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 Header Item Written Answers Nos. 277-284
 Header Item Medical Card Eligibility
 Header Item Home Care Packages
 Header Item Autism Support Services
 Header Item Medical Card Administration
 Header Item Hospital Services
 Header Item Hospital Procedures
 Header Item Disabilities Assessments
 Header Item Services for People with Disabilities

Wednesday, 4 July 2018

Dáil Éireann Debate
Vol. 971 No. 2

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Written Answers Nos. 277-284

Medical Card Eligibility

 277. Deputy Robert Troy Information on Robert Troy Zoom on Robert Troy asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if the medical card scheme will be extended to cover all long-term illnesses which require ongoing care and ensure patients with these illnesses have an automatic entitlement to a medical card; and if he will make a statement on the matter. [29503/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards on the basis of illness and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. The Expert Group also concluded that a person’s means should remain the main qualifier for a medical card. This position remains unchanged.

Medical card provision is based on financial assessment. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. The Act obliges the HSE to assess whether a person is unable, without due hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure and every application must be assessed on that basis. Under the legislation, having a particular illness, in itself, does not establish eligibility for a medical card and therefore, the medical conditions of applicants for this scheme are not monitored on that basis. Where the applicant's income is within the income guidelines, a medical card or GP visit card will be awarded.

Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. It should be noted, in certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds his or her income threshold, where he or she faces difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information documentation to fully take account of all the relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses.

Home Care Packages

 278. Deputy Robert Troy Information on Robert Troy Zoom on Robert Troy asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the improvements he plans in the home care system; his views on whether substantial investment in the system is required to supply the level of home care necessary; and if he will make a statement on the matter. [29505/18]

Minister of State at the Department of Health (Deputy Jim Daly): Information on Jim Daly Zoom on Jim Daly In advancement of the Government’s commitment to promote community-care so that people can continue to live independently in their own homes for as long as possible, the Department of Health is currently engaged in the development of a new, stand-alone statutory scheme and system of regulation for home-care services.

The new home-care scheme will introduce clear rules in relation to the services for which individuals are eligible and in relation to service-allocation. It will therefore be an important step in ensuring that the system operates in a consistent and fair manner and will help to improve access to home-care services on an affordable and sustainable basis. The introduction of a system of regulation for home-care will help to ensure public confidence in the services provided. The new scheme will also be designed to support family/unpaid carers and will complement and integrate effectively with other health and social-care services such as long-term residential care (including the Nursing Homes Support Scheme), primary and community services and hospital services.

The development of a statutory scheme for home-care is a complex process. A significant amount of preparatory work remains to be undertaken before decisions are reached on the form of the scheme and the system of regulation. This is required if reforms are to be successful, affordable and sustainable. Every effort is being made to advance this work as quickly as possible.

While the new home-care scheme is under development, the Department of Health and Health Service Executive are continuing efforts to improve existing home-care services. In 2018 the HSE brought the funding for Home Help and Home Care Packages together into a single Home Support Service for older people. As well as simplifying the application-process for home-care, the new service will be more responsive to service-users' changing needs. More broadly the HSE will continue to encourage local integration of services and to build appropriate care-pathways, in particular for people with complex needs. A consumer-directed approach to home-support provision will be introduced, giving service-users greater choice in relation to when they receive services and their selection of a service-provider.

In line with the commitment in A Programme for a Partnership Government (2016) to increase funding for home-care annually, funding for Older Persons’ Services rose from €763m in 2017 to €811m in 2018, including approximately €417m for the provision of home-support services. The HSE’s National Service Plan 2018 provides for a target of 17.094m home-support hours to be provided to 50,500 people, which compares with 16.34m hours delivered to 50,000 people in 2017. A further 156,000 hours, relating to adverse weather funding, will be provided in 2018. A target of 360,000 home-support hours for people with complex needs will be provided through 235 Intensive HCPs.

Despite this significant level of service-provision, the demand for home-support continues to grow. It is important to note that, although the funding for home-support across the system is significant, it is finite, restricting service-supply. At end of March 6,458 people were waiting for new or additional supports following assessment. All those waiting are provided with a service as soon as possible on the basis of their assessed needs, with priority given to those awaiting discharge from acute hospitals.

The Health Service Capacity Review 2018 outlines projections of demand and capacity requirements for a range of health services to 2031. Accordingly, it forecasts that a 120% increase in home-care services will be required by 2031 if key reforms and productivity measures are implemented.

Autism Support Services

 279. Deputy Brendan Smith Information on Brendan Smith Zoom on Brendan Smith asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the services publicly available for children with autism in an area (details supplied); and if he will make a statement on the matter. [29522/18]

Minister of State at the Department of Health (Deputy Finian McGrath): Information on Finian McGrath Zoom on Finian McGrath The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Medical Card Administration

 280. Deputy Caoimhghín Ó Caoláin Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the services covered by a full medical card that are not available free to holders of a 2015A scheme card; the reason a difference exists between both; and if he will make a statement on the matter. [29523/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The Redress for Women Resident in Certain Institutions Act 2015 (RWRCI Act) makes provision for a range of primary and community health services (and benefits) in Ireland for women who qualify under the Department of Justice & Equality Restorative Justice Scheme for women who were admitted to and worked in the Magdalene Laundries and similar institutions.

The RWRCI Act provides a statutory basis to grant a 2015A card to women who qualify under this Act. It therefore provides a statutory basis to more services than the medical card, e.g. physiotherapy, chiropody, counselling, home help. In addition, holders do not pay the prescription fee, have enhanced dental services and can attend a GP of choice, once that GP is registered. Furthermore, the ex-gratia payments awarded under the Department of Justice & Equality Restorative Justice Scheme are not included in the means assessment for a medical or GP visit card or the 'Fair Deal' scheme.

Hospital Services

 281. Deputy Fiona O'Loughlin Information on Fiona O'Loughlin Zoom on Fiona O'Loughlin asked the Minister for Health Information on Simon Harris Zoom on Simon Harris further to Parliamentary Question No. 740 of 12 June 2018, the reason convalescent care is not provided after an elective surgery; and if he will make a statement on the matter. [29524/18]

Minister of State at the Department of Health (Deputy Jim Daly): Information on Jim Daly Zoom on Jim Daly As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Hospital Procedures

 282. Deputy Fiona O'Loughlin Information on Fiona O'Loughlin Zoom on Fiona O'Loughlin asked the Minister for Health Information on Simon Harris Zoom on Simon Harris further to Parliamentary Question No. 740 of 12 June 2018, the reason the surgery is classed as an elective surgery when the person was told it was necessary for their health. [29525/18]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As this is a service matter, I have asked the Health Service Executive to respond to you directly, as soon as possible.

Disabilities Assessments

 283. Deputy Fiona O'Loughlin Information on Fiona O'Loughlin Zoom on Fiona O'Loughlin asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the length of time a person is waiting for an assessment with the NDT in County Kildare; the reason for delays in assessments; and if he will make a statement on the matter. [29526/18]

Minister of State at the Department of Health (Deputy Finian McGrath): Information on Finian McGrath Zoom on Finian McGrath The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Services for People with Disabilities

 284. Deputy Fiona O'Loughlin Information on Fiona O'Loughlin Zoom on Fiona O'Loughlin asked the Minister for Health Information on Simon Harris Zoom on Simon Harris further to Parliamentary Question No. 720 of 12 June 2018, the reason diagnoses have not been carried out within the recommended six-month period from referral. [29527/18]

Minister of State at the Department of Health (Deputy Finian McGrath): Information on Finian McGrath Zoom on Finian McGrath The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

As the Deputy's question relates to an individual case, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.


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