Vol. 1079 No. 3
1. Deputy David Cullinane asked the Minister for Health the measures she will take in 2026 to reverse the trend of increasing hospital and emergency department overcrowding and hospital waiting lists; the additional acute beds, step-down beds and home-care capacity added in 2025 and planned for 2026; the steps she will take to expedite elective centres; and if she will make a statement on the matter. [5082/26]
While the Deputy's question is quite broad, I know that it is really about access to healthcare which is what we all want. It is a priority for everyone in this Dáil, for me and for this Government.
In December, the HSE published its national service plan for 2026, which sets out the services that the HSE will provide with its funding allocation. This builds on progress we have already made this year and in 2025. For example we have seen a 10% reduction nationally in patients on trolleys at 8 a.m. in 2025 versus 2024. That does not even show the real performance of some regions and other regions which are performing less well. That story is much better in some regions again. Twenty-four hour PET breaches, the time spent in an emergency department, are down 16% for all patients and by 15% for patients aged 75 and over compared to 2024. We now have 58% fewer patients waiting over 12 months compared to September 2021. We will continue to reduce waiting times for scheduled and unscheduled care in 2026. We have opened 1,481 new acute inpatient beds since the end of 2020. This year, we will deliver 177 acute and 428 community beds. Those are just as important as acute beds because they provide the opportunity for people to move out of hospital at an earlier stage and have the more suitable care that they need. The first new surgical hub opened in Mount Carmel in 2025. We expected it to deliver 3,000 procedures and it delivered 3,700 procedures. Of course, we are opening five more surgical hubs this year. Crucially, we will roll out the outpatient toolkit. That will be a big subject of discussion this year. We will roll that out across the hospitals in 2026. It is in Naas now and is working really well in Mercy, Tullamore and Kilkenny. That will enable us to increase our outpatient attendances both for new attendances and we will provide more services and clinics at the weekends and in the evenings. We will expand virtual care in hospitals and the community. We are also targeting delivery of over 26.7 million home support hours.
I thank the Minister. I want to point out that families are waiting. I have dealt with a few patients in my constituency in the past month who were waiting to be transferred to Beaumont and the Mater hospitals in Dublin. It took up to four weeks before they were transferred so they are taking up beds in Cavan Hospital when they could be transferred on. I am wondering about the new HSE system, or app, that is in situ. Is it operating so other hospitals know when patients can be transferred and if bed management in other hospitals is actually happening and that hospitals are communicating with each other to ensure that patients are being moved out? A lot of the time people are taking up beds in hospitals where, in my constituency for instance, Cavan Hospital could not offer them the services they required and they need to be moved out. It is also happening in relation to step-down units. We have a perfectly good step-down unit in Monaghan Hospital. I have brought this issue to the Minister previously in relation to Cavan and Monaghan. More patients could be transferred to Monaghan Hospital to the step-down unit there to free up beds.
I am very glad to have this timely opportunity to have this discussion with the Deputy. The reason is officials from her region and the three Dublin regions will be in with me on Monday for a whole day to go through some of these issues exactly because we are trying to manage healthcare as a region. There are patients in Cavan who will need to be treated in Beaumont, a specialist centre for neurology, or the Mater, a specialist centre for cardiology. That patient flow is absolutely crucial and so patients are moving out of Beaumont at an appropriate stage so as to enable the specialist care. We have to think of healthcare as a region and that it is just as acceptable for people to move back from Beaumont to Cavan to free up the space for somebody from Cavan to go to Beaumont. Regarding what the Deputy said about the step-down facilities in Monaghan, I would be very glad if she has specific examples that she can give me before Monday because it is precisely those that I will be testing in person with the different regions on Monday in great detail. The better the local examples I have for that the better I can test and push and make sure the efficiency in that flow is there. I would really appreciate the Deputy’s support to me in giving me that local knowledge before Monday.
I thank the Minister. I would love to work with her to ensure that people do get the step-down units and be able to use them in Monaghan Hospital. Monaghan Hospital was closed a long time ago but there is so much potential there. There are rooms available that could be used for more step-down units. I will definitely come back to the Minister on that.
On the app, is there communication right across the board about patients, hospitals, doctors and nurses? Are they using the app to make sure that patients are being moved on? If there is, say, a cancer diagnosis that cannot be dealt with in Cavan, are they using the app to make sure that patients are being moved on in a timely manner?
There might be two slightly different issues there. The HSE app is a patient-focused app in the first instance. People can make appointments and see prescriptions. Its functionality is improving over time to be able to book appointments. It is slightly different from the broader shared care record and electronic health record. The shared care record which we are rolling out this year is the technology to be able to see if patients are moving from Cavan to Beaumont that Beaumont can immediately see all their healthcare needs without files needing to be transferred and all of those delays. It is separate to inter-hospital patient flow. That does happen but the delays are largely around space and capacity. That is why we need to make sure that we are increase our acute and community beds and really utilising fantastic hospitals like Monaghan that have so much capacity, not to do the acute work but to do other very important community-based work – to be able to do infusions and use step-down beds and the really important work it can do working in partnership with Cavan. I want to compliment both hospitals on how much progress they have made this year to serve the people of Cavan and Monaghan.
I thank the Deputy
2. Deputy Liam Quaide asked the Minister for Health the number of approved psychology posts, per population, in psychiatry of later life services across each health region; to indicate the integrated health areas that currently do not have approved psychology posts, in tabular form; and if she will make a statement on the matter. [5414/26]
I am asking for the number of approved psychology posts, per population, in older adult mental health teams across each health region and for the Minister to indicate whether there are integrated health areas that currently do not have approved psychology posts for older adult mental health teams. To be clear, I am not just asking about vacancies where there has been an attempt to recruit but where a post has not actually been approved to be advertised.
I thank the Deputy for asking this really important question. As Ireland’s population ages mental health services for older people need to continue evolving to meet the growing demand. Improving and expanding access to specialist mental health services for older people is something I am deeply committed to as Minister of State with responsibility for mental health, and as a former Minister of State with responsibility for older people.
In the community, HSE mental health services provide a national network of 34 psychiatry of later life teams to assess and treat mental health issues for adults over the age of 65. Teams are multidisciplinary, including psychologists, with over 400 staff working in older-age psychiatry teams nationwide. Over 85% of referrals are seen within 12 weeks. It is one area where we do not normally have challenges with waiting lists but we are seeing a slight change in that recently because of our ageing population.
On the specific information requested, the HSE has advised my Department that information on approved psychology posts for psychiatry of later life services is not readily or immediately available at subspeciality or IHA level. However, I have asked that they gather the data and respond to the Deputy directly. The HSE has confirmed that the latest workforce data for wider mental health services shows a head count of 509 psychologists at the end of November 2025. That is across all definitions.
I have secured an additional €2 million in funding this year for two new liaison teams for mental health services for older people, which will bring us to 36, and additional posts for community teams. These teams are advancing an important new model of specialist mental health services for older people.
As the Deputy will be aware we have the integrated care programme for older people, ICPOP. This has worked really well in the five areas it has been trialled, a really great example being Limerick in the mid-west where mental health and ICPOP teams are working together.
I thank the Minister of State for following up that data. I do not doubt her bona fides in this area at all but it is not credible that the HSE would not have that data to hand. It is very basic. The importance of psychology as a core part of older adult mental health teams is long established Government policy. A Vision for Change in 2006 was explicit that older adult mental health services must be delivered through fully resourced multidisciplinary teams with psychology as a core part. That principle was reaffirmed in Sharing the Vision, which again recognised the essential role of psychology assessment and intervention for older adults. The failure to meet a benchmark that is 20 years old leaves older adults more reliant on medication and more at risk of physical health issues associated with declining mental health.
The Mental Health Commission's latest annual electroconvulsive therapy activity report, which shows that in 2024 older adults formed a significant part of the population receiving ECT and the average age of a person receiving it has increased to 64, is also of great concern. There is also a well-established increased risk of unnecessary A and E admissions in older adults who are experiencing mental health difficulties. If we are serious about dignity, autonomy and quality of care for older adults, psychology cannot be seen as an optional add-on or a threadbare support.
I want to touch on the trial that has been running over the past three years. We all know ICPOPs are a one-stop shop for elderly people where everything is looked at in relation to their physical health. I am of the opinion that mental health should also be included here. We have trialled in five different areas where the psychiatrist of older age is also involved. I also want to give a shout-out to the psychiatry of later life teams working across the country. In the past few months in my own family, I had reason to have to avail of one of these. It is good that the psychiatrist of later life actually comes to the house of an elderly person and they do not experience the trauma of having to present at the hospital, for example. The psychiatrist will come, spend an hour there and be given a full history. Then there is a follow-up every two weeks with the mental health nurse coming back tweaking medication. It is an area that we do not hear a lot about because it functions very well.
The lack of adequate psychology staffing in older adult mental health teams represents a failure to meet the complexity of mental health needs of people in later life. It is also a failure by Government to meet wider obligations including under the UNCRPD, which emphasises access to appropriate mental health supports across the lifespan and the right to live in one's community with autonomy. Psychologists play a unique role in later life services supporting people to cope with ageing, loss, disability and cognitive decline. They work with families and carers reducing distress and behavioural symptoms, and helping people to remain autonomous for long as possible. My question is simple: what concrete steps is the Department taking to ensure that older adult mental health teams are staffed to the benchmarks that were established in 2006? Unfortunately Sharing the Vision did not include the same kinds of benchmarks, but that is the least we can expect.
I hope the Minister of State will direct some criticism back to the HSE that it could not provide that basic information today. All it would take is an email to middle management to find that out.
I also look forward to getting that information because I am also a person who is data-driven. I want to talk briefly about the work that I have been doing along with the Minister who recently met psychologists in relation to CORU. I will also have a meeting this week about assistant psychology and CORU, which is really important. The Minister is very keen that not only those with a PhD, but also those with a master's degree will be able to work in those roles.
I have secured €2 million in the budget to enhance the 34 teams we have already, which will increase to 36. I have convened a round table with my colleague the Minister of State, Deputy Kieran O'Donnell, to take place next month on mental health and older people, and all the key stakeholders will be there. I am always a glass half full person, and we need to appreciate and acknowledge that we have one of the highest life expectancies in the whole of Europe. Only seven countries in the whole of the EU have a life expectancy in advance of 82.
3. Deputy David Cullinane asked the Minister for Health if she will remove charges for blister packs for those with a clinician-determined need; and if she will make a statement on the matter. [5083/26]
There has been quite a degree of confusion on this and so it is very useful to set out the circumstances of it. As part of the community pharmacy agreement in 2025, all the parties agreed to introduce improved controls for phased dispensing. That would ensure that patients on high-risk medications such as antipsychotics or opioids are appropriately targeted with support for phased dispensing rather than getting everything in one go.
It is important that I clarify the difference between phased dispensing and what has become known as blister packs. The State has supported phased dispensing because it is a crucial patient safety initiative with antipsychotics and opioid drugs. The State has supported phased dispensing for medical card holders since 1996 and will continue to do so; there is no change in relation to that. Community pharmacies receive an additional service fee for that service. The State does not fund and never has funded blister packs. There is no change to that service. There has been no removal of that service because that service did not exist funded by the State.
It is important to say from a patient safety perspective that while I, as a non-medic, anecdotally perceive blister packs as a patient safety initiative, the evidence that I am getting both from the pharmaceutical regulator and from the National Centre for Pharmacoeconomics is that it is not in fact a patient safety initiative and that health outcomes are not in fact changed by blister packs. However, we regard them as convenient and important particularly for elderly people and that is an important part of the consideration.
Internationally the guidance is that blister packs should be a last resort with patients being supported by many other interventions. Nevertheless, I recognise that they are helpful but they have never been funded by the State. As I said before in this House, there are three groups of patients. I might come back to it because I am out of time.
I thank the Minister for answering my question. However, my question referred to clinically determined need. For me clinically determined would be the older person as well. Older people need blister packs to ensure safety and to ensure that they manage their medicines safely. It is a cruel move that the Government is not funding blister packs. It is a necessity and it saves a lot of time and effort allowing older people to take their prescription medication in a safe manner. I ask the Minister to reverse this policy and to ensure that blister packs are paid for by the Government.
I really have to address the language here first of all. There is no policy to reverse because nothing has changed. The basic facts are that nothing has changed and therefore nothing can be reversed. While the Deputy and I believe that and I totally understand the reasons for that, the science does not support that. The more important thing from the State's perspective is the degree to which this service was being used incorrectly by some, not all, pharmacists for their own financial benefit. That is what this State and this House must have an interest in. There are people who have always paid for blister packs charged by their pharmacy for convenience and for lots of different reasons as set out by the GP. There are those who have been getting blister packs for free from their pharmacy and have never been charged, and the pharmacist is simply doing this to support them in different ways. There are also people who were receiving blister packs free of charge but the pharmacist was incorrectly charging the State under the phased dispensing scheme for something that was not appropriate, not allowed and not legitimate.
The Minister has again said that the pharmacy was charging the State. I again ask that she would incorporate that cost. It is not fair on the older person or on the vulnerable person that he or she has to pay for it now. I ask the Minister that the State would pay for it and that she would get over this obstacle with the pharmacies. It is not fair to put the cost on older and vulnerable people which is what is happening now. Loads of people have come to me saying that it is costing them €20 some weeks. I ask her to ensure that this cost is not put on the vulnerable and the older person. She and the pharmacies need to work it out.
I am particularly intrigued to see left-wing parties coming in here and asking me to give money to pharmacists to make good what had been done illegitimately. I would like to use the State's money directly for the benefit of vulnerable people but not to reward those pharmacists to keep things even for them for something that they were doing wrong in the first place.
But it is the older person who now-----
There are many older people, including people who have contacted the Deputy - I see it on her social media pages the same as everyone else - who have told her that they have been paying for blister packs for years and they have always done so.
The older person does not have the income.
This is not a back-and-forth and I am trying to set out the facts on it. I would love to see left-wing parties come in here and defend the interests of the State and defend the interests of the taxpayer. Sometimes I think these roles are reversed. Perhaps for Fine Gael, I should come in and articulate the speaking points of the pharmacy union, but I am trying to articulate the position of the State and to get the best for patient safety, get the best for the taxpayer and make sure that we recognise that we are not rewarding activity that was illegitimate.
4. Deputy Brian Stanley asked the Minister for Health if she will ensure that Saint Anne's ward in St. Vincent's nursing unit in Mountmellick, County Laois, is kept in use when the new wing is open, to allow for the capacity of the hospital to go from 58 to 83; and if she will make a statement on the matter. [4891/26]
I ask the Minister to ensure that St. Anne's Ward in St. Vincent's Hospital in Mountmellick is kept in use when the new wing costing €31 million is opened to increase the capacity of the hospital from 58 to 83 and to make a statement.
The Minister must use taxpayers' money well. She should not waste it.
St. Vincent's Community Nursing Unit, CNU, Mountmellick, County Laois, is a public nursing home that currently provides 56 long-stay beds and one short-stay bed.
Phase 1 of the current capital project at St. Vincent's is substantially complete and consists of a new two-storey development containing 50 single en suite rooms, adjacent and linked to the existing facility. When complete, St. Vincent's will be registered for 58 beds, which includes the eight-bed dementia unit in the existing building, which will continue to operate.
HSE older persons services is currently in the initiation phase of project planning for the utilisation of the old building, taking account of the demand for additional rehab and long and short-stay beds in the CNU.
The current residents in St. Anne's ward will transfer to the new building. Future uses of St Anne's ward will form part of the assessment in respect of the future use of St. Vincent's campus. The scale and scope of future additional phasing of capital works at St. Vincent's is currently being reviewed by the HSE, and once completed, the specific scope for phase 2 of the capital project will be determined.
I thank the Minister of State for the reply. We have a huge shortage of nursing home beds in County Laois. There is also a shortage of respite beds and step-down beds when people are discharged from acute units such as in Portlaoise and Tullamore hospitals. The population, in particular of the elderly, is increasing rapidly. If we are going to spend €38 million on a new building with a 50-bed capacity, which I wholeheartedly welcome, we need to get extra capacity for that money. However, the plan is to move out the existing 50 patients to the new wing and to close the two existing wards. I have been in the unit and I accept that one of those wards is not fit to be used again, as it needs to be refurbished. However, St. Anne's ward was extensively refurbished in recent years. It is a fantastic facility and it is in perfect condition. It has en suite rooms. I urge the Minister, Deputy Carroll MacNeill, and the Minister of State with responsibility for the elderly, Deputy O'Donnell, not to let it be boarded up and lie idle. This would bring the capacity of the hospital from 58 to 83. The new wing will soon be open. It is important that St. Anne's ward is not boarded up. We must gain from the €31 million that is being spent in Mountmellick.
I thank the Deputy. He is way over time.
I very much appreciate and welcome the Deputy's kind comments on what will be the new state-of-the-art building for residents.
To put it in context, phase 1 of the St. Vincent's development is substantially completed, with the new unit currently being equipped. The HSE is committed to further development on the St. Vincent's campus. A scoping exercise is under way in conjunction with a local needs assessment to determine the future requirements for the people of Laois and Offaly. Areas for consideration include step-down beds, short-stay and long-stay beds, rehab beds, dementia-specific beds and respite beds. I will bring back to the HSE the particular points Deputy Stanley makes. Further developments will take place on the campus but phase 1 is virtually complete.
That is fine but St. Anne's ward is HIQA-approved already. The rooms are en suite. The Minister of State needs to have a look at this, as he has responsibility for older people. The Minister also needs to look at it. I say this in a very positive way. They will soon be there cutting the ribbon. That will be a good day for care of the elderly. I have argued long and hard here for the past 15 years, as have other Deputies, for the new wing in Mountmellick, and it is there now. We have a chronic shortage of nursing home beds. Not a week goes by but families are looking to get their loved ones into Mountmellick or Abbeyleix. The population in the county is mushrooming, especially of the elderly. There is a real chance here to get a gain. On the day when the Minister of State or the Minister is down to cut the ribbon, or before it – it will be a great day when it happens – will they visit St. Anne's ward? They have to see it. They were in Limerick opening the new hospital wings there. The wings are needed and that commitment was fulfilled.
I thank the Deputy.
This is needed and there is an opportunity for a gain in capacity. The unit is there and it has been refurbished.
I thank the Deputy.
We need to do it and look after it.
I very much look forward to the opening of the new 58-bed community nursing unit for the people of Laois and Offaly. I met with the HSE yesterday about a number of community nursing home facilities. I raised a particular issue in respect of a second phase at St. Vincent's. I asked directly about the scoping exercise the HSE will do in respect of the existing building.
I look forward to seeing Deputy Stanley, all the public representatives, and more particularly the residents in St. Vincent's when we open the new community nursing home facility on the St. Vincent's campus.
5. Deputy David Cullinane asked the Minister for Health the steps she will take to address the major shortfalls in school dental screening and extreme waiting times for orthodontic care; and if she will make a statement on the matter. [5084/26]
What steps will the Minister take to address the major shortfalls in school dental screening and the extreme waiting times for orthodontic care, and will she make a statement on same?
I will first concentrate on the wider challenges regarding oral healthcare. There is a significant challenge that continues to affect the delivery of school-based dental programmes. In the period to November 2025, over 138,000 new patients were assessed, including 90,000 under targeted programmes in respect of school and special care programmes, but in many cases screening is delayed, meaning some children do not receive an assessment until they have already entered secondary school, except in emergencies. While the HSE follows up to ensure those children are seen, the situation is simply not good enough. I am not happy with it.
The situation stems from long-standing workforce pressures and a totally outdated, episodic model of care that is not aligned with the prevention-focused approach we want. The response to this is multifaceted and requires some short-term interventions and meaningful strategic reform.
The HSE is funded to recruit an additional 15 oral health staff this year targeted at service areas experiencing the greatest delays. Good progress is being made in recruitment. We have recruitment campaigns completed for eight of them and three campaigns are currently active. Looking ahead, we need to think about how we use the wider dental workforce. I met with the Irish Dental Hygienists' Association last year. Hygienists are a fantastic group of people. They advocate for more direct access to patients. I believe they can play a much bigger role in preventive and periodontal care. I have instructed my Department to accelerate the necessary consideration of this matter. It must be safe and of course add value for patients. Legislative change will be required and the regulator will need to establish the necessary conditions and supports to make sure that it is done safely. That is an important part of how we use our workforce at the top of their expertise, and use every qualified professional resource.
In the medium-to-long-term the national oral health policy sets out a comprehensive vision for strategic reform, including new children's oral health services supported by age-appropriate packages of care. I regularly hear this cannot be achieved due to capacity constraints. The proportion of children that is already being seen in private dental practice and families paying out of their own pockets to do so is not acceptable.
I raised this question numerous times through parliamentary questions and at the Committee of Public Accounts and the health committee, among others, last week.
There was no school screening in Monaghan in 2024-25. That is just not good enough. I get a lot of emails and other contacts in this regard. There is no orthodontist in the north-east region at all. There used to be one in the Monaghan area. People are now being asked to travel to Dundalk, which is not acceptable. I do not even know if that orthodontist is still in operation. Could the Minister focus on the workforce plan and introduce targeted measures in that regard? It is completely acceptable if people are off on maternity leave but it must be projected that it will happen each year. She mentioned that she is recruiting in 15 areas. I hope Monaghan is one of those areas.
I am in complete agreement that this simply has to improve. While the services are there, looking at the wider workforce generally in relation to dental care, if we separate it out from orthodontics, how we use the workforce has come up a number of times. We train dentists at quite a considerable cost to the State. We do that because we want dentists to be available to do dental work, both in private practice and for the State. We want children to have screening. I do not want to deviate too much but I have been consistently concerned by one issue. This has been acknowledged by the Irish Dental Association and ADI, which is the group training dentists.
The issue relates to the number of dentists who are being trained in Irish State-funded facilities and the drift towards cosmetic dentistry, the scale of practice in injectables, Botox and other things being done by dentists. At a two-day conference of the dental association last May, one full day was dedicated to injectables. I want to train dentists to do dentistry on children.
I have to agree with the Minister. Children should be our priority here. As we know, early intervention is key. I have heard of cases, again in Monaghan, where a child of seven years of age had to get seven extractions done. There was no screening. That could have eliminated them. They could have put a wee filling in and helped with that process. Will the Minister make it a top priority that children are screened? It develops good habits and good oral hygiene for their lives. Therefore, I would make it a priority. On the dental training, perhaps there should be a recruitment drive to ensure that people are going back to college to study dentistry and that we make it a priority.
We have made some good progress on the training. The RCSI has opened a new community train-and-treat facility in Sandyford and has just started building one in Connolly Hospital as well. We are making some good progress there. On screening, the seven-year-old child mentioned by Deputy Bennett needed much earlier screening, which could have been provided by a dental hygienist. The actual dental work that might be needed has to be done by a dentist. When we are trying to identify problems at an early age, we need prevention, screening, cleaning and good habits; all of the things the Deputy has talked about. We are not using our workforce well enough at the moment. I want to see the role of dental hygienists amplified. They should be given better opportunities to do programmes in schools and to have more direct access to patients. We have to look at every lever. We will train more dentists but when we do so I would like to see a commitment to public service. We have increased the fees generally for HSE-funded dentistry, by between 40% and 60% in some instances. On average, we have increased them by 40% for doing certain procedures and we still cannot encourage dentists to come, at the scale that we want, into that practice, potentially because of the allure of more lucrative products.
6. Deputy Michael Murphy asked the Minister for Health the alternative arrangements being developed by the HSE to ensure continuity of coronial post mortem services for the south-east region from January 2026, given that consultant pathologists at UHW will no longer provide this service; and if she will make a statement on the matter. [5311/26]
I ask the Minister for an update on the provision of post mortem services at Waterford University Hospital following the decision by HSE pathologists operating as independent contractors for the Department of justice to withdraw from the service from 1 January.
As the Deputy will be aware, the Department of Justice, Home Affairs and Migration has responsibility for coroners’ legislation and policy and is actively engaging with all relevant stakeholders, including my Department and the HSE. Since 2 January 2026, coronial post mortems have been provided by locum consultants recruited by the Department of justice, and the facilities and auxiliary staff of University Hospital Waterford have been provided to support that. The Department of justice has advised my Department that the service will be provided three days per week; that is, Mondays, Tuesdays and Fridays. Historically, the health service has assisted in the provision of coronial post mortem services on a sort of grace-and-favour basis. While consultant pathologists are employed by the HSE, coronial post mortems are carried out independently for the Department of justice. Obviously, that grace-and-favour model is not working. Hospitals are withdrawing from the provision of coronial post mortem examinations for a range of diverse and complex reasons, including a shortage of consultant pathologists willing to undertake that work, and increasing diagnostic workloads for an increasing population. My Department and the HSE will continue to engage constructively with the Department of justice to support a long-term resolution of the issue. All stakeholders remain committed to ensuring the continuity, quality and efficiency of coroner-directed post mortem services.
As the Minister says, this is ultimately the responsibility of the Department of justice under the Coroners Act. I thank the Minister for her engagement with me over the last six months. As she knows, behind every post mortem is a family in deep distress and shock. Often, these post mortems are the result of a sudden, accidental or tragic death. I welcome these interim arrangements. It is not ideal. It is my understanding that these locum pathologists are coming in from the UK three days a week. I know that members of the clergy have spoken publicly on behalf of families. Delays are already occurring. There is a panel of three locum pathologists, but could we look at increasing that number to four or five? Flights can be delayed or cancelled, somebody can have a bereavement or somebody can be sick. I ask the Minister to continue to engage with the Minister for justice. Let us keep this arrangement under review so that families can have post mortems in the timely manner they deserve.
It is important to separate out the arrangements we are talking about. This arrangement is not for all post mortems; it is for coronial-directed post mortems in instances, as the Deputy correctly identifies, of sudden or unexpected death that require and are directed to have this type of post mortem carried out. That is very much an issue for the Department of justice. Clearly, pathologists are continuing to do the work they have always been doing. Where a family has experienced a sudden tragedy - a sudden bereavement of some kind - and the coroner has directed this form of post mortem, that is obviously the responsibility of the Department of justice. I will speak with my colleague, the Minister, Deputy O'Callaghan, and ask him to increase his efforts to try to ensure there are more locum pathologists coming. However, University Hospital Waterford remains there to provide support in that ancillary way for this specific type of post mortem, which is, of course, a subset of all post mortems.
I agree and I acknowledge that our HSE pathologists have been doing this work as independent contractors. However, these pathologists are primarily concerned and occupied by diagnostic, surgical pathology work, for example, in cancer diagnosis. Therefore, for obvious reasons, they are withdrawing as independent contractors. Between 3,000 to 4,000 coronial post mortems are carried out annually in the country at various locations, namely, Dublin, Limerick, Cork, Galway and Waterford. Is there merit in looking at this more closely in terms of some kind of a strategic plan and a national strategy for the next ten years? The real concern, certainly across the south east, is that we will become like the UK whereby there are delays of weeks and weeks. Will the Minister keep that under consideration?
Again, I will direct that to my colleague, the Minister for justice, because coronial post mortems are a different thing. There is a difficulty recruiting pathologists across the country. For example, our friends in Belfast are having real difficulty on the paediatric and perinatal pathology side, which is very distressing for families with the loss of a child or a baby. There is a shortage generally but we have to create a distinction between the justice system and the health system, which continues to do its work. We need pathologists to continue to do their work, both in terms of diagnostics and research and also in terms of something that is separate and ancillary and arises as a consequence of the coronial court process. The latter is very much a matter for the Department of justice. Nobody cares about that when it is their loved one whose funeral is being delayed. In that space of real tragedy, real hurt and real pain, nobody cares who is responsible for it; they just want the issue resolved. I will discuss it with my colleague, the Minister for justice.
