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 Header Item Written Answers Nos. 438-454
 Header Item Childcare Education and Training Scheme Expenditure
 Header Item Adoption Records Provision
 Header Item Water Fluoridation
 Header Item Speech and Language Therapy
 Header Item Hospital Trusts
 Header Item Primary Care Services Provision
 Header Item Hospital Services
 Header Item Health Services Reform
 Header Item Health Care Infrastructure
 Header Item Health Services Expenditure
 Header Item Hospital Services
 Header Item Health Insurance Cover

Tuesday, 11 December 2012

Dáil Éireann Debate
Vol. 786 No. 1

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Written Answers Nos. 438-454

Childcare Education and Training Scheme Expenditure

 438. Deputy Robert Troy Information on Robert Troy Zoom on Robert Troy asked the Minister for Children and Youth Affairs Information on Frances Fitzgerald Zoom on Frances Fitzgerald if there are grants available for childcare providers to obtain a level seven or eight qualifications; the criteria to qualify for such grants; the institutions that provide these courses; the amount they cost without a grant; and if she will make a statement on the matter. [55554/12]

Minister for Children and Youth Affairs (Deputy Frances Fitzgerald): Information on Frances Fitzgerald Zoom on Frances Fitzgerald The Early Childhood Care and Education (ECCE) programme was introduced in January 2010 with the objective of providing one free pre-school year for all eligible children prior to commencing primary school.

Childcare services participating in the ECCE programme are paid a standard capitation fee of €62.50 per week for each eligible child enrolled for the free pre-school year. Under the terms of the ECCE programme, the pre-school leaders delivering the programme must hold a certification for a major award in childcare/early education at a minimum of level 5 on the National Framework of Qualifications (NFQ) or an equivalent nationally-recognised qualification or a higher award in the childcare/early education field. My Department has part-subsidised on-line courses, developed by one of the National Voluntary Childcare Organisations (NVCOs), for unqualified practitioners in the current workforce who wish to achieve a level 5 award.

In keeping with the Government's commitment to increasing standards in the pre-school sector, a higher capitation payment of €73 per week is available to childcare services in which all childcare workers have qualification levels above the minimum requirements for the programme. One of the requirements for the higher capitation is that the pre-school leader holds a qualification in a relevant discipline at a minimum of a full level 7 award on the NFQ.

I have been successful in maintaining the ECCE programme as a free and universal programme despite the reduced funding available to my Department. Funding of €176 million is being made available this year to ensure that the increased cohort of eligible children have access to a quality free pre-school year.

Adoption Records Provision

 439. Deputy Andrew Doyle Information on Andrew Doyle Zoom on Andrew Doyle asked the Minister for Children and Youth Affairs Information on Frances Fitzgerald Zoom on Frances Fitzgerald if she will provide an outline of the staffing resources in the Adoption Authority of Ireland in view of the efforts to establish administrative agreements with other countries for the purposes of inter-country adoption and taking into account the new laws governing these processes with the introduction of the Adoption Act 2010, the subsequent sharp reduction in the numbers of children being available to adopt into Ireland through inter-country adoption since the passing of this law in November 2010. [55620/12]

Minister for Children and Youth Affairs (Deputy Frances Fitzgerald): Information on Frances Fitzgerald Zoom on Frances Fitzgerald The existing staff complement of the AAI is 25. Sanction has recently been provided for the recruitment of 4 additional staff and the Authority has begun the process of filling these posts. I am satisfied that these staffing numbers are adequate to enable the AAI to fulfil its statutory requirements under the Adoption Act 2010 and the Hague Convention.

Questions Nos. 440 to 444, inclusive, answered with Question No. 432.

Water Fluoridation

 445. Deputy Denis Naughten Information on Denis Naughten Zoom on Denis Naughten asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly his plans to review the inclusion of fluoride in public water supplies; and if he will make a statement on the matter. [55417/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White Water fluoridation and the use of appropriate fluorides is a major plank of public health policy in Ireland in the prevention and management of tooth decay. In 2002 the Forum on Fluoridation, which was established to review this policy, concluded that the fluoridation of public piped water supplies should continue as a public health measure. The Irish Expert Body on Fluorides and Health, established in 2004, monitors new and emerging issues on fluoride and its effects on health and related matters. It advises that the balance of scientific evidence worldwide confirms that water fluoridation, at the optimal level, does not cause any ill effects and is the safest and most cost effective method of protecting the oral health of the population. Given that the policy has been reviewed by the Forum on Fluoridation and that the Expert Body on Fluorides and Health continues to provide impartial, evidence-based, expert advice on fluoridation, a further review is not considered necessary.

Speech and Language Therapy

 446. Deputy Finian McGrath Information on Finian McGrath Zoom on Finian McGrath asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding assessment and speech therapy in respect of a person (details suppled) in Dublin 13. [55061/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.

Hospital Trusts

 447. Deputy Caoimhghín Ó Caoláin Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly further to Parliamentary Question No. 229 of 28 November 2012, if the report has been received by him; the date on which he will publish the report; and if he will make a statement on the matter. [55068/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Recommendations on the formation of specific groups and arrangements for the management and governance of all groups have been drafted as part of a report on the establishment of hospital groups as a transition to hospital trusts. This report is based on a comprehensive consultation process, as well as a significant number of submissions from stakeholders and individual citizens. These recommendations have been considered and endorsed by a Strategic Board composed of representatives with national and international expertise in health service delivery, governance and linkages with academic institutions. The report on the establishment of hospital groups as a transition to independent hospital trust will be presented formally to me by the Chair of the Strategic Board, Professor John Higgins, in the near future. I will prioritise consideration of that report, which will then be submitted to and presented to Government for decision on the hospital groups composition in light of the recommendations of the Report.

Primary Care Services Provision

 448. Deputy Caoimhghín Ó Caoláin Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the number of the 255 primary care posts announced last July that have been filled to date; and if he will make a statement on the matter. [55070/12]

 461. Deputy Michael Healy-Rae Information on Michael Healy-Rae Zoom on Michael Healy-Rae asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the number of the 260 primary care posts announced in July 2012 that have been filled; the locations of same; and if he will make a statement on the matter. [55163/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White I propose to take Questions Nos. 448 and 461 together.

An allocation of €20 million was set aside in the HSE's 2012 National Service Plan for approximately 250 Primary Care posts (including Public Health Nurses (PHNs), Registered General Nurses (RGNs), Occupational Therapists, Physiotherapists and Speech and Language Therapists) and 17 Integrated Care Diabetes Nurse Specialist posts. The Diabetes Nurse Specialist posts will support the phased roll out of the national chronic disease management programme for diabetes which is expected to commence shortly. The HSE recently held interviews for the Diabetes Nurse Specialist posts and it is expected that these posts will be filled early in 2013.

Due to financial constraints, it was not possible to fill the primary care posts in 2012. It is my firm intention to have these posts filled as soon as possible in 2013.

Hospital Services

 449. Deputy Caoimhghín Ó Caoláin Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the number of patients who have had hospital appointments cancelled at less than 48 hours notice; if he will provide a breakdown of same by reason and hospital; and if he will make a statement on the matter. [55071/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly In relation to the particular query raised by the Deputy, I have asked the Health Service Executive to respond directly to the Deputy in this matter.

Health Services Reform

 450. Deputy Caoimhghín Ó Caoláin Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the date on which he will publish the 2012 reviews of financial management systems in the Irish Health Service; and if he will make a statement on the matter. [55072/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly During 2012 my Department undertook a number of initiatives to address concerns around financial control in the Health Service Executive. These included engaging an expert from the UK NHS to examine the financial management of the HSE and make recommendations regarding strengthening and improving the management of its finances. An assessment of this report and an action plan for the implementation of its recommendations, was also undertaken by PA Consultancy. Both reports will be published shortly.

Health Care Infrastructure

 451. Deputy Caoimhghín Ó Caoláin Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the way primary, social and community care will be funded in 2016; if he will confirm that it will be through general taxation; and if he will make a statement on the matter. [55073/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The Government is embarking on a major reform programme for the health system, the aim of which is to deliver a single-tier health service, supported by universal health insurance (UHI), where access is based on need, not on income. Under UHI, every citizen will be insured and will have equal access to a standard package of primary and acute hospital services, including acute mental health services. A new Insurance Fund will subsidise or pay insurance premia for those who qualify for a subsidy. While primary and hospital care will be funded mainly via the UHI system, specialised and social care services, including long term care, will be funded by general taxation. Although funded separately, these services will still be delivered in an integrated manner around the needs of the person.

Health Services Expenditure

 452. Deputy Caoimhghín Ó Caoláin Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the efforts being made to introduce patient level costing across the health service; and if he will make a statement on the matter. [55074/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The HSE is currently undertaking a Patient Level Costing (PLC) project. This project involves tracing resources actually used by individual patients from the time of entry and admission to hospital until discharge. It enables individual hospitals to fully understand the economic and financial drivers underpinning service delivery.

The first PLC study commenced in 2010 and to date 3 costing studies have been completed. A further study is expected to be completed by the end of January 2013. The number of hospitals participating in the study has increased significantly from 6 in 2010 to 16 in 2012.

The PLC studies are an important prerequisite for the introduction of 'Money Follows the Patient' funding systems in acute hospitals.

Hospital Services

 453. Deputy Pearse Doherty Information on Pearse Doherty Zoom on Pearse Doherty asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly his plans to reinstate the rheumatology service at Letterkenny General Hospital in County Donegal; the commitment to reinstate the service upon completion of the new medical block at the hospital; if his attention has been drawn to the fact that patients are now having to travel to Sligo General Hospital; and if he will make a statement on the matter. [55103/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The HSE has significantly developed rheumatology services in the North West over the past two years. This has involved the appointment of two permanent rheumatologists in mid 2010 who are responsible for the delivery of the service in the North West. It is intended to re-establish an outpatient clinic at Letterkenny General Hospital.

Given that the new ED / Medical Block is now opened and the second consultant in Sligo has returned from leave, discussions will now commence regarding the restoration of the outreach service. It is hoped that a service can recommence in the 1st quarter of 2013.

The service is now managed regionally under the management of Sligo General Hospital. When the outreach clinic is restored it is anticipated that patients who need to be reviewed may be seen in Letterkenny General Hospital.

Health Insurance Cover

 454. Deputy David Stanton Information on David Stanton Zoom on David Stanton asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding the use of health insurance from another EU country (details supplied) to qualify for health services here [55108/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The rules on the coordination of social security systems, including healthcare within the EU/EEA and Switzerland, are currently contained in Regulation 883/04 and Implementing Regulation 987/09. One of the objectives of Regulation 883/04 is to ensure that persons exercising their right to move and to stay freely within the EU/EEA and Switzerland do not suffer disadvantages in the field of healthcare i.e. accessing or paying for same.

As a general rule, healthcare is provided according to the legislation of the country where you reside, or stay, as if you were insured in that country. The costs of this healthcare are the responsibility of the State whose social security system you are linked to. In principle, an insured person from one State, residing or staying in another State is entitled to access healthcare on the same basis as persons who are insured with and resident in that State.

In Ireland, the HSE is the competent institution for the purposes of the EU Regulations in this area. It is the competent institution which is responsible for the insured person receiving the service. I understand that a medical card has been issued in this case and that we have met our obligations under the EU Regulations. If the person concerns feels that their health insurance provider will cover the cost of treatment outside the public health system in Ireland this is a matter they should pursue with the provider.


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