Mark Ward
Question:332. Deputy Mark Ward asked the Minister for Health if the Central Mental Hospital is fully open; the current capacity; the capacity when its fully open; and if she will make a statement on the matter. [50886/25]
View answerMental Health Services
Questions (332)
Written answers
The HSE National Forensic Mental Health Service (NFMHS) relocated from Dundrum to Portrane on 4 November 2022. The 170-bed complex includes a new 130-bed Central Mental Hospital (CMH), a 30-bed Intensive Care Rehabilitation Unit (ICRU) and a 10-bed forensic Child and Adolescent Mental Health Service unit. These two latter units are the first of their kind nationally. It was always intended that the NFMHS facility in Portrane would become fully operational on a phased basis following relocation of this national service.
The NFMHS facility, with a capital cost in excess of €200 million, is one of the most modern of its type in the world and it presents new opportunities to deliver the highest quality care and outcomes for some of the most complex and vulnerable mental health cases in Ireland. The specialist NFMHS, including the CMH, is the national forensic mental health resource for teaching and training in all disciplines, driven by excellence in research and development, clinical risk management, rights and recovery.
The bed capacity in the new CMH increased from around 95 beds in Dundrum to 112 when relocation took place. These 112 operational beds across 9 units provide high and medium secure care for patients with major mental illness and associated violent behaviour. There are 88 beds for men, 14 for women, and 10 beds for men with both mental health and intellectual and developmental difficulties. The hospital receives admissions from prisons, courts and approved mental health centres nationally. Clinical care is delivered by 9 Multidisciplinary Teams each led by a Consultant Forensic Psychiatrist.
In addition, the NFMHS has 30 community beds stratified by level of support across 6 residences, for patients who have spent time in the CMH following a Court finding of Not Guilty by Reason of Insanity. The NFMHS also provides care to a further 30 patients who were previously in the CMH and who are living independently or in placements with private health care providers.
I secured additional funding of €2.1 million under Budget 2025 to open the remaining 18 beds in the CMH this year, which will bring the hospital to its full operational complement of 130 beds. Recruitment is progressing for the 41 WTEs funded, with 34 of the posts accepted and at various points of onboarding and final checks.
Mental Health Services
Questions (333)
Mark Ward
Question:333. Deputy Mark Ward asked the Minister for Health if the forensic intensive care rehabilitation ward in Central Mental Hospital is operational; if not the reason; when will it be open; and if she will make a statement on the matter. [50887/25]
View answerWritten answers
The HSE National Forensic Mental Health Service (NFMHS) relocated from Dundrum to Portrane on 4 November 2022. The 170-bed complex includes a new 130-bed Central Mental Hospital (CMH), a 30-bed Intensive Care Rehabilitation Unit (ICRU) and a 10-bed forensic Child and Adolescent Mental Health Service unit. These two latter units are the first of their kind nationally. It was always intended that the NFMHS facility in Portrane would become fully operational on a phased basis following relocation of this national service.
The NFMHS facility, with a capital cost in excess of €200 million, is one of the most modern of its type in the world and it presents new opportunities to deliver the highest quality care and outcomes for some of the most complex and vulnerable mental health cases in Ireland. The specialist NFMHS, including the CMH, is the national forensic mental health resource for teaching and training in all disciplines, driven by excellence in research and development, clinical risk management, rights and recovery.
The bed capacity in the new CMH increased from around 95 beds in Dundrum to 112 when relocation took place. These 112 operational beds across 9 units provide high and medium secure care for patients with major mental illness and associated violent behaviour. There are 88 beds for men, 14 for women, and 10 beds for men with both mental health and intellectual and developmental difficulties. The hospital receives admissions from prisons, courts and approved mental health centres nationally. Clinical care is delivered by 9 Multidisciplinary Teams each led by a Consultant Forensic Psychiatrist.
In addition, the NFMHS has 30 community beds stratified by level of support across 6 residences, for patients who have spent time in the CMH following a Court finding of Not Guilty by Reason of Insanity. The NFMHS also provides care to a further 30 patients who were previously in the CMH and who are living independently or in placements with private health care providers.
I secured additional funding of €2.1 million under Budget 2025 to open the remaining 18 beds in the CMH this year, which will bring the hospital to its full operational complement of 130 beds. Recruitment is progressing for the 41 WTEs funded, with 34 of the posts accepted and at various points of onboarding and final checks.
Additional funding will be sought in the Estimates process to commence opening the Intensive Care Rehabilitation Unit, which will also be on a phased basis. It is also intended that an evaluation of the operation of the ICRU will take place in due course to help inform the development of this or a similar model of care nationally over future years, in line with that envisaged under implementation of our national mental health policy Sharing the Vision 2020-2030.
Hospital Facilities
Questions (334)
Paul McAuliffe
Question:334. Deputy Paul McAuliffe asked the Minister for Health her plans to provide funding for a fully staffed adult multidisciplinary functional neurological disorder clinic in St James Hospital, Dublin; and if she will make a statement on the matter. [50892/25]
View answerWritten answers
As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
Health Services
Questions (335)
Paul McAuliffe
Question:335. Deputy Paul McAuliffe asked the Minister for Health her plans to develop a national funding pathway for FND with multi annual funding including regional teams; and if she will make a statement on the matter. [50893/25]
View answerWritten answers
The Department is committed to working with relevant stakeholders, including the HSE and patient representatives, to strengthen key services and supports for people with neurological conditions, including Functional Neurological Disorders, and has made significant investments in Budget 2025, as well as committing to further measures in the new Programme for Government.
Budget 2025 provided €4m for the recruitment of 5 consultant neurologists and an additional 25 WTEs to support the implementation of the Neurology Model of Care and the Hub and Spoke Model for neurology services.
I want to let you know that of the 30 WTEs announced for neurology services 3 of these will be dedicated to FND services at St. James Hospital. These posts will include a senior physiotherapist, a senior occupational therapist and a neuro-psychologist.
This new service development in 2025 aims to advance the implementation of the HSE Model of Care for Neurology. The focus of the neurology initiative and its FND Service sub-initiative are aimed at achieving the following:
- To improve access to appropriate neurology services,
- improve safety and quality in the delivery of patient-centred neurological care,
- and improve value for both patient and health services across neurology services.
More broadly, the National Clinical Programme for Neurology is actively working on a Hub and Spoke model to guide equitable neurology services around the country to align with the new health regions and to tackle the gaps in neurology services nationally. This will cater for people with all neurological conditions, including FND, and will deliver on the Sláintecare principle of delivering care closer to the patients' home.
This model will include one Model 4 Hospital ‘Hub’ per Health Region, catering for the most complex neurological care. These sites will support Model 3 hospital ‘Spoke’ sites, which will provide services for people with less complex needs, where efficient access to Hubs is required.
Many hospitals already have well-developed neurology services, but funding received in Budget 2025 will enable the delivery of Phase 1 of the Hub and Spoke model.
It is expected that this proposed Hub and Spoke model will enable a reduction in waiting lists, timely access to diagnosis and treatment and thus, improve quality of life and prognosis for people with neurological symptoms, including FND.
I am committed to making further progress developing services for those with Functional Neurological Disorders, and I will continue to work with the HSE to ensure improvements in Neurology services as a whole.
Health Service Executive
Questions (336)
Sorca Clarke
Question:336. Deputy Sorca Clarke asked the Minister for Health to provide a list of all the HSE owned buildings in counties Longford and Westmeath that are currently for sale or going through a defined process to facilitate a sale. [50910/25]
View answerWritten answers
As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
Health Services
Questions (337)
John Paul O'Shea
Question:337. Deputy John Paul O'Shea asked the Minister for Health to provide funding through the HSE to a charity (details supplied) who provide an invaluable service to public hospitals and other medical facilities for vital medical materials on an out-of-hours service; and if she will make a statement on the matter. [50911/25]
View answerWritten answers
I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Health Services
Questions (338, 339)
Cian O'Callaghan
Question:338. Deputy Cian O'Callaghan asked the Minister for Health if her Department will commit to the swift rollout of SMA screening as part of the heel prick test for newborns, as noted in the National Rare Disease Strategy 2025-2030; if her Department will publish a timeline for when this will happen; and if she will make a statement on the matter. [50913/25]
View answer
Thomas Gould
Question:339. Deputy Thomas Gould asked the Minister for Health for an update on the implementation of SMA screening in the newborn heel prick test. [50959/25]
View answerWritten answers
I propose to take Questions Nos. 338 and 339 together.
As Minister for Health, I am determined to support our screening programmes, which are a valuable part of our health service, enabling early treatment and care for many people, and improving the overall health of our population. Currently, all newborn babies (between 3 and 5 days old) are offered newborn bloodspot screening (generally known as the ‘heel prick’), which tests for nine rare but serious conditions that are treatable if detected early in life.
The Deputy references the new National Rare Disease Strategy, which was launched on 27 August. This Strategy aims to ensure that all people living with a rare disease, and their families, have access to equitable, inclusive and cross-sectoral care throughout their life journey that will enable them to reach their full potential and to live their best lives. Work is ongoing to ensure that the full implementation of the Strategy including the establishment of an Implementation Oversight Group and the development of a detailed implementation plan outlining the actions required to fully achieve the Strategy's 11 recommendations.
Incremental progress continues to be made on the expansion of the National Newborn Bloodspot (NNBS) Programme. In 2023, two recommendations from NSAC on the addition of Severe Combined Immunodeficiency (SCID) and Spinal Muscular Atrophy (SMA) to the NNBS Programme were approved. In Budget 2024, an additional €1.4 million of new development funding was provided to support the SMA/SCID implementation process. Once both conditions have been fully implemented, the number of conditions screened for in Ireland will increase to 11.
In terms of the current implementation status, the HSE has advised that the equipment needed to enable the roll-out testing for SMA and SCID has been procured, and that verification testing has commenced and is progressing well. The recruitment process to hire the additional staff required to support the expansion of the NNBS has almost concluded and work has commenced on developing screening pathways for both conditions.
Officials in my Department are actively engaged with the HSE to ensure that progress continues on implementing an ambitious timeline for the introduction of screening for SMA and SCID. Nevertheless, I am acutely aware of how difficult it is for parents, families and children who have received a diagnosis of a rare disease, and how challenging daily life can be for them. This is why I remain committed to the further expansion of screening in Ireland in accordance with internationally accepted criteria and best practice.
Question No. 339 answered with Question No. 338.
Vaccination Programme
Questions (340)
Carol Nolan
Question:340. Deputy Carol Nolan asked the Minister for Health the financial support options open to a person (details supplied) to access a costly vaccination for shingles; and if she will make a statement on the matter. [50962/25]
View answerWritten answers
Shingles vaccination is not currently provided as part of the national immunisation programme.
The Health Information and Quality Authority (HIQA) recently carried out a Health Technology Assessment (HTA) on the herpes zoster vaccine which protects against shingles. A HTA is a multidisciplinary research process that collects and summarises information about a health technology. The information can cover a range of fields, including clinical effectiveness and safety, cost-effectiveness and budget impact, organisational and social aspects, and ethical and legal issues. The information is collected and presented in a systematic, unbiased and transparent manner.
HIQA’s HTA examined the evidence on the clinical effectiveness and safety of shingles vaccines. The cost effectiveness and budget impact were also reviewed, along with the ethical, social and organisational implications of including the vaccine in the adult immunisation schedule.
HIQA published this HTA on 19 July 2024. The HTA found that adding the shingles vaccine to the routine immunisation schedule would not be cost effective and would be associated with a substantial budget impact.
Given that the healthcare budget is finite and decisions regarding increased spending relating to a change in one area could impact the provision of other health technologies and treatments within the healthcare system, the cost-effectiveness must be considered in any decision-making process.
My Department has considered the findings of this HTA and determined that the introduction of the vaccine could be reconsidered when the cost effectiveness of the vaccine is confirmed as being more favourable.
Patients undergoing medical treatment should discuss their vaccination requirements with their medical consultant in line with NIAC recommendations.
Hospital Staff
Questions (341)
Maurice Quinlivan
Question:341. Deputy Maurice Quinlivan asked the Minister for Health the steps being taken to address the shortage of pathologists in the mid-west region of Limerick, Clare, and part of Tipperary; and if she will make a statement on the matter. [50965/25]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Health Services
Questions (342)
Michael Healy-Rae
Question:342. Deputy Michael Healy-Rae asked the Minister for Health to provide details on a meeting regarding lyme disease (details supplied); and if she will make a statement on the matter. [50966/25]
View answerWritten answers
Lyme disease, also known as Lyme borreliosis, is an infection transmitted to humans through the bite of infected ticks, and it can occasionally lead to serious illness. Ticks are present throughout Ireland, including both urban and rural areas. Although ticks can be active year-round, the period of highest tick activity and therefore Lyme disease is between April and October.
The HSE’s National Health Protection Office, through the Health Protection Surveillance Centre (HPSC) provides information on the surveillance of Lyme disease. The HPSC offers a wide range of resources to help people reduce their risk of tick bites, including seasonal updates for both the public and healthcare professionals.
Each year in early May, the HSE marks Tick Awareness Day, by providing practical advice on the prevention of tick bites, which can transmit Lyme disease. This is done through website news articles, social media posts, press releases and media interviews. This initiative encourages individuals to take preventive measures during periods when tick activity is highest. Information is provided on common tick habitats, high-risk behaviours, prevention strategies, and how to safely remove and identify ticks.
My officials have engaged with the HSE regarding the matters discussed at the meeting on Lyme disease. Throughout the summer months, the HSE has continued its public awareness efforts through regular social media posts and public communications, aimed at keeping the public informed during the peak tick season.
To further spread public awareness, the HSE provides downloadable posters and leaflets that are intended to be distributed in community centres, schools, and recreational and other common public and private spaces, especially those with an increased risk of tick exposure. These materials are designed to inform individuals about the risks of tick bites and the importance of preventive actions.
A full suite of Lyme Disease resources, including posters and information leaflets, is available through the HPSC website. These posters are suitable for display on publicly accessible land, and the HPSC has actively promoted their availability to Government Departments and public agencies that manage such areas. Local authorities, healthcare professionals, and members of the public are encouraged to download and share these materials.
In addition to public awareness and prevention efforts, clinical pathways for diagnosis and treatment are well established. There is a National Clinical Programme in Infectious Diseases reporting to the office of the Chief Clinical Officer. There has been a significant expansion in the number of Infectious Diseases consultants appointed throughout the country. These Consultants see patients with Infectious Diseases, including patients with Lyme Disease.
GPs are familiar with the most typical presentation, often a rash with a bull’s eye appearance. Most cases can be treated with a brief course of antibiotics, while more complicated cases are referred to infectious disease clinics. Patients with post-Lyme syndrome can be referred by their GP to a public hospital infectious disease clinic in Ireland.
Diagnosis and treatment in clinics operating in the public hospital system is in line with national and international best practice guidelines, as outlined in Infectious Diseases Society of America guidelines that have been endorsed by the Infectious Diseases Society of Ireland.
Lyme testing in Ireland is available to all clinical sites, either onsite or via the National Virus Reference Laboratory (NVRL). Confirmatory testing (western blot - an analytical technique in molecular biology and immunogenetics to detect specific proteins in a sample of tissue) is referred to the UK Lyme Reference Service.
Cancer Services
Questions (343)
Fionntán Ó Súilleabháin
Question:343. Deputy Fionntán Ó Súilleabháin asked the Minister for Health the reason oncology patients cannot get a medication (details supplied), even though it has been licenced in Ireland (details supplied). [50968/25]
View answerWritten answers
Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for decisions on the pricing and reimbursement of medicines and medical devices; therefore, I have asked the HSE for an update in this matter.
The HSE has advised that it is committed to providing access to as many medicines as possible, in as timely a fashion as possible, from the resources available (provided) to it.
The HSE must robustly assess applications for pricing and reimbursement to make sure that it can stretch available resources as far as possible and to deliver the best value in relation to each medicine and ultimately more medicines to Irish citizens and patients.
HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds.
There are formal processes which govern applications for the pricing and reimbursement of medicines, and new uses of existing medicines, to be funded and / or reimbursed.
The HSE considers the following criteria prior to making any decision on pricing / reimbursement in line with the Health (Pricing and Supply of Medical Goods) Act 2013:
(1) The health needs of the public,
(2) The cost effectiveness of meeting health needs by supplying the item concerned rather than providing other health services,
(3) The availability and suitability of items for supply or reimbursement,
(4) The proposed costs, benefits, and risks of the item or listed item relative to therapeutically similar items or listed items provided in other health service settings and the level of certainty in relation to the evidence of those costs, benefits and risks,
(5) The potential or actual budget impact of the item or listed item,
(6) The clinical need for the item or listed item,
(7) The appropriate level of clinical supervision required in relation to the item to ensure patient safety,
(8) The efficacy (performance in trial), effectiveness (performance in real situations) and added therapeutic benefit against existing standards of treatment (how much better it treats a condition than existing therapies), and
(9) The resources available to the HSE.
In terms of the specific details of the applications for pricing and reimbursement of cemiplimab (Libtayo®):
Since the 1st October 2024, cemiplimab (Libtayo®) is approved for reimbursement under the Oncology Drugs Management System (ODMS) as monotherapy for the treatment of adult patients with metastatic or locally advanced cutaneous squamous cell carcinoma (mCSCC or laCSCC) who are not candidates for curative surgery or curative radiation.
The HSE received a complete application for pricing and reimbursement on the 9th January 2025 from Regeneron Pharmaceuticals, Inc (the applicant) for cemiplimab (Libtayo®) indicated as monotherapy for the treatment of adult patients with recurrent or metastatic cervical cancer and disease progression on or after platinum-based chemotherapy.
• The first step in the process is the submission of a Rapid Review dossier (a clinical and economic dossier) to the National Centre for Pharmacoeconomics (NCPE) for assessment. The HSE commissioned the Rapid Review process on the 2nd December 2024.
• The NCPE Rapid Review assessment report was received by the HSE on the 17th January 2025. The NCPE advised the HSE that a full Health Technology Assessment (HTA) is recommended to assess the clinical effectiveness and cost effectiveness of cemiplimab for this indication compared with the current standard of care.
• The HSE commissioned a full HTA on the 29th January 2025 as per agreed processes.
• The NCPE publishes details of medicines where the HSE has commissioned a Rapid Review assessment and / or a full health technology assessment on their website. The website is updated at regular intervals and includes assessment outcomes and updates on reimbursement for each individual medicine and indication listed. Details of the assessment(s) of cemiplimab (Libtayo®) are available at: www.ncpe.ie/cemiplimab-libtayo-hta-id-24048/.
• The HSE Corporate Pharmaceutical Unit (CPU) is the interface between the HSE and the Pharmaceutical Industry in relation to medicine pricing and reimbursement applications.
• The Drugs Group is the national committee which the HSE has in place to make recommendations on the pricing and reimbursement of medicines. The membership of the HSE Drugs Group includes public interest members. Pharmacoeconomic reports are reviewed by the HSE Drugs Group along with the outputs of any commercial negotiations, and any patient group submission(s) received. The HSE Drugs Group considers all of the evidence and makes a recommendation to the HSE Senior Leadership Team.
• The decision making authority in the HSE is the HSE Senior Leadership Team. The HSE Senior Leadership Team decides on the basis of all the demands it is faced with (across all services) whether it can fund a new medicine, or new use of an existing medicine, from the resources that have been provided to it in line with the Health (Pricing and Supply of Medical Goods) Act 2013.
Further information on the progress of cemiplimab (Libtayo®) through the HSE assessment and approval processes is available via the Pricing and Reimbursement Application tracker available at: www.hse.ie/eng/about/who/cpu/. HSE application ID HSE100011 has been assigned to this application.
The application remains under consideration with the HSE. The HSE cannot make any comment on possible outcomes from the ongoing process.
Disability Services
Questions (344)
Robert O'Donoghue
Question:344. Deputy Robert O'Donoghue asked the Minister for Health if she is aware of the difficulties in transitioning from paediatric disability services and adult disability services, particularly the lack of transition planning; if she has any plans to implement an automatic referral scheme for people transitioning from paediatric to adult disability services; her plans to provide a comprehensive outreach service to disabled people and people with additional needs, particularly in the area (details supplied); and if she will make a statement on the matter. [50969/25]
View answerWritten answers
This Parliamentary Question should be directed to the Department of Children, Disability and Equality, as the matters raised fall within their area of responsibility.
Health Services
Questions (345)
Claire Kerrane
Question:345. Deputy Claire Kerrane asked the Minister for Health to consider adding Ehlers–Danlos syndrome to the long-term illness card as the drugs payment scheme will not cover the drug Ozempic, which is reputed to improve the condition of sufferers. [50993/25]
View answerWritten answers
The Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013. Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority (HPRA).
In line with the 2013 Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the reimbursement list. In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact.
In terms of the specific details of the pricing and reimbursement of semaglutide (Ozempic®):
Reimbursement approval is in place for semaglutide (Ozempic®) for the treatment of adults with insufficiently controlled type 2 diabetes mellitus as an adjunct to diet and exercise as monotherapy when metformin is considered inappropriate due to intolerance or contraindications and in addition to other medicinal products for the treatment of diabetes under the General Medical Services and Long Term Illness Scheme from 1st September 2018.
Pharmaceutical companies are required to submit formal applications to the HSE if they wish their medicines to be added to the list of reimbursable items covered under community drugs schemes and arrangements / funded via hospitals. In order to submit a formal application, the medicine must hold a marketing authorisation.
The European Medicines Agency (EMA) is a centralised agency of the European Union (EU) responsible for the scientific evaluation, supervision and safety monitoring of medicines in the EU. The EMA plays an integral role in the authorisation of medicines in the EU via the centralised procedure. The Health Products Regulatory Authority (HPRA) is the competent authority responsible for the regulation of human medicines in Ireland.
To date neither the EMA nor the HPRA have granted marketing authorisation for semaglutide (Ozempic®) for the indication of treating symptoms of Ehler-Danlos syndrome.
As outlined above, the national assessment and decision process cannot commence in the absence of a marketing authorisation in this indication.
The Long-Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 conditions to be covered by the Scheme. These are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.
Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. While there are currently no plans to extend the list of conditions, it is important to remember that the LTI Scheme exists within a wider eligibility framework.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card under the General Medical Services (GMS) Scheme. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE.
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. The HSE afford applicants the opportunity to furnish supporting documentation to determine whether undue hardship exists and to fully take account of all relevant circumstances that may benefit them in assessment. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
The issue of granting medical card eligibility based on having a particular disability or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
Under the Drugs Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
There has been a significant focus on improving access to and the affordability of healthcare services over the last few years. This includes reductions in the DPS threshold, expansion of access to free GP care, and the abolition of all public in-patient hospital charges for children and adults. These measures continue to create a health and social care service that offers affordable access to quality healthcare.
Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
Capital Expenditure Programme
Questions (346)
Danny Healy-Rae
Question:346. Deputy Danny Healy-Rae asked the Minister for Health to examine the case for urgent approval of capital funding for a project (details supplied); and if she will make a statement on the matter. [50995/25]
View answerWritten answers
Officials in my department have contacted the HSE South West region who advised that a capital submission was made in 2021 for an interim modular building on the roof of the Palliative Care Unit and this was approved in February 2022 at an estimated total project cost of €9.38 million. That capital submission was developed in response to impacts arising from the covid pandemic and the limited available footprint resulted in a compromised brief where accommodation was to be shared between the Day Treatment Ward and Outpatient Services, and no space was available for an Aseptic Compounding Unit.
In November 2022, the HSE decided to advance a much smaller interim oncology arrangement within approximately 268 square metres of newly vacated accommodation, and this was opened on October 2023.
As part of the stage one preliminary design process for the originally approved project, it was determined in March 2023 that the development of an oncology unit on the roof of the palliative care building was not an appropriate option to meet the medium or long term needs of the service and it was decided to investigate alternative locations.
An option studies overview was undertaken, and a preferred alternative location was identified in April 2023. The HSE decided to pursue a more appropriate and more substantial permanent proposal.
A revised brief and schedule of accommodation was completed in September 2023 for the proposed permanent oncology day treatment ward and outpatients unit. The total project cost for this proposal is provisionally estimated to be approximately €46.9 million and this increased scope and cost has necessitated a new capital submission.
The drafting of a new capital submission and business case for the permanent proposal has been prioritised this year. University Hospital Kerry and HSE Estates are prioritising the preparation of the capital submission for the proposed oncology day treatment ward and outpatients unit at University Hospital Kerry. The prioritisation of the capital list will be a matter for the HSE Regional Executive Office and the Regional Director for Planning.
Ambulance Service
Questions (347)
John McGuinness
Question:347. Deputy John McGuinness asked the Minister for Health further to Parliamentary Question No. 196 of 31 January 2025, if she will review the question asked and the response issued by the National Ambulance Service dated 19 January 2024; if a request submitted by a patient’s GP for an ambulance service to transport a seriously ill patient to appointments in a Dublin hospital will be approved as a matter of urgency(details supplied); if she will outline the process by which such urgent requests are dealt with; and if she will make a statement on the matter. [50997/25]
View answerWritten answers
As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
Medicinal Products
Questions (348)
Ruth Coppinger
Question:348. Deputy Ruth Coppinger asked the Minister for Health to consider approving the use of CAR T-cell therapy in Ireland for those over the age of 26; and if she will make a statement on the matter. [51002/25]
View answerWritten answers
Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for decisions on the pricing and reimbursement of medicines and medical devices; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
Hospital Services
Questions (349)
John McGuinness
Question:349. Deputy John McGuinness asked the Minister for Health if she has been advised of the HSE/ University Hospital Waterford proposal to discontinue coronial post mortem's at University Hospital Waterford with effect from the 01 January 2026, which if implemented will result in there being no coronial post mortem service in the south east; if the unilateral decision taken by the HSE/University Hospital Waterford will be reversed; and if she will make a statement on the matter. [51013/25]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Health Services
Questions (350)
Donna McGettigan
Question:350. Deputy Donna McGettigan asked the Minister for Health if she has met with an organisation (details supplied); her plans to meet with the organisation; her plans to improve diagnostic and treatment services for Sjogren’s sufferers; and if she will make a statement on the matter. [51054/25]
View answerWritten answers
I have not received a request to meet directly with this organisation. An invitation was issued for me to attend a Photovoice Exhibition in July. Unfortunately, due to prior commitments, I was not in a position to attend in this instance, and regrets were issued.
All diary requests are considered by my office in the Department. Should this organisation wish to make a meeting request, my team can be reached by the following email address: ministers_office@health.gov.ie.
In relation to improving diagnostic and treatment services for people with Sjogren’s Syndrome, as this refers to service planning and delivery, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible on these matters.
Hospital Staff
Questions (351)
Matt Carthy
Question:351. Deputy Matt Carthy asked the Minister for Health the number of orthopaedic surgeons within Children’s Health Ireland (CHI) who are able to perform surgeries on children with arthrogryposis multiplex congenita (AMC); the qualifications, sub-specialities and fellowships of each; the experience or qualification of each which provides assurance to CHI that each have specialism in limb reconstruction; the total number of children with AMC each has performed surgery on in the past five years;; and if she will make a statement on the matter. [51056/25]
View answerWritten answers
Children’s Health Ireland has advised that the Limb Reconstruction Service is a subspecialty of orthopaedic surgery and is delivered at three locations; CHI at Crumlin, CHI at Temple Street and The National Orthopaedic Hospital Cappagh. Acquired deformities can arise due to trauma, infection, metabolic conditions, or tumours. Circular external fixators are regularly used to provide management for deformed and short limbs. Patients may have these devices in place for a period of 4 to 8 months with frequent attendances at clinics for planned specialist management. As such, the management is complex and requires a dedicated team committed entirely to these complexities. Some of the care is led by Clinical Nurse Specialists, and the service also includes multiple other disciplines including physiotherapy, social work, occupational therapy and psychology.
As your queries regarding orthopaedic surgeons focus on an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Disability Services
Questions (352)
Roderic O'Gorman
Question:352. Deputy Roderic O'Gorman asked the Minister for Health the reason hearing aids for persons who are deaf require them to make a very significant personal payment in view of the fact cochlear implants are free and both are equally important for different groups of deaf people; if she will consider if more can be done to lessen the cost of hearing aids for persons who are deaf; and if she will make a statement on the matter. [51065/25]
View answerWritten answers
The Health Service Executive (HSE) provides hearing aids and associated maintenance free of charge to children under the age of 18 and to adults with a medical card. Further information regarding the HSE's audiology service can be found at: www2.hse.ie/services/audiology/.
In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. In certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. Further information can be found at: www2.hse.ie/services/schemes-allowances/medical-cards/.
The Treatment Benefit Scheme, operated by the Department of Social Protection, provides for healthcare services to qualified people who have the required number of PRSI contributions. This includes up to €1,000 for a pair of hearing aids, and up to €100 toward repairs, within a 4-year calendar period. Further information can be found at: www.gov.ie/en/service/1fb655-treatment-benefit-scheme/. Any changes to these grants would need to be considered in an overall policy and budgetary context.
Individuals who do not possess a medical card or who are not eligible for the Treatment Benefit Scheme would have to purchase hearing aids privately from a commercial provider. If the individual has private health insurance, it may cover hearing aid costs. Hearing aids are exempt from VAT. People may also be entitled to claim tax relief at the standard rate of tax (20%) on the purchase of hearing aids where prescribed.
Hospital Staff
Questions (353)
Pa Daly
Question:353. Deputy Pa Daly asked the Minister for Health the number of applications received for a nursing post recently advertised for a hospital in west Kerry (details supplied); and if she will make a statement on the matter. [51072/25]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Medical Cards
Questions (354)
Pat Buckley
Question:354. Deputy Pat Buckley asked the Minister for Health to consider increasing the income threshold for the over 70s medical card in view of the cost of living/inflation increases which gave rise to small pension increases over the past few years; and if she will make a statement on the matter. [51073/25]
View answerWritten answers
Medical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card. It is specific to the individual’s own financial circumstances.
Persons aged 69 and under are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. Certain expenses are also taken into account. Detailed guidelines are available at: www2.hse.ie/services/schemes-allowances/medical-cards/applying/assessment/.
Persons aged 70 or older are assessed under medical card income thresholds which are based on gross income. However, it should be noted that those aged over 70 can also be assessed under the general means tested scheme where there are particularly high medical costs.
Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of any difficult circumstances in the case of applicants who may be in excess of the income guidelines. In such circumstances, the HSE may exercise discretion and grant a medical card, for example:
• Discretionary medical cards issued to patients with significant medical expenses but who do not satisfy the means test.
• Emergency medical cards are issued to patients that are terminally ill, or are seriously ill, and in urgent need of medical care that they cannot afford.
Where a person's sole income is derived from a social protection payment, he/she will be awarded a medical card.
It is important to acknowledge that the administration of medical card exists within a wider eligibility framework, for example:
• Since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card.
• Under the Long-Term Illness Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
• Under the Drugs Payment Scheme (DPS) no individual pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
• Individuals may also be entitled to claim tax relief on the cost of qualifying health expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
Furthermore, there are a range of additional measures implemented over recent Budgets to increase access and affordability to healthcare, for example:
• In 2023, GP visit card means-tested eligibility was extended to those who earn up to the median household income,
• GP visit card eligibility was extended from all children under 6 to children under 8, and
• Public in-patient charges in public hospitals were abolished.
I can assure the Deputy that, in order to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues under review and any proposals are considered in the context of any potential broader implications for Government policy, the annual budgetary estimates process and legislative requirements arising.
Hospital Staff
Questions (355)
Willie O'Dea
Question:355. Deputy Willie O'Dea asked the Minister for Health her plans to deal with the delays in completing coronial autopsies caused by the severe shortage of pathologists in the mid-west; her plans to deal with the proposed withdrawal of coronial autopsies from the end of 2025 in the south east; and if she will make a statement on the matter. [51082/25]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.