Written Answers Nos. 1100-1123
1100. Deputy Pádraig Rice asked the Minister for Health the number of children included in the external expert panel review established following the independent audit of hip surgeries at CHI and Cappagh Orthopaedic Hospital; the number with unstable hips; and the number with stable hips, in tabular form. [63606/25]
View answerAs this is an operational matter, the HSE has been asked to reply directly to the Deputy.
1101. Deputy Pádraig Rice asked the Minister for Health the legislation, regulations or policies in place related to privately funded procedures in a public hospital; the oversight arrangements in place (details supplied); and if she will make a statement on the matter. [63607/25]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
1102. Deputy Pádraig Rice asked the Minister for Health if private health insurance claims at a group of hospitals are audited (details supplied); if these audits are conducted internally or externally and by whom; and if she will make a statement on the matter. [63608/25]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1103. Deputy Pádraig Rice asked the Minister for Health to clarify if a statement is correct (details supplied); and if she will make a statement on the matter. [63609/25]
View answer1104. Deputy Pádraig Rice asked the Minister for Health if she has received a copy of the “snapshot” referred to at a meeting of the Oireachtas Committee on Health earlier this year (details supplied); if so, if she will provide a copy of this data; and if she will make a statement on the matter. [63610/25]
View answerI propose to take Questions Nos. 1103 and 1104 together.
As this is an operational matter, the HSE has been asked to reply directly to the Deputy.
1105. Deputy Malcolm Byrne asked the Minister for Health the total legal costs in defending judicial reviews of planning decisions involving her Department and/or agencies within the aegis of her Department for each of the years 2020 to 2024 and to date in 2025; and if she will make a statement on the matter. [63623/25]
View answer1106. Deputy Pádraig Rice asked the Minister for Health the work undertaken to implement the operational recommendations of the independent review of the Health (Regulation of Termination of Pregnancy) Act 2018, in tabular form; and if she will make a statement on the matter. [63631/25]
View answerAs the Deputy's question relates to service matters, I have referred it to the HSE for direct reply.
1107. Deputy Pádraig Rice asked the Minister for Health the status of the commitment in the National Sexual Health Strategy 2025-2035 to develop the necessary legislative supports to underpin clinical practice regarding consent and safeguarding, as requested by clinical experts prior to supporting access to free contraception for people under the age of 17 years; and if she will make a statement on the matter. [63632/25]
View answerThe National Sexual Health Strategy, 2025-2035 was published in June of this year and can be accessed on the Healthy Ireland website at [www.gov.ie/en/healthy-ireland/policy-information/national-sexual-health-strategy-2025-2035/] .
Actions that are included in the National Sexual Health Action Plan, 2025-28 are being prioritised. To note, the Action Plan is included in the main Strategy document from pages 61-71. An Implementation Group and sub-Groups to oversee specific areas of work are currently being set up.
1108. Deputy Claire Kerrane asked the Minister for Health if she will pause the sale of lands at a HSE-owned site (details supplied) until the HSE decides on the services which it will provide on the lands to be retained to ensure any future sale of lands will align with the use of the lands being retained and developed by the HSE; and if she will make a statement on the matter. [63663/25]
View answerAs the Health Service Executive is responsible for the management of the public healthcare estate, I have asked the HSE to respond to the Deputy directly in relation to this matter.
1109. Deputy Ged Nash asked the Minister for Health if she is aware of the difficulties people suffering from a rare genetic condition are having in accessing a drug (details supplied); the plans to make this drug more easily available; and if she will make a statement on the matter. [63665/25]
View answerUnder 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.
1110. Deputy Pat the Cope Gallagher asked the Minister for Health her plans to extend the long-term illness card to include pulmonary fibrosis given it is available for persons with cystic fibrosis; and if she will make a statement on the matter. [63666/25]
View answerThe 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. Further information, including the list of conditions, can be found at:
[www2.hse.ie/services/schemes-allowances/lti/about/].
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%.
1111. Deputy Paul Lawless asked the Minister for Health the provisions being put in place to address the difficulties faced by patients in securing access to local GP services following the retirement of their GP, particularly in areas experiencing population growth; and if she will make a statement on the matter. [63668/25]
View answer1114. Deputy Paul Lawless asked the Minister for Health the number of Irish residents who, following the retirement of their GP, have been refused access to a new GP practice on the grounds of capacity in each county over the past five years; and if she will make a statement on the matter. [63671/25]
View answerI propose to take Questions Nos. 1111 and 1114 together.
GPs are self-employed practitioners and therefore may establish practices at a place of their own choosing. There is no prescribed ratio of GPs to patients, and the State does not regulate the number of GPs that can set up in a town or community.
Under the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. Currently there are 2,587 GPs contracted to provide services under the GMS Scheme. A further 634 GPs do not hold a GMS contract but hold some other contract(s) with the HSE for the delivery of health services.
Where a vacancy arises in a practice with a GMS contract, the HSE becomes actively involved in the recruitment process to find a replacement GP for the panel concerned. While recruitment is ongoing, the HSE put a locum or other suitable arrangement in place to provide continuity of care. As of September, there were 24 GMS vacancies across the country, less than 1 percent of the total number of GMS panels.
Under the terms of the GMS contract, the HSE has the power to assign a medical card or GP visit card holder to a GP's GMS patient list where that person is unable to find a GP to accept them as a patient, in accordance with the terms of the GMS contract.
People who do not hold a medical card or GP visit card access GP services on a private basis and can make enquiries directly to any GP practice they wish to register with. As private contractors, it is a matter for each individual GP to decide whether to accept additional private patients.
As GPs are private practitioners, and as people who do not hold a medical card or GP visit card access GPs service on a private basis, neither the Department of Health nor the HSE hold the information requested in relation to private patients not accepted to a new GP practice.
Work is ongoing to increase the number of GPs practicing in the State and thereby improve access to GP services for all patients across the country.
Over €340 million in additional annual investment in general practice has been provided under the 2019 and 2023 GP GMS Agreements. The Agreements provide for increased GP capitation fees, increased and new supports for practices, as well as new fees for additional services. The 2023 Agreement also provided for the expansion of GP visit card eligibility in 2023 to all children under 8 years of age and all those who earn up to the median household income.
The annual intake of doctors into the GP training programme has been increased by approximately 80% from 2019 to 2024, with 350 new entrant training places made available in 2024 and again in 2025. The number of new entrant training places is to increase again next year by 50 places to 400. As a result, the number of GP graduates has increased in recent years and will continue to increase in the coming years.
In addition, recruitment of GPs from abroad is ongoing under the International Medical Graduate (IMG) Rural GP Programme. As of end of Q3, there are 115 IMG GPs within the programme currently placed in general practice and a further 39 have completed the 2-year programme. The placement of IMG GPs is targeted to rural and underserved areas.
1112. Deputy Paul Lawless asked the Minister for Health the supports being provided to GP practices to manage increased patient demand arising from population growth and inward migration; and if she will make a statement on the matter. [63669/25]
View answer1113. Deputy Paul Lawless asked the Minister for Health the measures planned to ensure that local residents are not left without access to a GP when practices reach capacity and are unable to take on new patients; and if she will make a statement on the matter. [63670/25]
View answer1115. Deputy Paul Lawless asked the Minister for Health the steps being taken to expand GP capacity nationally, and specifically in County Mayo, to ensure equitable access for all patients regardless of background or medical card status; and if she will make a statement on the matter. [63672/25]
View answerI propose to take Questions Nos. 1112, 1113 and 1115 together.
GPs are self-employed practitioners and therefore may establish practices at a place of their own choosing. The State does not regulate the number of GPs that can set up in a town or community. Where a vacancy arises in a practice with a GMS contract, the HSE becomes actively involved in the recruitment process to find a replacement GP.
Where a person that holds a medical card or GP visit card experiences difficulty in finding a GP to accept them as a patient, the person concerned having unsuccessfully applied to at least three GPs in the area (or fewer if there are fewer GPs locally) can apply to the HSE Eligibility Unit which has the power to assign a GMS patient to a GP's GMS patient list in accordance with the GMS contract.
Work is ongoing to increase the number of GPs practicing in the State and thereby improve access to GP services for all patients across the country. In addition, under the GMS scheme, specific supports are available to GP practices to support general practice capacity.
Over €340 million in additional annual investment in general practice has been provided under the 2019 and 2023 GP GMS Agreements. The agreements provide for increased GP capitation fees, increased and new supports for practices, as well as new fees for additional services. The 2023 Agreement also provided for the expansion of GP visit card eligibility in 2023 to all children under 8 years of age and all those who earn up to the median household income.
GMS GPs working in rural areas who meet the qualifying criteria receive an annual rural practice support allowance under the Rural Practice Support Framework. The 2019 Agreement increased the practice support package for rural GP practices by 10%. Practices in receipt of rural practice supports attract the maximum allowable rates for practice staff support subsidies and locum contributions for leave taking. The Agreement also introduced a €2 million per annum support for GP practices in disadvantaged urban areas. The funding may be used for additional health personnel costs or for the provision of additional services.
The 2023 Agreement increased the subsidy amounts paid towards the cost of employing practice staff. The Agreement also added General Practice Assistant to the staff subsidies available, and introduced a new support grant for additional staff capacity of up to €15,000, as well as a staff support for the taking of maternity leave.
The annual intake of doctors into the GP training programme has been increased by approximately 80% from 2019 to 2024, with 350 new entrant training places made available in 2024 and again in 2025. The number of new entrant training places is to increase again next year by 50 places to 400. As a result, the number of GP graduates has increased in recent years and will continue to increase in the coming years.
In addition, recruitment of GPs from abroad is ongoing under the International Medical Graduate (IMG) Rural GP Programme. As of end of Q3, there are 115 IMG GPs within the programme currently placed in general practice and a further 39 have completed the 2-year programme. The placement of IMG GPs is targeted to rural and underserved areas.
Lastly, it is worth noting that a Strategic Review of General Practice is underway. The review, with input from key stakeholders, is examining the broad range of issues affecting general practice including issues related to GP capacity. Following its completion, a final report will be presented to me outlining the findings of the review and setting out recommended actions for a more sustainable general practice.
1116. Deputy Claire Kerrane asked the Minister for Health if, given the success of the Genio Sasta pilot project it will be made permanent; if funding will be provided in health for homeless initiatives; and if she will make a statement on the matter. [63675/25]
View answerAs this refers to a service matter, I have sent this PQ to the HSE for direct response.
1117. Deputy Niamh Smyth asked the Minister for Health if she will review the case of persons (details supplied); if she will address the ongoing shortfall in their approved home support hours and the absence of weekend and emergency cover; the measures being taken to ensure continuity of care when regular carers are unavailable; and if she will make a statement on the matter. [63677/25]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1118. Deputy David Cullinane asked the Minister for Health further to Parliamentary Question No. 1948 of 4 November 2025, if she will ensure the issuance of a reminder to practitioners of the terms of the scheme and ensure that women who have been wrongfully charged for services are, insofar as possible, made aware of this and reimbursed (details supplied); and if she will make a statement on the matter. [63678/25]
View answerOfficials in my Department and the HSE will remind the organisation representing GPs of the obligations of contracted GPs under the Maternity and Infant Care Scheme at an appropriate time.
Where a patient who is registered believes they have been incorrectly charged for services covered by the scheme, then that patient should report the matter to their HSE Local Health Office who will investigate the matter.
1119. Deputy Pádraig O'Sullivan asked the Minister for Health the number of dental practices in Cork currently accepting new medical card patients; and if she will make a statement on the matter. [63680/25]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly
1120. Deputy Richard Boyd Barrett asked the Minister for Health the estimated cost of including all forms of diabetes on the long-term illness scheme, including the cost of issuing the associated medical cards. [63697/25]
View answerThe 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. Further information, including the list of conditions, can be found at:
https://www2.hse.ie/services/schemes-allowances/lti/about/.
Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. Qualifying for the LTI Scheme does not qualify an individual for a medical card.
Diabetes insipidus and diabetes mellitus are conditions under the LTI Scheme. Gestational diabetes is not covered under the LTI Scheme as it is a temporary condition.
173 diabetes insipidus patients have an LTI card with a year-to-date (as of end of October) cost of €0.2m. 160,324 diabetes mellitus patients have an LTI card with a year-to-date (as of end of October) cost of €270.4m
The Health Service Executive (HSE) have advised that this only captures the number of patients claiming under the LTI Scheme, there may be more patients who have diabetes insipidus or diabetes mellitus that have not made a claim under the LTI Scheme.
The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines and medical items, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
Reimbursement is for licensed 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. HSE decisions on which medicines are reimbursed are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).
Medical card and GP visit card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card and GP Visit 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 per week and still qualify for a card. It is specific to the individual’s own financial circumstances.
The issue of granting medical or GP visit cards on the basis of illness or a disability 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 or GP visit card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card or GP visit card.
Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card - in particular, to take full account of 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.
To ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues under review and any changes are considered in the context of any potential broader implications for Government policy, the annual budgetary estimates process and legislative requirements arising.
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%.
1121. Deputy Richard Boyd Barrett asked the Minister for Health the estimated cost of providing glucose monitoring devices to all individuals with diabetes in the State. [63698/25]
View answerUnder 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.
1122. Deputy Colm Burke asked the Minister for Health if consideration will be given to reviewing the case of a person (details supplied) who has been informed they have to make a repayment of a specialty allowance in the HSE, which was due to an administrative error; if the request for repayment of the allowance to date will be withdrawn due to the fact that this error was not on the part of the worker in question; and if she will make a statement on the matter. [63703/25]
View answerAs this is a service matter I have asked the HSE to respond to the Deputy as soon as possible.
1123. Deputy John Paul O'Shea asked the Minister for Health to request the HSE south west to consider extending a day care service (details supplied) for the benefit of older people in the area; and if she will make a statement on the matter. [63708/25]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
