance of sensitivity and specificity and therefore include both false negative and false positive results which could affect the screening outcome and treatment of a person who may or who may not have a disease. It would be expected that they would have occurred in all labs contracted by CervicalCheck since its inception. I again emphasise that false positives and false negatives are unavoidable and happen in every screening programme.
The Deputy has asked about the qualifications of screeners employed by laboratories outside of this country which provide services to CervicalCheck, and about a risk assessment in relation to the potential use of another laboratory. These are matters which directly relate to the quality of services provided by contracted laboratories.
The Scoping Inquiry, led by Dr. Gabriel Scally, reported in September. Its terms of reference, developed following cross-party engagement, included examination of the tendering, contracting, operation, conflict of interest arrangements, performance information and performance management, accreditation and quality assurance of contracted cytology laboratory services since the inception of the CervicalCheck programme. Dr. Scally's report was the result of a period of intensive work which included visits to the contracted laboratories.
Dr. Scally is clear in his report that the Inquiry is satisfied with the quality management processes in the laboratories contracted by CervicalCheck. All of the laboratories visited by the Scoping Inquiry are meeting the regulatory requirements current in their own country. Crucially, he has confirmed that there is no reason, on quality grounds, why the existing contracts for laboratory services should not continue until the new HPV testing regime has been introduced. This provides welcome reassurance for women in Ireland about the quality of these services.
Dr. Scally has undertaken to carry out a supplementary report into certain further aspects of the laboratories, including accreditation. He has also made a number of key recommendations in relation to laboratory services which I intend to implement and which will help to ensure that the cervical screening programme meets the highest possible standards.
298. Deputy Niamh Smyth asked the Minister for Health if the case of a person (details supplied) will be reviewed; and if he will make a statement on the matter. [40946/18]
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.
299. Deputy Stephen S. Donnelly asked the Minister for Health the number of new general practitioners required over the next five years to provide for the replacement of general practitioners retiring over the same period; the number that will be required for replacing retiring rural general practitioners by the HSE; and if he will make a statement on the matter. [40951/18]
Amharc ar fhreagraGeneral Practitioners play an important role in the primary care system. The number of GPs on the specialist register continues to increase – up from 2,270 in 2010 to 3,670 as of July 2018 and there are now 2,508 GPs contracted by the HSE under the GMS scheme compared to 2,098 in 2008. It should be noted that as at 1 September 2018 there were only 24 GMS panels that do not have a permanent GP in place – a vacancy rate of less than 1%.
Over the past 6 years, an average of 143 GPs per year entered the GMS scheme compared with an average of 111 GPs per year exiting the scheme for the same period. During 2016 and 2017, an average of 158 GPs per year entered the GMS Scheme compared with an average of 132 GPs per year exiting the scheme for the same period.
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.
The Government is aware of the manpower issues facing general practice and has taken steps to increase the number of GP training places. In 2009, there were 120 General Practice training places available and in 2018 193 training places were filled, an increase of around 60% over this nine year period. The Government is committed to achieving further increases in GP training places in future years, and ensuring that all places are filled, in order to meet the future manpower needs of general practice.
Further 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.
The Government is also committed to engaging with GP representatives on the development of a package of measures and reforms to modernise the current GMS contract. Agreement on the delivery of service improvements and contractual reform has the potential to facilitate a substantial increase in the resourcing of general practice on a multiannual basis.
300. Deputy Margaret Murphy O'Mahony asked the Minister for Health the efforts being made to reduce waiting times of circa 17 weeks for women participating in smear tests in circumstances in which they have been advised of abnormalities and have had issues with tests previously; and if he will make a statement on the matter. [40954/18]
Amharc ar fhreagraFollowing a Government decision on 1 May, I asked CervicalCheck to make the necessary arrangements to provide that any woman who has had a CervicalCheck smear test, and whose GP considers that they should have a further test, to access such a further test without charge. CervicalCheck laboratory activity has thus been significantly above normal levels. This is a result both of out-of-cycle smears and increased uptake generally. This has impacted turnaround times for results of smear tests.
The HSE has advised that every effort is being made to ensure that tests are processed as quickly as possible, having regard to the high standards required for testing. In relation to the specific query made, I have asked the HSE to respond directly to the Deputy in this regard.
302. Deputy Michael Healy-Rae asked the Minister for Health if a care centre (details supplied) will be opened for 52 weeks a year; and if he will make a statement on the matter. [40957/18]
Amharc ar fhreagraThe 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.
303. Deputy Róisín Shortall asked the Minister for Health the position regarding the introduction of the new transport support scheme to replace the mobility allowance; the timeframe for the provision of same; and if he will make a statement on the matter. [40960/18]
Amharc ar fhreagra350. Deputy Róisín Shortall asked the Minister for Health the position regarding the introduction of the new transport support scheme to replace the mobility allowance; the timeframe for the provision of same; and if he will make a statement on the matter. [41151/18]
Amharc ar fhreagraI propose to take Questions Nos. 303 and 350 together.
The Deputy will be familiar with the background to the closure of both the Mobility Allowance and Motorised Transport Grant schemes in February 2013.
My colleague, the Minister for Health and I brought a Memorandum to Government on proposals for a new Transport Support Payment Scheme towards the end of the last Dáil session. Following consideration of the matter, it was decided to withdraw the Memorandum from the Cabinet Agenda at the time. A new Transport Support Payment Scheme remains a priority and we intend to revert to Government with revised proposals to reflect the discussions at that Cabinet meeting and further discussions between ourselves, in due course.
With regard to the Motorised Transport Grant, this scheme operated as a means-tested grant to assist persons with severe disabilities with the purchase or adaptation of a car, where that car was essential to retain employment. The maximum Motorised Transport Grant, which was payable once in any three-year period, was €5,020. Following closure of the scheme in February 2013, no further Motorised Transport Grants have been payable.
It is important to note that the Disabled Drivers and Disabled Passengers scheme operated by the Revenue Commissioners, remains in place. This scheme provides VRT and VAT relief, an exemption from road tax and a fuel grant to drivers and passengers with a disability, who qualify under the relevant criteria set out in governing regulations made by the Minister for Finance. Specifically adapted vehicles driven by persons with a disability are also exempt from payment of tolls on national roads and toll bridges. Transport Infrastructure Ireland has responsibility for this particular scheme.
There are improvements in access to a range of transport support schemes available to persons with disabilities in the State and on-going work is being carried out by Government Departments, agencies and transport providers to further improve access to public transport services. Under the National Disability Inclusion Strategy, the Department of Transport, Tourism and Sport has responsibility for the continued development of accessibility and availability of public transport for people with a disability.
304. Deputy Sean Fleming asked the Minister for Health if a surgical procedure will be expedited for a person (details supplied); and if he will make a statement on the matter. [40961/18]
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.
305. Deputy Stephen S. Donnelly asked the Minister for Health the number of additional beds to be provided in modular units in 2018 for each relevant acute hospital in tabular form; and if he will make a statement on the matter. [40962/18]
Amharc ar fhreagra306. Deputy Stephen S. Donnelly asked the Minister for Health the number of additional beds provided in each relevant acute hospital to date in 2018, in tabular form; and if he will make a statement on the matter. [40963/18]
Amharc ar fhreagraI propose to take Questions Nos. 305 and 306 together.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
307. Deputy Stephen S. Donnelly asked the Minister for Health the detail of the allocation of €55 million in 2018 to fund the National Treatment Purchase Fund to address waiting lists for those on same; the amount of this funding which has been spent; the number of patients that have been treated under the fund to date in 2018; and the number that have been treated since the restoration of the fund in 2017. [40965/18]
Amharc ar fhreagraReducing waiting time for patients for hospital operations and procedures is a key priority for the Government and €50 million was provided to the National Treatment Purchase Fund (NTPF) in 2018 to secure treatment for patients. The estimated actual care expenditure to the end of September is €33.6m.
The Inpatient/Day Case Action Plan, published last April outlines the combined impact of HSE and NTPF activity in 2018. The Inpatient Day Case Waiting List figures published by the NTPF for August are showing an ongoing improvement with almost 74,200 patients waiting for hospital operations and procedures. This is a reduction of almost 9,800 compared with August 2017. There has been a significant reduction of almost 7,300 in the number of patients waiting longer than 9 months for an inpatient or day case procedure since this time last year.
The NTPF advise that in 2017, 9,500 patients accepted offers of treatment, while almost 6,000 patients were treated last year and to the end of September 2018, almost 18,000 patients accepted offers of treatment, while over 14,300 have completed their treatment.
In addition, the NTPF are working closely with Hospital Groups inviting proposals to facilitate the trialling of funded interventions for Outpatients, including weekend and out of hours clinics. At the end of September had approved almost 12,700 outpatient appointments.
308. Deputy Michael McGrath asked the Minister for Health the position in relation to the application by an organisation (details supplied) for further annual investment in its care centre; and if he will make a statement on the matter. [40970/18]
Amharc ar fhreagraThe 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.
309. Deputy Frank O'Rourke asked the Minister for Health the number of persons that required in-hospital treatment for diabetes related to foot complications and lower limb loss; the amount allocated to Naas General Hospital in this regard in the past five years; and if he will make a statement on the matter. [40971/18]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
