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 Header Item Written Answers Nos. 626-44
 Header Item Hospital Services
 Header Item Health Insurance Community Rating
 Header Item Health Insurance Cover
 Header Item Mental Health Services Provision
 Header Item Hospital Waiting Lists
 Header Item Disability Support Services Provision
 Header Item Primary Care Centres Provision
 Header Item Hospital Services
 Header Item Medical Card Eligibility
 Header Item Vaccination Programme
 Header Item Drugs Payment Scheme Threshold
 Header Item Friends of the Hospital Organisations
 Header Item Ministerial Staff
 Header Item Suicide Incidence
 Header Item Hospital Services
 Header Item Medical Card Eligibility

Tuesday, 22 January 2013

Dáil Éireann Debate
Vol. 789 No. 1

First Page Previous Page Page of 86 Next Page Last Page

Written Answers Nos. 626-44

Hospital Services

 626. Deputy Ciarán Lynch Information on Ciaran Lynch Zoom on Ciaran Lynch asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if funding allocated to the ophthalmology unit at Cork University Hospital has been reduced resulting in increased waiting lists; if he will confirm that the treatment programme for cataract removal has been restricted to two patients per week; and if he will make a statement on the matter. [2782/13]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The funding pressures now being experienced in the health services mean that the acute sector must reduce its costs in order to deliver the agreed level of activity within the resources available to it. This means that we must concentrate on maximising efficiency and getting the best possible services for patients from the budgets available to us. 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 Insurance Community Rating

 627. 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 actions he will take to protect the affordability of health insurance cover for the 16% of the market who currently have the lower level of cover; and if he will make a statement on the matter. [2783/13]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The Government is committed to keeping down the cost of health insurance so that it is affordable for as many people as possible and remains committed to protecting community rating, whereby everyone pays the same price for the same health insurance product, irrespective of age or health status. The Programme for Government contains a commitment to put a permanent scheme of risk equalisation in place, which is a key requirement for the existing private health insurance market and is designed to keep health insurance affordable for older persons and to maintain the stability of the market. The Health Insurance (Amendment) Act, 2012 gave effect to a new Risk Equalisation Scheme (RES) with effect from 1 January 2013. An effective and robust RES is required in the Irish private health insurance market in order to protect affordability for those who need it most.

Last year I announced the rates of risk equalisation credits to apply from 31 March 2013 under this Act. The rates are funded by a stamp duty payable by all insurers in respect of each insured person. The credit is provided at source – that is, the cost of the policy is reduced by the amount of the risk equalisation credit. The measures are designed to result in no overall increase of premiums paid in the market and to spread the risk more evenly between the healthy and the less healthy, as well as the old and the young. This action is in line with plans to move to Universal Health Insurance, under which everyone will be insured for health care.

I am concerned at the increasing cost of health care. Last year I established the Health Insurance Consultative Forum which comprises representatives from the country's main health insurance companies, the Health Insurance Authority (HIA) and the Department of Health. This Forum was established to generate ideas which would help address health insurance costs, whilst always respecting the requirements of competition law. The Forum will also give a voice to the insurers in the development of the new Universal Health Insurance model. I have also made it clear to the health insurers that I believe that significant savings can still be made, the effect of which can be to minimise the need for increases in premiums.

I would also strongly advise consumers to contact a number of health insurance companies to find the plan that best suits their needs. Consumers have a legal right to switch between or within insurers to get better value and to reduce their premium costs. The HIA provides information to consumers regarding their rights and also on health insurance plans and benefits. The HIA's website www.hia.ie has a useful plan comparison tool which assists in finding suitable and competitive health insurance plans.

In relation to the 16% of the insured population who currently have a lower level of cover, I am confident that when the new rates applicable under the Risk Equalisation come into effect on 31 March, there will continue to be a significant number of such policies available to consumers.

Health Insurance Cover

 628. 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 publish the list of advanced and non-advanced insurance cover which he referred to at the Oireachtas Health Committee on 27 November 2012; and if he will make a statement on the matter. [2784/13]

 668. 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, when introducing the Health Insurance (Amendment) Bill 2012, it was his intention that holders of lower level insurance cover such as plan A would not have the advanced cover levy applied to their policies; and if he will make a statement on the matter. [3105/13]

 669. 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 reason he has not ensured that the commitment he gave on 27 November 2012 to protect those who hold lower levels of health insurance cover such as plan A from the higher health insurance levy has not been met; and if he will make a statement on the matter. [3106/13]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I propose to take Questions Nos. 628, 668 and 669 together.

The Health Insurance (Amendment) Act 2012 was enacted last month. It delivers on the Government commitment to introduce a new Risk Equalisation Scheme from 1 January 2013. Under Section 11E of the Act, the Health Insurance Authority (HIA), as market regulator, is charged with evaluating and analysing all types of relevant contracts to be made available in the market. Where it is satisfied that a type of relevant contract does not provide for "advanced cover", the Authority shall specify by regulations, that the Authority is satisfied that this type of contract does not provide for such cover. After making such regulations, the Authority will enter the particulars of the relevant contract in the Register of Health Insurance Contracts.

Following consultation with the industry under the auspices of the Consultative Forum on Health Insurance, I introduced a number of amendments to the proposed Bill at Dáil Committee Stage. In order to allow the industry time to trade into the new Scheme, the legislation provided that the two stamp duty rates (and corresponding risk equalisation credits) would take effect from 31 March 2013. In addition, at the industry’s request, I made provision for an objective delineation between non-advanced and advanced cover. In relation to lower level products (providing cover mainly for public hospitals), in November last year, the HIA considered that there were 47 products that provided cover mainly in public hospitals. However, as then written, those products also provide some additional cover (e.g. full cover for some procedures or day case cover) which meant they did not comply with the definition of non-advanced cover.

The HIA had significant dialogue with all four health insurers in December 2012 in the run up to its determination at 1 January 2013 as to whether the products on sale at that time provided cover at advanced /non advanced level. These conversations included enquiries as to how it arrived at its decisions in December. I understand that the HIA has had further discussions with the industry and that it will continue to do so. Under the legislation a registered undertaking can: i, introduce new products at any time (subject to 30 days notice to the market regulator) or ii alter the benefits payable under an existing product (subject to 30 days notice, where the product has been available on the market for 60 days) with effect from 31 March in 2013 and 1 January of any subsequent year. By 31 March (when the split level of cover takes effect), the HIA expect a significant number of products will be at non-advanced level.

Mental Health Services Provision

 629. 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 reason Toghermore House, Tuam, County Galway, is closing; and if he will make a statement on the matter. [2786/13]

 630. 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 reason there has not been an independent review on the Fire safety Compliance Survey Report which was carried out on Toghermore House, Tuam, County Galway; and if he will make a statement on the matter. [2787/13]

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. 629 and 630 together.

  As this is a service matter these questions has been referred to the HSE for direct reply.

Hospital Waiting Lists

 631. Deputy Áine Collins Information on Áine Collins Zoom on Áine Collins asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the reason a person (details supplied) is still waiting for an urgent procedure after 18 months on the waiting list.  [2789/13]

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 matter it has been referred to the HSE for direct reply.

Disability Support Services Provision

 632. Deputy Patrick Nulty Information on Patrick Nulty Zoom on Patrick Nulty asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will ensure disability services will be provided to a child (details supplied) in Dublin 15; and if he will make a statement on the matter. [2796/13]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly This aims to increase the level of consistency and standardisation in the way both early intervention services and services for school-aged children with disabilities are delivered. A detailed action plan is being implemented with the following objectives: - One clear pathway to services for all children with disabilities according to need. - Resources used to the greatest benefit for all children and families. - Health and education working together to support children to achieve their potential.

The health and education sectors co-operate on a regular basis with a view to integrating their services for these children as much as possible and targeting them to areas of greatest need. At the same time there is a need to strengthen this co-operation and I am personally committed to this issue. I have established the Children, Adolescents and Young People with Complex Disabilities Unit in my Department led by a Principal Officer. This important development aims to foster greater collaboration between my Department, the Department of Education and Skills and the Department of Children and Youth Affairs on children’s disability issues including autism and to build on the cross-sectoral working arrangements that are already in place.

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.

Primary Care Centres Provision

 633. Deputy John Deasy Information on John Deasy Zoom on John Deasy asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will outline the process regarding the provision of new primary care centres; and if Dungarvan, County Waterford will be designated as one of the first ten centres to be put out to tender. [2842/13]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Progress is being made in the delivery of primary care centres. Primary care infrastructure is being delivered using three mechanisms which are - public private partnership - operational lease and - direct build.

With regard to the PPP process, the current position is that the HSE is engaging with the NDFA to progress the programme. The Executive is currently analysing the available sites in each location and engaging with the GPs in each location to determine their interest in participating in the primary care centre development. Also it has commenced the procurement of design teams and technical advisors to progress the designs and planning submissions and the preparation of the PPP procurement documents. Up to 20 of the 35 locations announced will be offered to the market subject to a) agreement between the local GPs and the HSE on active local GP involvement in the centres and b) site suitability and availability.

Using the operational lease mechanism the HSE has delivered primary care infrastructure at 30 locations and is continuing its collaboration with the private sector to progress suitable locations. The Capital Plan 2012-2016 - year 2012 has been approved and contains provision for the delivery of eight primary care centres. Work is underway on the Executive's multi-annual Capital Plan 2013-2017. My Department is reviewing the proposals and following up with the HSE where further details may be required. The draft Capital Plan 2013-2017 will require my approval with the consent of the Minister for Public Expenditure and Reform.

Hospital Services

 634. Deputy John Deasy Information on John Deasy Zoom on John Deasy asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when he will be publicising the Higgins Report into the reconfiguration of hospital groups; and if the South East Hospital Group will be fragmented or affected in any way. [2847/13]

 654. 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 the position regarding the planned hospital groupings with particular reference to a hospital (details supplied) in County Laois  [2978/13]

 655. 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 the position regarding the planned hospital groupings with particular reference to a hospital (details supplied) in County Westmeath; and if he will make a statement on the matter. [2979/13]

 656. 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 the position regarding the planned hospital groupings with particular reference to a hospital (details supplied) in County Offaly; and if he will make a statement on the matter. [2980/13]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I propose to take Questions Nos. 634 and 654 to 656, inclusive, together.

Recommendations on the formation of specific groups and arrangements for the management and governance of all groups have been drafted as part of a report on the establishment of hospital groups as a transition to hospital trusts. This report is based on a comprehensive consultation process, as well as a significant number of submissions from stakeholders and individual citizens. These recommendations have been considered and endorsed by a Strategic Board composed of representatives with national and international expertise in health service delivery, governance and linkages with academic institutions. The report on the establishment of hospital groups as a transition to independent hospital trust will be presented formally to me by the Chair of the Strategic Board, Professor John Higgins, in the near future. I will prioritise consideration of that report, which will then be submitted to and presented to Government for decision on the hospital groups composition in light of the recommendations of the Report.

Medical Card Eligibility

 635. Deputy John Deasy Information on John Deasy Zoom on John Deasy asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the percentage and number of people living in Waterford City and county who are in receipt of medical cards, general practitioner only cards, drugs refund scheme.  [2848/13]

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.

Vaccination Programme

 636. Deputy Derek Keating Information on Derek Keating Zoom on Derek Keating asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if, following on from his recent reply in relation to Narcolepsy, he will outline his plans to address the needs of the many cases that are now emerging; if his attention has been drawn to the fact that, in the Dublin Mid-West constituency alone, there are a significant number of chronic cases who are awaiting his report to assist them in addressing this crisis in which they find themselves; and if he will make a statement on the matter. [2860/13]

 671. Deputy Seán Kyne Information on Seán Kyne Zoom on Seán Kyne asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly further to Parliamentary Question No. 667 of 4 December 2012, the progress made on putting in place supports for those children and their families who developed narcolepsy as a result of side effects from the Pandermix vaccine which was administered to protect against the HINI virus; and if he will make a statement on the matter. [3112/13]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I propose to take Questions Nos. 636 and 671 together.

My priority is to ensure that children/adolescents affected by narcolepsy with symptom onset post pandemic vaccination are provided with services and supports to meet their health needs. The HSE and the Department of Education and Skills together provide a comprehensive range of services and supports to those affected. The Health Service Executive through its advocacy unit and regional co-ordinators assist individuals affected by narcolepsy following pandemic vaccination and family members of those so affected, in accessing appropriate services and supports. These supports and services include access to rapid diagnosis, clear treatment pathways, temporary medical cards and reimbursement of expenses incurred. This includes expenses for counselling services for individuals and also for families of children affected by narcolepsy following pandemic vaccination, in cases where such services are not already available through the HSE. Multi-disciplinary assessments which allow for the appropriate individualised health and educational supports to be put in place are ongoing. The National Educational Psychological Service (NEPS) is also engaging with the HSE and with the individual schools and parents of children concerned to identify and provide educational supports for the children and adolescents affected. My Department is considering other possible supports which may need to be put in place for those affected by Narcolepsy following pandemic vaccination.

Drugs Payment Scheme Threshold

 637. Deputy Robert Dowds Information on Robert Dowds Zoom on Robert Dowds asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will consider reviewing the age cut-off for dependents on the drugs payment scheme 23 years old to bring it into line with the cut-off for dependents on the medical card/general practitioner visit card scheme 25 years old; and if he will make a statement on the matter. [2875/13]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White Under the Medical Card Scheme, a person between the ages of 16 and 25 years, who is a dependant of a person who does not have a medical card, will only be provided with a medical card if the HSE assesses that it should be provided to avoid undue hardship to that person. This is set out in the Health Services (No 3) Regulations 1983 (S.I. No. 381 of 1983).

Under the Drugs Payment Scheme (DPS), an individual or family only has to pay €144 each month for approved prescribed drugs, medicines and certain appliances for use by that person or his or her family in that month. The definition of a family for this Scheme is an adult, their spouse, and any children under 18 years. Dependents over 18 years and under 23 years who are in full time education may also be included. There are no plans to review the DPS age limit.

Friends of the Hospital Organisations

 638. Deputy Robert Dowds Information on Robert Dowds Zoom on Robert Dowds asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will provide a list of all the hospitals which have a Friends of the Hospital organisation.  [2876/13]

 639. Deputy Robert Dowds Information on Robert Dowds Zoom on Robert Dowds asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the activities which are undertaken by Friends of the Hospital organisations. [2877/13]

 640. Deputy Robert Dowds Information on Robert Dowds Zoom on Robert Dowds asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if there is scope for Friends of the Hospital organisations to involve themselves in activities other than fundraising, such as visiting patients or providing activities for children, at present  [2878/13]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I propose to take Questions Nos. 638 to 640, inclusive, together.

  In relation to the particular queries raised by the Deputy regarding hospitals in Ireland which have a "Friends of the Hospital" organisation and their activities, as these are service matters, I have asked the Health Service Executive to respond directly to the Deputy in these matters. In relation to scope for these organisation to involve themselves in other patient services such as visiting patients or providing activities for children the Deputy may wish to contact the National Advocacy Unit in the HSE to explore this further. A key priority for the Advocacy Unit is to develop and support implementation of best practice models of customer care within the health service. The Deputy may be aware of the voluntary organisation, Children in Hospital Ireland (CHI) which receives funding support from the HSE. CHI has for many years has been directly working with children in hospital delivering a play, help and advocacy service to bring them fun and support. CHI uses its expertise to deliver unique daily and weekly play sessions that support child patients, parents and staff in 20 hospital wards and playrooms nationwide. The Deputy may also wish to contact CHI to explore the potential for Friends of the Hospital organisations to input to their work -CHI - .1890 25 26 82 , Email: info@childreninhospital.ie.

Ministerial Staff

 641. 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 number of immediate or extended family members employed by his Department; the names and remuneration in each case; and if he will make a statement on the matter. [2901/13]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly None of the advisors employed by me is a family member.

Suicide Incidence

 642. 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 his plans to compile information in relation to the number of persons who were in psychiatric units or hospitals and were subsequently released or discharged and committed suicide shortly thereafter; and if he will make a statement on the matter. [2912/13]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch The increasing number of deaths by suicide is of great concern to this Government. The challenge of suicide prevention is an urgent issue facing society and reducing the suicide rate is a priority. National mortality data including that relating to suicide is published by the Central Statistics Office (CSO). This data is made available on a quarterly and annual basis and is categorised by age, gender and county. A number of sources of information are used by the CSO to inform the classification of death including the Medical Cause of Death Certificate, the Coroner's certificate and Form 104, a statistical form which is completed by An Garda Síochána following an inquest. The information requested by the Deputy on the number of deaths by suicide of persons who are no longer in the care of the Mental Health Service is not compiled by the HSE.

Hospital Services

 643. 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 designated officer conveyed the recommendation to the National Director of Integrated Care and the Chief Executive of the Health Service Executive in relation to the report on the future of Abbeyleix District Hospital, St. Brigid's Hospital Shaen, Portlaoise; the position in relation to the future of these hospitals; and if he will make a statement on the matter. [2913/13]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch The Department has received recommendations from the Health Service Executive in relation to both facilities. The matter is now being considered by officials within the Department and a submission will be prepared for the Minister shortly.

Medical Card Eligibility

 644. 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 if a medical card will be reinstated to a person (details supplied) in County Kerry; and if he will make a statement on the matter. [2926/13]

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.


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