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Written Answers Nos. 380-407Medical Card Eligibility 380. Deputy Sean Sherlock Minister for Health (Deputy Simon Harris): Nursing Home Services 381. Deputy Fergus O'Dowd Minister of State at the Department of Health (Deputy Helen McEntee): Nursing Homes Support Scheme Data 382. Deputy Fergus O'Dowd Minister of State at the Department of Health (Deputy Helen McEntee): Nursing Homes Support Scheme Administration 383. Deputy Fergus O'Dowd Minister of State at the Department of Health (Deputy Helen McEntee): The NHSS covers the cost of the standard components of long-term residential care which are: - Nursing and personal care appropriate to the level of care needs of the person; - Basic aids and appliances necessary to assist a person with the activities of daily living; and A person's eligibility for other schemes, such as the medical card scheme or the drugs payment scheme, is unaffected by participation in the NHSS or residence in a nursing home. Although the NHSS covers core living expenses, residents can still incur some costs in a nursing home, e.g. social programmes, newspapers or hairdressing. In recognition of this, anyone in receipt of financial support under the NHSS retains at least 20% of their income. The minimum amount that is retained is the equivalent of 20% of the State Pension (Non-Contributory). An operator should not seek payment from residents for items which are covered by the NHSS, the medical card or any other existing scheme. Part 7 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 stipulates that the registered provider of the nursing home must agree a contract in writing with each resident on their admission to the nursing home. This contract must include details of the services to be provided to that resident and the fees to be charged. Residents should never be charged fees which are not set out in the contract. The Department of Health and the HSE are not a party to such contracts which are concluded between each resident and their nursing home. Registered providers of nursing home care are obliged to provide an accessible and effective complaints procedure. Concerns about additional charges should in the first instance be taken up with the nursing home provider. The Office of the Ombudsman can examine complaints about the actions of a range of public bodies and, from 24 August 2015, complaints relating to the administrative actions of private nursing homes. The Office of the Ombudsman normally only deals with a complaint once the individual has already gone through the complaints procedure of the private nursing home concerned. Nursing Home Services 384. Deputy Fergus O'Dowd 386. Deputy Fergus O'Dowd Minister of State at the Department of Health (Deputy Helen McEntee): The Health Information and Quality Authority is the independent authority established under the Health Act 2007 to drive continuous improvement and to monitor safety and quality in Ireland's health and personal social care services. Since 2009 all nursing homes - public, voluntary, and private have been registered and inspected by HIQA. This responsibility is underpinned by a comprehensive framework, including the National Quality Standards for Residential Care Settings for Older People and the Health Act, 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations, 2013. The Regulations require that registered providers must ensure that the number and skill mix of staff is appropriate having regard to the assessed needs of the residents and the size and layout of the designated centre. In addition registered providers shall, in so far as is reasonably practical, ensure that a resident has access to independent advocacy services. It is the responsibility of HIQA to assess whether residential services are providing high quality, safe and effective services and supports to residents, and to ensure that any issues or deficits are addressed to the satisfaction of the Authority. HIQA’s programme of both scheduled and unannounced inspections is aimed at ensuring that standards are maintained and where issues of non-compliance arise, that these are addressed and rectified. If a nursing home is found not to be in compliance with the Regulations it may either fail to achieve or lose its registration status. HIQA also has wide discretion in deciding whether to impose conditions of registration on nursing homes Nursing Homes Support Scheme Review 385. Deputy Fergus O'Dowd Minister of State at the Department of Health (Deputy Helen McEntee): When the Scheme commenced in 2009, a commitment was made that it would be reviewed after three years. The report of the Review was published in July 2015. In advance of the Review, submissions were sought from groups or bodies who wished to make a contribution, including groups representative of the needs and views of older persons. An Interdepartmental/Agency Working Group has been established to progress the recommendations contained in the Review. This Group is chaired by the Department of Health and includes representatives from the Department of the Taoiseach, the Department of Public Expenditure and Reform, the HSE, the Revenue Commissioners and, when required, the National Treatment Purchase Fund. An initial report on progress was submitted to the Cabinet Committee on Health in September 2016. Once all of the relevant Review recommendations have been considered, any amendments required to the Scheme will be identified. Question No. 386 answered with Question No. 384. Health Services Staff 387. Deputy John McGuinness Minister for Health (Deputy Simon Harris): HSE Reports 388. Deputy John McGuinness Minister of State at the Department of Health (Deputy Finian McGrath): I conveyed this view to the HSE on 1 November 2016, asking them to re-examine the issues around the publication of the two reports and to give serious consideration to publishing both reports, appropriately redacted. This followed the review by Conor Dignam SC which recommended further engagement between the HSE and An Garda Síochána regarding publication. Following a meeting between senior officials of the HSE and An Garda Síochána, the HSE has confirmed that it intends to publish redacted versions of both reports before the end of February. Arrangements are being put in place by the HSE to ensure the contents of both reports are conveyed in a meaningful way to service users with varying degrees of disability. Given the potential impact of the reports on service users, their families and the employees of relevant agencies, a communications plan is also being developed by the HSE and dedicated teams are being put in place to provide all necessary assistance and supports to those impacted by the publication of both reports. I wish to reiterate that the Government, for its part, is fully committed to the earliest possible establishment of the Commission of Investigation into the matters addressed by the reports. In that regard work is ongoing to frame appropriate Terms of Reference which can deliver answers in a timely manner. The Government will be guided by legal advice to ensure that the Commission of Investigation can and will be established in a way which will enable it to do its work correctly and efficiently. Public Sector Staff Retirements 389. Deputy Niamh Smyth Minister for Health (Deputy Simon Harris): HIV-AIDS Programmes 390. Deputy Eamon Ryan Minister for Health (Deputy Simon Harris): One of the priority actions identified in the Action Plan for 2016 is to 'Prioritise, develop and implement guidance to support clinical decision making for STI testing, screening and treatment and on the appropriate use of antiretroviral therapy in HIV prevention’. An Implementation Group has now been established within the HSE as an outcome of this action. This group will make recommendations on the appropriate use of HIV pre-exposure prophylaxis (PrEP) in the overall context of the national approach to HIV prevention. A multi-sectoral PrEP working group with professional and community representation has been established by the HSE Sexual Health and Crisis Pregnancy programme to make recommendations on HIV PrEP in Ireland. The first meeting was held in May 2016. To inform the group’s work a report on population estimates of MSM (men who have sex with men) eligible and likely to avail of PrEP in Ireland using data from the MISI 2015 survey has been drafted and is at the consultation stage with a view to publication at the end of Quarter 1 2017. In response to a specific request from clinicians, practical guidance for health care professionals on caring for those accessing PrEP online was circulated by clinicians on the PrEP working group to the learned societies for specialists working in the area of HIV and STIs. Priority questions in relation to the feasibility, acceptability and uptake of HIV PrEP in Ireland have been identified and work has commenced work on identifying how these priority questions can be answered through a project within existing clinical infrastructures. The timeframe for commencement of such a project and the number of participants involved is not yet known. The report on attitudes and beliefs of STI and HIV health care workers on timing of antiretroviral therapy and PrEP is complete. The results have been used to draft a HSE statement on the use of antiretroviral therapy for individuals living with HIV. This draft will be presented to the HSE leadership team in early 2017. Occupational Therapy 391. Deputy Eamon Scanlon Minister for Health (Deputy Simon Harris): Occupational Therapy 392. Deputy Eamon Scanlon Minister for Health (Deputy Simon Harris): Health Services Staff Data 393. Deputy Eamon Scanlon Minister for Health (Deputy Simon Harris): Primary Care Reimbursement Service Payments 394. Deputy Billy Kelleher Minister for Health (Deputy Simon Harris): €10m of the €20m was provided for the implementation of the commitment in the Programme for a Partnership Government to extend medical cards to all children in receipt of the Domiciliary Care Allowance. The implementation of this DCA\Medical Card initiative will mean that all children in respect of whom a DCA payment is made will automatically qualify for a medical card and, therefore, no longer be subject to the medical card means test at any point in the future while in receipt of DCA. In the region of 10,000 children in respect of whom a DCA payment is made and who do not have a Medical Card will benefit under this measure. A further €10m was provided for a reduction in the prescription charge for over 70s medical card holders. The reduction, to €2 per item with a monthly cap of €20, down from €2.50 per item and €25 a month, will potentially benefit 330,000 medical card holders over 70. Legislation to facilitate these two initiatives is currently being drafted. Drugs Payment Scheme Administration 395. Deputy Shane Cassells Minister for Health (Deputy Simon Harris): Cancer Screening Programmes 396. Deputy Clare Daly Minister for Health (Deputy Simon Harris): Invasive cervical cancer is extremely rare in women aged under 25, with less than 5 women in this age group being diagnosed with this condition in Ireland each year. While changes in the cells of the cervix are very common for those under 25, in the vast majority of cases these changes will settle and return to normal without intervention. If the screening age was lowered to invite those under 25 for smear tests, young women could be subjected to unnecessary treatment that could have potential long-term negative effects on their health and fertility. My Department encourages all women aged under 25 to be vigilant about their health and to consult their GP immediately if they have any symptoms which would raise the suspicion of cervical cancer. If necessary, their GP will refer them to a gynaecology clinic for further investigation. Similarly it is recommended that any woman concerned about cervical cancer on the basis of family history should discuss this with their GP. My Department also encourages all 12-18 year old schoolgirls to avail of the free HPV vaccination which aims to protect against cervical cancer and which is offered in second level schools. Services for People with Disabilities 397. Deputy Margaret Murphy O'Mahony Minister of State at the Department of Health (Deputy Finian McGrath): Hospitals Data 398. Deputy Margaret Murphy O'Mahony Minister for Health (Deputy Simon Harris): Health and Social Care Professionals Regulation 399. Deputy Maureen O'Sullivan Minister for Health (Deputy Simon Harris): The regulation of a new profession under the Act involves a consultation process and the making of a number of statutory instruments by the Minister for Health and by the relevant registration board. My Department has engaged in a consultation process in which interested persons and organisations were invited to formally submit their views on how the statutory regulation of the profession(s) should proceed. A total of 84 submissions were received on foot of the consultation process which concluded on 30th November 2016. I am undertaking an examination of these submissions which will inform the approach to be adopted in progressing the statutory regulation of psychotherapists and counsellors. I envisage that the next steps in the statutory regulation of the profession(s) under the Act will commence in the coming months with the submission of draft designation regulations to the Houses of the Oireachtas. While the profession or professions of counsellor and psychotherapist are not currently designated under the 2005 Act, counsellors and psychotherapists are subject to legislation similar to other practitioners including consumer legislation, competition, contract and criminal law. There are also various regulatory controls on many counsellors and psychotherapists operating in Ireland. The profession of psychologist, for example, is a designated profession under the 2005 Act which means that those psychologists who are counsellors and/or psychotherapists will begin to be regulated when the Psychologists Registration Board, which is due to be established during this year, opens its register. Psychiatrists, some of whom practice psychotherapy, are regulated under the Medical Practitioners Act 2007. Also, counsellors/therapists working in the publicly funded health sector are required to have minimum qualifications set by the Health Service Executive under the Health Act 2004. Medicinal Products Availability 400. Deputy Louise O'Reilly Minister for Health (Deputy Simon Harris): Services for People with Disabilities 401. Deputy Louise O'Reilly Minister of State at the Department of Health (Deputy Finian McGrath): As the HSE is responsible for leading out on the recommendations on "Time to Move on from Congregated Settings - A Strategy for Community Inclusion", I have arranged for the Deputy's question to be referred to the HSE for direct reply to the Deputy. Accident and Emergency Departments Closures 402. Deputy Mattie McGrath Minister for Health (Deputy Simon Harris): Hospitals Data 403. Deputy David Cullinane Minister of State at the Department of Health (Deputy Helen McEntee): Hospital Appointments Status 404. Deputy John Curran Minister for Health (Deputy Simon Harris): The scheduling of appointments for patients is a matter for the hospital to which the patient has been referred. Should a patient's general practitioner consider that the patient's condition warrants an earlier appointment, he or she should take the matter up with the consultant and the hospital involved. In relation to the specific case raised, I have asked the HSE to respond to you directly. HSE Properties 405. Deputy Catherine Connolly 406. Deputy Catherine Connolly 407. Deputy Catherine Connolly Minister for Health (Deputy Simon Harris): |
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