Written Answers Nos. 688-707
688. Deputy Marcella Corcoran Kennedy asked the Minister for Health if his attention has been drawn to the fact that persons that are in receipt of a social welfare payment and hold GMS cards are being charged for routine phlebotomy services provided by their general practitioner which are required to either assist in the diagnosis of illness or the treatment of a condition; and if he will make a statement on the matter. [45339/19]
Amharc ar fhreagraUnder 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 routine phlebotomy services provided by their GP which are required to either assist in the diagnosis of illness or the treatment of a condition.
The HSE has advised GPs that where a blood test forms part of the investigation or necessary treatment of a patient’s symptoms or conditions, this should be free of charge for patients who hold a medical card or GP visit card. Notwithstanding this, I am aware that some GPs are charging GMS patients for phlebotomy services in some circumstances.
This is a matter of concern for me as it has long been the position, under successive Governments, that no user charges should apply to GP services provided to GMS and GP visit card patients. If a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient should report the matter to their HSE Local Health Office.
689. Deputy Charlie McConalogue asked the Minister for Health his plans to provide adult intellectual disability and autism spectrum disorder speech and language therapist posts to cover Inishowen, County Donegal; and if he will make a statement on the matter. [45342/19]
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.
690. Deputy Louise O'Reilly asked the Minister for Health the way in which the reimbursement scheme for reimbursing medical expenses for persons in Northern Ireland laid down in the Health and Childcare Support (Miscellaneous Provisions) Act 2019 will work in practice; and if detailed instruction can be given on the workings of the scheme. [45345/19]
Amharc ar fhreagraThe Health and Childcare Support (Miscellaneous Provisions) Act 2019 was passed by the Houses of the Oireachtas on 15 October, 2019 and is ready to be commenced if required.
This legislation, which will only come into effect in the event of a no-deal Brexit scenario occurring, provides for the establishment of a direct reimbursement scheme which will enable eligible residents of Northern Ireland to be reimbursed for the cost of necessary healthcare incurred while abroad in an EU/EEA member state or Switzerland.
Statutory regulations are also required to define as necessary the administrative arrangements for the direct reimbursement scheme and these are currently being finalised by officials from my Department, in conjunction with the Office of the Attorney General.
Under the proposed direct-reimbursement scheme, eligible residents of Northern Ireland will pay upfront for necessary healthcare received in another EU/EEA member state or Switzerland and can then, following return home, apply for reimbursement of this expenditure from the HSE.
Residents of Northern Ireland will be able to apply for refunds via an online system which will refund eligible persons for necessary healthcare received.
691. Deputy Brendan Smith asked the Minister for Health if further consideration will be given to a request from a local authority for a meeting (details supplied); and if he will make a statement on the matter. [45347/19]
Amharc ar fhreagraRequests to meet my colleague Minister Harris are normally arranged through his office. As a request has been made, I have no doubt that the Minister's Office will reply in due course.
692. Deputy James Browne asked the Minister for Health the reason charges are imposed on a person in rehab care in a public hospital following a hip replacement surgery; the reason such charges are passed to clients; and if he will make a statement on the matter. [45348/19]
Amharc ar fhreagraI understand that the Deputy's question refers to care in a community hospital rather than an acute hospital and that, accordingly, residential support services maintenance and accommodation contributions are payable in certain circumstances under subsection 67C(1)(a) of the Health Act 1970 which provides that:
"Subject to subsections (3) to (6) and section 67D, a person provided with residential support services, whether provided by the Health Service Executive or on behalf of the Health Service Executive, shall pay a financial contribution, in accordance with regulations made by the Minister under this section, towards the costs of maintenance or accommodation, or both, associated with the provision of such residential support services."
On 1 January 2017, a "long-stay" residential support services maintenance and accommodation contributions framework under sections 67A to 67D of the Health Act 1970 and the Health (Residential Support Services Maintenance and Accommodation Contributions) Regulations 2016 replaced the former system of long stay charges for in-patient services, which had been in place from July 2005 until 31 December 2016 under the (now-repealed) section 53 of that Act.
As indicated in the Oireachtas in June 2013 by the then Minister for Health James Reilly TD,
"A key and well-established principle is that persons who are provided with residential care should make an affordable contribution towards the cost of their maintenance and accommodation. Quality service provision is expensive and it is fair and equitable that all those in receipt of publicly funded residential care make appropriate payment toward the maintenance and accommodation costs associated with providing such services, if they can afford to do so. Funding derived from maintenance and accommodation contributions will continue to be directly applied by the HSE towards the provision of health services.”
Residential support services maintenance and accommodation contributions apply to all forms of residential support services, other than acute in-patient services and nursing home services provided to those supported under the Nursing Homes Support Scheme (Fair Deal). In line with the system of charges it replaced, residential support services maintenance and accommodation contributions:
- apply to the maintenance and accommodation elements only of services which are provided by the HSE or by agencies funded to provide services on behalf of the HSE under section 38 of the Health Act 2004.
- become payable when a person has already received at least 30 days of residential support services during the immediately preceding 12-month period. Accordingly, each episode of rehabilitative care might not necessarily result in a contribution requirement.
The Health (Residential Support Services Maintenance and Accommodation Contributions) Regulations 2016 (as amended) provide for the rates of income-based contributions which are payable towards accommodation and maintenance costs. In accommodation such as a community hospital where full-time nursing and/or medical care is provided, the current contribution rates payable are subject to a maximum of €25.57 daily (€179 per week) for a person whose income is €223 per week or more.
Affordability and the avoidance of financial hardship are built-in features of the residential support services maintenance and accommodation contributions provisions. In all cases, the contribution rates are based on sliding scales, with proportionally lower contribution rates applying to those on lower incomes. Additionally, section 67D of the Health Act 1970 provides that the HSE may reduce or waive a contribution where appropriate, in order to:
- avoid undue financial hardship on the part of the service user and/or on the part of the service user’s dependants,
- advance a service user’s identified needs (e.g. care plan objectives), or
- take account of separate contributions (if any) made by a service user towards his or her maintenance or accommodation costs.
To assist in the fair application of the framework, the HSE has published, and periodically updated, national guidelines for the correct determination of the contributions and comprehensive waiver guidelines (approved by the Ministers for Health and Public Expenditure and Reform) on the individual circumstances where such contributions may need to be reduced or waived. The guidelines specify that service providers must have regard to the individual circumstances of each service user and his or her dependants. The guidelines ensure that the applicable contribution may be reduced or waived where appropriate, taking account of each person’s income and necessary outgoings, including reasonable regular financial commitments, with a view to ensuring there is no unfair burden on the service user or on his or her dependants.
The features of the residential support services maintenance and accommodation contributions framework ensure that it is reasonable and fair and that each service user's contributions are based on what he or she can afford, taking account of the service user's individual circumstances.
The HSE publishes detailed supporting documentation in relation to residential support services maintenance and accommodation contributions on its website at www.hse.ie/longstaycontributions.
693. Deputy Alan Kelly asked the Minister for Health his position regarding the widespread failure to implement full travel time for healthcare support assistants further to the confirmation of this legal entitlement by the HSE in August 2018; and if he will make a statement on the matter. [45350/19]
Amharc ar fhreagraI have asked the HSE to respond directly to the Deputy on this matter.
694. Deputy Joe Carey asked the Minister for Health when a medical procedure will take place for a person (details supplied) in County Clare; and if he will make a statement on the matter. [45354/19]
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.
695. Deputy Robert Troy asked the Minister for Health the status of future services at the South Westmeath Hospice facility; and if a commitment can be given regarding the long-term future of this facility. [45355/19]
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.
696. Deputy Michael Healy-Rae asked the Minister for Health the number of persons on a waiting list for Cork University Hospital to be assessed for cataract assessment with addresses in County Kerry; and the number of persons waiting for cataract removal in South Infirmary Cork. [45373/19]
Amharc ar fhreagraReducing waiting time for patients for hospital operations and procedures is a key priority for Government. Budget 2020 announced that the Government has further increased investment in tackling waiting lists, with funding to the National Treatment Purchase fund (NTPF) increasing from €75 million in 2019 to €100 million in 2019. The year-on-year increases to the NTPF since Budget 2017 reflect this Government’s priority to improve waiting times for patients to access hospital treatment.
My Department is working with the HSE and the NTPF to develop the Scheduled Care Access Plan 2020. In this regard, the HSE National Service Plan 2020 will set out a planned activity level for the year ahead, while the NTPF will work with the hospital system to provide additionality to reduce inpatient/day case, with a particular focus on improving access to hospital outpatient services.
In 2020, NTPF will further expand its list of targeted inpatient and daycase procedures to support further reductions in wait times as well as increasing funding towards supporting full packages of care for patients on the outpatient waiting lists, to include the surgery or treatment where required.
At the end of July 2017, the number of people waiting for a cataract procedure was 10,024. Under the Inpatient Day Case Access Plan 2018, cataracts were one of the specialties targeted by the NTPF, and by end December 2018, the number of patients waiting had fallen to 6,440, a reduction of 36%. The number of patients waiting for a cataract procedure at the end of September 2019 had further reduced to 5,074, with 506 of patients waiting over 9 months. This represents a reduction of 3,865 or 88% when compared to July 2017, when there were 4,371 patients waiting over 9 months for a cataract operation.
In relation to the particular query raised by the Deputy, the NTPF have provided details of the number of people with addresses in Co. Kerry waiting for an Ophthalmology Outpatient appointment in Cork University Hospital, and the number of people awaiting cataract surgery in South Infirmary Royal Victoria Hospital, at the end of September, in the following table.
Total Number of people from Co. Kerry waiting for an Ophthalmology Outpatient Appointment in CUH as at 26/09/2019
|
Date |
Area of Residence |
Hospital |
Specialty |
Total |
|
26/09/2019 |
Kerry |
Cork University Hospital |
Ophthalmology |
534 |
Total IPDC Cataract Waiting List in SIVUH as at 26/09/2019
|
Date |
Hospital |
Total |
|
26/09/2019 |
South Infirmary Victoria University Hospital |
463 |
697. Deputy Michael Healy-Rae asked the Minister for Health the number of persons waiting for an outpatient assessment and procedure, respectively in University Hospital Kerry, Cork University Hospital and the South Infirmary Hospital, Cork; and if he will make a statement on the matter. [45376/19]
Amharc ar fhreagraReducing waiting time for patients for hospital operations and procedures is a key priority for Government. Budget 2020 announced that the Government has further increased investment in tackling waiting lists, with funding to the National Treatment Purchase fund (NTPF) increasing from €75 million in 2019 to €100 million in 2019. The year-on-year increases to the NTPF since Budget 2017 reflect this Government’s priority to improve waiting times for patients to access hospital treatment.
My Department is working with the HSE and the NTPF to develop the Scheduled Care Access Plan 2020. In this regard, the HSE National Service Plan 2020 will set out a planned activity level for the year ahead, while the NTPF will work with the hospital system to provide additionality to reduce inpatient/day case, with a particular focus on improving access to hospital outpatient services.
In 2020, NTPF will further expand its list of targeted inpatient and daycase procedures to support further significant reductions in wait times as well as increasing funding towards supporting full packages of care for patients on the outpatient waiting lists, to include the surgery or treatment where required.
In relation to the particular query raised by the deputy, the following table shows the waiting list figures at the end of September 2019 for Outpatients and for Inpatient / Day Case procedures in University Hospital Kerry, Cork University Hospital and South Infirmary Victoria University Hospital, respectively.
698. Deputy Jan O'Sullivan asked the Minister for Health the primary healthcare centres being developed in the CHO3 area; if community mental health services are included in the planning of such centres; and if he will make a statement on the matter. [45377/19]
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.
699. Deputy Jan O'Sullivan asked the Minister for Health the posts in place for community dieticians in mental health, disability and primary care in each of the HSE areas; the plans in place to fill gaps in these services; and if he will make a statement on the matter. [45381/19]
Amharc ar fhreagraAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
700. Deputy Michael Healy-Rae asked the Minister for Health if he will address a matter (details supplied) regarding the HSE recruitment embargo; and if he will make a statement on the matter. [45382/19]
Amharc ar fhreagraI am advised by the HSE that while there is no national recruitment embargo or moratorium, there is a priority requirement for all HSE services to maintain, or get to, an affordable staffing level that is sustainable in 2019 and 2020, while also prioritising the delivery of safe services.
In light of this, the HSE have introduced control measures relating to staffing and recruitment to ensure that they live within the available resources provided to them. This does mean that in some Hospital Groups and Community Healthcare Organisations non-critical replacement posts will be paused, however the HSE report that there is on-going capacity for recruitment of newly funded posts and replacement of critical clinical posts within frontline services throughout this period.
I have been assured by the HSE that any difficulties which arise for applicants will be dealt with on a case by case basis.
701. Deputy John Curran asked the Minister for Health the details of the 1,000 posts for new frontline staff in the HSE primary care services announced in budget 2020; and if he will make a statement on the matter. [45385/19]
Amharc ar fhreagraThe recent Budget included an additional 2020 provision of €10 million (€60 million in a full year) for the enhancement of community and primary care. I particularly welcome the advance commitment to €60 million in 2021 as it will enable the recruitment of up to 1,000 therapists, nurses and other professionals in the community on a phased basis during the course of next year. This will allow for these funded posts to be in place by the end of next year and throughout 2021 in order to address the needs identified in the Health Service Capacity Review recommendations. This funding will also facilitate the recruitment of dementia advisers. The planning for these posts will be in conjunction with the development of the new regional health areas so as to reflect the specific needs of the region.
702. Deputy John Curran asked the Minister for Health if all persons on methadone treatment have received screening and treatment for hepatitis C; and if he will make a statement on the matter. [45393/19]
Amharc ar fhreagra703. Deputy John Curran asked the Minister for Health the expenditure incurred on needle exchange services in each of the years 2014 to 2018 and to date in 2019; and if he will make a statement on the matter. [45394/19]
Amharc ar fhreagra704. Deputy John Curran asked the Minister for Health the number of persons that engaged with needle exchange services in each of the years 2014 to 2018 and to date in 2019; and if he will make a statement on the matter. [45395/19]
Amharc ar fhreagraI propose to take Questions Nos. 702 to 704, inclusive, together.
As the information requested by the Deputy relates to service matters, the query has been referred to the Health Service Executive for attention and direct reply to the Deputy.
705. Deputy John Curran asked the Minister for Health his plans to increase the level of core funding for drugs task forces; and if he will make a statement on the matter. [45398/19]
Amharc ar fhreagraI am pleased that the additional funding of €1m announced by me in March 2019 to support the implementation of the National Drugs Strategy will be continued in 2020.
€240,000 of this funding will allow for the continuation of €10,000 in additional funding to each of the 24 Drug and Alcohol Task Forces in 2020.
706. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [45413/19]
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.
707. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [45414/19]
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.
