Vol. 1079 No. 3
7. Deputy Naoise Ó Cearúil asked the Minister for Health the status of developing and implementing a single point of access for children’s disability, mental health and primary care services to ensure timely access to appropriate supports; and if she will make a statement on the matter. [4955/26]
I am asking about the development and implementation of a single point of access for children's disability, mental health and primary care services to ensure timely access to appropriate supports. In many instances, cases are being sent from section to section within the Department itself and we are not getting proper conclusions for constituents and people coming to us.
I thank the Deputy for this important question. I welcome the opportunity to highlight this important initiative, which is being led by our colleague, the Minister of State, Deputy Higgins, her Department, and HSE disability services. The single point of access will create an integrated approach across disability services, primary care and mental health to strengthen collaboration and to deliver more consistent and equitable access for children and their families. The CEO of the HSE, Mr. Bernard Gloster, has directed that the single point of access will streamline the process for GPs in referring children with a therapeutic need to primary care, disability and mental health services. What this means in real terms is that the GP will only be able to refer the child to one of those services whereas previously they may have been referred to all three.
This approach will ensure the most appropriate service - primary care, disability or mental health - takes ownership of the care of the child, and facilitates input from one or both of the other two services if needed. It does not mean people are only going to have access to one service but that one service will take the lead on it. For example, when an autistic child is accepted into the care of a community disability network team but they also have a moderate to severe mental health disability or difficulty, CAMHS should also provide a therapeutic input into that child’s care. This is known as shared care. We have to get better at integrating care in this way. Too many cases are falling between the cracks in our system because the services are not working together.
A national implementation group is in place within the HSE. Health regions have established their own regional steering groups, which are responsible for developing local implementation plans and delivering this reform to simplify access to care for children and their families. These local implementation plans were signed off by the CEO in December. The single point of access is a key commitment of the HSE in its national service plan for 2026.
I welcome the positive news and the developments, particularly on the implementation plans. It would be great to get an idea of the timelines for implementation. We have had a number of cases in our office. One that strikes me quite strongly involves a young person with autism and mental health difficulties. They were referred by their GP to CAMHS, which said the young person fell below the threshold. CAMHS then referred the case, after a lot of back and forth with the Department of Health, and the young person was essentially told it was an issue for the Department of children. They went to the Department of children and they were told it was an issue for the Department of Health. These are young and vulnerable people, in particular. Their parents are trying their best and are at their wits' end. Hopefully, this approach will find resolutions for such children in the future but for this child, there needs to be a resolution as soon as possible.
To expand on the point I was making, I have adopted a youth mental health strategy which started two years ago. It is called the "no wrong door" approach. It connects young people who have a mental health difficulty with the most appropriate level of care to match that young person's needs. Referrals to CAMHS are up 48% in the past five years. We know that many young people could be treated earlier and more effectively. We are triaging it in three areas: north County Dublin, the Inishowen Peninsula and Galway. The one in north County Dublin is led out by Mellany McLoone, the integrated health area lead. She has been doing this for two years. When a child is referred by a GP, they are triaged. They look to see if the child might be better served with Foróige or a family resource centre such as Jigsaw, or a similar service like Mindspace Mayo, primary care psychology or maybe CAMHS. However, the most important thing is that a doorway will be found. Every parent who brings their child to the doctor wants a doorway.
These are all extremely positive initiatives. I commend the Minister of State on them. However, what remains to be addressed is how children and young people with autism are being dealt with through mental health supports. It is said that children's mental health supports need to be addressed through the relevant channels. Rather than actually analysing and looking at these two issues separately, the assertion is that the mental health difficulties here are due to the autism diagnosis. They may be connected, but they are two separate issues and need to be dealt with separately and supported separately. In this particular case, we are trying our best but we cannot get anywhere with it. I can only imagine how frustrating it is for the parents in this situation. It is about how people with autism are being dealt with in relation to mental health as well.
If the Deputy wants to send on that case, I will have it looked at again. There are situations where there are challenges with CAMHS and children with another diagnosis. In order to be accepted into CAMHS, there has to be a primary diagnosis of a mental health challenge. We have to get better at doing shared care and that is the whole purpose of having this new single point of access. Bernard Gloster of the HSE has been adamant that this has to be rolled out across all areas by the end of this year. That is why a national implementation group is in place to oversee this development. We have been leading out on mental health. We launched a document during the summer of last year about shared care because parents get extremely frustrated when they are sent from one team to another and they are not accepted within either team. I suppose "shared care" is the new buzz word we are really looking at. When a child who is accepted into a community disability network team needs mental health supports as well, that has to be facilitated.
8. Deputy Cathy Bennett asked the Minister for Health the waiting periods faced by people in counties Cavan and Monaghan to access cancer treatment, by number waiting and length of time; and the longest period a person waited for treatment in 2025. [5034/26]
I ask the Minister to set out the waiting times faced by people in Cavan and Monaghan to access cancer treatment, and to do so on the basis of the number of people waiting and the length of time for which they have been waiting. What was the longest period a person waited for treatment in 2025?
Cancer services in Ireland are organised on the basis of a centralised model of care rather than a per-county basis. That enables the specialists to support the specialist centres. There are eight designated adult centres, 26 systemic anti-cancer therapy centres and three public radiation oncology centres. While performance data is collected at each centre, it is not based on where the person lives; it is based on the performance of the centre.
Patients from Cavan and Monaghan are referred to the most appropriate centre for their treatment. For cancers, this would almost certainly be the HSE Dublin and north east designated centres at the Mater hospital or Beaumont Hospital. It is their data that matters for the people in Cavan and Monaghan. As with all patient care, the goal is to provide services as close to home as possible. Patients requiring less complex treatments, such as systemic anti-cancer therapy - chemotherapy and immunotherapy - would access that at Beaumont Hospital, the Mater hospital, Cavan General Hospital, Connolly Hospital or Our Lady of Lourdes Hospital in Drogheda. Oral chemotherapy is also being expanded for many patients in the community, including being delivered as close to home as possible.
As the Deputy will be aware, there has been really significant investment in community supports for cancer patients, including in Cavan and Monaghan. Approximately €5.5 million is being provided to the Alliance of Community Cancer Support Centres and Services. Of course, Cuan Cancer Support Centre is a full member of the alliance. Crocus Monaghan is a new associate member, providing additional psychosocial and other important supports to cancer patients and their families in the local region.
In terms of the waiting times in that region, my information is the performance of the systemic anti-cancer therapies and so on in that region is actually very good. It is actually close to or exceeding the targets nationally. The region is working quite well generally. It can always improve but it is working quite well generally. On the specific times and so on, we have to go on the KPIs generally and how they are set. There are many cases where somebody might be waiting a long time, not because of a failure to deliver the service but because of the complexity of their case and multiple different issues. It is important not to single out individual cases.
As we discussed earlier, the stress and anxiety that a cancer diagnosis can cause a person and their family is almost like no other. The fear and worry it can spread is excruciating. In Ireland, we are fortunate to have highly trained and passionate healthcare workers. We know that once people get into the system, they receive world-class care. Delayed treatment of cancer yields mortality. That simply is not acceptable. What timeline will the Minister commit to so that all cancer patients will receive the treatment they need when they need it? There have been numerous cases in Monaghan and Cavan where patients have been left in Cavan General Hospital for three or four weeks after getting a diagnosis without being transferred to Beaumont Hospital or the Mater Hospital. As we discussed earlier, it is about beds. Free up the beds in Cavan and move on the patients. They need the treatment and they need it urgently. I am asking the Minister today if she will give me a timeframe for patients to be moved on to receive their cancer treatment.
The timeline is the one we have all set in relation to the Sláintecare targets. We are all working towards that. As we discussed earlier, I would appreciate those specific examples so I can follow them up much better.
Yes.
Across 2025, in Beaumont Hospital, where many patients would be referred, 80% of urgent breast cancer referrals were seen within ten working days and 98% of the non-urgent referrals were seen within 12 weeks. It sounds so impersonal to talk about the metrics, but you have to look at how everybody is experiencing it and not an individual to see how we are doing over time. In December 2025, Beaumont Hospital increased its capacity for urgent outpatient slots by ten per day to try to clear any backlog. In addition, nearly 1,500 breast-imaging studies have been scheduled to be performed at evenings and weekends. We are trying to use all the resources we have, including the physical buildings and the diagnostic equipment in those buildings, in the best way. I have seen the new CT machine in Beaumont Hospital. I am assured by the region that it is an absolute priority to ensure the staffing is there for that in 2026.
The problem is that Fine Gael outlined the White Paper, The Path to Universal Healthcare, more than ten years ago. It was supposed to be completely implemented by 2019. The Minister announced a policy of the same name, with Sláintecare 2025+ tacked on, only last May. In a lot of ways, the Minister is still waiting to deliver the plan that was announced in 2014 and due for completion in 2019.
Only two months ago, after the Minister's announcement, the Irish Cancer Society sounded the alarm that cancer delays are causing unavoidable deaths. Therefore, I ask the Minister today if she accepts that these waiting times are unacceptable. Does she accept that cancer delays are causing unavoidable deaths? Could we do more to improve that service?
I might separate that into two things. I do not know what I was doing ten years ago, or what the Deputy was doing ten years ago. I do not know what that has to do with anything. I do not know who wrote that for the Deputy as a political point.
But-----
If we could get to the reality of the delivery of cancer services, this Oireachtas agreed Sláintecare. I am here at the moment - there will be somebody after me, as there was somebody before me - to try to implement that and make sure we have a public system that meets people's needs as close to home as possible and in a timely way. We are making good progress with that. If the Deputy looks at our cancer strategies and how they have contributed to that, she will see that when the first cancer strategy was launched in 1996, the average five-year survival rate was 43%. In 2022, that rate was 65% and it continues to grow because of the way we have organised services in specialist centres. Now, we need to ensure we make people's lives easier when they get a cancer diagnosis, for example by ensuring they get the treatment as close to home as possible so they do not have to travel and by ensuring they get really good treatment. We are all working on that together. We can create politics, but I remind the Deputy that her own party's manifesto specifically committed to Sláintecare. I am not sure what that point is really.
I am just asking for action.
9. Deputy Matt Carthy asked the Minister for Health the status of a new psychiatric unit at Cavan General Hospital; the timeframe within which it is expected to be delivered; and if she will make a statement on the matter. [4900/26]
I ask the Minister of State to give us an update on the status of the new acute mental health unit at Cavan hospital and, more importantly, the timeframe in which the unit will be completed and delivered.
I thank the Deputy for his question. I am really ambitious for transforming the mental health capital estate over the next three, five and ten years. I currently finalising a ten-year capital plan for mental health, which will guide our investment programme in mental health infrastructure. This plan is backed up by national development plan funding of up to €500 million for the next five years to the end of 2030. I am working with each of the regional executive officers, REOs, the national mental health office and the Minister, Deputy Carroll MacNeill, to ensure we grasp this opportunity to embark on a capital programme that will see record levels of investment. We will be investing in acute facilities, which the Deputy just referenced, community facilities, community residences and national priorities including additional adult eating disorder beds and the first perinatal mother and baby mental health unit on the island of Ireland.
The HSE capital plan for 2026 is being finalised and will be announced in the coming weeks. I will then also publish the longer-term vision for capital projects in mental health. I am not in a position to be able to update the Deputy in relation to that. As I said, we are working on finalising the capital plan. All details in relation to any new developments will become apparent there. However, one of the areas I will be specifically focusing on is the Mental Health Bill 2024, which is currently going through the Dáil, and for which I will be in the Seanad later today. There is going to be a change in relation to community residences for those with enduring mental health conditions who live in communities. We will have new governance and oversight in relation to those facilities. I will be putting a focus on them in the capital plan, but also with regard to areas that do not have any mental health inpatient beds. There are specific areas. We will look at maybe providing a crisis house in those particular areas. We will have news in the next few weeks. I hope the Deputy understands why I am not able to give that detail this morning.
I am a bit taken aback, to be quite honest. The Government and the HSE have given a commitment that there will be a new acute mental health unit - a psychiatric unit - on the grounds of Cavan hospital. Previously, a date of 2030 had been provided. I hoped that the Minister of State would be able to announce today that the preliminary processes had been advanced so that we could reach that. The Minister of State will know that previous Mental Health Commission reports in respect of this unit have been quite damning. That is no reflection on the staff within the ward who I am sure do a huge amount of work. However, this is a unit that is on the lower ground floor, which says all we need to know, essentially, about how mental health has been treated up to this point. I ask the Minister of State to ensure that greater clarity is given. Is this a priority or not? Can we be given an assurance that this unit will be delivered quickly?
As I said, the national capital plan for mental health is being finalised. The Deputy could ask me the exact same question about Waterford, where I am from, because we are in the exact same predicament as Cavan. He could ask me about the Jonathan Swift Clinic, the Lakeview unit in Kildare, Roscommon, the Mater Hospital or the St. Michael's unit in Cork. There is a myriad of various capital plans that are under consideration at the moment. I am not going to pre-empt the capital plan. I am not going to pre-empt it for my own area or any area. Suffice to say, however, that a huge amount of work is being done. Additional funding has been secured. It is the most funding ever in relation to capital infrastructure for mental health. I want to see many facilities being rolled out in parallel with each other the length and breadth of the country. I am very keen to address postcode lottery issues and geographical issues. Regardless of where people live in the country, they should be entitled to the best facilities possible if they have a mental health condition.
I will explain what I do not understand. I have a letter from the HSE, dated last July, which states that the HSE capital plan includes this provision and that the HSE is looking at appointing the design team. Has that happened or not? Is the Minister of State saying that the last year has basically been wasted in terms of moving this project forward? Will there now be a new appraisal of whether this project enters the capital plan at all? Along with Senator Tully, I recently met the mother of a young man who spent time in this unit in Cavan hospital and tragically, very shortly after leaving, he died by suicide. It was a very tragic case. This woman has made it her life's mission to ensure that future young people get a better service than she feels her son did. She believes that a new acute mental health service at Cavan hospital - a stand-alone facility above ground level, which should not be too much to ask - must be delivered as quickly as possible. The Minister of State can cite all the other failures in other parts of the country, but I and the people of Cavan and Monaghan and beyond need to know whether this is a commitment and a priority. When will it actually be delivered?
The Deputy is quoting from the capital plan from 2025. I am currently finalising the capital plan for mental health for 2026. It will be published very soon, and the Deputy will see the details. Once a proposal is on the capital plan, it is not going to be removed from the capital plan. I am not in a position-----
Is it going to be delivered?
It is not a question-and-answer session. I am not in a position to give the Deputy that information at the moment.
The Minister of State has not answered the question I asked.
On 1 September last year - I say this every opportunity I get - I launched free counselling supports for men across the country. Four out of every five suicides in Ireland are men, notwithstanding that we have seen a reduction in the numbers, thankfully. Every single suicide has a profound impact on people. That particular mother lost her son. I speak every chance I get about yourmentalhealth.ie/men and free counselling supports. Men can refer themselves to it. If all Deputies' constituency offices could share that news and that website, it would be very helpful.
It is an acute care unit that is needed.
10. Deputy Malcolm Byrne asked the Minister for Health for an update on the development of the new primary care centre, PPC, at Gorey, County Wexford. [4437/26]
I ask the Minister for Health for an update on the long-promised, long-awaited and long-overdue primary care centre at Gorey, County Wexford.
I thank the Deputy for allowing me to update the House on this matter. Primary care centres form an important part of our health infrastructure and provide a single point of access to primary and community care services for individuals. As the Deputy is more than aware, the need for a new primary care centre in Gorey was identified as part of the overall primary care centre development programme. The development of that centre had previously been progressing under the operational lease model. A tender process was undertaken and a preferred provider was identified, as the Deputy is aware. Unfortunately, that preferred provider encountered difficulties regarding the viability of the project. The HSE subsequently took the very difficult decision to withdraw from the process and to readvertise this location.
To inform the readvertisement of Gorey PCC, the HSE conducted a review of the current and future health service needs for the Gorey area. Following this, in June 2025, the HSE published stage 1 of the advertisement for this PCC location on the eTenders procurement platform. The expressions of interest received in stage 1 have since been evaluated. In quarter 4 of 2025, stage 2 of the advertisement, which seeks a priced offer, was published on eTenders.
The HSE has advised that the tender returns arising from stage 2 of that advertisement will be evaluated in this quarter, as the Deputy is aware. I thank him for his commitment to ensuring the HSE is actively engaging to progress the further development of primary care centres throughout the country, which, of course, includes Gorey primary care centre.
The Minister of State, Deputy Butler, will recall that in my time in the Seanad, I raised this issue four times as a Commencement matter. I raised it as a Topical Issue in this House on 13 February last year, which was also answered by the Minister of State. She concluded her response on that occasion by saying: "I have no doubt I will be back in here again to answer about the Gorey primary care centre." The commitment from the HSE at that time, which she said was certain, was that the advertising on the eTenders procurement platform would happen in quarter 1 of last year. As the Minister stated this morning, the project was not advertised until 24 June 2025.
The problem is that, time and again, the HSE, despite all its promises, does not meet any of its timelines. Will the Minister directly intervene to ensure this project progresses? When the former Minister, Stephen Donnelly, was in office, it was only through his intervention that certain decisions were secured. I am asking the Minister, please, to intervene. This is critical to the people of north Wexford.
The Deputy is well aware of the circumstances in which the previous process lapsed. We will continue to make sure it progresses at the appropriate pace. I will speak to the HSE about it. We will all be very pleased when we see a tender awarded and progress beginning on the site.
I recognise the Minister's commitment in this area. It is critical that we have a primary care centre that will include the local CDNT, have adequate facilities and include the planned additional CAMHS unit. My issue has been that when the project was conceived in 2010, everyone locally said the site identified by the HSE would not work. Finally, the HSE accepted that. When we had a meeting with the then Minister, Stephen Donnelly, his remark about the project was that even with all the time delays concerning the national children's hospital, the latter was conceived and will be delivered before we even see a shovel in the ground at the Gorey primary care centre.
One of the biggest issues we have in north Wexford, because of the rapid growth in population, is access to GP and other healthcare services. I do not doubt the Minister's commitment but the problem we see, time and again, is the HSE missing deadlines.
I appreciate the absolute commitment to this issue by Deputy Byrne and the other Deputies from the area on behalf of the people of the region. I think we will end up with a good-sized primary care centre but we want to see progress on that and facilities expedited as much as possible. I certainly will continue to work with the Deputy and with the HSE to try to maintain the appropriate schedule to ensure the project progresses.
11. Deputy Paul Murphy asked the Minister for Health if she will legislate to end the three-day wait for abortion services; and if she will make a statement on the matter. [4679/26]
I do not know whether there is any other law that imposes a three-day wait on any medical treatment. I do not know whether it applies when getting Viagra or rhinoplasty surgery. Forcing women to wait for a health treatment that is extremely time sensitive and very geographically difficult to access, where that wait is medically unnecessary, damaging and patronising and puts extra pressure on our health services, has to stop. Does the Minister agree with that?
I appreciate the Deputy's question. My Department is committed to ensuring there is safe and equitable access to termination of pregnancy services. We have taken a number of important actions to give effect to that, on which I will update the House.
In line with the programme for Government, all 19 maternity hospitals are now providing termination of pregnancy services. There has also been a continuous increase in the number of community providers, which currently stands at 487. That is hugely significant in the context of respecting women's rights and choices. My Department also approved the revised model of care, introduced during the Covid period, as the enduring model of care. Under its blended approach, it is possible for one of the two consultations currently prescribed by legislation for termination in early pregnancy to take place remotely. Safe access zones were introduced to protect the right to lawful access to healthcare services with dignity and privacy. The cumulative aim and effect of these measures is to substantially reduce barriers and increase the availability of services for those who need them.
The legislation in place is consistent with commitments given to the Irish people prior to the repeal of the eighth amendment. The issue of legislative change, including changes to the three-day wait, requires very careful consideration. I respect the different views on these benches and on the benches opposite regarding the next steps to be taken. That is the reason I voted last week to enable Deputy Paul Murphy's Bill to come back on the floor of the House. It is important to have a Chamber that enables freedom of speech and debate and that we have dialogue on this issue. Deputy Murphy's legislation deals with a number of specific issues, some of which I might agree with and some with which I definitely would not agree. It is important to have a very broad debate. I respect the work done in the review. There is no consensus at the moment in relation to the next steps. The Deputy, in putting forward this question today, is continuing the debate, which is so important.
To be frank, we should not really need consensus for an individual to get healthcare. It should not be up to men, predominantly, in the Dáil, or the State in general, to prevent women or pregnant people from accessing something for which the whole country voted. The Minister is right that we had telemedicine during the pandemic, and the sky did not fall in. In fact, telemedicine for abortion care has been shown to be exactly the same as visiting a doctor, and that was shown before the referendum as well.
The Irish Family Planning Association, WHO, the independent O'Shea report in 2023 and the UN are among the endless list of bodies that have said this wait is not necessary. It is also very unfair. Rural Deputies and others who think it must be kept are actually just penalising women and pregnant people in their areas. It is more difficult to find a doctor providing this service in rural areas, with some counties having one and others none. This is forcing women abroad again. It is taking them past the 12-week limit, with many ending up having to travel abroad.
I really do hear the Deputy. I respect that there are so many different views on this issue. I am broadly pro-choice and voted that way but I am not unreservedly pro-choice. Certainly, there are many elements of Deputy Murphy's Bill I simply do not agree with and cannot find a way to agree with. As Minister, I have tried to facilitate the broadest debate. I really do respect the very different opinions and the very different articulations of those opinions on all sides of the House. Prior to becoming Minister, I was involved with the family planning group. I think I am the first Minister to invite the pro-life groups into the Department of Health to hear their perspectives. I want to ensure all voices and perspectives on this issues are heard.
I would like to see the greatest of respect for individual personal choice. I respect that the Deputy says consensus is not necessary. In fact, in a legislative Chamber, consensus is very necessary. That is why I am somebody who tries to take every step to listen to everybody and reach a consensus, which is what is necessary in a legislative Chamber.
Consensus seems only to be necessary when it comes to the health, lives and choices of women. The Bill the Minister referenced was actually put forward in the previous Dáil by former Deputy, Bríd Smith.
I apologise.
That is no problem; I am just clarifying it. It was very undemocratic of TDs who had not debated that Bill - I had not debated it because I was not in the previous Dáil - just to block it. It should have been allowed to go forward for debate. My understanding is that all the provisions in the Bill were measures the citizens' assembly had proposed but that the politicians on the relevant committee, of which I was a member, were not willing to put forward. They were perfectly normal measures that the broad population agreed with but politicians were not willing to implement.
The three-day wait requirement was put in the legislation to appease Simon Coveney and people like him. That is the reality. I was here and I remember it. It was not indicated at the committee or anywhere else. The key point is that we now have very right-wing TDs in the Government who are anti-choice. The Minister should not be appeasing that bloc. The priority should be the health needs of women and pregnant people in this country.
The very essence of democratic choice is that those who are elected by the people may come into this House and freely choose how they wish to vote. I have every respect for Deputy Coppinger's vote, just as I have every respect for the votes of the Minister of State, Deputy Butler, and of Deputies O'Shea, Ó Muirí, Kerrane and every single person in this House. I respect their vote, their perspective, how they represent their constituents and what they are doing here. That is the democratic process.
Citizens' assemblies provide an important informative process but it is not a democratic process.
We are entitled to make choices about what we debate. Despite not agreeing with many parts of that Bill - though I agree with some of it - I would always choose to have that debate, but my choice is my choice as the Deputy's choice is hers. That is the essence of what she and I are saying to each other. I have such regard for listening to and respecting other voices. We reached the opportunity of the 2018 referendum precisely because of that approach and precisely because of an attempt to build consensus and to enable and facilitate that listening and respect. As Minister for Health, that is the approach I would like to continue to take.
It was a movement that achieved that, not this Dáil.
12. Deputy Claire Kerrane asked the Minister for Health the reason the rapid response vehicle at Roscommon ambulance base is no longer available on a 24-7 basis as promised; and if she will make a statement on the matter. [4433/26]
104. Deputy Claire Kerrane asked the Minister for Health when the rapid response vehicle at Roscommon ambulance base in County Roscommon will be restored on a 24/7 basis; and if she will make a statement on the matter. [4432/26]
A commitment was made in 2011 when the accident and emergency department in Roscommon town was closed that because of the much greater distance to the nearest such department, we would have 24-7 advanced paramedic cover from the rapid response vehicle. In the last number of months, the overtime that was being used, initially on a Thursday night and now on a Monday night, has been pulled so the rapid response vehicle is parked up for 12 hours. Why is that happening?
I propose to take Questions Nos. 12 and 104 together.
I thank the Deputy. I acknowledge how consistently she raises this. She had a Topical Issue on it last week and I acknowledge her complete commitment to this issue and to the people of Roscommon. As she will be aware, the National Ambulance Service serves County Roscommon from three 24-7 bases located in Roscommon, Boyle and Loughglynn. Emergency ambulances services at these bases are staffed by NAS paramedics, advanced paramedics and emergency medical technicians. In addition to these emergency ambulances, the NAS also operates rapid response vehicles from these bases. The RRV in Roscommon town is currently operated 24 hours six days per week and 12 hours on the seventh day, as the Deputy is aware.
The HSE has informed me it has made numerous attempts to fill two advanced paramedic vacancies for that additional 12-hour shift - that dropped shift, as it were. In the meantime, the HSE has outlined, 24-7 emergency ambulance services are covered for the county and that the RRV dropped shift is covered by these emergency ambulance resources as well as by the RRVs located in neighbouring areas. In recent days, the HSE has advised that as a result of recent efforts, an advanced paramedic has been identified to fill one of the two vacancies in Roscommon as early as this month. Of course, I welcome this development. I have been assured by the HSE that efforts will continue in 2026 to fill the outstanding vacancy. The HSE has also informed me that a new specialist paramedic advanced training programme commenced in January 2026 and that graduates will be eligible for appointment as advanced paramedics on successful completion of the course. I hope that will increase our pipeline of qualified people to perform exceptionally important functions, such as filling this important shift in Roscommon.
I thank the Minister. The advanced paramedic roster, which includes four advanced paramedics, has been in difficultly for some time. I have been raising this issue for about a year and a half and I met the director of the National Ambulance Service last year on the matter. For the last year and a half or so, paramedics have been put on the advanced paramedic roster. The overtime was in place for that Monday night and it is no longer there, yet there are four people on the advanced paramedic roster. One of them is a paramedic, while the third is an advanced paramedic, which I welcome, but the issue is not that we cannot fill the AP roster such that we cannot have the RRV on the road 24-7. That has been an issue for about a year and a half and the RRV has been on the road. The service has no problem using a paramedic on the AP roster, which is entirely wrong but that is what it has been doing. I am certain it is about overtime being pulled. It is not for want of filling the post, given there are four people on the roster. It is the overtime being pulled that I am trying to get to the bottom of.
I would be very pleased to speak with the Deputy about that in more detail. I think there is still a vacancy, based on the information I have, and I am glad the second vacancy has been filled. I would be very happy to discuss this with the Deputy more directly, but I am advised RRVs across the country are routinely crewed by paramedics or advanced paramedics and that is in accordance with the Pre-Hospital Emergency Care Council emergency dispatch crewing standards. Obviously, we want them to be advanced paramedics and that is why we have the additional course and why we are trying to recruit at that level. At the moment, it is consistent with the dispatch standards from the Pre-Hospital Emergency Care Council.
That is a line the director has given to me as well. However, Roscommon, Nenagh and Ennis all lost their accident and emergency departments and were all given a commitment to a 24-7 rapid response. Nenagh and Ennis had an action card that was put out there by the National Ambulance Service to protect the rapid response vehicle. Nenagh and Ennis got it but Roscommon did not. I am confident that if that same protection for the rapid response vehicle was put in place in Roscommon, that role would be filled. What is happening at the minute and what I am hearing back is that advanced paramedics were sent, in one recent case, to check an alarm that was going off. The RRV is protected in Nenagh and Ennis and they do not have these issues and the AP is never replaced on their roster with a paramedic. I am just asking for the same action card and the same protection for what is an entire county, unlike Nenagh and Ennis. We have a very rural constituency. I am not shouting and roaring about this issue but I am genuinely concerned that we are without this. It has been in place since 2011 and has no doubt saved lives. I really believe we deserve that cover.
I do not disagree with the Deputy and I respect the manner in which she consistently raises this and the concerns she has as a result of this not being resolved. I will it discuss it with the NAS and the region more generally. I will try to follow up and get this resolved. The Deputy and I will be pleased when that is so, for the benefit of the people of Roscommon and their safety.
13. Deputy John Paul O'Shea asked the Minister for Health to provide a breakdown of all planned and approved capital works for Mallow General Hospital; the nature and scope of each project; the current stage each project is at, including planning, design, tender or construction; the expected timelines for delivery; and if she will make a statement on the matter. [4138/26]
I thank the Minister for taking this question. I am asking her to provide a breakdown of all planned and approved capital works for Mallow General Hospital, the nature and scope of each project, the current stage each project is at including planning, design, tender or construction, the expected timelines and the further use of the hospital.
I thank the Deputy for giving me the opportunity to provide an update to the House on the capital works ongoing at Mallow General Hospital. In 2023, a new ward block for Mallow General Hospital was constructed and opened. As part of that project, two additional floors were constructed to facilitate subsequent infrastructure investment at the hospital, as the Deputy is aware. The subsequent development of the ward block is being progressed in two phases. Phase 1 involves the fit-out of the additional space to provide a 24-bed inpatient ward. This project is under way and is anticipated to be completed in quarter 1 of 2026, which obviously we are currently in. It is planned that facility will be put into service immediately. As a condition of the planning permission for the 24-bed inpatient ward, an extension to the existing car park is required. We have made that submission for planning permission and a tender will issue in quarter 2 of 2026. Phase 2 of the ward block development involves the fit-out of the existing ground floor shell and core space to provide an outpatient or day clinic ward, or both. This ward will include ten standard clinical rooms and an additional five clinical rooms configured for the establishment and operation of an obesity and bariatric clinic. The outpatient or day clinic ward project is at the detailed design stage. Subject to statutory approvals, it is anticipated the project tender will be issued in quarter 2 of 2026 and the timeline for delivery can then be determined.
Mallow hospital holds a particularly important place in the south-west region. We have invested very considerably in Mallow and we continue to invest in it for the benefit of the people of Mallow and also the people of the region. It forms a really important part of the patient flow infrastructure between Cork University Hospital, the Mercy Hospital and the way in which patients are moved through them for the benefit of patient safety. I have had concerns, which I am happy to discuss with the Deputy, about the use of the beds that are currently in Mallow. A question I have is how can we be sure the 24 new beds are going to be used when I have concerns about the use by the region of the beds that are currently there.
I thank the Minister. That building was completed in 2020 during Covid times and, in fairness to the HSE, it has retrospectively applied for planning permission. It is a wonderful extension to Mallow General Hospital. The two floors that are currently open are providing excellent care to the people the hospital serves. The staff there are excellent and I take this opportunity to wish them all well in their endeavours over the next couple of months. It is great to see the 24-bed inpatient unit will be opened in quarter 1. It is hugely important that we try to get that opened as quickly as possible because the beds are needed in the north Cork area.
I concur with the Minister about the bed use at the hospital. It is critical that we use the likes of Mallow General Hospital to relieve the pressure that is currently on Cork University Hospital, CUH, and Mercy University Hospital. I will be glad to work with the Minister on that over the coming months to make sure we get the best use out of the hospital.
It is an acute step-down unit for the larger model 3 and model 4 hospitals in the Cork and Kerry region that accepts patients who still require hospital care but no longer require an acute bed is absolutely critical. I have been looking at its usage. For example, during the fourth quarter of 2025, on average there were four vacant beds every day in Mallow hospital. There were 12 days in the fourth quarter of 2025 - remember that was a peak flu season in the early part of December - when ten or more beds were vacant. I will give an example. On 13 December, which was a Saturday - there are high numbers of discharges on Fridays - 13 beds were vacant in Mallow General hospital, a critical step-down facility, and 28 people in CUH on a Saturday morning were on trolleys. Thirteen beds were left vacant in Mallow while 28 people were on trolleys. That is a mortal sin. All week long CUH was under pressure with 53, 37, 39, 38 and 39 people on trolleys. It discharged patients on Friday and there were 13 beds in Mallow left vacant while 28 of the Deputy's constituents were on trolleys in CUH. The pattern was repeated two weeks later, with trolleys in Mercy University Hospital. It is not okay. It is not good enough. The Deputy and I are investing on behalf of the taxpayer in services across the south west for the benefit of the Deputy's people in Cork and it needs to be used.
I fully concur with the Minister that we do not see the full utilisation of Mallow General Hospital. I am glad she brought those figures to the House this morning, so we can discuss them in a public forum. I have been advocating for the further and better use of Mallow General Hospital for many years, in my roles as a councillor and, for the past 12 months, as a TD. I concur with the Minister. There is a lot of work to be done on utilising Mallow General Hospital beds and we need to work together to make sure they are used. We cannot have a system where we have overcrowding, people waiting for inpatient beds in CUH and Mercy University Hospital, while there are vacant beds in Mallow. Mallow General Hospital serves a huge area covering the border of Limerick, Kerry and Waterford and the metropolitan area of Cork city. Every patient I talk to who is waiting for a bed would go to Mallow for the care. We, therefore, need to work together to make sure it is utilised in the best way possible going forward.
I totally agree. Of course they would and of course they want access. Two weeks later on Saturday, 27 December, there were 15 beds in Mallow. That is not the fault of Mallow hospital. The beds are there. What is important for the region is that people are moved out of other hospitals that are under pressure to make sure they get good care in Mallow hospital. Fifteen beds were vacant in Mallow hospital on Saturday, 27 December. Ten beds were vacant on Sunday, 28 December and the following week, Mercy University Hospital, which is just down the road, was under pressure with 11 people on trolleys on the Sunday morning, 28 December and then 13 people on trolleys. Mallow had ten vacancies on Sunday, 28 December and on the same day, 11 people were on trolleys in Mercy University Hospital. I cannot stand over that. I have an obligation to point it out bed by bed because this is the type of usage we are talking about. This is the type of patient flow out of CUH and Mercy University Hospital.
CUH is an enormous hospital. There are patients who can be safely discharged to another excellent medical care facility but unless the Deputy and I acknowledge that, we will go down like eejits opening more beds and being delighted about it. Six weeks later, beds are left empty and people are in danger in emergency departments. It is not okay and that is why we have to investigate it and call it out where we see it.
Since 8 January 2026, no bed has been vacant in Mallow hospital and surge capacity is now being used consistently. We have seen an improvement in the region and I acknowledge that but it has to be consistent.
Hear, hear.
14. Deputy Barry Heneghan asked the Minister for Health for an update on the planned redevelopment of the emergency department at Beaumont Hospital, including the current status of the design and planning stages and projected timeline for tendering and construction; to confirm that the project remains a priority within the HSE capital plan; the expected opening date of the new emergency department; the expected opening date of the proposed 95 bed block; and if she will make a statement on the matter. [5027/26]
First, I thank the hardworking women and men of Beaumont Hospital. When I was in fifth year, I was extremely unwell and they looked after me and cared for me. When my mother suffered a polytrauma, they looked after me. However, thousands of constituents are contacting me about the accident and emergency department. Recently, I visited Patricia Anderson from Riverside whose husband spent 14 hours in a chair and then two months later would not go to the accident and emergency department. Sadly, he passed away in the driveway of his house. The current accident and emergency department is an absolute shambles. We need an update on the plans for redevelopment and expansion so northsiders can get the proper treatment they deserve.
I thank the Deputy. I am happy to talk to him about the accident and emergency department in Beaumont Hospital.
Following recent investments, there are a number of significant proposals for capital investment and all are progressing through the requisite design and planning stages. As a live hospital campus, it is more complex as things have to be moved where patients are being seen. The planning, sequencing and enabling of these projects are all being managed through the HSE capital development process, in line with the infrastructure guidelines.
In May 2025, the new emergency department received the final grant of planning permission. The project was moved to a detailed design stage through 2025 and 2026 and this will inform a tender and market engagement process that will ultimately determine construction timelines. The project remains funded on the HSE capital plan. There is no question but that it is happening.
Similarly, the 95-bed ward block is also progressing through the detailed design stage and, again, we will have a tender and market engagement for construction works. Separately, I am advised that the pre-tender business case for the radiation oncology unit was approved by the HSE just before Christmas. The first stage of that procurement process has been completed and we will have invitations to tender generally.
I will make a few observations more broadly on the accident and emergency department experience in Beaumont Hospital, with respect to the Deputy's constituents. The trolley situation - the number of people who are admitted and are on trolleys - improved enormously in Beaumont Hospital over 2025. What has not improved is the patient experience time, PET. At the moment, Beaumont Hospital has the worst PET in the country. There are few different things. Beaumont Hospital has improved its trolley process. There is no question about that and it is to be commended on that because it involves the whole hospital moving patients through. However, there is a new CT machine in the hospital, for example, which was delivered last year. I was there on a Saturday morning in recent weeks. I visited four hospitals that morning. Beaumont Hospital was the one under the most pressure. When I was there, the emergency department was incredibly crowded. There were at least six or seven patients there who needed a CT. I then visited the CT machine that was sitting there, brand-new with its light off and no one working on it. I am assured by the region that we have provided funding for staffing it and that staffing it is an absolute priority but that is not okay.
Thank you, Minister.
It is contributing to PET, which is too long in Beaumont Hospital, twice what it should be. It is approximately eight hours; it should be four hours.
Thank you, Minister.
While trolley numbers have improved enormously in Beaumont Hospital, that needs to be improved and it is the next job for Beaumont Hospital.
Gabhaim buíochas leis an Aire. Aontaím go hiomlán leí. Especially when the investment has gone in, there is a CT scanner and people are waiting, that needs to be looked at.
In the words of Patricia Anderson, nothing can bring her husband back. However, she would love to see the delays in the emergency department and the ambulance system change.
I thank the doctors, nurses, healthcare assistants, porters, cleaners and administrative staff and the carers of north Dublin. Beaumont Hospital is one of the most important hospitals in Ireland for head injuries and its emergency department, as the Minister acknowledged, is under extreme strain. Communities across Coolock, Artane, Clontarf, Raheny, Donaghmede and beyond deserve more than what is currently being made available. Speaking of taking pressure off the hospital, staff of Northside Home Care Services, who are in the Public Gallery, are currently on strike looking for pay parity. During the recession, they were promised their situation would be sorted out in the deal. Now, they sadly are on strike. They do not take it lightly. However, if the HSE can pay for staff to cover, why can it not pay the correct amount to these men and women?
Seven of these men and women from the Northside Home Care Services went into a homeless hub while working and they continue to help the men and women of north Dublin. Their situation needs to be sorted out. I thank them for everything they do for the people of north Dublin.
I will bring in Deputy Ó Muirí for a supplementary question.
I echo Deputy Heneghan's comments about Beaumont Hospital and thank him for raising it here. The Minister visited Beaumont Hospital with me recently. It is a workhorse hospital for the northside. Huge numbers of patients go through it. It has great staff, including great doctors, great nurses, great clinicians and great general staff but it is a hospital under pressure as the Minister saw. It is not just a local, workhorse hospital but it is a national centre for renal care and neuroscience. I heard Professor Arnold Hill talk about leading out on robotic brain surgery. A huge amount is going on in Beaumont Hospital and sometimes its staff are their own worst enemies. They do not tell people what they are doing or make people aware of all these expertise. I was delighted the Minister visited and saw it first hand. She made observations and I will be delighted to hear about them here. I look forward to that.
I also mention the staff of Northside Home Care Services. I know two things. They do not want to be on strike, and there are vulnerable patients across the northside who are not getting care services because of this.
I ask Government to knock heads together, whatever heads need to be knocked together, to see if we can get this resolved so those patients can get the care they need and these people can get back to work.
I thank the Deputies for that. This is the issue with Beaumont. It is an exceptional centre of clinical excellence. It is the place you want to be for neurology and it is a place that provides extraordinary renal treatment, but we have to look at the hospital as a whole.
While it does extraordinary surgery and neurosurgery, when somebody like Mrs. Anderson's husband presents, he needs the care, the throughput and acute medical care as well. That requires a concentration of the emergency department on the patient experience time. That requires a concentration on diagnostics and using all the assets for patient safety as much as for neurosurgery. There is no question that Beaumont is the place I would want to be for any of those issues but as Minister for Health, I am as responsible for every patient that comes through and their experience in the emergency department and how long they are there as the investment in the extraordinary clinical research happening for the future.
I am sorry, I only have ten seconds, but in respect of the Northside Home Care Services, I want to acknowledge people's presence here today. I have been informed of the extraordinary work done there. I have to o clarify for the House, it is not a public body as such. Terms and conditions are set by the organisation itself and it is a matter between the employer and employee. I can come back to that but it is not as straight forward as the HSE or a section 39 organisation issue that we might discuss.
Speaking to the current system in Beaumont and hospitals across Ireland, a lot of the time qualified healthcare staff are caught up in administrative roles when that could easily be automated. There are many things across the public sector that could be automated. We have systems now with generative AI, which can store data and automate systems to speed up the efficiency of these systems. Having people walking around with reports who are qualified and could be serving and helping with patients is not efficient. We can look at how China and Japan are currently dealing with their hospital systems. Deputy Ó Muirí and myself attended the launch of the report, and the current change in the systems for Beaumont will change and help lives.
On the Northside Home Care Services, agreement was reached with the ICTU unions. They do the same work and carry the same responsibility except they are facing extreme emotional and physical demands. They want to get back to work. These men and women are facing discrimination. I appreciate the Minister said she would get back to myself and Deputy Ó Muirí. It is extremely purposeful.
To clarify, the Northside Home Care Services are funded through a separate tender arrangement. It is different; it is not HSE and section 39. The organisation is in receipt of small grant funding under section 39 in respect of meals on wheels but that is different.
The HSE reached out to the Northside Home Care Services last week to remind them of the process for claiming an uplift in pay funding in respect of section 39 which it receives in respect of meals on wheels. However, beyond that, it is not a public sector body as such. In any dispute between an employer and employee, nobody wants the stress of going to work in those circumstances. Nobody wants to get to the point where they are initiating strike action, though they are entirely entitled to and I completely respect them doing that. I know they will want to get back to work as quickly as possible but I have to separate the organisations that are within the public service agreement and those that are not and that are tendered separately. We have a direct responsibility for some, while others are between employer and employee and are a tendered service to the HSE, which is different.
I thank the Minister for that. We only have time for one further question. I ask that the question be asked and then there will be a two-minute reply. Unfortunately, that is all we have time for.
15. Deputy Aisling Dempsey asked the Minister for Health for an update on the Assisted Human Reproduction Act 2024; and if she will make a statement on the matter. [4878/26]
I assure the Deputy that much progress has been made on the path to providing the necessary oversight and regulation of assisted human reproduction.
The Health (Assisted Human Reproduction) Act was signed into law by the President in July 2024. Some administrative sections of the Act have been commenced, specifically to establish the Assisted Human Reproduction Regulatory Authority, or AHRRA. In addition, work is under way to commence section 232 of the Act. This will result in the parentage of some donor-conceived children not covered currently by the Children and Family Relationships Act 2015 being recognised.
There is a small outstanding piece of work to do on timing and the statutory instrument with completing the rules of the court. I had hoped that could be done before Christmas, but I expect it to be done very shortly. However, there is a timing issue there as between the rules of the court and the statutory instrument.
When the 2024 Act, more broadly, was progressing through the Houses of Oireachtas, issues were identified which required further consideration and consultation with the Office of the Attorney General and there is an amendment bill at the advanced stage of drafting. It is a complex area, involving delicate balance of human rights and we have to get it right. For practical and legal reasons, the Act can only be fully commenced when the operational authority is in place.
We have a board and recruitment for the CEO is well progressed. I look forward to the Deputy’s input to the Bill when we are debating it. Together, we are going to need make sure we are achieving the best opportunity for families of all kinds to avail of assisted human reproduction, as well as protecting all the human rights of all the third parties who may be involved in that, recognising that many of those third parties may not be our citizens. We have an obligation to look beyond and outside at everybody’s human rights as well as ours.
