Written Answers Nos. 141-160
141. Deputy Willie Penrose asked the Minister for Health his plans to increase the €500 eligibility limit for receipt of a medical card by a single person over 70 years of age in view of the fact that this has been fixed since 1 January 2014; if this can be reviewed to reflect inflation in the interim from 1 January 2018; and if he will make a statement on the matter. [41163/17]
View answerUnder the Health (Alteration of Criteria for Eligibility) (No. 2) Act 2013, when a person attains the age of 70, the medical card income limits are €500 gross income per week for a single person and €900 gross income per week for a couple. Any revision of these medical card income thresholds requires primary legislation.
Persons aged 70 or older, who are assessed as ineligible under the gross income thresholds, may also have their eligibility assessed under the means-tested medical card scheme if they so wish, for example in the event that they face particularly high expenses, e.g. nursing home or medication costs. This scheme is open to all persons, irrespective of their age and assessment is based on net income and assessable outgoing expenses. The qualifying income thresholds under this scheme are lower than over-70s gross income thresholds. In setting the assessment guidelines, the Health Service Executive (HSE) has regard to Government policy as outlined by the Minister for Health, changes in the consumer price index and other issues which may be relevant.
Furthermore, persons, including those aged over 70 years, may be deemed eligible for a medical card on a discretionary basis, if they are judged to face undue hardship in arranging GP services as a result of medical or social circumstances. In addition, from August 2015, all persons aged 70 or older qualify for a GP Visit Card, regardless of income.
There are no proposals at present to amend the income guidelines for the granting of eligibility for medical cards for persons aged 70 and over. However, it should be noted that the gross income limits are reviewed annually and considered in the context of the budget.
142. Deputy Brendan Smith asked the Minister for Health the way in which it is proposed to reduce the long waiting times being experienced by children in counties Cavan and Monaghan who are in need of an assessment for occupational therapy. [40970/17]
View answerAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
143. Deputy Eugene Murphy asked the Minister for Health if the recommendations of the recent report on Roscommon mental health services will be implemented; and if so, the timeframe for same. [40978/17]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
144. Deputy John Curran asked the Minister for Health the way in which it is proposed to reduce the number of overdue assessments of need under the Disability Act 2005 in the Dublin west and Dublin south west local health areas. [40966/17]
View answerThe 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.
145. Deputy Bobby Aylward asked the Minister for Health if any child will have to wait longer than four months for a scoliosis operation by the end of 2017. [40952/17]
View answerThe HSE and the Children’s Hospital Group are actively implementing the action plan they developed to ensure that no child will be waiting over 4 months by year end and are focused on maximising all available capacity both internally and externally to achieve this target.
146. Deputy Noel Rock asked the Minister for Health the position regarding extending the fair deal scheme to allow persons receive care in their own home; and if he will make a statement on the matter. [41008/17]
View answerIt is Government policy to promote care in the community for older people so that they can continue to live in their own homes for as long as possible. The only statutory scheme in place at present to support older people is the Nursing Home Support Scheme, commonly known as ‘A Fair Deal’, and there have been calls to extend this scheme to cover home care services. However, the Government is committed to establishing a new separate statutory home care scheme along with a system of regulation for home care services. The Department of Health is currently engaged in a detailed process to progress this.
The statutory scheme for home care will introduce clear rules in relation to what services individuals are eligible for and how decisions are made on allocating services. For that reason, developing a new statutory scheme will be an important step in ensuring that the system operates in a consistent and fair manner for all those who need home care services. It will also help to improve access to the home care services that people need, in an affordable and sustainable way. The system of regulation for home care will help to ensure that the public can be confident that the services provided are of a high standard.
As an initial step, the Department commissioned the Health Research Board to undertake an evidence review of the home care systems that are in place in four other European countries. This review, which was published on 11 April, will help us to learn from the experiences of other jurisdictions and will inform the debate and future consideration of approaches to formal home care financing and regulation here in Ireland.
I, along with Minister Harris, also launched a public consultation on home care on 6 July. The purpose of this consultation is to allow all those who have views on this topic to have their say, including home care users, their families, and healthcare workers. It will also allow us to find out what people think about current home care services as well as the public’s views on what the future scheme should look like. The deadline for submissions is 2 October, 2017. A report of the findings of this consultation process will be published and the findings will be used by the Department in the development of the new home care scheme.
The development of a regulatory and funding model for home care services is a complex undertaking. While the public consultation and evidence review are important steps in the process of developing the new scheme, a significant amount of additional preparation needs to be carried out before final decisions are taken on the form of home care scheme and system of regulation. This is required if the reforms are to be successful, affordable and sustainable. Every effort will be made to progress this matter as quickly as possible.
147. Deputy Carol Nolan asked the Minister for Health the progress regarding the commitment under the programme for Government to address the discrimination faced by farmers in respect of the fair deal scheme; and if he will make a statement on the matter. [41013/17]
View answerThe Nursing Homes Support Scheme (NHSS) is a system of financial support for those in need of long-term nursing home care. Participants contribute to the cost of their care according to their income and assets 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.
When the NHSS commenced in 2009, a commitment was made that it would be reviewed after three years. The Report of the Review was published in July 2015. Arising out of the Review, a number of key issues have been identified for more detailed consideration across Departments and Agencies.
An Interdepartmental/Agency Working Group has been established to progress the recommendations contained in the Review. This Group is chaired by the Department of Health and includes representatives from the Department of the Taoiseach, the Department of Public Expenditure and Reform, the HSE, the Revenue Commissioners, and when required, the National Treatment Purchase Fund (NTPF). These recommendations include examining the treatment of business and farm assets for the purposes of the financial assessment element of the Scheme. The programme for a Partnership Government has also committed to reviewing the NHSS to remove any discrimination against small businesses and family farms. It is important to remember that the NHSS is largely underpinned by primary legislation and changes to the NHSS will require legislative implementation.
On this basis, I have requested legal advice from the office of the Attorney General regarding potential changes to the legislation that will address this matter. I have met with representatives from the I.F.A to discuss this matter and have apprised them of the current progress. I am committed to this review of the position with regard to family farms and small businesses for the purposes of the financial assessment of the scheme.
148. Deputy Louise O'Reilly asked the Minister for Health the details of the agreement reached with Portland hospital and Franziskus hospital for the provision of surgery for children with scoliosis from Ireland; the type of surgery to be provided; the number of surgeries to be provided; and if he will make a statement on the matter. [41019/17]
View answer149. Deputy Louise O'Reilly asked the Minister for Health the surgery plan for the 68 identified children with complex medical needs that are awaiting surgery for scoliosis; and if he will make a statement on the matter. [41020/17]
View answer150. Deputy Louise O'Reilly asked the Minister for Health if the 68 children with complex medical needs on the scoliosis waiting list are suitable for transfer to either England or Germany for surgery; and if he will make a statement on the matter. [41021/17]
View answer151. Deputy Louise O'Reilly asked the Minister for Health if his attention has been drawn to the fact that children and young adults are being referred from Crumlin children's hospital to the Mater hospital for scoliosis surgery and are being sent back to Crumlin due to the fact the Mater hospital cannot provide treatment; the numbers involved; and if he will make a statement on the matter. [41022/17]
View answer152. Deputy Louise O'Reilly asked the Minister for Health the time from the signing of the agreement for treatment with Stanmore hospital to the first child from the scoliosis waiting list being operated on; and if he will make a statement on the matter. [41023/17]
View answer153. Deputy Louise O'Reilly asked the Minister for Health the time between the first examination by Stanmore hospital of a child on the scoliosis waiting list and the time for that child's surgery; and if he will make a statement on the matter. [41024/17]
View answer154. Deputy Louise O'Reilly asked the Minister for Health if his attention has been drawn to the fact that there are at least five parents that have not heard back from Stanmore hospital regarding their children's surgery for scoliosis since July 2017; and if he will make a statement on the matter. [41025/17]
View answerI propose to take Questions Nos. 148 to 154, inclusive, together.
The HSE is actively implementing the action plan it developed to ensure that no child will be waiting over 4 months by year end and are focused on maximising all available capacity both internally and externally to achieve this target.
In relation to the queries raised by the Deputy, as these are service issues, I have asked the HSE to respond to you directly.
155. Deputy John Brady asked the Minister for Health if he will establish a general practitioner out-of-hours service in north Wicklow; if not, the reasons therefor; and if he will make a statement on the matter. [41027/17]
View answerGeneral practitioners contracted under the General Medical Services scheme must make suitable arrangements to enable contact to be made with them, or a locum/deputy, for emergencies outside normal practice hours. While there is no obligation on GPs to participate in GP out of hours cooperatives as a means of meeting this contractual requirement, such services have been developed and expanded over time and are now an essential part of our primary care services helping to ensure that, to the greatest extent possible, urgent care needs are met in the primary care setting.
The geographic area of North Wicklow, which covers Bray, Greystones and Enniskerry, is not currently serviced by a GP out of hours co-operative. The current out of hours service for the area is provided through a GP deputising service covering night time and weekend periods. The HSE has advised that the current service is unable to meet demand and is not sustainable long term.
I recognise the need for an improved out of hours service for North Wicklow which can provide the appropriate level of cover for the population of the area. The development of such a service would allow GPs to participate fully in the provision of an integrated healthcare system providing medical services that are appropriate, timely and effective, easily accessible and responsive to the needs of patients.
The HSE remains committed to the development of GP out of hours services in North Wicklow, and a proposal to provide a structured out of hours service for the area which would ensure 24/7 GP cover is being pursued. I expect to be in a position to provide further news on this in the coming weeks.
The HSE's National Primary Care Division has also undertaken a national review of current GP out of hours services and a final report is expected to be completed shortly. This report will make recommendations regarding the future provision of GP out of hours services and will have particular relevance to the currents gaps in service, in areas such as North Wicklow.
156. Deputy John Brady asked the Minister for Health the action he has taken to deal with inadequate protocols in place at St. Columcille's Hospital in Loughlinstown in cases in which persons attend the minor injuries unit without a general practitioner referral letter; and if he will make a statement on the matter. [41028/17]
View answerThe Ireland East Hospital Group has confirmed that GP referral letters became a part of the St Columcille's Hospital Operational Policy for the Medical Assessment Unit, in November 2016.
The protocol is in line with the operation of a Medical Assessment Unit in a Level 2 Hospital as outlined in the Acute Medicine Clinical Care Programme. The Medical Assessment Unit at St Columcille’s Hospital accepts GP referred patients and transfers of patients from St. Vincent’s University Hospital as per an agreed patient pathway.
The protocol is that when a person presents to the Medical Assessment Unit without a GP referral letter they are advised of the need for a letter in order to be seen. If however, they state they are unwell or indeed look unwell and are not happy to attend their GP or another healthcare facility the protocol is that they will be reviewed by the Triage Nurse on duty at the hospital and a decision made regarding their most appropriate management. This may include being seen by the Medical Assessment Unit doctor or an emergency transfer to another healthcare provider with an Emergency Department on site. On occasion the person will be treated in St. Columcille’s Hospital if appropriate.
157. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the position regarding the provision of a multidisciplinary team for a school (details supplied). [41033/17]
View answerThe 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.
The particular issue raised by the Deputy is a service matter for the HSE. Accordingly I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
158. Deputy Mick Wallace asked the Minister for Health the financial supports available for those that suffer from haemochromatosis and require regular venesection; his plans to introduce financial supports to help with the significant financial burden regular treatment creates; and if he will make a statement on the matter. [41043/17]
View answerThe IBTS has been running a Haemochromatosis clinic in the Stillorgan Blood Donation Clinic since 2007 and sees approximately 600 patients annually. In this clinic the IBTS only accepts Hereditary Haemochromatosis (HH) patients who are eligible to donate blood. In 2013 and 2014, the IBTS commenced provision of a programme for HH patients in their D’Olier Street (Dublin) and St Finbarr’s Hospital (Cork) clinics, respectively. The Clinics provide phlebotomy at no cost to the patient with a prescription from their treating clinician. The phlebotomy would be performed, regardless of whether the patient wanted to have their unit converted to a donation.
The Deputy will be aware of the ongoing review of the GMS and other publicly funded contracts involving GPs, and that the next phase of discussions to progress this work is under way. I expect that the issue of therapeutic venesection services for patients with Haemochromatosis will be considered in the context of the overall GP contract review process.
159. Deputy Kevin O'Keeffe asked the Minister for Health the status of an assessment for a person (details supplied) in County Cork. [41044/17]
View answerThe 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 an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
160. Deputy Paul Kehoe asked the Minister for Health the reason for refusal of a HSE national lottery grant application (details supplied); if there is an avenue for appeal; and if he will make a statement on the matter. [41045/17]
View answerAs I have no role or function in relation to the Health Service Executive (HSE) national lottery scheme, I have asked the HSE to reply to the Deputy directly.
