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 Header Item Written Answers Nos. 232-241
 Header Item Youth Services Data
 Header Item Family Support Services
 Header Item Inter-Country Adoptions
 Header Item Services for People with Disabilities
 Header Item Hospital Mortality Rates
 Header Item Hospital Mortality Rates Report
 Header Item Medical Card Applications
 Header Item Hospitals Funding
 Header Item National Treatment Purchase Fund

Thursday, 13 February 2014

Dáil Éireann Debate
Vol. 830 No. 3

First Page Previous Page Page of 77 Next Page Last Page

Written Answers Nos. 232-241

Youth Services Data

 232. Deputy Jonathan O'Brien Information on Jonathan O'Brien Zoom on Jonathan O'Brien asked the Minister for Children and Youth Affairs Information on Frances Fitzgerald Zoom on Frances Fitzgerald the number of youth workers employed by the Health Service Executive and their locations.  [7200/14]

Minister for Children and Youth Affairs (Deputy Frances Fitzgerald): Information on Frances Fitzgerald Zoom on Frances Fitzgerald There are no youth workers directly employed by the Child and Family Agency, TUSLA, formerly part of the Health Service Executive. The Social Work and Family Support workers employed by the Child & Family Agency work closely with their colleagues in all agencies to ensure that vulnerable young people fully engage in community youth services.

Family Support Services

 233. Deputy Jonathan O'Brien Information on Jonathan O'Brien Zoom on Jonathan O'Brien asked the Minister for Children and Youth Affairs Information on Frances Fitzgerald Zoom on Frances Fitzgerald the number of family support workers employed by the Health Service Executive and their locations.  [7201/14]

Minister for Children and Youth Affairs (Deputy Frances Fitzgerald): Information on Frances Fitzgerald Zoom on Frances Fitzgerald Family is the most important influence in a child's life. From birth, children depend on parents and family to protect them and provide for their needs. Sometimes parents need help, support and additional resources to do this. Family Support Services provide a flexible programme of interventions which are provided through a broad range of skilled personnel including Family Support Workers, Project Workers and Youth Workers. The 140.6 whole time equivalent Family Support Workers employed by the Child & Family Agency, TUSLA, are an important aspect of this multi-faceted service which supports parents, guardians and carers to sustain the care of their children within the home setting by engaging with them to meet their changing needs through the use of consultation, plans, reviews and feedback.

  The Child & Family Agency has identified as a priority objective for 2014 the development of a strategy for Family Support to complement the Department of Children & Youth Affairs National Policy Framework. This will address the alignment of the Family Resource Centres with the overall Agency approach to prevention and early intervention. This work will compromise a quality review of the implementation of family support processes in each area as well as the integration of Family Resource Centres within the Service Delivery Framework by the end of this year.

  I am pleased to set out below a breakdown of Family Support Workers in each location as requested.

AreaNumber
Carlow/Kilkenny/South Tipperary11.5
Cavan/Monaghan3
Cork3.53
Dublin City North21.73
Dublin North3.04
Dublin South Central10
Dublin South East/Wicklow12.42
Dublin South West/Kildare15.26
Galway/Roscommon1.33
Kerry1.02
Louth/Meath12.14
Mayo2.8
Midlands17.31
Mid West12.31
Waterford/Wexford13.21
Total140.6

Inter-Country Adoptions

 234. Deputy Thomas P. Broughan Information on Thomas P. Broughan Zoom on Thomas P. Broughan asked the Minister for Children and Youth Affairs Information on Frances Fitzgerald Zoom on Frances Fitzgerald if her attention has been drawn to a petition and submission from a group (details supplied) regarding inter-country adoption; and if she will make a statement on the matter.  [7293/14]

 235. Deputy Thomas P. Broughan Information on Thomas P. Broughan Zoom on Thomas P. Broughan asked the Minister for Children and Youth Affairs Information on Frances Fitzgerald Zoom on Frances Fitzgerald the current status of negotiations between Ireland and India to conclude a bilateral agreement on inter-country adoption.  [7294/14]

Minister for Children and Youth Affairs (Deputy Frances Fitzgerald): Information on Frances Fitzgerald Zoom on Frances Fitzgerald I propose to take Questions Nos. 234 and 235 together.

The Republic of India has ratified the Hague Convention on Protection of Children and Cooperation in Respect of Intercountry Adoption, as such it is not necessary to have a bilateral agreement with India. As a contracting state under the Hague Convention, the Adoption Act 2010 provides that adoptions by Irish prospective adoptive parents may be made subject to Irish and Indian requirements being satisfied in line with relevant laws and the provisions of the Hague Convention.

It is a matter for contacting states whether they wish to impose restrictions on whether and how intercountry adoptions of citizens of that State may be effected. In this regard, the Authority advises that there remains a general moratorium by the Indian Central Authority (CARA) on India accepting adoption applications from other countries other than in special circumstances. The Authority has recently received an announcement from CARA that India is currently accepting packs from non-resident Indian prospective adoptive parents for the adoption of Indian children (normal category). This means that India remains closed to non-Indian prospective adoptive parents at this time in respect of its normal categories of children. The Adoption Authority understands that CARA is accepting applications in respect of special needs children, which includes children over five years of age and sibling groups. The Authority is currently attempting to establish from CARA a possible time frame for the acceptance of application packs in the 'normal' category from non-Indian nationals.

The Adoption Authority has advised it is their position that it is necessary to have an Irish registered accredited body to facilitate intercountry adoptions from India in order to safeguard the process for the child and the adoptive parents. The Authority has two applications for India from Irish agencies which are being considered. Any accreditation being considered by the Authority can only apply to the Indian Special Needs Programme at this time. The accreditation of agencies to facilitate adoptions is solely a matter for the Adoption Authority under law. I have raised with the Adoption Authority the likely timescale of reaching conclusions on these applications and I understand it is intended to finalise the process promptly.

Furthermore, the Authority advises that it is the policy of CARA to impose the following age limits and age differentials. Again, they are a matter for the Indian authorities and are not specific to Ireland.

- To adopt a child in the age group of 0-3 years, the maximum composite age of the prospective adoptive parents should be 90 years wherein the individual age of the prospective adoptive parents should not be less than 25 years and not more than 50 years.

- To adopt children above three years of age, the maximum composite age of the

PAPs should be 105 years wherein the individual age of the PAPs should not be less than 25 years and not more than 55 years.

- In the case of a single applicant, he or she should not be less than 30 years of age and shall not be above the age of 50 years. The maximum age shall be 45 years to adopt children in the age group of 0-3 years and 50 years for adopting children above 3 years.

Updates in relation to intercountry adoption from India are posted on the Authority website when available (www.aai.gov.ie).

I have received a submission from this group in relation to intercountry adoption and arrangements for a meeting with this group are currently being finalised

Services for People with Disabilities

 236. 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 number of persons with an intellectual disability in residential day care and on respite waiting lists; and if he will make a statement on the matter. [6979/14]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch Specialist Disability services are provided by or on behalf of the HSE to enable children and adults with a disability to achieve their full potential and maximise independence, including living as independently as possible in the community. Disability services are provided in a variety of community and residential settings in partnership with service users, their families and carers and a range of statutory, non-statutory, voluntary and community groups. Voluntary agencies provide the majority of services in partnership with or on behalf of the Health Service Executive.

In planning for the delivery of intellectual disability services, the Health Service Executive (HSE) and disability service providers maintain the National Intellectual Disability Database (NIDD).

The NIDD provides a comprehensive database for decision-making in relation to the planning, funding and management of services for people with an intellectual disability. The 2012 Report of the NIDD forecasts the future residential, day care and respite requirements of people with an intellectual disability in the period 2013 to 2017 based on 2012 data. However, it is important to emphasise that the NIDD acts as a planning and forecasting tool and does not match individuals to the actual service they will require at the specific time it will be required. This will often depend on individual and family circumstances which will change over time.

The Report forecasts that in excess of 4500 additional residential, day and residential support/respite places will be needed to meet service requirements in the period 2013 – 2017. Of these 4500 individuals it is forecast that 197 will require a day service, 2054 will require a residential support or respite service and 2271 will require a full-time residential service.

In 2012, the 2271 individuals forecast as requiring a full-time residential service between 2013 and 2017 were in receipt of specialist disability services to meet their needs at that time. 99.4% of this group of 2271 were in receipt of a day service or a residential support service and 96.0% of the 2271 lived at home.

The HSE’s National Operational Plan for 2014 provides an additional €7m towards meeting the needs of approximately 1200 young people with a disability leaving secondary school or Rehabilitative Training. In addition, €3m has been allocated to provide emergency places for people whose care or family circumstances may have changed and who require an immediate response.

Hospital Mortality Rates

 237. Deputy Charles Flanagan Information on Charles Flanagan Zoom on Charles Flanagan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the number of perinatal deaths recorded at each maternity unit in the State each year for the past ten years.  [7202/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Information on perinatal deaths is not routinely published by individual maternity unit at a national level. In addition, as the Deputy may be aware, there are issues regarding differences between reporting systems. These issues are currently the subject of review in the context of the report which I have asked the Chief Medical Officer to prepare in relation to Portlaoise Hospital. When this report has been finalised, I will give a full account of its findings and recommendations in this area.

Hospital Mortality Rates Report

 238. Deputy Charles Flanagan Information on Charles Flanagan Zoom on Charles Flanagan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the number of Health Service Executive reviews carried out at maternity units in the State in respect of perinatal or infant hospital deaths each year for the past ten years.  [7204/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The Health Service Executive's Risk and Incident Investigation Process provides a framework for conducting investigations into serious incidents. Investigations of serious incidents including baby deaths have been conducted under the Process with support provided by the Executive's National Incident Management Team as appropriate. The Department does not receive information on HSE investigations as a matter of course.

The Chief Medical Officer (CMO) of my Department is currently preparing a report for me on the issues at Portlaoise. I have assured the families concerned that the process will be transparent, that they will be involved and will have the opportunity to see the report in advance of the release. The findings of the CMO's report will inform any subsequent work to be undertaken by HIQA or others including any wider review.

Medical Card Applications

 239. 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 expedite a medical card application in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [7218/14]

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.

The Health Service Executive operates the General Medical Services scheme, which includes medical cards and GP visit cards, under the Health Act 1970, as amended. It has established a dedicated contact service for members of the Oireachtas specifically for queries relating to medical cards and GP visit cards, which the Deputy may wish to use for an earlier response. Contact information has issued to Oireachtas members.

Hospitals Funding

 240. 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 figures on the amount of public money provided to St. Vincent's Private Hospital, including the salaries of staff who may be working in the public and private hospitals; if the State pays for treatment in the private hospital; if any State grant money is going toward the hospital, or any other public money; and, if so, the purpose for which it is being given.  [7227/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I am advised that St Vincent’s University Hospital and St Vincent’s Private Hospital financially trade as two separate entities on the campus of St Vincent’s Healthcare Group. The HSE has a Service Level Agreement (SLA) in place with St Vincent's University Hospital against which public funds are provided to the hospital for the provision of health services. This SLA is monitored by the HSE to ensure compliance. The HSE has no role in relation to the management or financing of St Vincent's Private Hospital.

In relation to the specific queries raised by the Deputy, I have asked the Health Service Executive to respond to him directly.

National Treatment Purchase Fund

 241. Deputy Mary Mitchell O'Connor Information on Mary Mitchell O'Connor Zoom on Mary Mitchell O'Connor asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if it is his policy that the National Treatment Purchase Fund ask nursing homes that are not charging for social programmes to so charge and to give the discount to the NTPF; and if he will make a statement on the matter.  [7232/14]

 243. Deputy Mary Mitchell O'Connor Information on Mary Mitchell O'Connor Zoom on Mary Mitchell O'Connor asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the way the National Treatment Purchase Fund defines a local area and the local average rate; if he will supply a copy of the NTPF policy document on the said definition; and if he will make a statement on the matter.  [7236/14]

 244. Deputy Mary Mitchell O'Connor Information on Mary Mitchell O'Connor Zoom on Mary Mitchell O'Connor asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will provide full details on the National Treatment Purchase Fund policy not to prepay for future events or take account of future capital expenditure or the future impact of Health Information and Quality Authority standards; and if he will make a statement on the matter.  [7238/14]

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. 241, 243 and 244 together.

  In order to be an "approved nursing home" for the purposes of the Nursing Homes Support Scheme, all private and voluntary nursing homes must negotiate and agree a price for the cost of care with the National Treatment Purchase Fund (NTPF). This is a necessary feature of the Scheme due to the commitment by the State to meet the full balance of the cost of care over and above a person's contribution. The NTPF has statutory independence in the performance of this function and, in carrying it out, it must ensure value for money for both the individual and the State. The NTPF negotiates with each nursing home individually and may examine the records and accounts of nursing homes as part of the process.

  The NTPF assesses nursing home process under four criteria:

  - costs reasonably and prudently incurred by the nursing home and evidence of value for money;

  - price(s) previously charged;

  - local market price; and

  - Budgetary constraints and the obligation on the State to use available resources in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the public.

  Under the Nursing Homes Support Scheme, services and supports which are common to the vast majority of nursing home residents are included in the cost of care. These are:

  - nursing and personal care appropriate to the level of care needs of the person;

  - bed and board;

  - basic aids and appliances necessary to assist a person with the activities of daily living; and

  - laundry service.

  Goods and services that are already available to individuals under an existing scheme are not included in the goods and services covered by the Nursing Homes Support Scheme. A person's eligibility for other schemes, such as the Medical Card Scheme or the Drugs Payment Scheme, is unaffected by the Nursing Homes Support Scheme.

  Part 8 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009 stipulates that the registered provider of the nursing home must agree a contract with each resident within one month of their admission. This contract must include details of the services to be provided to that resident and the fees to be charged. Residents should not be charged fees which are not set out in the contract.

  The Deputy will be aware that the Nursing Homes Support Scheme is currently the subject of a review. The terms of reference for this review are as follows:

  Taking account of Government policy, demographic trends and the fiscal situation:

  - To examine the on-going sustainability of the Nursing Homes Support Scheme,

  - To examine the overall cost of long term residential care in public and private nursing homes and the effectiveness of the current methods of negotiating/setting prices,

  - Having regard to 1 and 2 above, to consider the balance of funding between long-term residential care and community based services,

  - To consider the extension of the scheme to community based services and to other sectors (Disability and Mental Health), and

  - To make recommendations for the future operation and management of the Scheme.


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