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 Header Item Written Answers Nos 323-339
 Header Item Health Services Provision
 Header Item Hospital Charges
 Header Item Medical Card Applications
 Header Item HSE Expenditure
 Header Item Food Safety Standards Inspections
 Header Item Health Promotion Issues
 Header Item Health Services Charges
 Header Item Primary Care Services Provision
 Header Item Hospital Bed Data
 Header Item Hospital Complaints Procedures
 Header Item Health Services Staff Issues
 Header Item Services for People with Disabilities
 Header Item Health Services Staff Issues
 Header Item Ministerial Responsibilities

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 323-339

Health Services Provision

 323. 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 current provision of therapeutic apheresis services here; the role of the Irish Blood Transfusion Services in the delivery of same; if these services will continue to be provided by the IBTS in 2013; and if he will make a statement on the matter. [57634/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly A number of hospitals provide a Therapeutic Apheresis Service and the Irish Blood Transfusion Service (IBTS) provides an outreach service to a number of hospitals in Dublin and Cork. However, due to its inability to recruit or retain sufficient numbers of staff to meet service demands, the IBTS has informed the HSE that it will cease to provide this service in Dublin from 31 December 2012. All affected hospitals have also been informed and plans are underway in these hospitals for alternative provision of the service.

Hospital Charges

 324. 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 it is the case that, due to changes in section 53 and 72 of the Health Act 1970 as amended by the Health (Amendment) Act 2005, charges may be applied for inpatient services for people with disabilities, and that a maximum weekly charge of €175 applies; if this will be the case at a care facility (details supplied) in County Meath from January 2013; if he will confirm that this is a new charge and if he will outline all other services and facilities that will implement this charge from January 2013; and if he will make a statement on the matter. [57636/12]

 325. 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 when the health charges for inpatient services amendment regulations 2011 came into effect; if he will outline the extent of its implementation; the services and facilities to which it applies; if he will provide a breakdown of same by the Health Service Executive region and in tabular form; if its application will be extended in 2013 and details of same; and if he will make a statement on the matter. [57637/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I propose to take Questions Nos. 324 and 325 together.

Charges for long-stay in-patient services were provided for under the Health (Amendment) Act 2005 and came into effect on 15 July 2005 under the subsequent Health (Charges for In-Patient Services) Regulations 2005. These Regulations have been amended on a number of occasions since then, most recently by the Health (Charges for In-patient Services) (Amendment) Regulations 2011, which came into effect on 23 July 2011.

The Act provides that the maximum weekly charge cannot exceed 80% of the maximum rate of the weekly State Pension (non-contributory). The Regulations made under the Act provide for two different classes of charges:

- Class 1- charges for those receiving in-patient services on premises where 24 hour nursing care is provided are based on income (subject to a current maximum of €175 per week) and

- Class 2- charges for those receiving in-patient services on premises where 24 hour nursing care is not provided are based on income (subject to a current maximum of €130 per week).

The maximum charge applicable since July 2011 for Class 1 (€175.00) represents just under 80% of the weekly State Pension (non-contributory) while the maximum rate for Class 2 (€130.00) represents almost 60%. These charges are structured to ensure that those paying charges retain a minimum income for personal use i.e. at least €33 per week for those paying Class 1 rates and at least €64 per week for those paying Class 2 rates.

A person in receipt of Disability Allowance at the current maximum rate of €188 p.w. would be liable, subject to a financial assessment, to a maximum charge under Class 1 of €155 p.w. and under Class 2 of €120 p.w.

Section 53(4) of the Health Act 1970 provides that the HSE may reduce or waive a charge imposed on a person in order to avoid undue financial hardship to that person. To assist in the fair application of the provisions of the Act and the related Regulations, the HSE has developed national guidelines for the determination and levying of charges for in-patient services, which include the need to have regard to the income of the person, the provisions of the Regulations and the patient's individual circumstances.

Subject to exceptions specified in the Act, charges are applicable to the maintenance element of in-patient services provided to a person under section 52 of the Health Act 1970 for a period of over 30 consecutive days (or an aggregate period of over 30 days during the preceding 12 months). Among the exclusions from these charges are persons who are subject to the provisions of the Nursing Homes Support Scheme Act 2009 ("the Fair Deal") and those in acute hospitals who require medically acute care and treatment.

The facilities to which the charges apply include all hospitals, convalescent homes and homes for persons suffering from physical or mental disability in which the HSE delivers, or arranges for the delivery of, in-patient services. I understand that the HSE at present arranges for and funds the delivery of services, including long-stay residential in-patient services, to a number of individuals in the facility referred to in the question.

The HSE is required under the 2005 Act to levy the appropriate charges on individuals in receipt of in-patient services, subject to any relevant exemptions, waivers or reductions provided for in the Act and the Regulations. The funding derived from these charges is directly applied by the HSE towards the provision of health services. Provision of quality public long term care is expensive and it is fair and equitable that those in receipt of such care should pay towards its cost in accordance with their means.

There are no proposals to extend the application of the Act or related Regulations from January 2013.

Medical Card Applications

 326. Deputy Bernard J. Durkan Information on Bernard Durkan Zoom on Bernard Durkan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when a medical card will issue in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [57642/12]

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.

HSE Expenditure

 327. Deputy Dara Calleary Information on Dara Calleary Zoom on Dara Calleary asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will outline the amount the Health Service Executive paid for taxi services in County Donegal since the patient bus service between Letterkenny and Dublin was abolished in July 2012; and if he will make a statement on the matter. [57676/12]

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.

Food Safety Standards Inspections

 328. Deputy Heather Humphreys Information on Heather Humphreys Zoom on Heather Humphreys asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will confirm that poultry used in meals for hospitals is Bord Bia quality assured; and if he will make a statement on the matter. [57680/12]

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.

Health Promotion Issues

 329. 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 if he will investigate the regulating of the salt content in foods in view of the fact that medical experts say it would help reduce the number of high blood pressure fatalities; and if he will make a statement on the matter. [57684/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly High salt intake is implicated in the development of high blood pressure and in my Department’s National Cardiovascular Health Policy we have set a salt consumption target to reduce salt intake to the recommended 6 grams per day for adults by 2019.

  To help achieve this we are participating in the EU Salt Reduction Framework which focuses on the reformulation of everyday foods that are the key providers of salt in the Irish diet.

  The Food Safety Authority of Ireland have a salt reduction initiative in place since 2004 and have worked with major Irish food companies towards receiving the 16% reduction target recommended by the EU Framework.

Health Services Charges

 330. 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 measures he will take to prevent undue financial hardship on patients attending for vital medical treatment, in view of reports from the Irish Cancer Society; the assessment of ability to pay that is conducted and the waivers that apply; and if he will make a statement on the matter. [57695/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White Under the provisions of the Health Act 1970, eligibility for health services in Ireland is based primarily on residency and means.There are currently two categories of eligibility for all persons ordinarily resident in Ireland i.e. full eligibility (medical card) and limited eligibility (all others).Full eligibility is determined mainly by reference to income limits, and is granted to persons who, in the opinion of the Health Service Executive, are unable to provide general practitioner, medical and surgical services to themselves and their dependents without undue hardship.There is no automatic entitlement to a medical card for persons who have cancer.

There is a provision for discretion to grant a card in cases of "undue hardship" where the income guidelines are exceeded.The HSE recently set up a clinical panel to assist in the processing of applications for discretionary medical cards where there are difficult personal circumstances. There is an emergency process for a person who is terminally ill, or in urgent need of medical attention and cannot afford to pay for it, that provides a card within 24 hours while the normal application process is completed. Details of this procedure have been made available to all GPs and Social Workers. Such applications can be initiated through the Local Health office whose manager has access to a dedicated fax and e-mail contact line to the Primary Care Reimbursement Service (PCRS). Once the medical condition is verified by a GP or a consultant, and the required personal details are provided, an emergency card is issued to that person for a six-month period.

Primary Care Services Provision

 331. Deputy Róisín Shortall Information on Róisín Shortall Zoom on Róisín Shortall asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly his plans for the continuation of child psychology as a critical element of primary care services; if he will provide an assurance that the model of full multi-disciplinary teams including psychology will continue to be the model employed for primary care. [57697/12]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White There is a commitment in the Programme for Government to introducing a better and more efficient health system, a single-tier health service that will deliver equal access to care based on need, not income. The development of primary care services must be an essential component of the health service reform process. In a developed primary care system, up to 95 per cent of people’s day-to-day health and social care needs can be met in the primary care setting.

Fully developed Primary Care Teams give people direct access to integrated multi-disciplinary teams of general practitioners, nurses, physiotherapists, occupational therapists and others. There are currently 422 Primary Care Teams in place, albeit at varying stages of development. The intention is that Primary Care Teams will be supported by a wider range of professionals, including pharmacists, dieticians, psychologists and chiropodists who will form a Health and Social Care Network. No change to this model is anticipated.

Hospital Bed Data

 332. 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 number of cystic fibrosis beds available at St. Vincent's University Hospital, Dublin; if he will provide a detailed up to date report on the new cystic fibrosis unit at Cork University Hospital; and if he will make a statement on the matter. [57700/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly St Vincent's University Hospital (SVUH) is the designated National Adult Referral Centre for patients with Cystic Fibrosis (CF). The new Nutley Wing at the hospital, built at a cost of just under €29m and opened this summer, is designed to provide a state of the art clinical building which includes up to date isolation facilities with accommodation for people with cystic fibrosis. In the new unit 20 beds are set aside for patients with cystic fibrosis. Each bed is in a separate room with its own toilet and washing facilities. The 20 beds include 4 complete isolation rooms. The unit also provides a dedicated CF Day Unit, containing offices, treatment rooms, together with 10 single day treatment rooms, each with en-suite sanitary facilities for treating patients with cystic fibrosis.

  Under a protocol for the treatment of CF patients at SVUH, signed off in July 2012 with the hospital, the HSE, Department of Health and CFA, up to 34 isolation beds will be made available in the new wing.and the 10-bed day unit will be used effectively to help ensure that patients are treated in the optimum setting. Except in certain circumstances,   the additional 14 single inpatient rooms when required will be located in the Nutley Wing and these rooms will be grouped together as far as possible. 1-2 inpatient rooms in the Nutley Wing will be kept available at all times for emergency admissions. In circumstances where the emergency admission rooms have already been utilised and all the other inpatient rooms in the Nutley Wing are occupied, patients with CF will be accommodated elsewhere in clinically appropriate single rooms until such time as a room becomes available in the Nutley Wing and then the patient will be transferred there as a priority.

  CUH is one of six specialist centres providing services for patients with cystic fibrosis. The adult cystic fibrosis day centre at Cork University Hospital (CUH) is an ambulatory care facility for adults with cystic fibrosis in the Munster region. I am advised that this centre caters for the majority of clinical needs of CF patients and includes 5 isolation rooms, a dedicated CF gym, a multidisciplinary team room and consultant rooms. The capital costs for this build were supported by a partnership of the HSE South and Build4Life.

  With regard to in-patient services, I am advised that a location has been identified for a combined adult CF in-patient designated bed facility and respiratory unit on the CUH campus.   The hospital has established a working group to progress this facility and is working in partnership with the Build4Life organisation to co-fund this development. To date Build4Life have raised over €2m to support the development of adult inpatient cystic fibrosis facilities at CUH. The HSE South and CUH management are finalising plans for the inpatient facility within the available capital resources, and within the physical space currently available on the hospital campus to facilitate the unit. A Design Team has been appointed and preliminary drawings for the unit have been prepared. The need to develop the adult in-patient facility at CUH remains a priority proposal of the Executive Management Board at CUH and the HSE South, and the HSE will continue to work with Build4Life to complete this project

Hospital Complaints Procedures

 333. 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 consider the issues raised in correspondence (details supplied); if he will ensure that the hospitals involved address the concerns raised; and if he will make a statement on the matter. [57706/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly There is a formal complaints policy for issues concerning hospitals under the aegis of the Health Services Executive (HSE), as Tallaght Hospital is.   Details of this procedure are on the HSE website, at www.hse.ie/eng/services/ysys/Complaint. In addition, advice and instructions for making complaints about a service or an individual may be found at www.healthcomplaints.ie.

  From the details forwarded to me by the Deputy, it would seem that the first stage of this process in already underway in this case.

  Where an individual is not satisfied with the outcome of a complaint to a hospital and wishes to take the complaint further, they can ask for a review from the HSE’s Director of Advocacy or they may go to the Office of the Ombudsman.

  HSE Director of Advocacy

  Oak House

  Millennium Park

  Naas

  Co Kildare

  Tel 1890 424 555

  Office of the Ombudsman

  18, Lower Leeson Street

  Dublin 2

  Tel 1890 223 030

Email: ombudsman@ombudsman.gov.ie  

  I have no role to play in this complaints procedure.

  Issues relating to the Coroner and Coroner’s Court are a matter for the Department of Justice and Equality.

  I have forwarded the details of this request to the HSE which will be dealing with the matter under the appropriate procedure and will reply directly to the Deputy.

Health Services Staff Issues

 334. 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 direct the Health Service Executive to provide an appropriate work placement for a staff member recovering from a severe eating disorder and if he will consider the issues raised in correspondence (details supplied) [57707/12]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly As this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.

Services for People with Disabilities

 335. 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 decrease in funding provided for the disability sector in 2013 compared to 2012 in both financial terms and percentage terms; if this money will be ring-fenced by his Department for disability in its allocation to the Health Service Executive for 2012; if the HSE has any discretion to change this allocation and assign it to other health priorities; and if he will make a statement on the matter. [57721/12]

 337. 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 provision made in the estimates for 2013 for school leavers in the disability budget; and if he will make a statement on the matter. [57723/12]

 338. 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 if the Health Service Executive will in allocating funding to the disability sector be obliged to take into account the effects of cuts to date in each organisation; the efficiency measures already put in place by them; the differing ways the staff moratorium impacted on different organisations and the impact on service users; and if he will make a statement on the matter. [57729/12]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch I propose to take Questions Nos. 335, 337 and 338 together.

The funding situation for the disability sector in 2013 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 it is expected that these will be outlined when the Minister for Health approves the National Service Plan in the near future.

  In relation to the specific queries raised by the Deputy, as these are service issues they have been referred to the HSE for direct reply.

Health Services Staff Issues

 336. 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 projected reduction or increase in staff in the disability sector in 2013; and if he will make a statement on the matter. [57722/12]

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.

Following the publication of the Health Estimates on 5 December, the HSE's National Service Plan is in preparation. In accordance with the Act, the HSE's service plan will set out the type and volume of health and personal social services to be provided by the Executive in 2013. The plan will also set out the net employment reduction to be achieved for 2013. It is not possible at this stage to outline the effect of the required employment reduction on any particular service area.

  Questions Nos. 337 and 338 answered with Question No. 335.

Ministerial Responsibilities

 339. Deputy Timmy Dooley Information on Timmy Dooley Zoom on Timmy Dooley asked the Minister for Transport, Tourism and Sport Information on Leo Varadkar Zoom on Leo Varadkar his key priorities for 2013; and if he will make a statement on the matter. [57535/12]

Minister for Transport, Tourism and Sport (Deputy Leo Varadkar): Information on Leo Varadkar Zoom on Leo Varadkar I expect to finalise priorities for 2013 over the coming days in consultation with Ministers of State Kelly and Ring.  The priorities, which flow from the Programme for Government, the Department's Statement of Strategy 2011-2014 and Ministerial initiatives were considered by the Ministerial Management Board of the Department last week. As was the case for 2012, I will be publishing the new priorities on the Department's website early in the new year. I also yesterday published a report on my Departments website on the progress made on the 2012 priorities


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