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 Header Item Written Answers Nos 166-179
 Header Item Departmental Expenditure
 Header Item Drug Treatment Programmes Availability
 Header Item HSE Expenditure
 Header Item Primary Care Services Provision
 Header Item Medical Aids and Appliances Applications
 Header Item HSE Funding
 Header Item Medical Card Applications
 Header Item Medical Card Applications
 Header Item Medical Card Appeals
 Header Item Hospital Waiting Lists
 Header Item Social Workers Register
 Header Item Health Services Provision
 Header Item Medical Card Eligibility
 Header Item Medical Card Eligibility

Thursday, 13 December 2012

Dáil Éireann Debate
Vol. 786 No. 3

First Page Previous Page Page of 73 Next Page Last Page

Written Answers Nos 166-179

Departmental Expenditure

 166. Deputy Caoimhghín Ó Caoláin Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin asked the Minister for Children and Youth Affairs Information on Frances Fitzgerald Zoom on Frances Fitzgerald in view of the announcement in budget 2013, if she will provide the full detail of the funding allocation to the youth sector for 2013; if an impact assessment has been carried out on these cuts; and if she will make a statement on the matter.  [56179/12]

Minister for Children and Youth Affairs (Deputy Frances Fitzgerald): Information on Frances Fitzgerald Zoom on Frances Fitzgerald The Youth Affairs Unit of my Department supports the delivery of a range of youth work programmes and services for all young people, including those from disadvantaged communities, by the voluntary youth sector. Targeted supports for disadvantaged, marginalised and at risk young people are provided through the Special Projects for Youth Scheme, the Young Peoples Facilities and Services Fund Rounds 1 and 2 and Local Drugs Task Force Projects.

Funding of €53.173m has been provided to my Department for the provision of youth services in 2013. Within this total funding, €1.75 has been provided in a new capital funding programme for 2013. This will include €1.5m for youth cafés and youth projects and €250,000 for play and recreation initiatives in 2013. My Department will be announcing further details regarding the application process for the 2013 funding programme early in the New Year.

My Department is working on the current funding allocations (total of €51.423m) for youth services in 2013. Having regard to the savings requirements identified in the Comprehensive Review of Expenditure my Department is seeking to ensure that, in the determination process for the allocations, the front line youth services, particularly those for the most vulnerable young people are protected as far as is possible from the impact of any necessary reductions in funding. Youth organisations and projects will be advised of their 2013 allocations as soon as possible.

Going forward to 2013, my Department is developing proposals to streamline the existing five separate funding lines so that projects will receive one funding stream allowing more flexibility in setting priorities, managing savings and reconfiguring service provision. In addition, my Department will be commencing a formal Value for Money review which is expected to report by mid 2013. There will be no cut to funding for local voluntary youth clubs.

Drug Treatment Programmes Availability

 167. Deputy Eoghan Murphy Information on Eoghan Murphy Zoom on Eoghan Murphy asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly his views on methadone clinics (details supplied). [56062/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The HSE provides opioid substitution (mainly methadone) in a number of treatment settings to meet the needs of individual drug users. These settings include:

- primary care through GPs and community pharmacies;

- satellite clinics that facilitate opioid substitution provision through community pharmacies;

- treatment centres where opioid substitution treatment is dispensed on site; and

- residential rehabilitation facilities. 

  The HSE recognises that drug treatment is best provided at the lowest level of complexity, matching the patient's needs and as close to the patient's home as possible. There are currently 52 clinics within the four Dublin Local Authority Areas of which only 6 are based in the city centre. The city centre clinics cater for 1,082 people which is less than a quarter of the overall Dublin figure.   85% of those availing of services in the Dublin city centre clinics are from the local area.

  The HSE has reviewed waiting lists for opioid substitution treatment over the past few years with a view to maximising the utilisation of existing services and developing new services where required. I support the provision of services in local communities but some concentration of services in Dublin city centre is needed in view of the number of clients from these areas, the fact that some people wish to avail of services outside their local area and the need to provide services for some people who have more complex needs. This approach is in line with that in many EU countries.

  HSE clinics, as well as a number of voluntary service providers, have "good neighbour" policies and protocols in place and a strong focus on inter-agency working. Some provide a range of outreach and drop-in services to encourage engagement with a view to moving more people into treatment. C.C.TV is used at some centres to monitor movements and as an aid towards deterring anti-social behaviour. Drug treatment centres also work closely with An Garda Síochána with the aim of minimising any potential problems.

HSE Expenditure

 168. Deputy Billy Kelleher Information on Billy Kelleher Zoom on Billy Kelleher asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the costs that have been incurred by the Health Service Executive in hiring motivational coaches to boost morale within its management; and if he will make a statement on the matter. [56000/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The HSE will be undergoing radical reform in the coming years. Strong leadership and management in the health service will be of crucial importance in order to deliver on reforms and changes of this scale. As a result, the HSE is implementing a Succession Management Programme in order to strengthen management capacity.

It is anticipated that most executive coaching requirements will be delivered by qualified HSE staff. However, some additional coaching capacity is required and the HSE has tendered for such services on a regional basis. As this tendering process a matter for the HSE in the first instance, I have referred the Deputy's question to the HSE for a more detailed response.

Primary Care Services Provision

 169. Deputy Billy Kelleher Information on Billy Kelleher Zoom on Billy Kelleher asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will provide, in tabular form, a breakdown of the way the €323 million reduction in the cost of primary care schemes will be achieved; and if he will make a statement on the matter. [56001/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White Due to the very difficult and challenging economic environment the Government has committed to achieving additional savings in health expenditure during 2013 and 2014 with €781m savings targeted in 2013. The Government is committed to achieving these savings while protecting front line services to the most vulnerable to the greatest extent possible. Reductions in the cost of Primary Care Schemes will contribute €323m towards this overall savings target, as set out in the following table:

  Primary Care Reimbursement Service

IPHA/APMI Agreement on Drug Price Reductions €120 million
Quality Prescribing Initiative €20 million
Reduce price of oral nutritional supplements €5 million
Reduce fees payable to health professionals €70 million
Increase prescription charges €51 million
Delisting products from GMS scheme €15 million
Changes in means test for medical cards €20 million
Replace medical cards with GP visit cards for persons over 70 with high incomes €12 million
Increase DPS threshold €10 million
Total Primary Care Schemes €323 million

Medical Aids and Appliances Applications

 170. Deputy Tom Fleming Information on Tom Fleming Zoom on Tom Fleming asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding orthotic shoes in respect of a person (details supplied) in County Kerry; and if she will expedite same. [56015/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch 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.

HSE Funding

 171. Deputy Seán Ó Fearghaíl Information on Seán Ó Fearghaíl Zoom on Seán Ó Fearghaíl asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will make recommendations for funding to be provided in respect of a facility (details supplied); and if he will make a statement on the matter. [56036/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White Coolmine Therapeutic Community receives funding from my Department and the HSE to provide a range of services, including a specific residential programme targeting women, many of whom are mothers. Reflecting the Government's ongoing commitment to the National Drugs Strategy, I have recently approved an additional €100,000 in funding to enable the facility to provide a creche service. This will allow mothers to keep their children with them during residential treatment and remove potential barriers for women who wish to access this service.

Medical Card Applications

 172. 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 when a decision will issue on a medical card application in respect of a person (details supplied) in County Cork; and if he will make a statement on the matter. [56055/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Medical Card Applications

 173. Deputy Robert Troy Information on Robert Troy Zoom on Robert Troy asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding a medical card in respect of a person (details supplied); and if he will make a statement on the matter. [56063/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Medical Card Appeals

 174. Deputy Robert Troy Information on Robert Troy Zoom on Robert Troy asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding a medical card rejection appeal in respect of a person (details supplied) [56064/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The Health Service Executive has been asked to examine this matter and to reply to the Deputy as soon as possible.

Hospital Waiting Lists

 175. Deputy Sean Fleming Information on Seán Fleming Zoom on Seán Fleming asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when a person (details supplied) in County Laois will get a hospital appointment; and if he will make a statement on the matter. [56070/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Should the patient's general practitioner consider that the patient's condition warrants an earlier appointment, he/she would be in the best position to take the matter up with the consultant and hospital involved. In relation to the specific query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.

Social Workers Register

 176. Deputy Éamon Ó Cuív Information on Éamon Ó Cuív Zoom on Éamon Ó Cuív asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the reason the proposed registration fee for social workers is €295 per annum when the equivalent registration fee for other similar professions is much lower, nurses €88 and teachers €65; and if he will make a statement on the matter. [56121/12]

 191. Deputy Willie Penrose Information on Willie Penrose Zoom on Willie Penrose asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the steps he will take to reduce the proposed annual registration for social workers from €295 to a more realistic level, which would be commensurate with registration fees which are levied and payable by professionals with similar qualifications; if same will be reviewed in this context; and if he will make a statement on the matter. [56182/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I propose to take Questions Nos. 176 and 191 together.

Under the provisions of the Health and Social Care Professionals Act 2005, there is a two-year transitional period from the date on which the register of the members of that profession is established, during which existing practitioners may apply for registration.

The Health and Social Care Professionals Council (the Council) is an independent statutory body and is responsible for setting the level of fees.

The Council has set the following fee structure:a registration fee of €100 for new graduates, who have obtained recognised professional qualifications within two years of applying for registration; an annual retention fee of €295 for registrants, including those who paid the lower rate on graduation, is payable on the annual renewal date.

All health regulators are self funding by way of annual fee income with operational costs being determined by the complexity and breadth of statutory functions specified in its legislation. The greater the registrant base the lower the annual fee charged. Given the enormous registrant base in teaching and nursing, for example, the annual fee charged amounts to less than €100 per annum. Health regulators are single profession regulators whereas the Council is charged with regulating twelve disparate professions, which can add significantly to operating costs. The twelve designated professions to be registered by the Council range in number from under 50 Clinical Biochemists to 5,550 Social Care Workers, which amounts to about 20,000 registrants in total across all professions. This is an extremely low registrant base when compared to a registrant base of well in excess of 60,000 for nurses.

The Council has extensive statutory functions under the 2005 Act, and considers the annual fee of €295 the minimum required to enable it to operate. The fee charged by the Council, which takes account of the requirement to become self funding by end 2015, is on a par with that charged by other health regulators and less than some in certain cases. The State is currently funding the Council in its establishment phase (€1.937 million in 2012) to offset the current shortfall in income from registration fees and will continue to do so on a reducing basis for the next 3 years.

In response to concerns about the level of fee, the Council has reviewed the regulatory structure to establish what scope exists for controlling registration fees and operational costs and has adopted the following measures:

- where an existing practitioner with the necessary experience and recognised professional qualifications, or equivalent, pays the registration fee of €295 and is granted registration during the transitional period, also known as grandparenting, the application fee will cover them for the remainder of the grandparenting period and one full year of retention of registration after expiration of grandparenting. This concession will only apply to existing practitioners availing of the transitional provisions set out in the Act;

- The Council has entered into discussions with the HSE in regard to the feasibility of arrangements for the deduction of the registration fee from monthly salary thereby spreading the cost throughout the year;

- Finally, the Council has proposed significant restructuring of the way in which the designated professions will be registered and regulated to provide a more cost effective operating system and keep costs to a minimum. This will require the enactment of primary legislation in due course.

Health Services Provision

 177. Deputy Patrick O'Donovan Information on Patrick O'Donovan Zoom on Patrick O'Donovan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the number of children in the mid west region that require access to a paediatric neurologist; if the Health Service Executive plans to appoint one; and if he will make a statement on the matter. [56144/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly In relation to the specific matter raised by the Deputy, as this is a service issue it has been referred to the HSE for direct reply.

Medical Card Eligibility

 178. Deputy Billy Kelleher Information on Billy Kelleher Zoom on Billy Kelleher asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if there will be any changes to the qualifying criteria in respect of medical cards for the under-70s in 2013; and if he will make a statement on the matter. [56148/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White It is intended to tighten the rules relating to a person’s income and spending that is taken into account when carrying out the means test for the medical card. A date has not been set for the implementation of these new rules. In advance of that, the Department will develop this proposal in more detail in consultation with the HSE. The new rules and the implementation date will be announced and publicised in advance by the Department and the HSE.

Medical Card Eligibility

 179. 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 in view of the announcement in budget 2013, if he will provide the full detail of the new criteria/thresholds to be applied to medical card applications in 2013; and if he will make a statement on the matter.  [56169/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White Changes to the income limits for medical card applicants over 70 years of age were announced in Budget 2013.

At present, people over 70 are entitled to a medical card if their income is less than €700 per week for a single person or €1,400 for a couple. In line with measures announced in the Budget, the income limits are being reduced to €600 a week for an individual and €1,200 a week for a couple. This will mean that a single person with an income under €600 per week or a couple with an income under €1,200 per week, will still qualify for a medical card. If a single person has an income of between €600 and €700 per week, or a couple has an income of between €1,200 and €1,400 per week, they will qualify for a GP visit card instead of a medical card.

It is estimated that these changes will affect about 20,000 persons out of 360,000 over-70's medical card holders. This is about 5% of the entire over 70's population. Under the new arrangements, it is envisaged that 92% of the over 70's will retain their medical cards. The implementation date will be announced at a later date in 2013.

In relation to medical card applicants under 70 years of age, it is intended to tighten the rules relating to a person’s income and spending that is taken into account when carrying out the means test for the medical card.

A date has not been set for the implementation of these new rules. In advance of that, the Department will develop this proposal in more detail in consultation with the HSE. The new rules and the implementation date will be announced and publicised in advance by the Department and the HSE.


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