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 Header Item Written Answers Nos. 307-322
 Header Item General Medical Services Scheme Administration
 Header Item Alcohol Pricing
 Header Item Hospital Staff Issues
 Header Item Health Services Provision
 Header Item HSE Funding
 Header Item Medical Card Appeals
 Header Item Health Services Provision
 Header Item Health and Safety Regulations
 Header Item Medical Card Delays
 Header Item Misuse of Drugs
 Header Item Health Services Provision
 Header Item Medical Records
 Header Item Hospital Services
 Header Item Nursing Home Services

Thursday, 20 December 2012

Dáil Éireann Debate
Vol. 787 No. 5

First Page Previous Page Page of 76 Next Page Last Page

Written Answers Nos. 307-322

General Medical Services Scheme Administration

 307. 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 if he plans to bring forward proposals to standardise the cost structure for blood tests in respect of those patients on general practitioner visit and medical cards; and if he will make a statement on the matter. [57558/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White Section 11 of the General Medical Services (GMS) GP Capitation Contract, which was introduced in 1989, provides that the medical practitioner shall provide for eligible persons, on behalf of the Health rvice Executive (HSE), all proper and necessary treatment of a kind usually undertaken by a general practitioner (GP) and not requiring special skill or experience of a degree or kind which GPs cannot reasonably be expected to possess.

GPs who hold GMS contracts with the HSE must not seek or accept money from medical card or GP visit card holders for services covered under the GMS contract. In circumstances where the taking of blood is necessary to either: (a) assist in the process of diagnosing a patient; or (b) monitor a diagnosed condition the GP may not charge the patient if they are eligible for free GMS services.

The Programme for Government provides for the introduction of a new GMS GP contract with an increased emphasis on the management of chronic conditions, such as diabetes and cardiovascular conditions. It is envisaged that the new contract, when finalised, will focus on prevention and will include a requirement for GPs to provide care as part of integrated multidisciplinary Primary Care Teams. Officials in the Department are in consultation with the HSE with a view to drawing up a new contract. The appropriate arrangements in relation to phlebotomy services and other such services will be considered as part of the new contract.

Alcohol Pricing

 308. 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 when the alcohol pricing proposals relating to the sale of alcohol at below cost prices will be brought before Dáil Éireann; and if he will make a statement on the matter. [57559/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Real and tangible proposals are currently being finalized on foot of the recommendations in the Substance Misuse report. I intend to submit these proposals to the Government for consideration and approval as soon as possible. These proposals cover all of the areas mentioned in the report, including: legislation on minimum unit pricing which is about setting a statutory floor price per gram of alcohol; access and availability of alcohol - including of course structural separation in retail units where alcohol is sold; and advertising and sponsorship.

My officials and I are in continuing discussions with the Departments of Justice & Equality; Transport, Tourism & Sport; Communications, Energy & Natural Resources; Arts, Heritage & Gaeltacht Affairs; and Agriculture, Marine & Food on various aspects of the proposals. I therefore expect to make progress on this important area early in the new year when the proposals will be brought to Government. In the meantime, work by my officials on developing a framework for the necessary Department of Health legislation governing, among others, minimum unit pricing, is continuing.

For example, in conjunction with Northern Ireland, a health impact assessment is being commissioned as part of the process of developing a legislative basis for minimum unit pricing. The health impact assessment will study the impact of different minimum prices on a range of areas such as health, crime and likely economic impact.

Hospital Staff Issues

 309. 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 a urologist for Temple Street Hospital, Dublin (details supplied) [57568/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The Children's University Hospital, Temple Street is the national tertiary care centre for Spina Bifida and hydrocephalus. All infants born in Ireland with Spina Bifida are transferred to Temple Street after birth for ongoing neonatal management.

A multi-disciplinary Spina Bifida clinic was established in Temple Street in February 2011. A recruitment process was underway in 2009/2010 from which the Hospital hoped to recruit a urologist, but unfortunately that recruitment process found no suitable candidate for the post. However, approval has been given by the HSE to recruit a Consultant Urologist and it is hoped that this post will be advertised before year end. The HSE are hopeful that this new recruitment process will succeed in hiring a suitable candidate.

Children requiring urgent urological input are prioritised clinically and seen in the UK under the Treatment Abroad Scheme. Where patients have been refused under the Treatment Abroad Scheme, the hospital is currently in final negotiations with St Georges Hospital in London with a view to having the hospital treat these children, pending the appointment of a permanent urologist. Arrangements are currently being made to have a consultant visit from the UK to cover clinical priorities here. This Government is acutely aware of the challenges that patients with Spina bifida and their families face in managing their condition. I am committed to providing the best possible health service and will continue to work with the HSE to ensure the best possible outcomes for these patients.

Health Services Provision

 310. 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 he will review the lack of services and supports relative to the care of a person (details supplied) in County Kilkenny; if the staff/client ratio at the centre is adequate; if the clients needs and activity programme are all being met; if some nurses have acquired a class D licence as committed to in Health Service Executive correspondence of 18 May 2012; and if he will make a statement on the matter. [57571/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch As this is a service matter the question has been referred to the HSE for direct reply.

HSE Funding

 311. 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 position regarding funding in respect of an organisation (details supplied) in County Kerry; and if he will make a statement on the matter. [57573/12]

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.

Medical Card Appeals

 312. 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 a review of a medical card application will be carried out in respect of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [57574/12]

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.

Health Services Provision

 313. 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 the steps he is taking to integrate access to and use of blood results both in primary care and acute hospitals; the estimated saving of such a system; and if he will make a statement on the matter. [57578/12]

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

Health and Safety Regulations

 314. 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 the position regarding the regulation for sunbed use here; the regulations in place at present and the plans for reform; and if he will make a statement on the matter. [57579/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The Deputy will be aware that there is growing evidence over recent years that sunbed use, especially by children, should be restricted because of the associated increased risk of skin cancer and other health problems.

  Currently, there are no statutory regulations governing sunbed use. There are, however, regulations governing the product safety aspects of sunbed appliances which are enforced by the National Consumer Agency.

  The Government has given its approval to the drafting of the Public Health (Sunbeds) Bill by the Office of the Attorney General. It is proposed to prohibit sunbed use by persons under 18 years of age and to promote a greater public awareness across all age groups of the dangers of developing skin cancer, premature ageing and eye damage from exposure to ultraviolet radiation (UVR). Key provisions proposed for inclusion in the Bill are:

  (i) a prohibition on operators of sunbed premises from allowing anyone under 18 years of age to use a sunbed on their premises;

  (ii) a prohibition on the sale to or hire of sunbeds to anyone under 18 years of age;

  (iii) an exemption for medical treatment to be provided;

  (iv) a prohibition on the use of sunbeds in unsupervised commercial premises;

  (v) control on the remote sale or hire of sunbeds (internet transactions);

  (vi) a requirement that sunbed operators provide training for staff;

  (vii) an enforcement regime and the imposition of penalties for non-compliance;

  (viii) an obligation on all sunbed operators to provide protective eyewear;

  (ix) a requirement that warning signs be displayed in all sunbed premises;

  (x) a prohibition on promotional marketing practices; and

  (xi) a requirement on operators to ensure that sunbed users are made fully aware of the potential dangers of sunbed use.

  My Department is currently working with the Office of the Attorney General on this legislation. The Bill, when drafted, will need to be notified to the EU Commission under the Technical Standards Directive prior to its publication.

Medical Card Delays

 315. 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 the current processing time for medical cards and appeals; the number of persons in each county in receipt of a medical card and general practitioner card, respectively; and if he will make a statement on the matter. [57581/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The current processing time for medical cards applications and appeals is 96.05% within 15 days as at 3rd December 2012.

  I have referred the remaining elements of the Deputy's question to the HSE for direct reply to the Deputy.

Misuse of Drugs

 316. 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 when he expects the misuse of drugs legislation to be updated to tackle the street sale of Benzodiazepines; and if he will make a statement on the matter. [57582/12]

 317. 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 the current cost of Benzodiazepines prescribing to the GMS system; the steps being taken to address over prescribing; the estimated cost to the GMS system of over prescribing; and if he will make a statement on the matter. [57583/12]

 319. 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 further to Parliamentary Question No. 146 of 21 September 2012, if he will furnish the data promised; if he will provide current figures; and if he will make a statement on the matter. [57590/12]

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. 316, 317 and 319 together.

Benzodiazepines, as a group of medicines, are commonly used to treat anxiety, sleep disturbance and insomnia. Benzodiazepines are known to be associated with dependence and withdrawal symptoms and consequently are primarily recommended for short-term treatment only. There is increasing evidence of the inappropriate use of benzodiazepines in Ireland.

The 'Z drugs' are a group of medicines (zopiclone, zolpidem and zaleplon) which are used to treat insomnia. They have a shorter duration of action than benzodiazepines. However, there are increasing reports of dependence and misuse of these substances also.

Overuse of benzodiazepines is an international issue and not specific to Ireland. The International Narcotics Control Board 2009 statistics show that Europe has the highest average consumption of benzodiazepines internationally. In its 2009 Report the INCB noted that it has observed a growing international problem of abuse of prescription medicines, including opiates, benzodiazepines and codeine.

My Department is reviewing the Misuse of Drugs Regulations with a view to, amongst other issues, introducing additional controls on certain prescription drugs being traded illicitly, including benzodiazepine medicines.

My Department has consulted with key stakeholders in relation to the proposed amendments, which include introducing import and export controls as well as an offence of possession, thereby assisting the law enforcement roles of Customs and of the Garda Siochána. It is anticipated that new legislation will be introduced in early 2013. The Health Service Executive is responsible for the administration of the GMS scheme and the cost of benzodiazepine prescribing within that scheme. The HSE has therefore been asked to examine this matter and I will revert to the Deputy as soon as possible with this information.

Health Services Provision

 318. 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 the number of specific stroke units within the health system; the incidence of stroke; the number of rehabilitative consultants employed here; and if he will make a statement on the matter. [57586/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The HSE National Clinical Care Programmes provide a national, strategic and co-ordinated approach to a wide range of clinical services. They have three main objectives – to improve the quality of care, to improve access and to improve cost-effectiveness. The primary aim is to modernise the way hospital services are provided across a wide range of clinical areas. This is being done through standardising access to and delivery of high quality, safe and efficient hospital services, and maximising linkages to primary care and other community services. Currently there are a number of Clinical Care Programmes in different stages of development/implementation including a Stroke Programme.

  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.

  Question No. 319 answered with Question No. 316.

Medical Records

 320. 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 if the medical records of a person (details supplied) in County Laois regarding all their treatment in Portlaoise General Hospital will be made available to them; and if he will make a statement on the matter. [57608/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly It is not possible to comment on the release of specific records. Each case must be dealt with individually and each officer making a decision whether to release, not release or partially release records must make the decision based on the specific record set and specific relevant circumstances.

  In general, the Freedom of Information Acts 1997 and 2003 enable an individual to request access to records held by a public body as named in the schedule to the legislation. Access may be granted subject to conditions set out in the legislation. For personal records, as this case would seem to involve, there is no fee for an individual seeking access to their own records, although there may be administrative charges. In the case of medical records, an individual requesting access to their medical records may be asked to nominate a health professional to whom the records will be released in the first instance. This nominated individual should have the expertise to interpret and explain the records to the requester.

  Similarly, the Data Protection Acts, 1988 and 2003 provide for access to personal information, again subject to conditions in the legislation. This legislation, however, concerns itself more with protection of data and the length of time that data can be held.

  An individual record holder, in this case Portlaoise General Hospital, is responsible for the maintenance of its own records and for decisions in relation to release, non-release or partial release of those records. In all cases, reasons for a decision not to release or to partially release must accompany the decision.

  In 2007, the HSE published a National Code of Practice for Healthcare Records Management, providing guidelines for hospitals in relation to the management of their healthcare records. This code of practice can be accessed on line at:http://www.hse.ie/eng/services/Publications/services/Hospitals/NHO_Code_of_Practice_for_Healthcare_Records_Management_Version_2_0.pdf.

  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.

Hospital Services

 321. Deputy Brendan Smith Information on Brendan Smith Zoom on Brendan Smith asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding the proposal to provide a Medical Assessment Unit at Monaghan General Hospital; and if he will make a statement on the matter. [57628/12]

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

Nursing Home Services

 322. Deputy Brendan Griffin Information on Brendan Griffin Zoom on Brendan Griffin asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the efforts he has made, since his meeting in Dingle, County Kerry, with representatives of Valentia Community Hospital last February, to help ensure the bodies affecting its future would work to help secure its future; the effort he is willing to make at this juncture; his views on whether it would be useful for the Health Service Executive, National Treatment Purchase Fund and his Department to meet collectively with representatives of the hospital; if he will encourage such a meeting; and if he will make a statement on the matter. [57632/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch Officials from the Department of Health met with representatives from both the National Treatment Purchase Fund (NTPF) and the HSE on the 21st March to discuss the issue of nursing homes, including Valentia Hospital, which received funding for long-term residential care services under Section 39 of the Health Act 2004 prior to the commencement of the Nursing Homes Support Scheme.

As the Deputy is aware, the outcome of this meeting was that the NTPF undertook to tender for a forensic accounting service to support it in its role of negotiating prices with private and voluntary nursing homes under Section 40 of the Nursing Homes Support Scheme Act 2009. This would include an assignment to provide factual input to an NTPF review of section 39 nursing homes, including Valentia Hospital.

Following the appointment of the forensic accountants, a review of the section 39 nursing homes was carried out. I understand that, in the case of Valentia Hospital, the NTPF offered an increase to the rate following the review. This offer was rejected, however, I understand that the NTPF remains open to negotiations with Valentia Hospital.

With regard to the question of a meeting between the Department, the HSE, the NTPF and Valentia Hospital, I do not consider that this would be appropriate. The NTPF is independent in the performance of its function under Section 40 of the Nursing Homes Support Scheme Act 2009 and, in carrying it out, must ensure value for money for both nursing home residents and the State.


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