Catherine Murphy
Question:619. Deputy Catherine Murphy asked the Minister for Health the number of WTE neuropsychologists in Beaumont Hospital in 2022 and to date in 2023, in tabular form. [42382/23]
View answerHospital Staff
Questions (619)
Written answers
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Hospital Staff
Questions (620)
Catherine Murphy
Question:620. Deputy Catherine Murphy asked the Minister for Health the number of WTE senior physiotherapists in paediatric endocrinology and paediatric obesity at CHI Temple Street in the years of 2021, 2022 and to date in 2023, in tabular form. [42383/23]
View answerWritten answers
As this is an operational matter I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Hospital Staff
Questions (621)
Catherine Murphy
Question:621. Deputy Catherine Murphy asked the Minister for Health the number of WTE accident and emergency department nurses in Naas General Hospital in the years of 2020, 2021, 2022 and to date in 2023, in tabular form; and if this number will be increased. [42384/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Question No. 622 answered with Question No. 597.
Question No. 623 answered with Question No. 597.
Medical Cards
Questions (624, 627)
Richard Bruton
Question:624. Deputy Richard Bruton asked the Minister for Health what the means thresholds for the medical card and for the GP-only card that will apply from the start of 2024, will be; and whether it is intended that these will be indexed, in line with incomes or the cost of living, in the years ahead. [42413/23]
View answerRichard Bruton
Question:627. Deputy Richard Bruton asked the Minister for Health the provisions in respect of means test for the medical card and for assessing savings for those aged 70 years and over from the start of 2024. [42416/23]
View answerWritten answers
I propose to take Questions Nos. 624 and 627 together.
Eligibility for a Medical Card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970 (as amended). The HSE assesses each medical card application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card. It is specific to the individual’s own financial circumstances.
The current medical card thresholds are outlined below:
• Single person living alone under 66: €184.00
• Single person living alone 66-69: €201.50
• Single person living with family under 66: €164.00
• Single person living with family 66-69: €173.50
• Couple, married/cohabiting/civil partners, one parent family under 66: € 266.50
• Couple, married/cohabiting/civil partners, one parent family 66-69: € 298.00
Persons aged 69 and under are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. Certain expenses are also taken into account. Examples of allowable expenses include rent, mortgage, certain insurance costs, childcare, maintenance, nursing home net costs which help to increase the amount a person can earn and still qualify for a medical card. Detailed guidelines are available at: Assessment for a medical card - HSE.ie.
Persons aged 70 or older are assessed under the over 70s medical card income thresholds which are based on gross income. It should be noted that in November 2020, the weekly gross medical card income thresholds for those aged 70 and over were increased to €550 per week for a single person and €1050 for a couple. This increase helps to ensure that a greater proportion of those aged 70 and over qualify for a medical card. However, it should be noted that those aged over 70 can also be assessed under the general means tested scheme where there are particularly high costs, e.g., medication, nursing home fees. Furthermore, the Deputy may be aware that, since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card.
As provided for under the GP Agreement 2023, the expansion of GP visit card eligibility to all children aged 6 and 7 years commenced from the 11th of August. The expansion of GP visit card eligibility to all people who earn the median household income or less is underway and will be completed in two phases, the first commenced 11th of September 2023, and the second starting 13th of November 2023.
From the 13th of November 2023, the qualifying weekly financial thresholds for a GP visit card will be:
• Single person living alone aged up to 69: €418
• Single person living with family: €373
• Married or cohabiting couple with or without dependents: €607
• Lone parent: €607
All children under 8 years of age and Persons aged 70 years and over are eligible for a GP visit card on the basis of their age. No changes are made under the GP Agreement 2023 in relation to the current qualifying weekly financial thresholds for a medical card.
I can assure the Deputy that, in order to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues, including the current medical card income thresholds, under review and any proposals are considered in the context of any potential broader implications for Government policy, the annual budgetary estimates process and legislative requirements arising.
Medical Cards
Questions (625)
Richard Bruton
Question:625. Deputy Richard Bruton asked the Minister for Health the expected number of medical card holders and the expected number of GP-only card holders; and the respective total number of people who will have cover under these cards. [42414/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
General Practitioner Services
Questions (626)
Richard Bruton
Question:626. Deputy Richard Bruton asked the Minister for Health the annual capitation payments which will be in place in 2024 for GPs to cover the provision of service to the different age groups; and the increase that this represents in each case. [42415/23]
View answerWritten answers
The capitation rates payable to GPs under the GMS scheme and other GMS payment/support rates, as well as fees for certain non-GMS services, are set out in the Public Service Pay and Pension Act 2017 (Section 42) (Payments to General Practitioners) Regulations 2019 as amended.
It is important to note that the capitation rates payable to a GP under the GMS scheme are dependent on the contract they hold and whether they have signed up to the 2019 GP Agreement and the recent GP Agreement 2023. The 2019 regulations have been amended to reflect the increased capitation rates available under both Agreements.
As of the start of September, 2,544 GPs hold a GMS contract, over 2,450 GPs have now signed up for the GP Agreement 2023. Therefore for the vast majority of GMS GPs the capitation rates payable are those set out among the fees included in S.I. 458 of 2023, while the new capitation fee for children aged 6 and 7 under the Under 8s Contract is set out in S.I. 459 of 2023.
The capitation rates set under the GP Agreement 2023 represent an increase on the rates provided under the 2019 GP Agreement as follows: an average increase in the rate for 6 and 7 year old GMS patients under the Under 8s Contract from approximately €65.00 to €100.00, and a 10% increase to the rates for GMS patients aged between 13 and 69 years (inclusive).
The capitation rates applicable now to over 96% of GMS GPs, those who hold an Under 8s contract and have signed up to the GP Agreement 2023, are set out below. There is no change to these rates scheduled for 2024 following the 10% increase provided for under the 2023 Agreement. For clarity, the other payment rates provided under the GMS scheme, including capitation rates specific to the Asthma Cycle of Care programme and the Chronic Disease Management programme, are not listed.
|
Child Patient Aged under 6 years |
€125 |
|
Child Patient Aged between 6 and 7 years (inclusive) |
€100 |
|
Child Patient Aged between 8 and 12 years (inclusive) |
€100 |
|
Male patient aged 13 years or more and less than 16 years |
€70.71 |
|
Male patient aged 16 years or more and less than 45 years |
€90.26 |
|
Male patient aged 45 years or more and less than 65 years |
€180.29 |
|
Male patient aged 65 years or more and less than 70 years |
€189.92 |
|
Patient aged 70 years or more residing in the community |
€403.31 |
|
Patient aged 70 years or more residing in a private nursing home (approved by the HSE) for continuous periods in excess of 5 weeks |
€644.63 |
|
Female patient aged 13 years or more and less than 16 years |
€71.52 |
|
Female patient aged 16 years or more and less than 45 years |
€147.60 |
|
Female patient aged 45 years or more and less than 65 years |
€198.10 |
|
Female patient aged 65 years or more and less than 70 years |
€211.87 |
Question No. 627 answered with Question No. 624.
Departmental Policies
Questions (628)
Richard Bruton
Question:628. Deputy Richard Bruton asked the Minister for Health the regime for sharing for prescriptions and for drugs refund from the start of 2024. [42417/23]
View answerWritten answers
The Government is committed to making healthcare more accessible and affordable and has introduced several reductions in the cost of healthcare.
Prescription charges were introduced in the Health (Amendment) (No. 2) Act 2010. On 1 November 2020, prescription charges under the General Medical Services (GMS) scheme were reduced as follows:
• To €1.00 per item for persons over 70, with a maximum monthly charge of €10.00.
• To €1.50 per item for persons under 70, with a maximum monthly charge of €15.00.
The Drug Payment Scheme (DPS) provides for the refund of the amount by which expenditure on approved prescribed medicines or medical and surgical appliances exceeds a named threshold in any calendar month. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS threshold was reduced twice in 2022:
• From €114 to €100 per month on 1 January 2022.
• From €100 to €80 per month on 1 March 2022.
Therefore, currently, under the DPS, no individual pays more than €80 a month towards the cost of approved prescribed medicines. The DPS significantly reduces the cost burden for people with ongoing expenditure on medicines.
While preparations in respect of Budget 2024 are ongoing, any health measures introduced will be in the context of the implementation of the health commitments in the Programme for Government and the funding available.
Hospital Charges
Questions (629)
Richard Bruton
Question:629. Deputy Richard Bruton asked the Minister for Health what the charges at hospitals will be from the start of 2024 for A&E attendance, outpatient attendance, blood tests/diagnostic tests, inpatient care, and for private beds from the start of 2024. [42418/23]
View answerWritten answers
If you attend the outpatients department or emergency department (A+E) of a public hospital without being referred by your GP or family doctor, you may be charged a standard fee. There is no charge if you are referred by your GP. You must show the referral letter from your GP when you attend the outpatients department or emergency department (A+E).
Since January 1 2009, this charge is €100.
This charge is not applicable if you are in one of the following groups:
• Medical card holders
• People admitted to hospital after attending the emergency department
• People receiving treatment for prescribed infectious diseases - including coronavirus (COVID-19)
• Children, in respect of the following diseases and disabilities: “mental handicap, mental illness, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, haemophilia and cerebral palsy”
• People who are entitled to hospital services because of EU Regulations
Note that in select cases where people have difficulty paying, the HSE may provide the service free of charge. You should also note that return visits in relation to each episode of care will not be subject to any additional charge.
If you are referred by your GP to outpatients for specialist assessment by a Consultant or his or her team for diagnostic assessments such as x-rays, laboratory tests or physiotherapy, there is no charge if you attend as a public patient.
It is longstanding Government policy that private patients in the public hospital system should pay for the costs of providing acute in-patient services that are provided to them.
The charge for private care in a public hospital covers the costs of providing the service, including accommodation, non-consultant hospital doctors, nursing staff, medicines, blood, medical and surgical supplies, radiology, diagnostics, operating theatres, laboratories, administration and support staff.. Patients opting to be treated privately must also pay the consultant fees associated with their treatment if the treating doctor has private practice rights in a public hospitals.
The private patient charging provision is Section 55 of the Health Act 1970 and the charges are set out in Schedule 4 of that Act (see table below). These charges were introduced with effect from 1 January 2014 and have not been revised in the interim.
|
Hospital Category |
Daily Charge - Single Occupancy Room |
Daily Charge - Multiple Occupancy Room |
Daily Day Case Charge |
|
HSE Regional Hospitals, Voluntary & Joint Board Teaching Hospitals |
€1,000 |
€813 |
€407 |
|
HSE County Hospitals, Voluntary Non-Teaching Hospitals |
€800 |
€659 |
€329 |
Departmental Schemes
Questions (630)
Richard Bruton
Question:630. Deputy Richard Bruton asked the Minister for Health the terms under which a patient can obtain treatment abroad under the schemes from the start of 2024; and whether rules of access for care in Northern Ireland or the UK differ from those applying within Member States of the European Union. [42419/23]
View answerWritten answers
The HSE currently operates three schemes that facilitate patients accessing treatment abroad.
The HSE operates the EU Treatment Abroad Scheme (TAS), for persons entitled under EU Regulation 883/04. The TAS is a consultant led scheme and allows for an Ireland-based public consultant to refer a public patient who is normally resident in Ireland for treatment in the public healthcare system of another EU member state, the UK or Switzerland. Subject to the EU Regulations and Guidelines, the TAS provides for the cost of approved public treatments in another EU/EEA member state, the UK or Switzerland through the issue of form S2 (IE) where the treatment is:
• among the benefits provided for by Irish legislation;
• not available in Ireland;
• not available within the time normally necessary for obtaining it in Ireland, taking account of the patient's current state of health and the probable course of the disease;
• medically necessary and will meet the patient’s needs;
• a proven form of medical treatment and not experimental or test treatment;
• provided in a recognised public hospital or other institution that will accept EU/EEA form S2 (IE) and;
• is under the control of a registered medical practitioner.
The HSE provides further information for patients on the HSE TAS website: www2.hse.ie/services/schemes-allowances/treatment-abroad-scheme/
The EU Cross Border Directive (CBD) provides rules for the reimbursements to patients of the cost of receiving treatment abroad, where the patient would be entitled to such treatment in their home Member State, and supplements the rights that patients already have at EU level. The HSE operates the EU Cross Border Directive (CBD) in Ireland. Under the terms of the CBD, patients in Ireland can seek to be referred to another EU/EEA country for medical treatment that is available in the public health service in Ireland. The patient may access the overseas service in either the public or private health sector of the country they choose to receive the service in. The patient pays for the treatment and claims reimbursement from the HSE at the cost of that treatment in Ireland or the cost of it abroad, whichever is the lesser. The HSE, in fulfilling its role as the National Contact Point (NCP) in Ireland, provides information for patients on the operation of the CBD, including on its website. www2.hse.ie/services/schemes-allowances/cross-border-directive/
The Northern Ireland Planned Healthcare Scheme (NIPHS) has been in effective operation since 1 January 2021. This Scheme was introduced to mitigate the loss of access to care from private providers in Northern Ireland under the EU Cross Border Directive, which ceased to apply as a result of Brexit. The current administrative scheme enables persons ordinarily resident in the State to access and be reimbursed for private healthcare in Northern Ireland by the HSE, provided such healthcare is publicly available within Ireland. Such healthcare will be reimbursed at the cost of providing that treatment in the State or the cost of same in Northern Ireland, whichever is the lesser. The HSE provides further information for patients on the HSE NIPHS website: www2.hse.ie/services/schemes-allowances/niphs/
National Treatment Purchase Fund
Questions (631)
Richard Bruton
Question:631. Deputy Richard Bruton asked the Minister for Health whether he has received any reports from the NTPF of the main types of procedures which it has been supporting; whether the target waiting time before an offer is made to patients is reported to be different for different procedures; and the scale of these differences. [42420/23]
View answerWritten answers
The National Treatment Purchase Fund looks to source treatment or an appointment for all patients waiting more than 3 months subject to available public and private capacity.
As part of the 2023 Waiting List Action Plan (WLAP) 20 specific high volume procedures were identified, that at the end of 2022 accounted for more than 40% of the IPDC waiting list, with a commitment that anyone waiting 3 months or over who is clinically suitable will receive an offer of care from the NTPF. As at the end of August, 80% of patients waiting more than 3 months have either been removed from the waiting list or have received an authorisation for an offer of NTPF funded treatment.
The Waiting List Task Force continues to meet monthly and oversee progress of the delivery of the 2023 Plan, including updates from the NTPF in relation to the 20 high volume procedures identified in the Plan. The Task Force then provides regular updates to me and the Sláintecare Programme Board.
Nursing Homes
Questions (632)
Richard Bruton
Question:632. Deputy Richard Bruton asked the Minister for Health the system of assessing contribution by patients from their income and from their assets towards the cost of nursing home care under the fair deal scheme, that will be in place from the start of 2024; and if there are particular changes being made. [42421/23]
View answerWritten answers
The 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 scheme is the Nursing Homes 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.
Participants in the Nursing Homes Support Scheme contribute a proportion of their income and the value of their assets towards their cost of care. Couples are assessed jointly but the value of their assets and income that is assessed is halved: participants contribute up to 80% of their income (40% if part of a couple) and 7.5% per annum of the value of their assets (3.75% if part of a couple). The first €36,000 in assets (€72,000 if part of a couple) is excluded from assessment. Participants in the scheme who own property/land-based assets in the State also have access to Ancillary State Support, or the Nursing Home Loan, which is an optional feature of the Nursing Homes Support Scheme. It is a loan 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. It should be noted that the capital value of an individual’s principal private residence is only included in the financial assessment for the first three years of their time in care. This is known as the three-year cap, which is intended to protect the value of a principal private residence.
The Department of Health has introduced the Nursing Homes Support Scheme (Amendment) Act 2021, which became operational in October 2021. This introduced a three-year cap on contributions from family farm and business assets, provided that a family successor is appointed to run the asset for at least 6 years. The Act also extended the three-year cap to the proceeds of sale of a principal residence, which means that, from the fourth year in care onwards and provided the house was sold while the person is in care, a nursing home resident may sell their principal private residence without incurring additional costs.
Effective from 1 November 2022, the amount of rental income that nursing home residents can retain under the Fair Deal from renting their principal private residence increased from 20% to 60%.
Prior to the change being implemented, participants under the Fair Deal scheme were able to rent out their homes or other assets, with rental income was subject to assessment at 80% like all other income (such as pension income).
The rate of assessment for rental income from a principal residence is now reduced from 80% to 40%. This means that for someone renting out their principal residence, they retain 60% of the income and 40% is assessed under Fair Deal. This measure allows residents in Fair Deal to keep more of their income and will also help address pressures on the rental market. It is important that residents who choose to rent out their homes do so in a safe and supported way. This policy change is currently under review.
The Department of Health has also announced plans to amend the Nursing Homes Support Scheme to broaden the definition of who could act as the family successor, to improve the viability and sustainability of family farms and businesses. The amendment also provides for the withdrawal or lapsing of an application to address unintended outcomes in relation to the provision for transferred assets.
Hospital Appointments Status
Questions (633)
Mattie McGrath
Question:633. Deputy Mattie McGrath asked the Minister for Health when a person (details supplied) will be scheduled for their urgent neuro-surgical operation at Beaumont Hospital. [42430/23]
View answerWritten answers
Under 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.
Departmental Reviews
Questions (634)
Ivana Bacik
Question:634. Deputy Ivana Bacik asked the Minister for Health if any reviews or studies have been conducted by his Department into the use of reinforced autoclaved aerated concrete in the construction buildings providing health services; and if he will make a statement on the matter. [42436/23]
View answerWritten answers
As the Health Service Executive is responsible for the management of the public healthcare property estate, I have asked the HSE to respond directly to you in relation to this matter.