Terence Flanagan (Dublin North East, Fine Gael)
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Question 113: To ask the Minister for Health and Children if he will respond to correspondence (details supplied); and if he will make a statement on the matter. [8098/11]

James Reilly (Dublin North, Fine Gael)
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The Health Amendment Act (HAA) Card is given to men, women and children who contracted Hepatitis C from the administration within the State of blood or blood products. It is not the same as a medical card, a GP visit card or a Drug Payment Scheme card. The HAA Card gives entitlements to additional services, on more flexible terms and conditions than the medical card. The HAA card and the entitlements attached to it are for the lifetime of the cardholder. At this stage some people have been infected for over 30 years. There are currently 1,485 HAA cardholders being provided with services by the HSE. Home support is one of the statutory entitlements under the terms of the Health (Amendment) Act, 1996. Home support is available when required to assist people with normal day-to-day household activities. As the group ages their health care needs will change from home support to home care and then home nursing. To date home support was provided on the basis of a referral letter from a GP or consultant stipulating the number of hours to be provided. Less than half of the eligible cohort are currently in receipt of home care services. Part of the plan around introducing the needs assessments is to check the present and future needs of those who do not presently avail of services in order that the HSE complies with its duty of care to these people.

In many cases the HSE has no details of patients' health status or future home support/home care/home nursing needs. In order to plan for the changing needs of the cohort the HSE has developed an assessment process. The assessments will be carried out by nurses who will have relevant experience and training in the specific needs of those living with hepatitis C and associated conditions. Nurses carrying out the assessments will be assisted by a multi-disciplinary approach, which will involve all aspects of a person's care.

The assessment tool and the manner in which assessments will be carried out are being developed in consultation with the support groups representing the cohort - the Irish Haemophilia Society, Positive Action, Transfusion Positive and the Irish Kidney Association. A set of proposed review guidelines have been developed which will support the introduction of standardised health and social care needs assessments and allow individualised care plans to be established for all HAA cardholders who require home care. The process will identify the specific needs relating to domestic, continual care and nursing care as well as establishing a review plan following the initial assessment. All HAA cardholders will undergo a complete health and social care needs assessment to establish the supports required and old arrangements where a GP/Consultant letter prescribing a number of home support hours will cease.

Consultations have taken place with key stakeholders including the HSE public health nursing service, consultant hepatologists, GPs and my Department. All clinicians strongly support this review and see in the best interests of patients to introduce a more managed care approach to health and social care needs assessments, allowing optimum care to be provided to all.

Certain members of the support groups dispute the need for the assessment and argue that it will change or curtail their entitlements under the Act. On the contrary, the objective of the assessment is to ensure that all patients for whom the HSE has a duty of care are provided with the optimum supports necessary. In order to progress the implementation of the proposed new guidelines, work is ongoing to agree the mechanisms to be put in place to support a standardised multi-disciplinary approach to needs assessment which is in line with existing arrangements throughout the HSE.