Tuesday, 14 May 2024

General Practitioner Services

Ceisteanna (554)

Holly Cairns

Ceist:

554. Deputy Holly Cairns asked the Minister for Health the number of GPs practising in Cork aged over 60 years, by region, in tabular form. [21243/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

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

Health Services Staff

Ceisteanna (555)

Holly Cairns

Ceist:

555. Deputy Holly Cairns asked the Minister for Health the number of health care support assistants in Cork; the number of individuals using the service; and the areas that are using the 4-TEAM rota system, by local area, in tabular form. [21245/24]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health

As this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Health Services Staff

Ceisteanna (556)

Aengus Ó Snodaigh

Ceist:

556. Deputy Aengus Ó Snodaigh asked the Minister for Health if all the staff in the HSE, including agency staff and staff working for HSE contractors working in St. James's Hospital, Dublin and other hospitals on the minimum wage, are in receipt of the new rate of €12.70 since its introduction on 1 January 2024; and if he will make a statement on the matter. [21250/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

Employees in the public health sector are paid in line with the Department of Health consolidated salary scales which are available to view online here: www.gov.ie/en/publication/150f8-1-january-2024-pay-scales/

All grades in the public health sector are paid in excess of the national minimum wage, and receive pay increases as set out in the public service agreements and associated Acts such as the Public Service Pay and Pensions Act 2017.

While workers employed in the health sector via an employment agency are not direct employees of the public health sector, I can confirm that Part 2 of the Protection of Employees (Temporary Agency Work) Act 2012 provides that they are entitled to the 'the same basic working and employment conditions as the basic working and employment conditions to which he or she would be entitled if he or she were employed by the hirer under a contract of employment to do work that is the same as, or similar to, the work that he or she is required to do during that assignment'.

Hospital Appointments Status

Ceisteanna (557)

John McGuinness

Ceist:

557. Deputy John McGuinness asked the Minister for Health if an urgent appointment will be arranged for a person (details supplied) at the neurosurgical clinic at Cork University Hospital as this was requested by their GP on 9 January 2023; if he will expedite a positive response as the patient's condition has seriously deteriorated; the reason for the delay; and if he will make a statement on the matter. [21271/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

Under 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.

Hospital Procedures

Ceisteanna (558)

John McGuinness

Ceist:

558. Deputy John McGuinness asked the Minister for Health if a date for an operation will be arranged for a person (details supplied); and if he will make a statement on the matter. [21272/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

Under 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.

Addiction Treatment Services

Ceisteanna (559)

John McGuinness

Ceist:

559. Deputy John McGuinness asked the Minister for Health if the issues regarding funding of an organisation (details supplied) by the probation services and the HSE have now been resolved; the status of the appeal; and if a decision will be expedited as the funding is urgently required. [21277/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

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

Medical Cards

Ceisteanna (560)

Leo Varadkar

Ceist:

560. Deputy Leo Varadkar asked the Minister for Health the estimated average or median cost of a GP visit card per person per annum; the cost of a full medical per person per annum; and to provide a detailed explanation of the difference in cost, given the abolition of inpatient hospital charges and the reduction in the household cap on monthly medicine bills. [21281/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

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

Departmental Data

Ceisteanna (561, 562)

Leo Varadkar

Ceist:

561. Deputy Leo Varadkar asked the Minister for Health the estimated cost of reducing the drug payment scheme threshold to €50 per household per month. [21282/24]

Amharc ar fhreagra

Leo Varadkar

Ceist:

562. Deputy Leo Varadkar asked the Minister for Health if any costings exist on moving the drug payment scheme to an individual patient basis rather than a household limit. [21283/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

I propose to take Questions Nos. 561 and 562 together.

The Drugs Payment Scheme (DPS) provides for the refund of the amount by which expenditure on approved prescribed medicines or medical and surgical appliances exceeds a named threshold in any calendar month. The DPS is not means tested and is available to anyone ordinarily resident in Ireland.

Currently, under the DPS, no individual pays more than €80 a month towards the cost of approved prescribed medicines. The DPS significantly reduces the cost burden for people with ongoing expenditure on medicines.

It is estimated that the cost of reducing the DPS threshold from the current threshold of €80 per month to €50 per month would be approximately €64m. This costing does not take account of demographic changes, changes in eligibility (e.g., loss of medical cards), or how the reduction in the threshold may impact claimant behaviour.

The DPS is deliberately designed as a simple universal non-means tested scheme which is in place to protect those who do not qualify for a medical card. There is a process around means testing for medical cards which requires that the HSE consider hardship and inability to pay for required health care when making determinations around eligibility for healthcare services.

The removal of the DPS threshold applying on a household or family basis in favour of a threshold applied only on an individual patient basis would present savings to the state as more people would have to meet the cost of receiving their medicines. On the other hand, the introduction of diverse DPS thresholds (for families, couples, individuals, etc) would introduce a level of complexity into the operation of the Scheme that is not justified when there is another scheme in place to assist in cases of hardship brought on by meeting medical costs.

Question No. 562 answered with Question No. 561.

Dental Services

Ceisteanna (563)

Brendan Griffin

Ceist:

563. Deputy Brendan Griffin asked the Minister for Health when a teenager in County Kerry (details supplied) will receive an appointment for braces; and if he will make a statement on the matter. [21299/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

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

Medical Aids and Appliances

Ceisteanna (564)

Robert Troy

Ceist:

564. Deputy Robert Troy asked the Minister for Health if there is any financial assistance towards the cost of oxygen cylinders for people dependent on same; and if he will make a statement on the matter. [21306/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

The Health Service Executive (HSE) provides a wide range of medical and surgical aids and appliances, free of charge to eligible persons following assessment by a relevant health professional. There are a range of HSE administered schemes that assist individuals in meeting their medical costs.

People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE.

In certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness.

The Drug Payment Scheme (DPS) ensures that no individual or family pays more than €80 a month towards the cost of approved prescribed medicines, including rental costs for oxygen. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines who are not eligible for a medical card.

Nursing Homes

Ceisteanna (565)

Pádraig O'Sullivan

Ceist:

565. Deputy Pádraig O'Sullivan asked the Minister for Health if consideration has or will be given to the relaxation of the five-year rule for farmers in respect of the nursing home support scheme (details supplied); and if he will make a statement on the matter. [21312/24]

Amharc ar fhreagra

Freagraí scríofa

Minister of State at the Department of Health

The Nursing Home Support Scheme (NHSS), commonly referred to as 'Fair Deal', is a system of financial support for people who require long-term residential care. The primary legislation underpinning the NHSS is the Nursing Home Support Scheme Act 2009. Participants in the NHSS 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. Participants within the NHSS contribute up to 80% of their income (40% if part of a couple) and 7.5% per annum of the value of their assets (3.75% if part of a couple). The first €36,000 (€72,000 if part of a couple) is excluded from assessment. The value of a person's principal residence is only assessed for contributions for their first three years on the scheme. Assets assessed include cash assets as well as non-cash assets such as the principal private residence, other property and land, including farmland. Transferred assets and income, defined as assets or income transferred to another person up to five years before a person's application to the scheme, are also assessed. Schedule 1, Part 3 defines a transferred asset as follows:

““transferred asset” means an interest of the person in an asset (whether a cash asset or a relevant asset) which has been transferred at any time in the period of 5 years prior to the date on which an application for State support is first made by or on behalf of that person which transfer is made— (a) for no consideration, (b) for nominal consideration, or (c) for consideration which is less than 75 per cent of the estimated market value of the interest of the person in the asset at the time of the transfer but does not include the transfer of an asset made in respect of the settlement of any claim made in respect of the maintenance of a child or other matrimonial proceedings, and that the Executive is satisfied that such transfer was made for that purpose, and the estimated market value of a transferred asset shall be determined on the basis of the value of the asset at the time of the transfer, and where the asset comprises monies not being in the currency of the State, or other assets held in a place outside the State, the currency of which is not the currency of the State, converted into the currency of the State at the date of the transfer of the asset concerned;”

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. While there are currently no plans to review this element of the legislation, 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. All questions arising in respect of title, as they pertain to the lawful ownership and transfer of property, are matters between the HSE and the applicant and their representatives.

General Practitioner Services

Ceisteanna (566)

Matt Carthy

Ceist:

566. Deputy Matt Carthy asked the Minister for Health how he proposes a person (details supplied) can get a GP, following the retirement of their own GP; and if he will make a statement on the matter. [21333/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

GPs are private practitioners, most of whom hold a GMS contract with the HSE for the provision of GP services without charge to medical card and GP visit card holders.

Where a person who holds a medical card or GP visit card, experiences difficulty in finding a GP to accept them as a patient, that person having unsuccessfully applied to at least three GPs in the area (or fewer if there are fewer GPs in the area) can apply to the HSE National Medical Card Unit which has the power to assign a GMS patient to a GP's GMS patient list in accordance with the GMS contract.

Where a GMS GP retires or otherwise resigns his GMS contract, a GMS vacancy arises and the HSE becomes actively involved in the recruitment process to find a replacement GP. Medical card and GP visit card holders on the GMS panel concerned are transferred to the new GP upon recruitment.

People who do not hold a medical card or GP visit card access GP services on a private basis and can make enquiries directly to any GP practice they wish to register with. As private practitioners, it is a matter for each individual GP to decide whether to accept additional private patients. Where a GP practice has a full list of patients and cannot take on new patients, patients should contact other GP practices in the surrounding areas.

It is worth noting that eligibility for a GP visit card was extended last year to all those who earn up to the median household income, which has greatly increased the number of persons eligible for a GP visit card. The qualifying threshold calculation takes into consideration the applicant’s particular expenses and the number of dependents as well as their income, allowing for those who have a higher income but also experience high expenses to potentially qualify for a card.

The Government is working to increase the number of GPs practicing in the State and thereby improve access to GP services across the country.

Under the 2019 GP Agreement additional annual expenditure provided for general practice was increased by €211.6m. This provided for significant increases in capitation fees for participating GMS GPs, and new fees for additional services and increased practice supports. The GP Agreement 2023 further increased GP capitation fees, increased the existing subsidy rates for practice staff, and introduced a grant support for additional staff capacity as well a practice staff maternity leave support.

These measures make general practice in Ireland a more attractive career choice for doctors. Figures released by the ICGP show that 1,311 medical graduates applied for GP training in 2024, a notable increase on the previous year and higher than any other year.

The number of doctors entering GP training has been increased significantly in recent years, with 286 new entrants in 2023 and 350 places planned for new entrants for this year. Annual intake to the GP training scheme has been increased by over 80% from 2015 to 2023, and the number of new entrant places to be available this year is a 22% increase on last year's intake.

Furthermore, GP recruitment is ongoing under the joint International Medical Graduate Rural GP Programme between the HSE and the Irish College of General Practitioners (ICGP). 121 non-EU GPs were enrolled under the training programme last year and it is planned to recruit up to 250 more GPs from outside Ireland this year. The placement of GPs under the programme is targeted to rural and underserviced areas.

Lastly, a Strategic Review of General Practice is underway. The review, with input from key stakeholders, is examining the broad range of issues affecting general practice including issues related to GP capacity. When completed, the review will set out the measures necessary to deliver a more sustainable general practice into the future.

Medical Aids and Appliances

Ceisteanna (567)

Louise O'Reilly

Ceist:

567. Deputy Louise O'Reilly asked the Minister for Health the status of standardising post-mastectomy supports; what are the financial supports for all areas, in tabular form; if any areas will see a decrease in supports; the reason the HSE does not directly provide post-mastectomy support from approved vendors; and if he will make a statement on the matter. [21342/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

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

Medical Aids and Appliances

Ceisteanna (568)

Louise O'Reilly

Ceist:

568. Deputy Louise O'Reilly asked the Minister for Health if there is a circular regarding post-mastectomy supports; if there is a reference number on the circular, if he will provide this number; and if he will make a statement on the matter. [21343/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

The Health Service Executive (HSE) provide an extensive range of aids and appliances to individuals living with a wide variety of different medical conditions. These support individuals to continue living within their communities and to enjoy a greater quality of life than would otherwise be the case. The Community Funded Schemes (CFS) is the collective name for the provision of these products and services.

The CFS Service Improvement Programme had published two new national procedures for the provision of an allowance for cancer treatment in respect of hair loss and post mastectomy products.

I instructed the HSE to ensure that no patient, either currently availing of the scheme or accessing it in the future, should be at any financial loss as a result of the proposed changes.

The HSE communicated to each CHO advising them to revert to the previous levels of contribution until such time as the new procedures can be reviewed in terms of the proposed allowances to be provided. The relevant HSE circulars regarding the two national procedures for the provision of an allowance for cancer treatment in respect of hair loss and post mastectomy products have since been rescinded.

I want to reiterate that progressing Women's Health is a priority within the Programme for Government, and a top priority for me as Minister for Health. I am proud to have overseen unprecedented levels of funding in women's health services over the last few years. I want to ensure that the necessary supports are put in place so that every woman has the same level of access to appropriate healthcare no matter where they live in Ireland.

Medical Cards

Ceisteanna (569)

Michael Collins

Ceist:

569. Deputy Michael Collins asked the Minister for Health the reason persons diagnosed with life-term illnesses who have already been approved for a medical card are required to go to their local GP and hospital consultants for medical reports, which will not have a changed outcome on them, then go to their local pharmacy and ask for the cost of high-tech medicines and regular daily prescribed medicines to put in an assessment for a box to be reticked. [21347/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

All chronic long-term illnesses require regular clinical reassessment by a medical professional. In circumstance where a prescription for medication is issued by the relevant medical professional, it has a maximum validity for twelve months. However, the priority for all healthcare professionals in the continued treatment of their patients is that the treatment offered is both appropriate and safe. Therefore, a prescription may be issued for a shorter duration as deemed clinically appropriate.

For six-month prescriptions issued on or after the 1 March 2024, pharmacists may be able to extend them for up to a maximum of another six months. They will exercise their professional judgement in considering such requests.

There are two schemes, administered by the Health Service Executive (HSE) which assist people with their medical costs – these are the General Medical Services (GMS) Scheme, and the Drug Payment Scheme (DPS). Reimbursable claims under both these schemes are based on prescriptions which are transmitted to the pharmacist.

People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card under the GMS Scheme. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the Health Service Executive (HSE).

In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. Medical cards may be subject to review and medical reports may be needed to support the renewal or continuation of the eligibility.

Under the Drug Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for those who are not eligible for a medical card but incur ongoing expenditure on medicines. In some cases, when applying for a DPS card, a medical report for any family member who cannot maintain themselves may be required.

Reimbursements under the High-Tech Medicines Arrangement are based on prescriptions issued by hospital consultants – these cannot be extended by pharmacists. These require the continued care of hospital consultants and there are procedures in place to ensure that patients being dispensed medicines under this scheme are eligible for same.

It is important to note that the medical decision to prescribe or not prescribe any treatment for an individual patient is strictly a decision for the treating clinician, in consultation with their patient. The Minister for Health has no role in this clinical decision-making process. In addition, 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.

Health Services Staff

Ceisteanna (570)

Neasa Hourigan

Ceist:

570. Deputy Neasa Hourigan asked the Minister for Health if he will provide an update on his Department's position on the embargo on recruitment to the health service, particularly its effects on acute hospital services; and if he will make a statement on the matter. [21354/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

As this is an operational matter for the Health Service Executive, the HSE has been asked to respond directly to the Deputy.

Medical Aids and Appliances

Ceisteanna (571)

Neasa Hourigan

Ceist:

571. Deputy Neasa Hourigan asked the Minister for Health if consideration is under way to reduce wait times and update the paper-based system for the reimbursement scheme for oxygen provision systems; and if he will make a statement on the matter. [21356/24]

Amharc ar fhreagra

Freagraí scríofa

Minister for Health

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

Healthcare Infrastructure Provision