Written Answers Nos. 1537-1551
1537. Deputy Marc Ó Cathasaigh asked the Minister for Health what financial supports or benefits are available to purchase wigs for children under the age of 18 years who have lost hair due to alopecia or other conditions; and if he will make a statement on the matter. [17136/23]
View answerThe Health Service Executive (HSE) currently provides a wide range of medical and surgical aids and appliances free of charge to eligible persons following assessment by a relevant health professional.
These are provided by the HSE through community services known as Community Funded Schemes. This may include the provision of wigs and hairpieces, but the level of access varies across Community Health Organisations. HSE Local Health Offices will be able to advise as to what services are available locally (see www.hse.ie/eng/services/list/1/lho/).
The Treatment Benefit Scheme, operated by the Department of Social Protection, provides funding up to a maximum of €500 towards the cost of hair replacement products where hair loss results from a disease or treatment of a disease such as cancer or alopecia. Qualifying conditions are a matter for that Department. The types of alopecia which qualify are:
- Alopecia areata (which includes alopecia totalis/universalis, diffuse alopecia areata, alopecia ophiasis);
- Primary scarring alopecias (also known as cicatricial alopecias);
- Frontal fibrosing alopecia and lichen planopilaris (scarring alopecia);
- Chemotherapy induced alopecia (anagen effluvium); and
- Alopecia resulting from surgery or trauma, including burns.
Further details on the scheme are available here: www.gov.ie/en/service/1fb655-treatment-benefit-scheme/#what-the-treatment-benefit-scheme-is.
1538. Deputy James Lawless asked the Minister for Health if he will examine the case of a person (details supplied); and if he will make a statement on the matter. [17139/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
I would also like to remind the Deputy that it is against Department policy to comment on individual cases.
1539. Deputy Gary Gannon asked the Minister for Health if he is aware of the lack of paediatric palliative care in the south-east region; if there are plans to rectify this; and if he will make a statement on the matter. [17146/23]
View answerThe Programme for Government 2020 is committed to increasing resources for the Children’s Palliative Care Programme. This will be supported by consultants with a special interest in children’s palliative care and children’s outreach nurses to coordinate care for children with life-limiting conditions and their families. When children are at end of life, they and their families deserve the best possible care. It is vital that such care is available when needed either in their home or in a hospital setting. A priority for 2023 is to implement the recommendations from the HSE 2020 report for supporting a model of care for children with life-limiting conditions in the community in Ireland.
There have been significant increases in funding to enhance the provision of children’s palliative care services across Ireland in recent years. Across 2021 and 2022, funding has been allocated for the recruitment of 12.5 additional whole-time equivalents to enhance the provision of children’s palliative care services across acute and community settings. These posts will support the provision of specialist palliative care to children as close to home as possible. Budget 2023 has an allocation of €3.7million to be provided for new measures in palliative care. The new measures will enhance the provision of adult and children’s specialist palliative care services across the country and will include funding to support bereavement services for parents and families who have experienced the death of a child. The Palliative Care Budget increased to a total national service plan allocation in 2022 of €121.9 million from a national service plan allocation of €119m in 2021. In 2023, the budget is €130.1m.
The Specialist Palliative Care team for Children is based in Children’s Hospital Ireland, Crumlin. This team is a consult, advisory and supportive service which works in close liaison with Medical Teams providing care to children in need of palliative care across the country. With regards to children’s palliative care provision in the South Tipperary and South-East area, a sustainable, long-term solution for the provision of such services is under development. There are two clinical nurse co-ordinators for children with life limiting conditions in the South-East who support the provision of safe care in the home. Progress has been made in relation to the recruitment of a Consultant Paediatrician with a specialism in palliative care for the South-East. Community Healthcare Organisations (CHOs) in conjunction with South/South-West Hospital Group and Ireland East Hospital Group are working to ensure a care plan based on patient need is in place. South-East CHO are actively working with Children’s Health Ireland to progress the required supports in line with the Model of Care for children with life limiting conditions. I have been advised that South-East CHO, in association with the relevant hospital groups, continue to engage and support families as required.
The new HSE Service Plan 2023 will underpin further improvements in children’s palliative care services. A multi-agency approach is adopted to provide palliative care to children in their homes. This approach involves: collaboration between primary care, regional paediatricians, and adult community palliative care services - coordinated by the Clinical Nurse Coordinator (CNC) - and supported by paediatric palliative care team located in CHI Crumlin/Temple. One of the cornerstones of children’s palliative care is to facilitate a fully integrated approach to care.
The Department and HSE will continue to progress developments for children’s palliative care services in Ireland, working towards the highest possible quality of end-of-life care and support for children with life limiting illnesses across the country.
1540. Deputy Richard Bruton asked the Minister for Health if he is aware that outstanding deferred payments under the Fair Deal scheme are currently being increased at the very high current rate of inflation, which is very tough at a time when Government borrowing costs for carrying the debt is only a small proportion of this; and if he will consider amending the legislation to deal with this anomaly. [17157/23]
View answerThe Nursing Homes Support Scheme (NHSS), commonly referred to as 'Fair Deal', is a system of financial support for people who require long-term residential care. The primary legislation underpinning the NHSS is the Nursing Home Support Scheme Act 2009. Participants in the NHSS contribute to the cost of their care according to their means 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.
One feature of the NHSS scheme is that participants who own property/land-based assets in the State also have access to Ancillary State Support, or the Nursing Home Loan, an optional feature of the Fair Deal Scheme. It is a loan which may be applied for at any time that is advanced by the HSE to help people meet the portion of their contribution to the cost of care that is based on property/land-based assets, most typically against the personal residence. If an individual secures ancillary state support, they will not need to contribute against the value of the relevant property during their time on the scheme, unless the property is sold during that time.
Payment of the Nursing Home Loan (Ancillary State Support) by the HSE results in the creation of a charge (a simple type of mortgage) in favour of the HSE against the interest of the applicant and his/her partner in the asset(s). The HSE will notify the Property Registration Authority of the charge who will register it against the specified asset(s).
Ancillary State Support becomes repayable following the occurrence of a relevant event, most commonly after the death of the client. If the loan is repaid in a timely fashion (in the event of the death of the scheme participant, this is 12 months), no interest is applied. In certain conditions - for example, where a partner or child continues to reside in the property - a further deferral to the repayment of the loan can be granted.
The Department of Health accepts that the Nursing Homes Support Scheme can place a potentially onerous burden on participants and their families. In attempting to alleviate some of the costs associated with long-term residential care, the legislation has been amended in recent years to extend the 3-year cap to the proceeds of sale of the principal private residence and to the financial assessment of family owned farms and businesses, provided certain conditions are met, to preserve their sustainability and future viability. Additional amendment to the scheme permits participants to retain 60% of income accrued from renting their principle private residence - rental income accrued from property that is not a principal private residence continues to be assessed at 80%.
In respect of calculating the rate and terms of interest relating to outstanding Ancillary State Support scheduled for repayment, the Department of Health keeps this element of the legislation under ongoing review with relation to changes in economic conditions.
1541. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [17162/23]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1542. Deputy James Lawless asked the Minister for Health when the changes to the income limits for GP visit cards will come into place; and if he will make a statement on the matter. [17163/23]
View answer1586. Deputy Róisín Shortall asked the Minister for Health the timeline he is now working towards for expanding eligibility for GP visit cards to people who earn the median household income or less; the reason this was not implemented by 1 April 2023, as committed to in budget 2023; and if he will make a statement on the matter. [17363/23]
View answer1698. Deputy John Brady asked the Minister for Health from what date in April 2023 median family income will be increased for a GP visit card; and if he will make a statement on the matter. [17835/23]
View answer1709. Deputy Cian O'Callaghan asked the Minister for Health if the new income threshold for GP visit cards announced in budget 2023 has been implemented; and if he will make a statement on the matter. [17879/23]
View answerI propose to take Questions Nos. 1542, 1586, 1698 and 1709 together.
The Government is committed to the extension of GP visit card eligibility to those who earn the median household income or less, as announced in Budget 2023.
In total, approximately 400,000 additional individuals are estimated to become eligible under this expansion. This measure will remove the cost of accessing GP care from those for whom cost is most likely to prevent access; helping reduce the cost of living for young adults and young families in particular.
The necessary planning and administrative development work to provide for the expansion is well advanced in preparation for the commencement of the expansion. However, officials from my Department and the HSE are currently engaged in intensive discussions with the IMO regarding the expansion and in particular their concerns on the impact of increased eligibility on general practice and the best use of the additional funding provided in Budget 2023 to support capacity in general practice.
Information in relation to the commencement of the expansion and further operational information will be provided when available.
1543. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [17169/23]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1545. Deputy Michael Healy-Rae asked the Minister for Health the reason for the slow process of cases being dealt with by alternative dispute resolution (details supplied); his plans to speed up cases; and if he will make a statement on the matter. [17174/23]
View answerThe State Claims Agency (SCA) has a statutory remit to manage personal injury claims on behalf of delegated State authorities. I have been informed by the SCA that it has a small number of active claims in respect of hip replacement, none of which are being dealt with by way of alternative dispute resolution.
I am also informed by the SCA that there are a number of other claims, to which the Deputy may be referring, in which there are multiple defendants; the manufacturer, the HSE and in some cases the treating consultant. In respect of this latter cohort of claims the manufacturer may have entered into alternative dispute resolution to which the SCA is not a party.
1546. Deputy Carol Nolan asked the Minister for Health when staff and former staff of an organisation (details supplied) will receive the pandemic unemployment payment; and if he will make a statement on the matter. [17176/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
1547. Deputy Carol Nolan asked the Minister for Health to address concerns that there are insufficient funding supports available to trainee counselling psychologists who incur significant debt while completing their course work (details supplied) and if he will make a statement on the matter; and if he will make a statement on the matter. [17177/23]
View answerAs the Deputy is aware, €750,000 has been provided in Budget 2023 to support counselling psychology training places. This funding demonstrates the Government’s commitment to strengthen access to psychology training.
I am focussed on supporting counselling psychology students in an equitable way and that delivers value for money. The structure of this funding is currently being finalised by officials in the Department. The approach will be based on best practice and knowledge gained from other health and social care funded training models.
Further detailed discussions are now taking place between the Department and HSE to progress this. I hope to be in a position to announce the details shortly for academic year 2023-2024.
1548. Deputy Seán Canney asked the Minister for Health if private nursing home residents in the Tuam primary care team, PCT, area with leg ulcers can be seen at the leg ulcer clinic in Tuam Primary Care, County Galway; if this clinic cannot see nursing home residents, given local residents with leg ulcers have difficulty travelling; and if he will make a statement on the matter. [17178/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1549. Deputy Robert Troy asked the Minister for Health if he will expedite the provision of home help hours for a person (details supplied). [17181/23]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
1550. Deputy Louise O'Reilly asked the Minister for Health given the positive clinical results being achieved by the HSE's structured chronic disease management programme, the reason certain cohorts of medical cardholders (details supplied) are excluded from the programme; if he will now extend the programme to include these groups; and if he will make a statement on the matter. [17184/23]
View answerThe General Practitioner (GP) Chronic Disease Management (CDM) Programme commenced in 2020 and has been rolled out on a phased basis to adult GMS (Medical Card and GP Visit Card) patients over a 4-year period as planned. The specified chronic conditions included in the Programme are Type 2 Diabetes; Asthma; Chronic Obstructive Pulmonary Disease (COPD) and Cardiovascular Disease (including Heart Failure, Ischaemic Heart Disease, Cerebrovascular Disease (Stroke/Transient Ischemic Attack (TIA), Atrial Fibrillation).
94% of eligible GPs have signed up to providing the CDM programme. To date, 307,630 patients have been registered – on track to reach the target of 430,000 patients registered to the programme by the end of Q4 2023.
The CDM programme is an entirely new healthcare service in Ireland that has brought the care for chronic disease further into the community and it aims to reduce hospital attendance by patients with one or more of these specified conditions.
To support patients in managing their chronic condition(s), under the CDM Treatment Programme each patient receives two scheduled reviews with the GP in a 12-month period, each preceded by a practice nurse visit. These reviews include patient education, preventative care, medication review, physical examinations, scheduled investigations and individual care planning.
The Opportunistic Case Finding Programme identifies those at high risk of cardiovascular disease or diabetes for entry to the Preventive Programme and those with undiagnosed chronic disease(s) are enrolled under the Treatment Programme. Those enrolled under the Preventive Programme receive an annual GP and practice nurse visit.
The first phase of the CDM Treatment Programme commenced at the end of January 2020, starting with patients aged 75 years and over. In response to the COVID-19 public health emergency, the CDM Programme was modified in July 2020 to allow for greater use of remote consultations and was extended to those aged 70 years and over.
In 2020, approximately 115,000 patients were registered on the programme, and GPs and practice nurses undertook over 126,000 consultations for people aged over 70 years.
In 2021, approximately an additional 68,000 new patients were registered on the programme and over 219,700 consultations were provided to people aged over 65 years.
In 2022, a further 124,466 patients were registered on the CDM Treatment Programme, and GPs and practice nurses undertook over 415,000 consultations for people aged over 18 years.
In addition, in 2022, the Opportunistic Case Finding and Prevention elements of the programme commenced for eligible people aged 65 years and over. From January-December 2022, 11,090 patients were assessed under the High-Risk Preventative Programme, and 38,628 patients were assessed through Opportunistic Case Finding.
The final phase of the programme commenced on 1 January 2023 with the extension of Opportunistic Case Finding and Preventative components to all eligible patients aged 45 and over.
Further expansion of the programme to include additional conditions is currently under consideration.
