Written Answers Nos. 574-590
574. Deputy Holly Cairns asked the Minister for Health what steps are being taken to recruit staff so existing eating disorder treatment teams can reach full capacity; if more staff will receive specific training to treat eating disorders; and if funding for specialised staff will be ring-fenced. [7730/24]
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.
575. Deputy Holly Cairns asked the Minister for Health if funding will be made available to update the expired 2018 Eating Disorders Services Model of Care; if funding will be ring-fenced for more beds; and if funding can be ring-fenced to consistently fund the HSE Clinical Programme for Eating Disorders. [7731/24]
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.
576. Deputy Holly Cairns asked the Minister for Health if transitional supports for eating disorders such as meal support and mental health supports can be provided to patients in order to improve the transition between hospitals and homes, CAMHS and AMHS. [7732/24]
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.
577. Deputy Holly Cairns asked the Minister for Health what avenues are available for families who wish to seek recourse where the level of care for an eating disorder is not adequate; and if he will commit to putting in place such a process if one is not available. [7733/24]
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.
578. Deputy Holly Cairns asked the Minister for Health if his Department would conduct research to gain an accurate picture of how many people are suffering with eating disorders in Ireland and what resources are actually needed; and if a needs assessment for bed capacity will be carried out. [7734/24]
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.
579. Deputy Kathleen Funchion asked the Minister for Health if there is any circumstance where the fair deal payment owed at the end of a nursing home resident's stay is deferred or can be paid in instalments over a period of time; and if he will make a statement on the matter. [7743/24]
Amharc ar fhreagraOne feature of the Nursing Homes Support Scheme (NHSS) is that NHSS participants who own property/land-based assets in the State also have access to Ancillary State Support, or the Nursing Home Loan, which is an optional feature of the Fair Deal Scheme. It is a loan advanced by the HSE to help people meet the portion of their contribution to the cost of care that is based on property/land-based assets, most typically against the personal residence. If an individual secures Ancillary State Support, they will not need to contribute against the value of the relevant property during their time on the scheme, unless the property is sold during that time.
Advancing of the Nursing Home Loan by the HSE results in the creation of a charge (a simple type of mortgage) in favour of the HSE against the interest of the applicant and his/her partner in the asset(s). The HSE will notify the Property Registration Authority of the charge who will register it against the specified asset(s).
It is advisable to seek independent legal advice before applying for a Nursing Home Loan, however there is no requirement to do so.
The Nursing Home Loan may be applied for at any time, not just when entering into long-term nursing home care. Applications for the Nursing Home Loan may be granted by the HSE subject to the overall budget available to it.
The Nursing Home Loan together with interest accumulated is repayable (unless the applicant has voluntarily repaid the loan prior to it falling due for repayment):
• when the applicant dies, or
• when any part of the charged asset is transferred/sold (HSE must be notified within 10 working days of transfer/sale) or
• if the applicant or his/her partner is made bankrupt, or
• if the HSE determines that it has been given false/misleading information relating to this loan application
The Revenue Commissioners has responsibility for recouping the cost of the Nursing Home Loan and all queries in respect of repayment should be directed to them for their attention.
In certain conditions - for example, where a partner or child continues to reside in the property - a further deferral to the repayment of the loan can be granted.
These conditions are outlined in the Nursing Homes Support Scheme Act and can be found by following this link: www.irishstatutebook.ie/eli/2009/act/15/enacted/en/print#sec20
The conditions under which a person make seek a deferral are also outlined on page 29 of the NHSS Application form which can be accessed from the following link:
assets.hse.ie/media/documents/HSE_Nursing_Homes_Support_Scheme_Application_form_and_support_information.pdf
Where a connected person is seeking to defer payment of the Nursing Home Loan, it is advisable to contact their local Nursing Home Support Office within 3 months of the relevant event for advise on the appropriate steps necessary to defer repayment.
S.I. No. 436 of 2009 Nursing Homes Support Scheme (Collection and Recovery of Repayable Amounts) Regulations 2009, provides for the charging of interest on late payments. It states:
‘the amount of interest to be carried by a repayable amount, or any part of a repayable amount shall be determined by the formula— R x D x 0.0219% where—R is the repayable amount, or any part of that amount, which remains unpaid, and D is the number of days (including part of a day) forming the period of delay’.
In situations where a person encounters difficulties in respect of repayment of the Nursing Home Loan amount they should contact Revenue’s helpline at 01 7383663 as soon as possible for further assistance.
580. Deputy Thomas Pringle asked the Minister for Health the waiting list numbers to see a child neurologist in CHI Crumlin for each year from 2016 to date, in tabular form; and if he will make a statement on the matter. [7751/24]
Amharc ar fhreagra581. Deputy Thomas Pringle asked the Minister for Health how many children are presently waiting 0 - 6 months for an appointment to see a child neurologist in CHI Crumlin; and if he will make a statement on the matter. [7752/24]
Amharc ar fhreagra582. Deputy Thomas Pringle asked the Minister for Health how many children are presently waiting 12-18 months for an appointment to see a child neurologist in CHI Crumlin; and if he will make a statement on the matter. [7753/24]
Amharc ar fhreagra583. Deputy Thomas Pringle asked the Minister for Health how many children are presently waiting 18 – 24 months for an appointment to see a child neurologist in CHI Crumlin; and if he will make a statement on the matter. [7754/24]
Amharc ar fhreagra584. Deputy Thomas Pringle asked the Minister for Health how many children are presently waiting over 24 months for an appointment to see a child neurologist in CHI Crumlin; and if he will make a statement on the matter. [7755/24]
Amharc ar fhreagraI propose to take Questions Nos. 580 to 584, inclusive, together.
It is recognised that waiting times for many scheduled appointments and procedures are too long and continue to be impacted by the Covid-19 pandemic.
The Department of Health continues to work with the HSE and the National Treatment Purchase Fund (NTPF) to identify ways to improve access to care.
The 2023 Waiting List Action Plan built on the foundational work done in previous plans, achieving significant progress in relation to waiting lists, including advancements made on overall waiting list reduction for the second year in a row, and progress made in addressing long waiting times.
The Department of Health is working with the HSE and the NTPF to finalise both the End of Year Report against the 2023 WLAP as well as the new WLAP 2024, which will take account of learnings from 2023 as well as the funding envelope provided for 2024.
With regard to the information requested by the Deputy, the NTPF has provided the data in the attached table which shows the number of children by time-band on the Neurology outpatient waiting list at CHI Crumlin at the end of December each year from 2016 to 2023 and at the end of January 2024.
Neurology Outpatient Waiting List at CHI Crumlin 2016 - January 2024
|
0-6 Mths |
6-12 Mths |
12-18 Mths |
18+ Mths |
SmallVolTimeBands |
Grand Total |
|
|
30/12/2016 |
177 |
172 |
34 |
7 |
390 |
|
|
29/12/2017 |
175 |
76 |
106 |
67 |
424 |
|
|
20/12/2018 |
185 |
53 |
35 |
26 |
299 |
|
|
19/12/2019 |
152 |
83 |
54 |
58 |
347 |
|
|
23/12/2020 |
134 |
43 |
60 |
109 |
346 |
|
|
23/12/2021 |
202 |
59 |
33 |
52 |
346 |
|
|
22/12/2022 |
160 |
34 |
6 |
200 |
||
|
28/12/2023 |
140 |
31 |
6 |
1 |
178 |
|
|
25/01/2024 |
152 |
38 |
7 |
1 |
198 |
585. Deputy Thomas Pringle asked the Minister for Health when a person (details supplied) in County Donegal will receive a scheduled appointment with their neurologist in Crumlin Children's Hospital, given they been waiting over 15 months; and if he will make a statement on the matter. [7756/24]
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.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
586. Deputy Verona Murphy asked the Minister for Health if kleinfelters syndrome patients have an eligibility to free blood testing specific to their condition through their own GP practices; and if he will make a statement on the matter. [7758/24]
Amharc ar fhreagraGP services are provided without charge to people who hold a medical card or GP visit card under the GMS scheme. 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.".
Clinical determinations as to whether a blood test should be taken to either assist in the diagnosis of illness or the treatment of a condition are made by the GP concerned. There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for such blood tests.
People who do not hold a medical card or GP visit card access GP services, including phlebotomy services, on a private basis. The fees charged by individual GPs for private consultations are a matter of private contract between clinicians and their patients.
587. Deputy Verona Murphy asked the Minister for Health if sperm retrieval and storage is available to kleinfelters syndrome patients in Ireland; and if he will make a statement on the matter. [7759/24]
Amharc ar fhreagraThis PQ is being referred to the HSE for direct reply to the Deputy as it relates to a service delivery matter.
588. Deputy Emer Higgins asked the Minister for Health for an update on the implementations on recommendations from the nursing homes support scheme (fair deal); and if he will make a statement on the matter. [7812/24]
Amharc ar fhreagraFair Deal was designed to protect and support vulnerable older people, to ensure equal access to nursing home care based on what they could afford. This gives certainty to people and families. Government funding for Fair Deal is to support vulnerable older people at a time in their lives where full time care is essential.
In 2015 a comprehensive review of the operation of the Nursing Homes Support Scheme was completed and subsequently published. The review can be found by following this link: www.gov.ie/en/publication/6f512a-review-of-the-nursing-homes-support-scheme-a-fair-deal/.
The Nursing Homes Support Scheme Review (2015) identified a number of recommendations for immediate implementation and a number of other complex issues that were deemed to require more detailed consideration. Emerging from this review, several subsequent reviews and actions incorporating different elements of the Nursing Homes Support Scheme have been completed.
In December 2021, the Department published the independently chaired Value for Money (VFM) review on nursing home costs. The review found that the cost differential between public and private/voluntary nursing homes is largely driven by variances in staff-to-resident ratios and the skill mix in public and private nursing homes.
The VFM Review made nine recommendations which the Department continues to take forward. The Value for Money Review can be found by following this link: www.gov.ie/en/publication/3859f-a-value-for-money-review-of-nursing-home-care-costs/.
The long-established statutory mechanism through which private and voluntary nursing homes are funded was established by the Oireachtas under the Nursing Homes Support Scheme Act 2009. This legislation outlines the process for private and voluntary providers to negotiate the prices for their services with the designated State agency, the National Treatment Purchase Fund (NTPF).
Maximum prices for individual nursing homes are agreed with the NTPF following negotiations and based on the NTPF’s cost criteria. These criteria include costs reasonably incurred by the nursing home, local market prices, historic prices and overall budgetary capacity.
The NTPF carry out this role independently under the 2009 Act. The NTPF has statutory independence, and there is no role for Ministers or the Department of Health in these negotiations.
The Department of Health published a review of the National Treatment Purchase Fund (NTPF) pricing system in June 2021 and continues to work on bringing forward the recommendations that emerged from this review. This review can be found by following this link: www.gov.ie/en/publication/41377-review-of-pricing-system-for-long-term-residential-care-facilities/.
A steering group has been established to oversee the delivery of the recommendations; this group has met on a regular basis since publication of the review. The group made four recommendations which are being progressed by the NTPF and the Department of Health.
• Recommendation 1: Formal assessment of using a formulaic approach in the pricing system as set out in Section 4 of the Report.
• Recommendation 2: Formal assessment of amending the approach to the assessment of “Local Market Price” to reflect prices within other nursing homes within a certain distance of the nursing home rather than within the same county.
• Recommendation 3: The NTPF to engage with nursing homes and their representatives in relation to enhancing the internal NTPF Review process.
• Recommendation 4: Amending the process for allowing for high dependency residents when the necessary systems are in place.
The delivery of recommendations 1-3 primarily sit with the NTPF. As per the recommendations of the review, the NTPF is reporting periodically to the steering group on progress in implementing the recommendations. It is recognised, however, that recommendation 4 has dependencies going well beyond the scope of the pricing review. This recommendation is therefore being addressed within the broader context of the reform of older persons' services, with appropriate links established between the pricing review steering group (including shared membership) to ensure that appropriate links are made between this recommendation and the others.
In addition to progressing the recommendations that emerged from the Pricing Review, important strands of reform to the nursing home sector are being, or have been, brought forward. The Government remains committed to delivering on the 86 recommendations of the COVID-19 Nursing Homes Expert Panel, especially those recommendations related to long-term sectoral reform,
Furthermore, addressing the shortage of care workers in Ireland is an urgent priority for the Government. To this end, the cross departmental Strategic Workforce Advisory Group was established in March 2022 to examine, and formulate recommendations to address, the challenges in front-line carer roles in the home support and long-term residential care sectors. The Report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Healthcare Assistants was published on 15 October 2022 and it contains 16 recommendations. The report can be viewed below:
www.gov.ie/en/publication/492bc-report-of-the-strategic-workforce-advisory-group-on-home-carers-and-nursing-home-health-care-assistants/.
Implementation of these recommendations is underway and is being overseen by a cross departmental Implementation Group, chaired by the Department of Health. The group meets quarterly and publishes progress reports thereafter. The last meeting was scheduled for 1 February 2024. The most recent progress report was published in October 2023 which can be viewed below:
www.gov.ie/pdf/?file=https://assets.gov.ie/275876/c0889fbf-3f9c-4235-9e79-e1240790fac7.pdf#page=null.
It should be noted that given the size, complexity and cost of the NHSS, implementation is complex and any changes in policy direction need to be carefully assessed and kept under review. The Department of Health is consistently seeking to identify improvements and introduce enhancements to the scheme, where feasible, which aims to ensure that long-term nursing home care is sustainable, accessible and affordable for everyone and that people continue to be cared for in the most appropriate settings.
589. Deputy Michael McNamara asked the Minister for Health when a person (details supplied) in County Clare will receive an urgent appointment at the urology department in Galway University Hospital; and if he will make a statement on the matter. [7816/24]
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.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
590. Deputy Brendan Griffin asked the Minister for Health for clarification on a matter (details supplied); and if he will make a statement on the matter. [7832/24]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
