Liz McManus (Wicklow, Labour)
Link to this: Individually | In context

Question 93: To ask the Tánaiste and Minister for Health and Children the reason a patient was sent from Dublin to Limerick by taxi at a rate of €600 for minor eye surgery under the national treatment purchase fund while other patients have been denied access to treatment by private hospitals due to the fact that the hospitals had been informed that the national treatment purchase fund has filled its quota of patients for the year 2005; the steps she will take to ensure that the Comptroller and Auditor General requests a full review of the national treatment fund in 2005 to assess whether it is providing value for money; and if she will make a statement on the matter. [29481/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

In its service plan for 2005 the national treatment purchase fund set a target of having treatment arranged for 16,000 patients. Up to the end of September a total of 12,000 patients were treated. Under the fund more than 35,000 patients have been treated to date and waiting times have been significantly reduced.

The majority of these patients have had their treatment provided in private hospitals in Ireland. The NTPF is working closely with private hospitals to identify and locate the necessary capacity to have patients treated while at the same time managing the number of treatments being provided in order to reach its target for 2005. My Department has been informed by the NTPF that patients have not been denied access to treatment in private hospitals. There is no reason any patient should have been turned away. All surgery planned to the end of the year is set to go ahead.

With regard to the transport of patients, I remind the Deputy that the policy of the NTPF is to provide transport for patients where it is deemed medically necessary or where there are people with special needs, for example the elderly or the infirm. In the case to which the Deputy refers, the procedure involved was not minor eye surgery as it required the patient to have a general anaesthetic and to stay overnight in hospital. Transport was decided having regard to patient safety and best medical practice. There was no taxi fare of €600.

In general, the number of patients that require transport is small and the cost of taxis to the NTPF last year was under €4 per patient treated. In the case of a patient going abroad for treatment the travel costs are paid for by the fund. The authorisation of transport is considered on an individual basis, particularly in circumstances where lack of transport would present a barrier to a patient being treated. Otherwise patients are responsible for their own transport.

In the context of his examination of my Department's Appropriation Account for 2004, the Comptroller and Auditor General carried out a review of the operation of the NTPF in 2004. During his review the Comptroller and Auditor General received the full and comprehensive co-operation of the fund. The responses from the fund and my Department to the issues raised in the Comptroller and Auditor General's report have been fully recorded in the text of the report. As a statutory body funded by the Exchequer, the annual accounts of the national treatment purchase fund will be audited by the Comptroller and Auditor General.

Additional information not given on the floor of the House.

The fund's accounts for 2004 are currently being audited by the Comptroller and Auditor General. It is a matter for him to decide which State organisations or State funded programmes are to be the subject of value-for-money audits.

The fund will continue to arrange treatment for patients and the immediate priority for it in 2006 will be to ensure the fullest co-operation from individual hospitals and consultants in dealing with patients waiting longest for surgery. The Health Service Executive has been asked to ensure that this co-operation continues so that those patients waiting for treatment can be facilitated by the fund.

Liz McManus (Wicklow, Labour)
Link to this: Individually | In context

I thank the Tánaiste for her reply, but it is not very satisfactory. It was reported that a patient requiring minor eye surgery was transported by taxi from Dublin to Limerick at a cost of €600. That report was made on 7 October, but now the Tánaiste says it is not true. I am surprised, if it was not true, that it was not immediately rebutted.

Will the Tánaiste accept there are question marks over the national treatment purchase fund? This may grieve her because the fund is the particular baby of the Progressive Democrats. There are serious questions with regard to the value for money or otherwise of the fund. We know now that 36% of cases were seen in public hospitals which means in effect that those hospitals were paid twice to look after patients.

Will the Tánaiste reflect again on what she said about no patient being denied access to care through the national treatment purchase fund? I have evidence to the contrary. A constituent of mine ——

Rory O'Hanlon (Cavan-Monaghan, Ceann Comhairle)
Link to this: Individually | In context

Has the Deputy a question?

Liz McManus (Wicklow, Labour)
Link to this: Individually | In context

Is the Minister aware there have been a number of cases where patients were approached by the NTPF, but when they were directed towards a hospital they were denied care? One was a constituent of mine. Is the Minister also aware of a case relating to a person from Dunboyne in County Meath? When the family phoned the hospital, it replied that it had received a written directive from the NTPF not to take any patients until January.

Will the Minister reflect on her reply because I am sure she does not intentionally want to mislead the House? The examples I have given are the actual record and I ask the Minister to comment on it.

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

I corrected the report of the €600 taxi fare on the day it appeared. Many inaccuracies have been reported in recent weeks, including one that somebody turned up for surgery and it was cancelled and another that we had changed the medical guidelines for assessing terminally ill patients. Both were untrue, as is this report.

When the treatment purchase fund arranges treatments for people, they proceed unless there is some medical or other reason they cannot, not a lack of funding. The fund got a budget for this year which I increased by 50% and it will spend that money this year. It arranges treatment with various hospitals, some 10% of which will be in public hospitals. The reason that 10% will be in public hospitals is that some of the surgery is very complex, particularly that relating to paediatrics. The facilities do not exist in private hospitals to have that treatment carried out. The figure was higher, but when I came to the Department of Health and Children I directed that no more than 10% of the treatment would take place in public hospitals because the idea is to provide treatment in spare capacity in the private sector for those that are waiting longest.

The figures for those waiting more than 12 months for treatment are down by 70%. Those waiting for six to 12 months are down by 50%. For some 17 of the top 20 surgical procedures, the waiting period is two to four months. This is huge progress.

Liz McManus (Wicklow, Labour)
Link to this: Individually | In context

Does the Tánaiste accept that I have a written reply from the HSE stating there was a change with regard to medical card and means testing for terminally ill patients? I have this in writing and will send it to her.

Since I made that statement public, I have received quite a number of letters and phone calls from terminally ill patients or their families stating that they are being means tested——

Rory O'Hanlon (Cavan-Monaghan, Ceann Comhairle)
Link to this: Individually | In context

We have to move on as we have been seven minutes on this question. The Tánaiste may make a brief reply.

Liz McManus (Wicklow, Labour)
Link to this: Individually | In context

——and nothing the Tánaiste can say will go against the experiences of terminally ill patients who are being means tested for medical cards-——

Rory O'Hanlon (Cavan-Monaghan, Ceann Comhairle)
Link to this: Individually | In context

The Deputy is using up other Deputies' time.

Liz McManus (Wicklow, Labour)
Link to this: Individually | In context

——on which the Tánaiste persists in misleading the House and the public.

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

The guidelines used for assessing terminally ill patients for medical cards are the guidelines that were used when Deputy Howlin or Deputy Noonan were Ministers for Health and Children or even the former Minister, Mr. Brendan Corish, if the Deputy wants to go back that far. The guidelines have been used for the past 30 years without change and will not change.

Liz McManus (Wicklow, Labour)
Link to this: Individually | In context

The Tánaiste should tell that to the HSE.

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

It knows that.