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 Header Item Written Answers Nos. 252-261
 Header Item National Lottery Funding Disbursement
 Header Item Dental Services Provision
 Header Item Hospital Waiting Lists
 Header Item Hospitals Building Programme
 Header Item Hospital Staff Recruitment
 Header Item Hospital Appointments Administration
 Header Item Health Insurance Cover
 Header Item Health Services Funding

Thursday, 13 February 2014

Dáil Éireann Debate
Vol. 830 No. 3

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Written Answers Nos. 252-261

National Lottery Funding Disbursement

 252. Deputy Eoghan Murphy Information on Eoghan Murphy Zoom on Eoghan Murphy asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will provide a breakdown of funding in respect of an organisation (details supplied).  [7312/14]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch The Department of Health provided Lottery funding of €6,000 to the Galway branch of this organisation in 2010, and Lottery funding of €34,000 to the organisation in Waterford in 2012.

  Having regard to any payments issued by the HSE the Deputy's question has been referred to the Executive for direct reply.

  Question No. 253 answered with Question No. 26.

Dental Services Provision

 254. Deputy Paul J. Connaughton Information on Paul Connaughton Zoom on Paul Connaughton asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the dental treatment available to a person (details supplied) in County Galway in view of the fact that there is currently no dentist available in Portiuncula Hospital, Ballinasloe, County Galway; the provisions that are in place for children in County Galway who have medical cards and who require treatment; and if he will make a statement on the matter. [7325/14]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The HSE is responsible for providing dental care to schoolchildren. The matter has therefore been referred to the HSE for attention and direct reply to the Deputy.

Hospital Waiting Lists

 255. Deputy Denis Naughten Information on Denis Naughten Zoom on Denis Naughten asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the steps he is taking to address the two year wait to see a cardiology consultant at Temple Street University Children's Hospital, Dublin; and if he will make a statement on the matter.  [7355/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The target as set out in the HSE National Service Plan 2014 is that no-one should be waiting longer than 12 months for a first-time outpatient appointment. The HSE has advised that Children's University Hospital Temple Street was 96% compliant with this target at the end of 2013. As paediatric cardiology waiting times were not in compliance with the target, the HSE has advised that measures are being put in place to address the matter. These include an extra weekly combined clinic between Children's University Hospital Temple Street and Our Lady's Children's Hospital Crumlin, scheduled on Saturdays and commencing this month. I understand that all patients are currently being advised of the new clinic service and an earlier appointment date. In addition, training of existing paediatricians to undertake screening is to be progressed this year. In the region of 85% of patients are discharged after a first visit, and screening will enable these patients to be seen and discharged in a shorter timeframe.

Hospitals Building Programme

 256. Deputy Clare Daly Information on Clare Daly Zoom on Clare Daly asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will direct the Health Service Executive to organise a public briefing for the community in Portrane and Donabate and elected public representatives with regard to the redevelopment plans currently on display by Fingal County Council relating to the redevelopment of lands at St. Ita's Hospital in Portrane.  [7363/14]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch Replacing the Central Mental Hospital (CMH), Dundrum with an appropriate modern facility is one of the priority health projects set out in the Infrastructure and Capital Investment 2012-2016: Medium Term Exchequer Framework. This Government's policy on mental health incorporates the recommendations of A Vision for Change, including delivery of new facilities for the National Forensic Mental Health Service (NFMHS) in replacement of the CMH.

  The first phase of this project involves provision of a new 120 bed Adult Forensic Hospital at St. Ita's, Portrane, together with a 10 bed Forensic Child and Adolescent Unit, and a 10 bed Forensic Mental Health Intellectual Disability Unit on the same site.

  Project and Design Teams have been appointed. The project, which is progressing satisfactorily, is being delivered by the HSE which is working closely with Fingal County Council. As the particular issue raised by the Deputy is a detailed service matter, the question has been referred to the Executive for direct reply.

  Question No. 257 withdrawn.

Hospital Staff Recruitment

 258. 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 when a urologist will be appointed to Temple Street hospital, Dublin; and if he will make a statement on the matter.  [7368/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly In relation to the particular query raised by the Deputy, as this is a service matter, I have asked the Health Service Executive to respond to her directly.

Hospital Appointments Administration

 259. 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 cataract treatment in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [7370/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly  The National Waiting List Management Policy, A standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, January 2013, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the Health Service Executive, sets out the processes that hospitals are to implement to manage waiting lists.

   In relation to this particular query raised by the Deputy, I have asked the HSE to respond directly to the Deputy in this matter.

Health Insurance Cover

 260. 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 the extent to which private health insurance increases continue to be monitored by his Department with a view to ensuring that all insurers carry a fair and equitable share of the demographic profile; and if he will make a statement on the matter. [7372/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The main legislative provisions for the regulation of the Irish private health insurance market are included in the Health Insurance Acts 1994 to 2013 and Regulations made under those Acts. Under this legislation, my Department oversees the maintenance of a competitive and sustainable private health insurance market and monitors developments on an ongoing basis.

  There is a significant disparity in the membership age profile among the four commercial insurers operating in the market. VHI Healthcare continues to have a much greater proportion of members in the age groups 60-69 and above when compared to other insurers. Insurers with more older customers have higher claims costs. For example, in 2012:

- VHI had market share of 56% but had claims of 67% of the total claims paid in the market.

- Laya had 22% market share but had 14% of total claims paid in the market.

- Aviva had 17% market share and 13% of total claims paid.

  Given the disparities in claims costs, mostly related to age and health status, between competitors operating in the health insurance market, there is a need to support community rating with a robust risk equalisation scheme, to create a level playing field in the market. The aim of risk equalisation is to look at the market as a whole, and to distribute fairly the differences that arise in insurers’ costs due to the differing health status of all of their customers. It does so by providing risk equalisation credits (based on age, gender and level of cover) in respect of insured people aged 50 years and over. Without such support, health insurers have a strong financial incentive to ‘segment’ the market by offering policies targeted at younger, healthier people.

  The Health Insurance (Amendment) Act, 2013 sets out revised risk equalisation credits and the corresponding stamp duties that will apply under the Risk Equalisation Scheme from 1 March 2014. These revised RE credits will further level the playing field within the market, by making older members less costly to insure. The Scheme supports competition by encouraging insurers to move their focus away from avoiding older, less healthy customers and is intended to support the Government’s efforts to maintain community rating in the Irish health insurance market.

Health Services Funding

 261. 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 the extent to which he expects to be in a position to meet in full the total cost of providing the health services as outlined within budget 2014; and if he will make a statement on the matter.  [7373/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly This is a time of undoubted challenge for the Irish health system as a consequence of the emergency financial situation the State has had to address over recent years. Along with significant and sustained financial pressure on the health system and reductions in health and social care funding and workforce numbers, the health services have also had to respond to significant demographic pressures, with the population of the State increasing by 8% and the proportion of persons aged 65 and over growing by one fifth since 2008.

Undoubtedly, therefore, 2014 is a challenge, perhaps the most challenging year so far. The 2014 HSE Service Plan, in setting out the health and social care services to be provided during the course of this year, outlines a comprehensive response to these challenges. The preparation of a Service Plan that complies with the Budget ceiling set for Health spending this year has been made possible as a consequence of the Government’s Revised Estimates Volume adjustment, providing an additional €47 million in funding for health services this year, the ‘probity’ target reduction from €133 million to €23 million, and the further process that has been put in place regarding €108 million in pay savings. These factors considerably changed the landscape within which the HSE prepared and adopted its 2014 Service Plan and enabled the HSE to submit a Service Plan, later approved by me, that the Director General considers can deliver both significant health reform and benefits to the general public throughout this coming year.

The delivery of this years’ Service Plan will focus on the dual challenge of protecting patient outcomes while, at the same time, reducing costs. This requires, inter alia, increasing emphasis on models of care that treat patients at the lowest level of complexity and provide safe quality services at the least possible cost. I have every confidence that, despite the unavoidable resource reductions already referred to, the HSE will again, throughout 2014, manage, to a very significant extent, to maintain core services while also supporting growing demand for services arising from population growth, increased levels of chronic disease, increased demand for drugs, higher numbers of medical card holders (up by 590,000 since 2008) and new costly medical technologies and treatments.

The HSE has management systems in place to monitor service delivery throughout the course of the year. Should any unexpected contingencies arise the HSE is well positioned to identify such contingencies and to promptly take any necessary remedial actions without undue delay.


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