Header Item Written Answers Nos. 112-131
   Header Item Medical Card Eligibility
   Header Item Hospital Appointment Status
   Header Item Obesity Strategy
   Header Item Autism Support Services
   Header Item Autism Support Services
   Header Item Proposed Legislation
   Header Item Medical Card Applications
   Header Item Medical Card Eligibility
   Header Item General Practitioner Services
   Header Item Health Services Provision
   Header Item Home Care Packages
   Header Item Home Care Packages
   Header Item Medical Aids and Appliances Provision
   Header Item Medical Card Eligibility
   Header Item Medical Card Reviews
   Header Item Disease Awareness
   Header Item Medical Card Applications
   Header Item Semi-State Bodies

Wednesday, 28 May 2014

Dáil Éireann Debate
Unrevised

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Written Answers Nos. 112-131

Medical Card Eligibility

 112. 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 the rate of interest on savings used to assess earnings for the purpose of medical card applications and-or reviews; and the way this rate is calculated  [23421/14]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The interest rate, to which the Deputy refers, is only relevant to the supplementary assessment process for medical cards for persons aged 70 years and over, where means testing is on a gross income basis. For the purposes of assessment for this medical card, savings or similar investments of €36,000 for a single person or €72,000 for a couple are disregarded. For amounts in excess of these limits, the applicant can have the actual interest rate that s/he received applied to the savings by providing a certificate of interest paid in the last full calendar year, or alternatively can have the current notional rate applied. It is always the applicants choice to have the actual interest rate or the notional rate applied.

The notional rate is set by the HSE quarterly by taking an average of the current deposit interest rates of a number of the major Irish Banks & Building Societies, e.g. regular saver deposits, instant access deposits, three month and six month deposits, one year fixed deposits, five year fixed deposits and 10 year savings bonds. The notional rate is 2.3 % with effect from 1st January 2014 and remains unchanged for Quarter 2.

Hospital Appointment Status

 113. Deputy Colm Keaveney Information on Colm Keaveney Zoom on Colm Keaveney asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when children (details supplied) in County Galway may expect to receive urgent medical appointments; and if he will make a statement on the matter.  [23422/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly In relation to the particular patient queries raised by the Deputy, as these are service matters, I have asked the Health Service Executive to respond to him directly.

Obesity Strategy

 114. Deputy Dominic Hannigan Information on Dominic Hannigan Zoom on Dominic Hannigan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the work his Department is undertaking to deal with obesity here; and if he will make a statement on the matter. [23425/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly As Minister for Health, I set up a Special Action Group on Obesity (SAGO), comprising representatives from Department of Health, the Department of Children and Youth Affairs, The Department of Education and Skills, the Health Service Executive, the Food Safety Authority of Ireland and safefood to examine and progress a number of issues to address the problem of obesity. Progress has been made on the Healthy Eating guidelines, Calories on Menus initiative and the Report on Recommendations to reduce consumption of high fat, salt and sugar foods and drinks from the Top Shelf of the Food Pyramid. Treatment algorithms are available for those in Primary Care health services. Arising out of the Irish Presidency of the EU and the Informal Meeting of Health Ministers, the EU Commissioner supported the call for an EU Action Plan on Childhood Obesity to be developed by the EU High Level Group On Nutrition and Physical Activity. This Plan has been drafted and will be finalised in 2014.

  As one of the measures specifically designed to combat Childhood Obesity, I launched the safefood/HI/HSE three year Childhood Obesity Campaign – Childhood Obesity: Let's take it on – one small step at a time - which is designed to create greater awareness among parents about the threat of childhood overweight and obesity and provide practical tips to help address the problem with the ultimate aim and effecting behaviour change. Healthy Ireland supports a whole-of-government approach to address the determinants and predictors of health and well-being, many of which fall outside the health sector, e.g. housing, transportation, education, workplaces and environment along with an individual's socioeconomic status. It sets out four central Goals and outlines actions under six Thematic Areas, in which all people and all parts of society can participate to achieve these goals through 64 Actions. Progress in the first year is being focused on a small number of key actions with the greatest potential to make a difference and, in particular, to establish the foundations on which future progress will depend.

  Comprehensive, multi-level approaches are required to address the obesity epidemic and the work of SAGO and Healthy Ireland is ongoing.

Autism Support Services

 115. Deputy Mattie McGrath Information on Mattie McGrath Zoom on Mattie McGrath asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the State's current statutory obligations in relation to the provision of psychological, psychiatric and all other relevant services for children and young adults clinically diagnosed with autism and Asperger's syndrome; and if he will make a statement on the matter.  [23439/14]

 117. Deputy Mattie McGrath Information on Mattie McGrath Zoom on Mattie McGrath asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the courses of action open to parents and families who have children or members diagnosed with autism and who wish to seek redress for the State's failure to adhere to its minimum statutory obligations; and if he will make a statement on the matter.  [23441/14]

 119. Deputy Mattie McGrath Information on Mattie McGrath Zoom on Mattie McGrath asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly his view regarding the resources available within the health care system to deal with clinically assessing whether or not a child or adult has a condition on the autism spectrum; and if he will make a statement on the matter.  [23443/14]

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. 115, 117 and 119 together.

  Under the Health Act 2004, the Health Service Executive (HSE) is charged with managing and delivering, or arranging to be delivered on its behalf, health and personal social services to the population as a whole, from within available resources. Notwithstanding the existing financial pressures, the Government is fully committed to ensuring the on-going delivery of services and supports to children and adults with disabilities, including those with ASD. The HSE has been provided with funding in the order of €1.4 billion in 2014 to fund its disability services programme for children and adults with disabilities, including those with ASD. 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.

  Services provided include assessment, diagnosis and ongoing treatment and intervention supports. These may include home support services, respite services and multi-disciplinary team supports to assess the individual needs of each person with ASD and provide for the appropriate interventions. Part 2 of the Disability Act, 2005, also provides for an Assessment of Need process, which at present encompasses younger children. This process provides for the needs of eligible applicants, occasioned by their disability, to be assessed within specific timeframes.

  The Health Service Executive's National Review of Autism Services: Past, Present and Way Forward Report (2012) and its National Programme on Progressing Disability Services for Children and Young People (0-18 years) set out the overall policy context for the provision of autism services to children and young people. The objective of the Progressing Children's Disability Services Programme is to achieve a national, unified approach to delivering disability health services. This Programme aims to ensure greater equity in accessing services, based on need, clearer referral pathways to these services and improved collaboration between the relevant sectors. An additional €4m has been specifically allocated in 2014 to drive implementation of the Programme. This equates to approximately 80 therapy posts. In addition, the Cabinet Committee on Social Policy has been examining issues around autism across Government Departments, in association with the National Disability Authority (NDA). This work by the NDA, which has included consultation with families, will be of significant assistance in informing how best to address the needs of people with ASD in order to ensure that they are appropriately reflected and included in policies and actions.

  With regard to access to redress in general terms, the Health Act 2004, provides that all service users of the HSE have the right to make a complaint where they believe that the standards of care, treatment or practice fall short of what is acceptable. More information in relation to this complaints process is available on the HSE's website,
www.hse.ie. In terms of seeking redress in relation to unmet statutory obligations, under the Disability Act, 2005, applicants for the Assessment of Need process have access to a dedicated redress system consisting of a complaints process to a designated Complaints Officers and an onward appeal to an independent Disability Appeals Officer.

Autism Support Services

 116. Deputy Mattie McGrath Information on Mattie McGrath Zoom on Mattie McGrath asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will provide in tabular form the resources that are available on a Health Service Executive regional basis to families who have children or members diagnosed with autism; and if he will make a statement on the matter.  [23440/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The particular issue raised by the Deputy is a service matter for the Health Service Executive. Accordingly I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.

  Question No. 117 answered with Question No. 115.

Proposed Legislation

 118. Deputy Mattie McGrath Information on Mattie McGrath Zoom on Mattie McGrath asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly his plans in relation to accepting the provisions outlined in the Autism Bill 2012; and if he will make a statement on the matter. [23442/14]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch In March 2013, a Private Members Bill entitled the Autism Bill 2012 was debated and passed Second Stage in the Dail. The Bill, as introduced, makes provision for the preparation of an autism strategy and a national framework for addressing the specific needs of adults with autism. The broad thrust of the Bill was accepted by Government and it was not opposed at Second Stage. Although the needs of people with autism have received some recognition in recent years, the Bill is seen as contributing to a more enlightened and educated public debate.

In the context of the Autism Bill, it is important to note that the Government is already committed under the National Disability Strategy (NDS) to ensuring that people with autism are empowered by policy and programmes to participate meaningfully as citizens in Irish society. The NDS is driven by this basic but fundamentally important objective and is the most effective combination of legislation, policies, institutional arrangements and services to support and reinforce equal participation for all people with disabilities.

The Cabinet Committee on Social Policy has been examining issues around autism across Government Departments in association with the National Disability Authority (NDA). This work by the NDA, which has included consultation with families, will be of significant assistance in informing how best to address the needs of people with ASD, so that we can be sure that they are appropriately reflected and included in policies and actions. The ongoing work of the Cabinet Committee on Social Policy will inform this process.

  Question No. 119 answered with Question No. 115.

Medical Card Applications

 120. 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. [23448/14]

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.

Medical Card Eligibility

 121. Deputy Ciarán Lynch Information on Ciaran Lynch Zoom on Ciaran Lynch asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will review the refusal of a medical card in respect of a person (details supplied) in County Tipperary in view of the fact that their condition is incurable and progressive and that a medical card was provided since diagnosis; and if he will make a statement on the matter. [23455/14]

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.

General Practitioner Services

 122. Deputy Dan Neville Information on Dan Neville Zoom on Dan Neville asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding a refund in respect of a person (details supplied) in County Limerick; and if he will make a statement on the matter. [23459/14]

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.

Health Services Provision

 123. Deputy Michael Healy-Rae Information on Michael Healy-Rae Zoom on Michael Healy-Rae asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding hydrotherapy in respect of a person (details supplied) in County Kerry; and if he will make a statement on the matter. [23475/14]

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.

Home Care Packages

 124. 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 the position regarding a home care package application in respect of persons (details supplied) in Dublin 9; and if he will make a statement on the matter. [23476/14]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch As this is a service matter it has been referred to the Health Service Executive for direct reply.

Home Care Packages

 125. 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 the position regarding a home care package application in respect of a person (details supplied) in Dublin 11; and if he will make a statement on the matter. [23477/14]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch As this is a service matter it has been referred to the Health Service Executive for direct reply.

Medical Aids and Appliances Provision

 126. 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 position regarding equipment in respect of a person (details supplied) in Dublin 5; and if he will make a statement on the matter. [23479/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The Deputy's question relates to service delivery matters and accordingly I have asked the HSE to respond directly to him.

Medical Card Eligibility

 127. Deputy Sean Fleming Information on Seán Fleming Zoom on Seán Fleming asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will consider lifting the discrimination against persons with mental and psychiatric illnesses who apply for medical cards, especially persons who have long-term diagnoses such as a bipolar condition that can lead to suicide and life-threatening events; and if he will make a statement on the matter.  [23485/14]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White Under the Health Act, 1970, eligibility for a medical card is founded primarily on the undue financial hardship test and every application must be assessed on that basis. Under the legislation, determination of an individual's eligibility for a medical card is the responsibility of the HSE. The 1970 Health Act obliges the HSE to assess whether a person is unable, without undue hardship, to arrange GP services for themselves and their family, having regard to their overall financial situation and reasonable expenditure. The legislation is clear that qualification for a medical card is means-tested. Medical cards are not awarded - nor have they ever been - on the basis of a particular illness or disease. Medical cards are not issued 'automatically' - or irrespective of means - even if an applicant is suffering from a serious medical condition or a life long condition.

While there is no automatic entitlement to a medical card for persons with specific illnesses, or with a disability, the HSE has discretion to award a medical card to avoid undue hardship, having regard to person's or the family's overall financial situation, even where the person's income exceeds the income guidelines. The HSE is obliged to operate within the legal parameters as set out in the Health Act, while also responding to the variety of circumstances and complexities faced by individuals who apply for a medical card. As I have outlined, the 1970 Act established a financial means assessment and medical card eligibility is granted on the basis of the financial situation of the applicant. The nature of a disease or illness an applicant may have is not the basis for granting eligibility and I can assure the Deputy that all applicants are treated in a standard, uniform manner.

The HSE is currently examining how individuals, who are not entitled to a medical card, could still receive services that meet their needs. This issue is being addressed in a manner that includes all of the services and supports provided by the HSE with as much flexibility as is available and at a local level.

Medical Card Reviews

 128. 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 if he will intercede with the Health Service Executive to ensure that all cards that are under review will not be cancelled while the review is ongoing and the medical card holder is genuinely engaging with the HSE, as this administrative rule is not being fully followed currently by the HSE and not all staff appear to be aware of it.  [23487/14]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White I am aware that HSE has a very structured protocol in place for the review process and makes every effort to ensure on-going engagement with clients during this process. A person (and their dependants, if it applies), the subject of a medical card/GP visit card eligibility review assessment, will continue to have their eligibility extended pending the outcome of a review assessment, provided they have returned their review form within the time specified, and are engaging with the HSE in enabling their review assessment to complete.

  The HSE local health offices can offer assistance to those completing their Medical Card/GP Visit Card application form or seek clarification on any aspect regarding the process of assessing eligibility for a Medical Card/GP Visit Card. In addition, in this regard, a help and information Callsave phone line 1890 252 919 is available to the public. It is advised that applicants should avail of this information helpline, where they have concerns regarding assessments and review. The HSE will give every assistance to persons that contact their offices, in advising and facilitating them in meeting the requirements to have their eligibility for a Medical Card/GP Visit Card fully assessed.

  If the Deputy has the particulars of the person or persons concerned, she should forward the individual's medical card number or PPS number and PCRS will investigate further.

Disease Awareness

 129. 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 if he will highlight the issue of Lyme disease, of which Ireland has the second highest rate in Europe, with the west having the highest number of cases in the country; and if he will make a statement on the matter.  [23501/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly The Health Protection Surveillance Centre of the HSE is responsible for the surveillance of notifiable infectious diseases such as Lyme Disease. The HPSC has begun the process of establishing a Lyme Borreliosis Sub-Committee with the primary aim to examine best practice in prevention and surveillance of Lyme Disease and to develop strategies to undertake primary prevention in order to minimise harm caused by Lyme Borreliosis in Ireland. This will involve, inter alia, raising awareness among clinicians and the general public.

As part of the recent HPSC "Lyme Awareness Week", a supply of information was made available to the public and attention was drawn to a "Tickborn Disease Toolkit" developed by the European Centre for Disease Control (ECDC) which is available on the ECDC website. In addition, this toolkit has been modified for local use in Ireland and posted on the HPSC website. The Deputy will be interested to hear that the ECDC has informed the HPSC that Ireland is the first European Member State to make such extensive use of this material.

One important strand of the work of the Lyme Borreliosis Sub-Committee will be to explore methods to highlight such preventive material with the media and the general public. What is clear from the available evidence is that public health advices such as measures to minimise tick bites are quickly forgotten. It is crucial, therefore, that such messages are repeated frequently and in such media that the general public will take full notice of the messages and act upon them. Obviously, these messages should be prominent in areas where there is a heightened risk of being bitten by an infected tick and the Sub-Committee will be exploring ways to ensure that these messages are brought to the public's attention with frequency and in forms in which they can be most effective.

Medical Card Applications

 130. Deputy Sandra McLellan Information on Sandra McLellan Zoom on Sandra McLellan asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the position regarding a medical card in respect of a person (details supplied) in County Cork; and if he will make a statement on the matter. [23503/14]

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.

Semi-State Bodies

 131. Deputy Michael McGrath Information on Michael McGrath Zoom on Michael McGrath asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly the current credit rating of all commercial semi-State bodies operating under the aegis of his Department; and if he will make a statement on the matter.  [23516/14]

Minister for Health (Deputy James Reilly): Information on Dr. James Reilly Zoom on Dr. James Reilly Vhi Healthcare, the only commercial semi State under the aegis of my Department, does not have a credit rating as the company does not have any long term borrowings.


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