Written answers

Tuesday, 19 November 2019

Department of Health

Traveller Community

Photo of Éamon Ó CuívÉamon Ó Cuív (Galway West, Fianna Fail)
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405. To ask the Minister for Health if the bureaucratic barriers for Travellers accessing medical cards will be reduced in view of the literacy challenges faced by some Travellers; if free general practitioner healthcare will be provided to all Travellers within five years in line with Sláintecare; if Travellers will be prioritised in the process in view of their poor health outcomes; and if he will make a statement on the matter. [47514/19]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Every effort is made by the HSE, within the framework of the legislation, to provide a medical card application system that is responsive and sensitive to people’s needs. If the HSE is made aware that a person has particular requirements, assistance will be afforded to help that person complete the application. This assistance can be availed of through a person's local health office or by calling LoCall 1890 252 919.

Regarding eligibility for health services in Ireland, this is based primarily on residency and means, in accordance with the provisions of the Health Act 1970 (as amended). The Act provides that persons who are unable, without undue hardship, to arrange GP services for themselves and family can qualify for full eligibility (a medical card). The HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards and concluded that a person’s means should remain the main qualifier for a medical card. This position remains unchanged.

Sláintecare provides the framework within which a system-wide health reform programme will be advanced, including a phased expansion of eligibility to move towards universal healthcare. To that end, it will be necessary to review the current eligibility framework for all services and consider different options that will enable a phased expansion of universal access to a prescribed range of services. These options will take account of the ability of the health system to meet the increase in demand that would be expected, including the resource requirements needed from a workforce and service delivery perspective, as well as the impact on the effective management of the financial resources of the total health service.

Photo of Éamon Ó CuívÉamon Ó Cuív (Galway West, Fianna Fail)
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406. To ask the Minister for Health his plans to ensure the retention of medical cards for Traveller health workers in view of the importance of Traveller community health workers in improving traveller health; if the retention of Traveller health workers will be ensured by increasing the funding to primary health care projects and by linking their payscales to the relevant HSE payscale taking into account the experience of these workers; if progression routes for Traveller health workers into mainstream employment will be identified including full-time employment; if redundancy and pension payments will be ensured for Traveller health workers in line with the rest of the HSE; and if he will make a statement on the matter. [47515/19]

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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Traveller community health workers are employed to provide primary health care to members of the Traveller Community. The projects are supported by the HSE via Section 39 funding

The HSE grant-aids a range of service providers under section 39 of the Health Act 2004. Employees of agencies that receive grant-aid from the HSE under Section 39 are not public servants and are not specifically subject to the pay-scales approved for public servants. These employees have a private sector employment relationship with their employer.

The HSE does not have a role in determining the salaries or other terms and conditions applying to these staff. It is a matter for Section 39 organisations to negotiate salaries with their staff as part of their employment relationship and within the overall funding available for the delivery of agreed services.

In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. Eligibility for health services is based primarily on residency and means. The HSE is obliged under the Act to undertake periodic reviews of eligibility in order to ensure that a person continues to meet the qualifying criteria required to continue holding eligibility. Where a medical card is due to expire, these cards are reviewed and a renewal notice is sent out to the medical card holder three months in advance of the expiry date. It is important to note that the person under review maintains eligibility for the card while the review is being conducted, including any period where additional information is requested.

Photo of Éamon Ó CuívÉamon Ó Cuív (Galway West, Fianna Fail)
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407. To ask the Minister for Health the steps he will take to ensure each health policy and the implementation of same including Sláintecare are Traveller proofed to ensure that the distinct health needs of Travellers and health inequalities are addressed; and if he will make a statement on the matter. [47516/19]

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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Sláintecare is a high-level delivery programme, tasked with delivering a health and social care service that meets the needs of all our population.

As part of Sláintecare, a resource allocation model is to be implemented on a regional basis. The model will be based on the population profile of the regions, which, it is intended, will capture the differing health needs of the region. As committed to in the Sláintecare Action Plan 2019, work is ongoing under the Population-Based Planning Programme to establish population quantum and profile by region, which includes factors such as age, deprivation and ability.

The Department of Health is developing an inclusion health framework to enhance the delivery of health and social care services to meet the complex health needs of socially excluded groups.

The HSE Intercultural Health Strategy provides an integrated approach to addressing the many unique health and support needs experienced by service users of diverse ethnic, cultural and religious backgrounds who live in Ireland.

The HSE is developing a Traveller health action plan, based on the findings of the All Ireland Traveller Health Study, to address the specific health needs of Travellers, using a social determinants approach.

I understand the health action plan will be finalised by the HSE by the end of the year. The Minister for Health and I are engaged with and supportive of the health action plan. We are committed to providing leadership to support the implementation of the action plan.

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