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Wednesday, 26 Jun 2019

Written Answers Nos. 174-188

Health Services Provision

Ceisteanna (174)

Brian Stanley

Ceist:

174. Deputy Brian Stanley asked the Minister for Health the progress made regarding the competitive dialogue and establishment of a framework agreement for the provision of private services for the HSE. [27035/19]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Counselling Services Provision

Ceisteanna (175)

Robert Troy

Ceist:

175. Deputy Robert Troy asked the Minister for Health if the situation will be addressed in which patients referred to counselling services in CHO area 8 receive seven counselling sessions at the primary care stage and then must wait a further six months before being re-referred; the reason for same; and if the waiting period will be removed in view to the urgent and sensitive nature of counselling cases [27038/19]

Amharc ar fhreagra

Freagraí scríofa

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

Hospital Staff Recruitment

Ceisteanna (176)

Brendan Griffin

Ceist:

176. Deputy Brendan Griffin asked the Minister for Health if an additional podiatric post (details supplied) will be sanctioned for University Hospital Kerry to address the increased demand; and if he will make a statement on the matter. [27039/19]

Amharc ar fhreagra

Freagraí scríofa

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

Home Help Service

Ceisteanna (177)

Brendan Griffin

Ceist:

177. Deputy Brendan Griffin asked the Minister for Health his views on home help employees (details supplied); and if he will make a statement on the matter. [27049/19]

Amharc ar fhreagra

Freagraí scríofa

I have asked the HSE to look into this matter and respond to the Deputy directly.

Mental Health Services

Ceisteanna (178)

Robert Troy

Ceist:

178. Deputy Robert Troy asked the Minister for Health the public mental health services available at weekends [27083/19]

Amharc ar fhreagra

Freagraí scríofa

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 Review

Ceisteanna (179)

Brendan Smith

Ceist:

179. Deputy Brendan Smith asked the Minister for Health when he plans to publish the review of the system for setting nursing home prices under the fair deal scheme; and if he will make a statement on the matter. [27085/19]

Amharc ar fhreagra

Freagraí scríofa

The Nursing Homes Support Scheme (NHSS), commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.

The Report of the NHSS Review published in 2015 identified a number of issues for more detailed consideration, including a review of the pricing mechanism used by the NTPF, with a view to:

- Ensuring value for money and economy, with the lowest possible administrative costs for clients and the State and administrative burden for providers;

- Increasing the transparency of the pricing mechanism so that existing and potential investors can make as informed decisions as possible; and

- Ensuring that there is adequate residential capacity for those residents with more complex needs.

A Steering Group was established to oversee and manage the pricing review. The Steering Group is chaired by the NTPF and includes representatives from the Department of Health and the Department of Public Expenditure and Reform. As part of its work on the review the NTPF sought various inputs including external expertise and stakeholder engagement to inform the review. These inputs were considered in detail. It is recognised that any change to any part of the Scheme must be considered in terms of the short- and long-term impact on the viability of the Scheme and accessibility of long-term residential care in general. It is therefore important that the relevant issues are considered thoroughly.

The NTPF has now completed its report and the Steering Group has completed its consideration of it, the report was recently submitted by the NTPF to the Department. It is now being reviewed by Department officials and any recommendations included in the report will be appraised before publication. I expect the report to be published in the coming weeks.

General Practitioner Contracts

Ceisteanna (180)

Brendan Smith

Ceist:

180. Deputy Brendan Smith asked the Minister for Health if the general practitioner contract will provide sufficient resources for the provision of appropriate services to patients in nursing homes; and if he will make a statement on the matter. [27086/19]

Amharc ar fhreagra

Freagraí scríofa

I am happy that we have been able to conclude an agreement with the IMO on a major package of GP contractual reforms which will benefit patients and general practitioners, and make general practice a more attractive career option for doctors.

Agreement has been reached on the provision of new services, including a structured chronic disease programme, commencing in 2020, which will benefit over 430,000 medical card and GP visit card patients. A wide-ranging set of modernisation measures has also been agreed in the areas of eHealth, medicines management and multidisciplinary working.

There will be increased support for GPs working in rural practices and for those in disadvantaged urban areas. Improvements in the maternity and paternity leave arrangements have also been agreed, in recognition of the need to ensure that general practice is compatible with doctors’ family friendly commitments.

Under the terms of the current GMS contract, GPs are required to provide eligible patients with ''all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess." There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for medical services provided under the contract.

GPs contracted by the HSE under the GMS scheme are obliged to provide services to their medical card and GP visit card patients, including those resident in nursing homes. 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. Currently, an annual capitation payment of €434.15 is payable in respect of each GMS patient over 70 years of age residing in a private nursing home approved by the HSE for periods in excess of 5 weeks.

The recent phase of talks with GP representatives did not specifically address the provision of services to residents of nursing homes but focused on the development of a range of modernisation, reform and sustainability measures for GMS and GP visit card patients. Along with most other capitation rates, the nursing home rate will increase by approximately 48% over the next 4 years, under the recent agreement.

Proposed Legislation

Ceisteanna (181)

Denis Naughten

Ceist:

181. Deputy Denis Naughten asked the Minister for Health when the human tissue (transplantation, post-mortem, anatomical examination and public display) Bill will be introduced; when legislation will be enacted on the opt out for organ donation; and if he will make a statement on the matter. [27096/19]

Amharc ar fhreagra

Freagraí scríofa

The Government approved the publication of the General Scheme of a Human Tissue (Transplantation, Post-Mortem, Anatomical Examination and Public Display) Bill on the 01 May 2019.

The General Scheme, which is wide-ranging, includes provisions on:

- organ donation and transplantation;

- hospital post-mortems;

- anatomical examination (including medical education and training); and

- the public display of bodies after death.

The General Scheme will:

- regulate the removal, retention, storage, use and disposal of human tissue from deceased persons;

- provide general conditions for the removal, donation and use of organs and tissues from deceased and living persons for the purposes of transplantation; and

- provide for an opt-out system of consent for organ donation and for an associated register.

My Department is working with the Office of Parliamentary Counsel on the drafting of the Bill. The General Scheme has been referred to the Joint Oireachtas Committee on Health for pre-legislative scrutiny. It is anticipated that this process will commence in September.

Civil Defence

Ceisteanna (182)

Alan Kelly

Ceist:

182. Deputy Alan Kelly asked the Minister for Health if the emergency medical operations of the Civil Defence have a new licence in place from the Pre-Hospital Emergency Care Council when the current one expires at the end of July 2019 [27124/19]

Amharc ar fhreagra

Freagraí scríofa

The Pre-Hospital Emergency Care Council (PHECC) is an independent statutory body with responsibility for professional regulation in the area of pre-hospital emergency care including the recognition of professional qualifications.

Accordingly, the Deputy's query has been referred to PHECC for direct response.

Proposed Legislation

Ceisteanna (183)

Louise O'Reilly

Ceist:

183. Deputy Louise O'Reilly asked the Minister for Health if his Department and the drafters of the assisted human reproduction Bill will be taking into account the concerns raised during pre-legislative scrutiny regarding surrogacy and the removal of anonymity in relation to donor conception [27126/19]

Amharc ar fhreagra

Freagraí scríofa

As the Deputy will be aware, the Joint Oireachtas Committee on Health is currently conducting a review of the General Scheme of the Assisted Human Reproduction Bill as part of the pre-legislative scrutiny process, which began in January of last year. The Joint Committee intends to report thereon before the summer recess. The recommendations in the Committee’s report, including any in relation to surrogacy, will be considered during the ongoing process of drafting this Bill in conjunction with the Office of the Attorney General.

Parts 2 and 3 of the Children and Family Relationships Act 2015 provide for the introduction of non-anonymous gamete and embryo donation.

Medicinal Products

Ceisteanna (184)

Louise O'Reilly

Ceist:

184. Deputy Louise O'Reilly asked the Minister for Health the area to which the cost of medication (details supplied) is charged to; and if the cost is charged to the budget of the prescribing practice of the doctor concerned, if this has a negative effect on the budget of the doctor concerned. [27129/19]

Amharc ar fhreagra

Freagraí scríofa

Clarification has been sought from the Deputy's office in relation to this PQ. Once this has been received, I will arrange for a response to issue to the Deputy.

Medical Card Applications

Ceisteanna (185)

Alan Kelly

Ceist:

185. Deputy Alan Kelly asked the Minister for Health the reason a discretionary medical card was not granted to a person (details supplied). [27140/19]

Amharc ar fhreagra

Freagraí scríofa

As the Deputy is aware, the HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards on the basis of illness and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. The Expert Group also concluded that a person’s means should remain the main qualifier for a medical card. This position remains unchanged.

However, it is undoubtedly important that the medical card application system is responsive and sensitive to people's needs, especially arrangements relating to the issuing of medical cards on a discretionary basis. To that end, the HSE has sought to implement revised processes to provide a more compassionate and more efficient process in the assessment of medical card applications. Such measures include the development of a Burden of Illness Questionnaire which is now being rolled out in selective circumstances where the assessing doctor in the HSE's National Medical Card Unit requires a more comprehensive assessment of an applicant's medical and social circumstances and any resulting undue financial hardship.

In addition, in January 2018 a new streamlined online medical card application system was launched. This enables applicants to find out immediately if they are eligible for a medical card and brings considerable benefits for people in terms of turnaround times, convenience and security. This measures aid the HSE's National Medical Card Unit to provide an enhanced service to applicants ensuring that the application process is as efficient and timely as possible.

While it is none the less important to note that eligibility for a medical card remains primarily on the basis of financial assessment, I do recognise that patients require a responsive and efficient health system to meet their medical needs, which may often be required urgently. With regard to persons suffering from cancer and other serious medical conditions the HSE also has a system in place for the provision of medical cards in response to emergency situations i.e. in circumstances where persons are in need of urgent or on-going medical care that they cannot afford and also for persons in palliative care who are terminally ill. These medical cards are issued within 24 hours of receipt of the required patient details and a letter which confirms the medical condition from a doctor or consultant. With the exception of terminally ill patients, all medical cards, granted on an emergency basis, are followed up with a full application within a number of weeks.

I would also like to note that since 1 July 2015, the HSE adopted the position that all children under 18 years of age with a diagnosis of cancer are awarded a medical card. This card is valid for a period of 5 years.

As the administration of medical cards is the responsibility of the Health Service Executive, I have asked them to reply to the Deputy as a matter of urgency.

Medical Conditions

Ceisteanna (186)

Helen McEntee

Ceist:

186. Deputy Helen McEntee asked the Minister for Health the status of the ongoing investigation into Guillain-Barre syndrome; and if he will make a statement on the matter. [27141/19]

Amharc ar fhreagra

Freagraí scríofa

I have referred this PQ to the Health Service Executive for a direct reply as the HSE previously carried out the investigation into this matter.

Home Help Service

Ceisteanna (187)

Denis Naughten

Ceist:

187. Deputy Denis Naughten asked the Minister for Health further to Parliamentary Question No. 135 of 20 June 2019, if he will report on the meeting held on 13 June 2019 with the CHOs; and if he will make a statement on the matter. [27142/19]

Amharc ar fhreagra

Freagraí scríofa

Following recent media reports of cuts in the provision of home supports, I met with senior HSE management and representatives from Community Health Organisation management on 20th June. The HSE reconfirmed to me that there are no cuts to the home support service, nor is it correct to say that no new clients will be allocated home help hours for the next five months. The HSE has assured me that it will meet its service plans targets this year.

In 2019 with a budget of almost €446 million the HSE intends to provide over 18.2 million home support hours, including intensive home care packages, to over 53,000 people. The allocation of new hours will be based on client’s needs and the resources available.

Home Help Service Data

Ceisteanna (188, 190)

Denis Naughten

Ceist:

188. Deputy Denis Naughten asked the Minister for Health the number of persons in counties Roscommon, Galway and Mayo, respectively, approved for home help and home care hours; the number of persons in receipt of home help approved for additional hours; the number of hours required to meet that need in each county; the number of persons on the waiting list in each county despite having already been approved for hours; the number of hours required to meet that need; the number of hours provided in each month to date in each county; the number of new hours allocated; the number of hours that became available for recycling; and if he will make a statement on the matter. [27143/19]

Amharc ar fhreagra

Denis Naughten

Ceist:

190. Deputy Denis Naughten asked the Minister for Health the number of persons waiting on home help hours in each CHO area; the number of hours required to meet that need; the number of persons in receipt of home help that are approved for additional hours; the number of hours required to meet that need in each CHO; and if he will make a statement on the matter. [27150/19]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 188 and 190 together.

As these are service matters I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

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