Written Answers Nos. 873-892
873. Deputy Louise O'Reilly asked the Minister for Health the estimated savings if all private patients in public hospitals were charged in full for services provided rather than being charged a maintenance or per diem charge. [18048/20]
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.
874. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of providing staffing cover for HSE staff who engage in continuing professional development courses. [18049/20]
Amharc ar fhreagraI have asked the HSE to respond directly to the Deputy on this matter.
875. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of ensuring all maternity leave is covered across the HSE. [18050/20]
Amharc ar fhreagraI have asked the HSE to respond directly to the Deputy on this matter.
876. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of increasing the HSE contribution for approved clinical courses and examinations under the clinical course and examination refund scheme for NCHDs from €450 to €550. [18051/20]
Amharc ar fhreagraI have asked the HSE to reply directly to the Deputy on this matter.
877. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of increasing the annual general practitioner training intake to 250 for 2020. [18052/20]
Amharc ar fhreagra878. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of increasing the annual general practitioner training intake to 250 for 2020. [18053/20]
Amharc ar fhreagraI propose to take Questions Nos. 877 and 878 together.
As GP training is currently the responsibility of the Health Service Executive, I have arranged for this question to be referred to the Executive for direct reply to the Deputy.
879. Deputy Louise O'Reilly asked the Minister for Health the estimated cost for one doctor and ten doctors, respectively, on the general practitioner training scheme. [18054/20]
Amharc ar fhreagraAs GP training is currently the responsibility of the Health Service Executive, I have arranged for this question to be referred to the Executive for direct reply to the Deputy.
880. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of directly employing one, ten and 50 general practitioners, respectively, inclusive of salary and PRSI costs. [18055/20]
Amharc ar fhreagraGeneral Practitioners are self-employed private practitioners, most of whom have contracts with the HSE to provide services under various public health schemes.
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.
As there is currently no approved salary scale in the public service for a GP post, it is not possible to quantify the financial implications for the HSE of GPs being hired to provide services to the public health system under the GMS and other schemes.
881. Deputy Louise O'Reilly asked the Minister for Health the estimated cost and breakdown of providing practice nurses to work with 50 general practitioners; and the estimated cost of their training and pay for work for a first and full-year period. [18056/20]
Amharc ar fhreagraUnder the GMS scheme, GPs can claim a subsidy towards the cost of employing a practice nurse. Payment is made to participating doctors with a panel size of at least 100 patients and payment increases in bands of 100 with a maximum payment applicable at a panel size of 1,200. The subsidy rate applies to staff employed on a full-time basis and varies depending on the nurses experience. In relation to staff not employed on a full-time basis, payment is made on a pro rata basis. There is no provision under the terms of the GMS contract to pay for the training of practice nurses.
Schedule of Current Subsidies Payable in respect of Practice Nurses
1. Nursing subsidy (per year) — 1 year’s experience €30,945.86
2. Nursing subsidy (per year) — 2 years’ experience €32,665.07
3. Nursing subsidy (per year) — 3 years’ experience €34,384.29
4. Nursing subsidy (per year) — 4 or more years’ experience €37,822.72
The HSE does not fund practice nurse posts in full therefore the costings provided below are based on the current level of subsidy payments.
Assuming the GP has a panel of 1,200+ patients, the cost of the subsidy for 50 practice nurses would range between €1.547 million and €1.891 million depending on the experience of the nurse.
882. Deputy Louise O'Reilly asked the Minister for Health the estimated cost and breakdown of providing medical secretaries to work with 50 general practitioners including the cost of their training and pay for work for a first and full-year period; and if he will make a statement on the matter. [18057/20]
Amharc ar fhreagraUnder the GMS scheme, GPs can claim a subsidy towards the cost of employing a practice secretary. Payment is made to participating doctors with a panel size of at least 100 patients and payment increases in bands of 100 with a maximum payment applicable at a panel size of 1,200. The subsidy rate applies to staff employed on a full-time basis and varies depending on the secretary’s experience. In relation to staff not employed on a full-time basis, payment is made on a pro rata basis. There is no provision under the terms of the GMS contract to pay for the training of practice secretaries.
Schedule of Current Subsidies Payable in respect of Practice Secretaries
1. Secretarial subsidy (per year) — 1 year’s experience €20,630.57
2. Secretarial subsidy (per year) — 2 years’ experience €22,349.80
3. Secretarial subsidy (per year) — 3 or more years’ experience €24,068.99
As the HSE does not fund practice secretary posts in full, the costings provided below are based on the current level of subsidy payments.
Assuming the GP has a panel of 1,200+ patients, the cost of the subsidy for 50 medical secretaries would range between €1.032 million and €1.203 million depending on the experience of the secretary.
883. Deputy Louise O'Reilly asked the Minister for Health the cost paid by the State for a general practitioner visit under the general medical services scheme. [18058/20]
Amharc ar fhreagraUnder 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 rather than a per-visit basis, with a range of additional support payments and fees for specific items of service. It is therefore not possible to calculate the cost of a GP visit under the GMS scheme.
The table below outlines the current capitation fees payable in respect of medical card and GP visit card patients, by age group.
|
Age Cohort |
Medical Card/GP Visit Card Male |
Medical Card/GP Visit Card Female |
|
0 – 4 years |
€74.59 |
€72.76 |
|
5 year-old, where GP does not hold an under 6 contract |
€43.29 |
€43.79 |
|
0 - 5 years, where GP holds an under 6 contract - includes two periodic assessments, one at age two and one at age five |
€125.00 |
€125.00 |
|
0 – 5 years where GP holds an under 6 contract - initial Asthma diagnosis and registration after the child reaches the age of two years |
€50.00 |
€50.00 |
|
0 – 5 years where GP holds an under 6 contract - enhanced capitation (in respect of child in year one post asthma registration (subject to submission of annual dataset return). Includes two visits, one at three months post registration and an annual review visit |
€90.00 |
€90.00 |
|
0 – 5 years where GP holds an under 6 contract - enhanced capitation for asthma patients for each subsequent year up to and including the age of five years (subject to submission of annual dataset return) |
€45.00 |
€45.00 |
|
6 – 15 years |
€53.38 |
€54.00 |
|
16 – 44 years |
€68.15 |
€111.44 |
|
45 – 64 years |
€136.12 |
€149.57 |
|
65 – 69 years |
€143.39 |
€159.97 |
|
Aged 70 years and over, residing in the community |
€334.95 |
€334.95 |
|
Aged 70 years and over, residing in a private nursing home (approved by the HSE) for continuous in excess of 5 weeks |
€535.38 |
€535.38
|
In addition to capitation fees, GPs receive a range of supports including practice nurse and practice secretary subsidies, rural practice support grants, allowances to cover locum expenses for annual leave, sick leave and maternity and paternity leave, as well as fees for the provision of special items of service. Details of the fees and allowances payable to GPs who hold a GMS contract are set out in the Public Service Pay and Pensions Act 2017 (Section 42) (Payments to General Practitioners) Regulations 2019 – S.I. No. 692 of 2019.
884. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of expanding the specialist training fund for higher specialist trainees scheme for general practitioners in first and second year giving €500 per year as is the case for third- and fourth-year trainee general practitioners. [18059/20]
Amharc ar fhreagraAs GP training is currently the responsibility of the Health Service Executive, I have arranged for this question to be referred to the Executive for direct reply to the Deputy.
885. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of increasing the specialist training fund for the higher specialist trainees scheme from €500 to €600 for general practitioners in third and fourth year. [18060/20]
Amharc ar fhreagraI have asked the HSE to revert directly to the Deputy on this matter.
888. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of providing an additional 500,000 hours under the personal assistant scheme. [18063/20]
Amharc ar fhreagraAs the Deputy's question relates to a service matter, it has been referred to the HSE for direct reply.
889. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of guaranteeing a medical card for all members of the Traveller community. [18064/20]
Amharc ar fhreagraUnder the provisions of the Health Act 1970 (as amended), eligibility for health services in Ireland is based primarily on residency and means. The Act provides that persons who are unable, without due hardship, to arrange GP services for themselves and family can qualify for full eligibility (a medical card). The HSE awards medical cards in accordance with the Health Act, and assesses applicants on the overall financial situation of the applicant and his or her spouse or partner.
Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of any difficult circumstances in the case of applicants who may be in excess of the income guidelines. In relation to the cost of medical card provision for all members of the Travelling community, the data required to model this is not readily available and it is therefore not possible to provide an estimate of the cost of the proposal.
890. Deputy Louise O'Reilly asked the Minister for Health the average cost per person of providing healthcare under a medical card annually. [18065/20]
Amharc ar fhreagraUnder 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.
891. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of increasing funding to BreastCheck by 10%. [18066/20]
Amharc ar fhreagraThe National Screening Service has responsibility for four population-based screening programmes in Ireland CervicalCheck, Diabetic RetinaScreen, BowelScreen and BreastCheck. BreastCheck plays a central role in diagnosis and management of breast cancer in Ireland.
I am pleased that in the Programme for Government we have committed to extend the free screening age range in BreastCheck to those aged 69. This is an important development for the BreastCheck screening programme.
Based on the 2020 allocated funding for the BreastCheck Programme the HSE has advised the impact of a 10% increase in funding for BreastCheck would be €2.8m.
892. Deputy Louise O'Reilly asked the Minister for Health the estimated cost of increasing funding for CervicalCheck by 10%. [18067/20]
Amharc ar fhreagraGovernment has committed to fully implementing the recommendations of Dr Scally’s Report of the Scoping Inquiry.
Full implementation represents a very broad programme of work incorporating improvements across the National Screening Service and wider health services, and funding to support this work was allocated in Budget 2020, together with funding to support the switch to HPV primary testing.
The HSE has advised that based on the 2020 allocated funding for CervicalCheck programme the impact of a 10% increase in funding for the programmes would be €4.46m.
