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 Header Item Written Answers Nos. 180-193
 Header Item Services for People with Disabilities
 Header Item Nursing Homes Support Scheme Applications
 Header Item HSE Planning
 Header Item Universal Health Insurance Provision
 Header Item Medical Card Drugs
 Header Item Home Help Service Redundancies
 Header Item Mental Health Services Report
 Header Item Primary Care Services Provision
 Header Item Medicinal Products Expenditure
 Header Item General Practitioner Services
 Header Item HSE Staffing
 Header Item Hospital Procedures
 Header Item Capital Expenditure Programme Issues

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. 180-193

Services for People with Disabilities

 180. 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 funding allocation to the disability sector for 2013; if an impact assessment has been carried out on these cuts; and if he will make a statement on the matter.  [56170/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch The funding situation for the disability sector is not yet available pending the finalisation of the HSE's National Service Plan for 2013. Savings required globally from the Health Budget will have an impact on all services, including disability services, and these will be outlined later this month when the Minister for Health approves the National Service Plan.

Nursing Homes Support Scheme Applications

 181. 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 changes to the funding of nursing home care/fair deal; the way this will affect individual service users; and if he will make a statement on the matter.  [56171/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch There were two changes to the Nursing Homes Support Scheme announced in Budget 2013. Firstly, the asset contribution will be increased from 5% to 7.5% per annum. This will be capped at three years, or 22.5%, in the case of the principal private residence. This change will apply to both new and existing nursing home residents. However, for existing residents, it should be noted that, in the case of the principal private residence, the higher percentage will only apply for the time remaining of the three year cap. In the case of all other assets, it will apply for as long as the person remains in receipt of financial support under the Scheme.

Secondly, the entitlement for State support to be backdated to the 27th October 2009 for people who were in nursing home care prior to the Scheme commencing will be abolished.

  It is important to note that the legislation underpinning the Scheme must be amended before these measures can be implemented. Therefore, an effective date will be announced in 2013.

  Finally, the review of the Nursing Homes Support Scheme will proceed as planned. A considerable amount of preparatory work for the review has already been completed. It will progress within the constraints of available staff and other priorities. It is envisaged that the review will be completed in 2013.

HSE Planning

 182. 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 expects to receive the Health Service Executive National Service Plan 2013; and if he will make a statement on the matter. [56172/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The Health Act 2004 states that within 21 days after the publication by Government of the Estimates, the Health Service Executive shall prepare a service plan and submit it to me for my approval.

The Service Plan, to be submitted before Christmas, will set out the level and type of health services to be provided in 2013. It will include plans for delivering on the Programme for Government commitments in mental health and primary care. In accordance with the Act I am required to lay a copy of the plan before both Houses of the Oireachtas within 21 days of approving it. However, it is my intention to do so as soon as is reasonably possible, after I have approved it.

Universal Health Insurance Provision

 183. 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 received the Higgins Report; the date on which he will publish it; and if he will make a statement on the matter. [56173/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly A key stepping stone towards the introduction of Universal Health Insurance will be to develop independent not-for-profit hospital trusts in which all hospitals will function as part of integrated groups. The rationale behind the establishment of hospital groups and trusts is to support increased operational autonomy and accountability for hospital services in a way that will drive service reforms and provide the maximum possible benefit to patients. Reform across the three domains of access, quality and resources is not achievable unless there is real clinical and managerial accountability at hospital level.

The work on hospital groups is not about downgrading hospitals. It is about the bringing together groups of hospitals to form single cohesive entities to allow maximum flexibility in management, budgets and service delivery. Hospital groups will be established on an administrative basis pending the legislation required to set up hospital trusts by 2014. Before those trusts are established the make-up and functioning of the Groups will be reviewed and if changes prove necessary then they will be made with Government approval when the hospital trusts are being formed.

Last June I appointed Professor John Higgins to chair a Strategic Board on the Establishment of Hospital Groups. The Strategic Board is composed of representatives with both national and international expertise in health service delivery, governance and linkages with academic institutions. A Project Team was established to make recommendations to the Strategic Board on the composition of hospital groups, governance arrangements, management frameworks and linkages to academic institutions.

The Project Team is currently finalising a Report on the recommendations outlined above, taking account of the observations and comments made by the Strategic Board at their meeting on 14th November. It is anticipated that this work will be completed within the next few days. Upon completion, the finalised Report will be submitted to me and I will then bring it to Cabinet. The composition of Hospital groups will be a Government decision, taking into account the recommendations of that Report.

Medical Card Drugs

 184. 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 the number of medical card recipients aged over 70 years who will have their full cards replaced with general practitioner only cards; and if he will make a statement on the matter. [56174/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White It is estimated that the changes referred to by the Deputy will affect about 20,000 persons out of 360,000 over-70s medical card holders. This is about 5% of the entire over 70s population. Under the new arrangements, it is envisaged that 92% of the over 70's will retain their medical cards.

Home Help Service Redundancies

 185. 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 if he will provide detail of the home help/home care package budget for 2013; the estimated number of home help hours funded; and the way these figures compare to 2012 and 2011 [56175/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch Protecting the vulnerable, including supporting older people to remain at home and in their communities for as long as possible, is a priority for this Government. The issues raised by the Deputy in relation to the 2012 out-turn position, and home care provision for 2013, are being considered at present in the context of finalising the HSE Service plan for next year. The position on the questions raised will be reflected in the forthcoming Service Plan, which will be published in the near future.

In relation to 2011, the HSE provided just over 11 million Home Help hours with funding of €211m. In that year, over 10,900 people were in receipt of a Home Care Package at any one time, with total annual funding of €138m for this enhanced care provision.

Mental Health Services Report

 186. 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 the ring fenced €35m for mental health was spent in 2012; the way the 2013 allocation will be spent; and if he will make a statement on the matter. [56176/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch Funding from the €35 million special provision for mental health in 2012 was allocated for measures primarily to further strengthen Community Mental Health Teams in both Adult and Children’s mental health services, to advance activities in the area of suicide prevention, to initiate the provision of psychological and counselling services in primary care, specifically for people with mental health problems and to facilitate the re-location of mental health service users from institutional care to more independent living arrangements in their communities, in line with A Vision for Change.

  414 posts were approved to implement the €35 million package of special measures for mental health. To date 17 posts have been filled and over 270 offers of employment have already been accepted and the appointments are proceeding. Most start dates are expected to commence this month.

  The provisional outturn for mental health services has, like many other areas, been running ahead of budget and the end of year excess in this area will be met from the unexpended portion of the €35 million. It is not possible to say yet exactly how much of the €35 million will be spent on mental health services by the end of this financial year. Budget 2013 provides a further €35 million for the continued development of our mental health services and I will be engaging fully with the Health Service Executive to ensure that the developments to be put in place for this additional funding are reflected in the National Service Plan for 2013.

Primary Care Services Provision

 187. 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 the ring fenced €20 million for primary care was spent in 2012; the way the 2013 allocation will be spent; and if he will make a statement on the matter. [56177/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White 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. The time-related savings associated with the non recruitment of the posts in 2012 was used by the HSE to defray expenditure in other primary and community care areas.

Medicinal Products Expenditure

 188. 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 his plans regarding illness oriented prescribing; and if he will make a statement on the matter. [56178/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The HSE has established a clinician-led Medicines Management Programme (MMP), the aim of which is to ensure that all people have access to the essential medicines they need, that the medicines are safe, effective, and are prescribed and used rationally.

The MMP will be led out by the National Medicines Information Centre (NMIC) and the National Centre for Pharmacoeconomics (NCPE) and will work closely with the HSE’s Primary Care Reimbursement Service. The MMP team will include people with prescribing database analytical expertise and prescribing advisors.

An important task of the MMP will be the focus on cost-effective prescribing and the reduction in drug expenditure through more rational prescribing. Proposed initiatives in this regard will include the identification of preferred medicines (or medicines of first choice) in high cost areas such as Proton Pump Inhibitors (PPIs) and statins as these two groups account for approximately 20% of all expenditure under the GMS scheme. Generic prescribing will also be promoted as it is generally accepted as the most cost-effective prescribing.

General Practitioner Services

 189. 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 proposed implementation of free general practitioner care; when the necessary legislation will be introduced; and if he will make a statement on the matter. [56180/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The Programme for Government commits to reforming the current public health system by introducing Universal Health Insurance with equal access to care for all. As part of this, the Government is committed to introducing, on a phased basis, GP care without fees within its first term of office. Primary legislation is required to give effect to Government commitment to introduce a universal GP service without fees.

Legislation to allow the Minister for Health to make regulations to extend access to GP services without fees to persons with prescribed illnesses is currently being drafted by the Office of the Attorney General and the Department and it will be published shortly. Implementation dates and application details will be announced in due course.

An additional amount of €15 million was provided in Budget 2013 for the roll out of GP care without fees.

HSE Staffing

 190. 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 if he will provide details of the proposed staffing reduction in the Health Service Executive in 2013 in terms of total number, staff grade, location, and so on; the way that this reduction will be achieved; the timeline and cost saving of same; and if he will make a statement on the matter. [56181/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The Government has decided that the numbers employed across the public service must be reduced to 282,500 by the end of 2014 in order to meet its fiscal and budgetary targets. The health sector must make a proportionate contribution to the achievement of this reduction.

The Health Estimates published on 5 December are based on an expected reduction in 2013 of approximately 3,200 wholetime equivalents. The final staffing ceiling will be confirmed by the Minister for Public Expenditure and Reform.

  Question No. 191 answered with Question No. 176.

Hospital Procedures

 192. Deputy John McGuinness Information on John McGuinness Zoom on John McGuinness asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if an early date for a hip operation will be arranged at Cappagh Hospital, Dublin, in the case of a person (details supplied) in County Kilkenny; the action he is taking to reduce the six to nine month waiting list; and if he will make a statement on the matter. [56189/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The management of inpatient and daycase waiting lists for patients awaiting public health care is based on the principle that after urgent and cancer patients are treated, then clinically assessed routine patients should be seen in chronological order (i.e. longest waiter first).

  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.

Capital Expenditure Programme Issues

 193. Deputy Seán Ó Fearghaíl Information on Seán Ó Fearghaíl Zoom on Seán Ó Fearghaíl asked the Minister for Transport, Tourism and Sport Information on Leo Varadkar Zoom on Leo Varadkar if he will provide an update on the €17 billion Capital Programme for 2012 - 2013; the funds that have been spent in this respect thus far; and if he will make a statement on the matter.  [56040/12]

Minister for Transport, Tourism and Sport (Deputy Leo Varadkar): Information on Leo Varadkar Zoom on Leo Varadkar The Infrastructure and Capital Investment 2012-2016 Medium Term Exchequer Framework set out a gross capital allocation of €17 billion of which my Department has an allocation of €4.6 billion.  The 2012 allocation of €1,231 million for my Department was subsequently increased in the Revised Estimate for 2012 to €1,245 million.  Following a supplementary estimate in November 2012, the capital allocation for 2012 was reduced to €1,214 million.  €803 million has been spent to end November 2012 and it is anticipated that all funding will be spent.

Investment in capital infrastructure will be scaled back significantly over the next five years.  Specifically, capital expenditure confirmed for my Department in 2013 will fall by €314 million to €900 million.


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