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 Header Item Written Answers Nos. 544-560
 Header Item Disability Services Funding
 Header Item Medical Card Eligibility
 Header Item Mental Health Services Funding
 Header Item National Maternity Hospital
 Header Item Disability Support Services Funding
 Header Item Disability Services Data
 Header Item Ambulance Service Data
 Header Item Ambulance Service Data
 Header Item Ambulance Service Data
 Header Item Ambulance Service Staff
 Header Item Ambulance Service
 Header Item Departmental Properties
 Header Item Suicide Prevention
 Header Item Mental Health Services Data
 Header Item Primary Care Centres
 Header Item Hospital Services
 Header Item Nursing Homes Support Scheme Eligibility

Tuesday, 11 April 2017

Dáil Éireann Debate
Vol. 946 No. 2

First Page Previous Page Page of 109 Next Page Last Page

Written Answers Nos. 544-560

Disability Services Funding

 544. Deputy Jim Daly Information on Jim Daly Zoom on Jim Daly asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his plans to restore funding to an organisation (details supplied); and if he will make a statement on the matter. [17881/17]

Minister of State at the Department of Health (Deputy Finian McGrath): Information on Finian McGrath Zoom on Finian McGrath The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

The particular issue raised by the Deputy is a service matter for the HSE. Accordingly I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Medical Card Eligibility

 545. Deputy Mary Butler Information on Mary Butler Zoom on Mary Butler asked the Minister for Health Information on Simon Harris Zoom on Simon Harris if he will include the process of blood removal for haemochromatosis patients, venesection, by general practitioners for medical card holders to be covered by the scheme and for general practitioners to be reimbursed accordingly; and if he will make a statement on the matter. [17882/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris Under the terms of the current GMS contract, GPs are required to provide eligible patients with ''all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess." Venesection for the treatment of Haemochromatosis is not considered a routine service under the GMS contract. Consultation fees charged by GPs outside the terms of the GMS or GP Visit Card contracts are a matter of private contract between the clinicians and their patients. While I have no role in relation to such fees, I would expect clinicians to have regard to the overall economic situation in setting their fees.

The Deputy will be aware of the ongoing review of the GMS and other publicly funded contracts involving GPs, and that the next phase of discussions to progress this work is underway. The aim is to develop a new modern GP services contract which will incorporate a range of standard and enhanced services to be delivered. I expect that the issue of therapeutic venesection services for patients with Haemochromatosis will be considered in the context of the overall GP contract review process.

Mental Health Services Funding

 546. Deputy Pat Buckley Information on Pat Buckley Zoom on Pat Buckley asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the funding provided by the Exchequer for patient advocacy in mental health for each respective body from 2011 to 2016 and to date in 2017.  [17890/17]

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

National Maternity Hospital

 547. Deputy Róisín Shortall Information on Róisín Shortall Zoom on Róisín Shortall asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the precise nature of the ownership and governance structure of the new national maternity hospital. [17895/17]

 630. Deputy Ruth Coppinger Information on Ruth Coppinger Zoom on Ruth Coppinger asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his views on the removal of ex officio positions for the Roman Catholic Church in the governing bodies of the National Maternity Hospital; if he will seek a change in the hospital's charter relating to the composition of the governing bodies; and if he will make a statement on the matter.  [18262/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I propose to take Questions Nos. 547 and 630 together.

Last November, following mediation discussions, agreement was reached between the National Maternity Hospital (NMH) and the St. Vincent's Healthcare Group on a new governance structure for the co-located hospitals on the St. Vincent's campus.

The agreement provides for the establishment of a new company - The National Maternity Hospital at Elm Park DAC (limited by shares). It envisages the transfer of significant statutory powers from the existing Charter to the new company. As such, the new company will have clinical and operational independence in the provision of maternity, gynaecology and neonatal services, as well as financial and budgetary independence. It is intended that the Trust, or a successor thereof, would retain certain activities, including those relating to nominations to the new company, fund raising and teaching and research etc.

The agreement secured protects the identity and branding of the NMH and the right to use of the new maternity hospital facility. The autonomy of the NMH Board will be underpinned by reserved powers to ensure clinical and operational independence, and the Minister for Health will hold the power to protect those reserved powers. The financial interests of the State will be protected through a requirement for a lien to be placed on the hospital.

Disability Support Services Funding

 548. Deputy Carol Nolan Information on Carol Nolan Zoom on Carol Nolan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the estimated cost of filling all vacancies in early intervention and school age disability teams; and if he will make a statement on the matter. [17896/17]

Minister of State at the Department of Health (Deputy Finian McGrath): Information on Finian McGrath Zoom on Finian McGrath The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

The particular issue raised by the Deputy is a service matter for the HSE. Accordingly I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Disability Services Data

 549. Deputy Carol Nolan Information on Carol Nolan Zoom on Carol Nolan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the number of complaints that have been made to the disability complaints officer in relation to failure to provide an assessment within the timeframes envisaged in the Disability Act or the EPSEN Act; the number of these that have been processed; the waiting time for a decision; the number that have been upheld; the number that have been deemed invalid; and if he will make a statement on the matter. [17897/17]

Minister of State at the Department of Health (Deputy Finian McGrath): Information on Finian McGrath Zoom on Finian McGrath The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Ambulance Service Data

 550. Deputy Carol Nolan Information on Carol Nolan Zoom on Carol Nolan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the number of private ambulances being used to service public hospitals or to provide an inter hospital service; and if he will make a statement on the matter. [17898/17]

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

Ambulance Service Data

 551. Deputy Carol Nolan Information on Carol Nolan Zoom on Carol Nolan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the number of immediate care vehicles available in the HSE midlands region; if the HSE has considered utilising these vehicles in place of private ambulances; and if he will make a statement on the matter. [17899/17]

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

Ambulance Service Data

 552. Deputy Carol Nolan Information on Carol Nolan Zoom on Carol Nolan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the amount of money that is currently being spent by the HSE midlands region on private ambulance operators; and if he will make a statement on the matter.  [17900/17]

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

Ambulance Service Staff

 553. Deputy Carol Nolan Information on Carol Nolan Zoom on Carol Nolan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the number of ambulance staff over each of the past ten years; the arrangements in place to provide holiday cover for ambulance staff; the number of requests for annual leave that have been refused in the past three years due to lack of cover; and if he will make a statement on the matter. [17901/17]

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

Ambulance Service

 554. Deputy Carol Nolan Information on Carol Nolan Zoom on Carol Nolan asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the amount of money spent on private ambulances by the HSE over each of the past ten years, in tabular form; and if he will make a statement on the matter. [17902/17]

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

Departmental Properties

 555. Deputy John Deasy Information on John Deasy Zoom on John Deasy asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the number of vacant buildings in his department’s ownership or control; the locations of same; and the length of time they have been unoccupied in each case.  [17919/17]

 641. Deputy John Deasy Information on John Deasy Zoom on John Deasy asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the amount of money spent across his Department over the past five years on maintaining vacant or unused State owned properties, including security arrangements; and if he will make a statement on the matter.  [18727/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris I propose to take Questions Nos. 555 and 641 together.

  My Department does not have any vacant or unused State owned properties and did not maintain any such properties over the past five years.

Suicide Prevention

 556. Deputy Pat Buckley Information on Pat Buckley Zoom on Pat Buckley asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the number of suicide crisis intervention nurses positions filled here; the number currently being advertised for; his future plans for new positions; and his views on the level which constitutes an adequate number of these position for best practice. [17930/17]

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

Mental Health Services Data

 557. Deputy Pat Buckley Information on Pat Buckley Zoom on Pat Buckley asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the estimated cost of establishing a crisis house for crisis intervention in mental health; the number currently in operation here; and the cost of these services to the Exchequer annually. [17932/17]

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

Primary Care Centres

 558. Deputy Sean Fleming Information on Seán Fleming Zoom on Seán Fleming asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the position regarding persons in County Laois that attend the local health centre (details supplied) in a location in which blood tests are taken; the hospital they are sent for analysis; and if he will make a statement on the matter. [17933/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris As this question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply.

Hospital Services

 559. Deputy Mary Butler Information on Mary Butler Zoom on Mary Butler asked the Minister for Health Information on Simon Harris Zoom on Simon Harris his views on the Herity report (details supplied); and if he will make a statement on the matter. [17940/17]

Minister for Health (Deputy Simon Harris): Information on Simon Harris Zoom on Simon Harris The Programme for a Partnership Government committed to an independent clinical review of the need for a second catherisation laboratory at University Hospital Waterford (UHW). This commitment has been fulfilled and the review was completed by Dr Niall Herity, a highly respected Belfast-based NHS cardiologist. I consider that Dr Herity's approach to the analysis and interpretation of the available evidence was independent, thorough and scientifically robust and took account of best international practice and guidance. Accordingly, I have accepted Dr Herity's findings and recommendations in their entirety.

To facilitate the implementation of those recommendations, I have provided additional funding of €0.5m for UHW in 2017 which will enable the hospital to provide 8 hours additional cath lab activity each week. However, in relation to the cessation of PPCI services at the hospital, as Minister for Health, I want to be sure that any service changes which we implement, will result in improved services for patients using that service. Therefore, I have asked my Department to address the implications of this recommendation by undertaking a national review of all PPCI services with the aim to ensure that as many patients as possible have access, on a 24/7 basis, to safe and sustainable emergency interventions following a heart attack. In the meantime, patients in the South East will continue to have access to out of hours PPCI services at Cork University Hospital or St James's Hospital, Dublin.

Nursing Homes Support Scheme Eligibility

 560. Deputy Mary Butler Information on Mary Butler Zoom on Mary Butler asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the criteria used to determine the subvention allowed or granted under the fair deal scheme for private nursing homes; and if he will make a statement on the matter. [17943/17]

 561. Deputy Mary Butler Information on Mary Butler Zoom on Mary Butler asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the criteria used to determine the subvention allowed or granted under the fair deal scheme for public nursing homes; and if he will make a statement on the matter. [17944/17]

 562. Deputy Mary Butler Information on Mary Butler Zoom on Mary Butler asked the Minister for Health Information on Simon Harris Zoom on Simon Harris the reason the subvention under the fair deal scheme for nursing homes is higher in public nursing homes than in private nursing homes; and if he will make a statement on the matter. [17945/17]

Minister of State at the Department of Health (Deputy Helen McEntee): Information on Helen McEntee Zoom on Helen McEntee I propose to take Questions Nos. 560 to 562, inclusive, together.

  The Nursing Homes Support Scheme (NHSS) is a system of financial support for those in need of long-term nursing home care. Participants contribute to the cost of their care according to their income and assets while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings. A financial assessment is carried out by the HSE to determine how much a participant in the Scheme will contribute to the cost of their care.

  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;

- Bed and board;

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

- Laundry service.

  The legislation underpinning the Nursing Homes Support Scheme requires each private nursing home to negotiate and agree a price for long-term residential care services with the National Treatment Purchase Fund (NTPF) should they wish to be an approved nursing home for the purposes of the Scheme. The NTPF has statutory independence in the performance of its function, and negotiates with each nursing home on an individual basis. The NTPF may examine the records and accounts of nursing homes as part of the process with the objective of setting a fair price which delivers value for money to the individual and the State. In negotiating with nursing homes, the NTPF has regard to:

- 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.

  When the NHSS 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. A number of issues have been identified for more detailed consideration, including a review of pricing mechanisms by the NTPF, with a view to:

- Ensuring value for money and economy, with the lowest possible administrative costs for clients and the State and administrative burden for providers;

- Increasing the transparency of the pricing mechanism so that existing and potential investors can make as informed decisions as possible; and

- Ensuring that there is adequate residential capacity for those residents with more complex needs.

  A Steering Committee has been established to oversee the review of the pricing system for private long-term residential care facilities. This Steering Committee is chaired by the NTPF and includes representatives from the Department of Health, the Department of Public Expenditure and Reform, and the NTPF, and work in this area is well advanced.

  In relation to the cost of care in public residential facilities, Section 33(2) of the Nursing Homes Support Scheme Act, 2009 provides for the HSE to charge for the cost of care in long-term residential care settings. The components that make up the cost of care are laid before the Houses of the Oireachtas.

  There are a number of reasons why the costs of public facilities are generally higher than those in the private sector, including a higher nurse staffing ratio and the impact of public service rates of pay and conditions of employment.

  The geographical spread of residential placements is also a factor. In some rural areas long stay beds are provided for geographical reasons in smaller centres which would not be profitable for a private provider to supply, e.g. Achill Island and Donegal.

  With that said, it is important that public facilities operate as efficiently and economically as possible and deliver the best possible value for money. Towards that end the HSE is already engaged in a comprehensive exercise to review and streamline the operation and cost structures of public facilities. Differences in the comparative cost of public and private long-term residential care will also be the subject of a Value for Money and Policy Review which will be commenced by the Department of Health in 2017 to assess reasons for and components of current cost differentials.


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