Written Answers Nos. 459-478
459. Deputy Ken O'Flynn asked the Minister for Health when her Department last assessed unmet need for chronic pain treatment in adults aged over 65, in light of TILDA Wave 6 findings that two-thirds of older adults with moderate to severe chronic pain receive no medication; and the actions taken following this assessment. [68703/25]
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.
460. Deputy Ken O'Flynn asked the Minister for Health if her Department plans to introduce a dedicated older persons pain strategy aligned with Sláintecare’s integrated-care objectives; and if so, the planned scope, timelines and implementation milestones. [68704/25]
Amharc ar fhreagraAs this is a clinical operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
461. Deputy Ken O'Flynn asked the Minister for Health the number of applications from persons aged 70 years and over that were refused any form of card, including a GP visit card, in each of the years 2020 to 2025; and the recorded reasons for refusal. [68706/25]
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.
462. Deputy Ken O'Flynn asked the Minister for Health the number of appeals lodged by persons aged 70 years and over following the refusal of a medical card or GP visit card in each of the years 2020 to 2025; and the number of appeals upheld. [68707/25]
Amharc ar fhreagra472. Deputy Ken O'Flynn asked the Minister for Health the number of appeals lodged by persons aged 70 or over following a refusal of a medical card or GP visit card in each of the past four years, and the number of appeals subsequently upheld. [68717/25]
Amharc ar fhreagraI propose to take Questions Nos. 462 and 472 together.
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
463. Deputy Ken O'Flynn asked the Minister for Health the current income thresholds used for assessing medical card eligibility for persons aged 70 years and over; when they were last reviewed; and the evidence base used in that review. [68708/25]
Amharc ar fhreagra464. Deputy Ken O'Flynn asked the Minister for Health if her Department has conducted any assessment of whether the current income thresholds for over-70s are aligned with the cost of living for that age group; and if she will provide details of any such assessment. [68709/25]
Amharc ar fhreagraI propose to take Questions Nos. 463 and 464 together.
Eligibility for a Medical Card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970 (as amended). The HSE assesses each medical card application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card. It is specific to the individual’s own financial circumstances.
Persons aged 70 or older are assessed under the over 70s medical card income thresholds which are based on gross income. However, it should be noted that those aged over 70 can also be assessed under the general means tested scheme where there are particularly high medical costs. In November 2020, the weekly gross medical card income thresholds for those aged 70 and over were increased to €550 per week for a single person and €1,050 for a couple.
It is important to acknowledge that the administration of medical card exists within a wider eligibility framework, and that a range of other measures have also been implemented over recent years to help increase access to and the affordability of healthcare services, for example:
• since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card.
• under the Long-Term Illness Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
• under the Drugs Payment Scheme (DPS) no individual 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 families and individuals with ongoing expenditure on medicines.
• In 2023, GP visit card means-tested eligibility was extended to those who earn up to the median household income.
• GP visit card eligibility was extended from all children under 6 to children under 8.
• Public in-patient charges in public hospitals have been abolished.
• Individuals may also be entitled to claim tax relief on the cost of qualifying health expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
I can assure the Deputy that my Department keeps medical card issues under review in order to ensure the medical card system is responsive and sensitive to people's needs. There is a programme of work currently underway in my Department which is reviewing the existing eligibility framework, to clearly assess what is working well and to inform future policy proposals regarding the eligibility framework based on robust evidence. This is an important step towards delivering on universal healthcare in Ireland.
465. Deputy Ken O'Flynn asked the Minister for Health the number of over-70s whose applications for a medical card were reclassified to GP visit card awards due to marginal threshold exceedance since 2020, broken down by year. [68710/25]
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.
466. Deputy Ken O'Flynn asked the Minister for Health the number of over-70s whose medical card applications were discontinued due to incomplete documentation or verification requests in each of the years 2020 to 2025; and the number subsequently resubmitted. [68711/25]
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.
467. Deputy Ken O'Flynn asked the Minister for Health the average processing time for medical card applications submitted by persons aged 70 years and over in each of the years 2020 to 2025, including the longest recorded waiting time. [68712/25]
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.
468. Deputy Ken O'Flynn asked the Minister for Health the number of over-70s who reported financial hardship, delayed medical care, or difficulty accessing medication following the refusal of a medical or GP visit card since 2020; and if such data is recorded. [68713/25]
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.
469. Deputy Ken O'Flynn asked the Minister for Health if her Department has carried out any review of the decision-making accuracy in over-70s medical card assessments since 2020; and the findings of that review, including identified error rates. [68714/25]
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.
470. Deputy Ken O'Flynn asked the Minister for Health the number of over-70s who had an existing medical card withdrawn following a means review in each year since 2020, broken down by year. [68715/25]
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.
471. Deputy Ken O'Flynn asked the Minister for Health the income bands of applicants aged 70 or over whose medical card or GP visit card applications were refused in each of the past four years, in order to identify the financial proximity to the threshold. [68716/25]
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.
473. Deputy Ken O'Flynn asked the Minister for Health if she will provide a table showing changes to income thresholds for over-70s medical cards and GP visit cards since 2019, alongside the Consumer Price Index over the same period. [68718/25]
Amharc ar fhreagraEligibility for a Medical Card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970 (as amended). The HSE assesses each medical card application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card. It is specific to the individual’s own financial circumstances.
Persons aged 69 and under are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. Certain expenses are also taken into account. Detailed guidelines are available at: www2.hse.ie/services/schemes-allowances/medical-cards/applying/assessment/. Persons aged 70 or older are assessed under the over 70s medical card income thresholds which are based on gross income. However, it should be noted that those aged over 70 can also be assessed under the general means tested scheme where there are particularly high medical costs.
In November 2020, the weekly gross medical card income thresholds for those aged 70 and over were increased to €550 per week for a single person and to €1,050 for a couple. The Deputy may also wish to note that, since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card.
The Central Statistics Office (CSO) is Ireland's national statistical institute and details regarding the Consumer Price Index are available at: cso.ie.
I wish to assure the Deputy that, to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues under review and any changes are considered in the context of Government policy, the annual budgetary estimates process and other issues which may be relevant.
474. Deputy Ken O'Flynn asked the Minister for Health the number of over-70s who were subject to a means review more than once within a 24-month period in each of the past four years. [68719/25]
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.
475. Deputy Ken O'Flynn asked the Minister for Health the number of medical card and GP visit card holders aged 70 or over who incurred out-of-pocket medical expenses exceeding one thousand euro in the past year following a refusal or withdrawal of their card. [68720/25]
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.
476. Deputy Ken O'Flynn asked the Minister for Health the formal mechanisms her Department has in place to obtain assurance that the HSE is monitoring governance, audit, and compliance issues in voluntary hospitals; the process by which her Department is notified of any significant governance risks or failures identified by the HSE in those hospitals; and the actions her Department takes when such risks or failures are escalated. [68737/25]
Amharc ar fhreagraUnder the Health Act 2004, primary responsibility for funding the Voluntary Hospitals for the provision of healthcare services on behalf of the HSE, was placed with the HSE. As a result, primary oversight responsibility for the Voluntary Hospitals is with the HSE and this includes dealing with issues relevant to the delivery of healthcare services as they arise.
Service Arrangements with Section 38 and 39 Agencies enable the HSE to enforce compliance with governance requirements. The HSE implements the Performance and Accountability Framework (PAF) which sets out how the HSE’s six regions and national services are held to account for their performance. The PAF sets out levels of accountability, including for Section 38 and 39 Agencies, and the HSE approach to addressing performance challenges through a tiered escalation model.
The Department measures performance of all of the HSE, including Section 38 and 39 Agencies, against the objectives and targets set out in the National Service Plan (NSP) through the Performance Engagement Model. As part of an escalation process, underperformance against NSP targets is the subject of discussion at monthly engagements between the Department and HSE, with actions identified and agreed.
The Department also manages appointments to all Boards under the aegis of the Department including the Board of the HSE. Quarterly high-level meetings take place involving the CEO of the HSE, the Chair of the HSE Board, the Secretary General of the Department of Health and the Minister for Health. The main agenda items for these meetings include HSE Board appointments, the HSE Statement of Internal Control and topical issues as agreed.
477. Deputy Ken O'Flynn asked the Minister for Health the procedure within her Department for responding to serious governance concerns in voluntary hospitals when such issues are escalated by the HSE; and the criteria her Department uses to determine when further action or intervention is warranted. [68738/25]
Amharc ar fhreagraUnder the Health Act 2004, primary responsibility for funding the Voluntary Hospitals for the provision of healthcare services on behalf of the HSE, was placed with the HSE. As a result, primary oversight responsibility for the Voluntary Hospitals is with the HSE and this includes dealing with issues relevant to the delivery of healthcare services as they arise.
Service Arrangements with Section 38 and 39 Agencies enable the HSE to enforce compliance with governance requirements. The HSE implements the Performance and Accountability Framework (PAF) which sets out how the HSE’s six regions and national services are held to account for their performance. The PAF sets out levels of accountability, including for Section 38 and 39 Agencies, and the HSE approach to addressing performance challenges through a tiered escalation model.
The Department measures performance of all of the HSE, including Section 38 and 39 Agencies, against the objectives and targets set out in the National Service Plan (NSP) through the Performance Engagement Model. As part of an escalation process, underperformance against NSP targets is the subject of discussion at monthly engagements between the Department and HSE, with actions identified and agreed.
The Department also manages appointments to all Boards under the aegis of the Department including the Board of the HSE. Quarterly high-level meetings take place involving the CEO of the HSE, the Chair of the HSE Board, the Secretary General of the Department of Health and the Minister for Health. The main agenda items for these meetings include HSE Board appointments, the HSE Statement of Internal Control and topical issues as agreed.
478. Deputy Ken O'Flynn asked the Minister for Health the number of inspections, compliance notices, closure orders or enforcement actions issued by the FSAI and authorised officers in meat processing facilities over the past three years; the types of breaches detected; and the follow-up actions taken in each category. [68741/25]
Amharc ar fhreagraThe Food Safety Authority of Ireland (FSAI) has overall responsibility for the enforcement of food law in Ireland; therefore, as this is an operational matter, I have asked the FSAI to reply directly to the Deputy.
