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 Header Item Written Answers Nos. 1092-1109
 Header Item Hospital Staff Recruitment
 Header Item EU Directives
 Header Item Regulatory Bodies
 Header Item Drug Rehabilitation Clinics
 Header Item Vaccination Programme
 Header Item Hospitals Capital Programme
 Header Item Hospitals Building Programme
 Header Item Hospital Staff
 Header Item Audiology Services Provision
 Header Item Health Services
 Header Item Medical Card Administration
 Header Item National Stroke Programme

Tuesday, 25 March 2014

Dáil Éireann Debate
Vol. 835 No. 1

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Written Answers Nos. 1092-1109

  Question No. 1092 answered with Question No. 1090.

Hospital Staff Recruitment

 1093. 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 when the vacant geriatrician post will be filled at Portiuncula Hospital Ballinasloe; the date on which the post became vacant; when approval to fill the post was sought and sanctioned; the reason for the delay in filling the post; and if he will make a statement on the matter. [13518/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly As this is a service matter, I have asked the HSE to respond directly to the Deputy.

EU Directives

 1094. Deputy Róisín Shortall Information on Róisín Shortall Zoom on Róisín Shortall asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when the cross-border healthcare directive will become operational; the statutory requirements required to give effect to this directive; the projected budgetary implication of this directive over each of the next three years; and if he will make a statement on the matter. [13551/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The Directive on Patients' Rights in Cross Border Healthcare provides rules for the reimbursement to patients of the cost of receiving treatment abroad, where the patient would be entitled to such treatment in their home Member State (Member State of Affiliation) and supplements the rights that patients already have at EU level through the legislation on the coordination of social security schemes (regulation 883/04). The Directive seeks to ensure a clear and transparent framework for the provision of cross-border healthcare within the EU, for those occasions where the care patients seek is provided in another Member State rather than in their home country. However, it should be emphasised that the vast majority of EU patients receive healthcare in their own country and prefer to do so. The Department of Health is continuing to work on the necessary statutory provisions to fully implement the Directive and will have them in place as soon as possible. Nevertheless, there are arrangements in place in respect of the key provision of the Directive in relation to a national contact point (NCP), which has been set up within the HSE and will administer the information and reimbursement aspects of the Directive. The principal function of the NCP is to facilitate exchange of information for patients concerning their rights and entitlements relating to receiving healthcare in another Member State, in particular the terms and conditions for reimbursement of cost, the procedures for accessing and determining those entitlements. The NCP also has a responsibility to ensure that all enquirers are informed of the rights, if any, that they may have through the legislation on the coordination of social security schemes (regulation 883/04) and which may be more beneficial to them. The NCP will be able to inform patients what the cost of their treatments would be in Ireland to allow them make a comparison with the costs they are being quoted for comparable treatment in another Member State.

The Directive allows Irish residents to avail of health care in other EU member states that they would be entitled to within the public health system in Ireland, and which is not contrary to Irish legislation. The costs must be born by the individual and he/she then seeks reimbursement for the cost of the healthcare upon return to Ireland. Costs will only be reimbursed up to the level that would have been arisen if the health care had been provided in Ireland or the actual cost of the healthcare in the other member state, whichever is the lesser. Where the medical treatment being sought is not available in Ireland, patients may, as at present, apply for the Treatment Abroad Scheme operated by the HSE under EU Regulation 883/04.

Regarding the financial implications of the Directive it has not been possible to estimate with a degree of certainty the financial implications of this Directive at a national level. What can be said is that the majority of patients are expected to choose to be treated in their own member state, for family support, language, cultural and financial reasons (the patient pays the costs of the healthcare under the Directive to his\her provider in their preferred member state and only receives reimbursement on completion of the treatment). Any estimation is made more difficult in that the experience of cross border health care to date has been limited to that provided to patients under EU Regulation 883/2004, in the form of the Treatment Abroad Scheme (TAB), and that with the Directive, there will now be two potential routes for patients to receive planned healthcare in another Member State. My Department and the HSE will be monitoring the number and cost of reimbursements under these two routes over the next year.

  Questions Nos. 1095 and 1096 answered with Question No. 1035.

Regulatory Bodies

 1097. Deputy Seán Crowe Information on Seán Crowe Zoom on Seán Crowe asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly his views on a matter concerning a person (details supplied) in Dublin 24; if recommendations from the Medical Council were acted upon; if reports sought and obtained in respect of this case were destroyed, altered or fabricated; and if he will make a statement on the matter. [13562/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I understand from the Medical Council that this case is still under consideration and as such I am unable to comment on this matter.

Drug Rehabilitation Clinics

 1098. Deputy Seán Crowe Information on Seán Crowe Zoom on Seán Crowe asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the timescale for the roll out of the ENDRIC-ECASS system in task force and community based drug rehabilitation projects.  [13563/14]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White I understand that the Deputy is referring to ICT systems for case management under the National Drug Rehabilitation Framework. As the HSE is the lead agency for the rollout of the Framework nationally, I have referred the question to the HSE for direct reply.

  Question No. 1099 answered with Question No. 1035.

Vaccination Programme

 1100. 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 for the lengthy delay in NIAC coming to a decision on whether to recommend the vaccine for Meningitis B for a national programme; and if he will make a statement on the matter. [13566/14]

 1101. 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 acceptable length of time for the NIAC to make a decision; the circumstances would he consider bypassing the NIAC process; and if he will make a statement on the matter. [13567/14]

 1102. 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, in view of recent cases of Meningitis B in counties Cavan and Westmeath he will consider making a direct decision regarding the introduction of the Meningitis B vaccine as he did with the vaccine for HPV; and if he will make a statement on the matter. [13568/14]

 1157. Deputy Jerry Buttimer Information on Jerry Buttimer Zoom on Jerry Buttimer asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will take into account the fact that Ireland has the highest prevalence of Meningitis B in Europe when making a decision on whether to introduce a Meningitis B vaccination programme; and if he will make a statement on the matter. [13878/14]

 1158. Deputy Jerry Buttimer Information on Jerry Buttimer Zoom on Jerry Buttimer asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly his policy on the availability of the Meningitis B vaccine; and if he will make a statement on the matter. [13879/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly I propose to take Questions Nos. 1100 to 1102, inclusive, 1157 and 1158 together.

The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The NIAC is a committee of the Royal College of Physicians of Ireland comprising of experts in a number of specialties including infectious diseases, paediatrics and public health. A Health Technology Assessment which includes a cost benefit analysis is carried out prior to any new vaccine being considered. This has a vital role in ensuring that care technologies, including vaccines, are used in a manner appropriate to their ability to maximise health gain and achieve value for money. The NIAC has not made any recommendation in relation to the use of Bexsero in the primary childhood immunisation programme in Ireland. However NIAC has issued guidance in relation to the use of Bexsero in the control of clusters or outbreaks of Meningococcal B disease. I have sought a report from the HSE concerning the recent cases in Cavan and Westmeath.

Hospitals Capital Programme

 1103. 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 his plans for the urgent refurbishment of the 95 bed Sacred Heart Hospital, Roscommon; the total cost of the project; when construction will commence; and if he will make a statement on the matter. [13584/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly There will always be more projects than can be funded by the Exchequer.  As with all capital projects, further development of the CNU programme, including this project, must be considered within the context of the overall capital envelope available to the health service. There is limited funding available for new projects over the period 2014-2018 given the level of commitments and the costs to completion already in place. The HSE is concentrating on applying the limited funding available for capital works in the most effective way possible to meet residential need now and in the future.

Hospitals Building Programme

 1104. 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 further to Parliamentary Question No. 1375 of 18 September 2013, if the construction project has been approved; the estimated cost of the development; the current status of the recruitment of the consultant; the date on which the successful applicant will be appointed to Roscommon County Hospital; and if he will make a statement on the matter. [13585/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly As this is a service matter, I have asked the HSE to respond directly to the Deputy.

Hospital Staff

 1105. 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 his plans to appoint dedicated Parkinson's nurses in counties Roscommon, Leitrim and Galway; and if he will make a statement on the matter. [13587/14]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch 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.

Audiology Services Provision

 1106. 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 if he will approve the development of a sound proof audiology room for Roscommon town; and if he will make a statement on the matter. [13589/14]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White As this is a service matter this question has been referred to the HSE for direct reply.

Health Services

 1107. 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 number of outpatient clinics by speciality held at Roscommon County Clinic by each consultant in each year 2010 to 2013 inclusive; the number of patients attending each clinic annually; the steps being taken to increase the number of outpatient clinics; and if he will make a statement on the matter. [13590/14]

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

Medical Card Administration

 1108. Deputy Caoimhghín Ó Caoláin Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if there is provision for individual health and social support facilities to apply for a medical card or to receive special access to services (details supplied); and if he will make a statement on the matter. [13601/14]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The information sought by the Deputy is not readily available. However, I have asked the Health Service Executive to supply this information to me and I will forward it to the Deputy as soon as possible.

National Stroke Programme

 1109. 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 if an audit of stroke services and thromobolysis rates has been carried out by the national stroke programme; the outcome of the audit; if he will provide the up to date thrombolysis rates; and if he will make a statement on the matter.  [13607/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Improvements in Stroke services were envisioned in the "Changing Cardiovascular Health; Cardiovascular Health Policy 2010 - 2019" which was launched in 2010. The policy establishes a framework for the prevention, detection and treatment of cardiovascular diseases, including stroke, which seeks to ensure an integrated and quality assured approach in their management, so as to reduce the burden of these conditions. The implementation of the National Stroke Programme, since 2011 to date has resulted in improved services for stroke patients. One of the programme's targets was to increase the rate of safe thrombolysis from 3% to 7.5% by the end of 2013. In 2013 the HSE reported a national stroke thrombolysis rate of 10.5% for the third quarter of that year, which exceeded targets and is comparable to the highest rates internationally.

The national 24/7 access to safe stroke thrombolysis is progressing, with emergency thrombolysis provided now to patients in all regions of the country, via improved hospital and ambulance protocols, health professional training and the appointment of new physicians. available now in 23 hospitals. As mentioned earlier, significant improvements in thrombolysis rates have been noted as high as 10.5% in the third quarter of 2013. The National Stroke Programme is currently planning the second national audit of stroke care, to independently validate data provided via the HIPE system. The audit will include a review of the organisation of stroke care at hospital level and the outcome of care for the patient. Previous national and international audits of acute stroke care will inform the methods used in order to all for comparison of the findings.


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