Written Answers Nos. 417-437
417. Deputy Ken O'Flynn asked the Minister for Children, Disability and Equality the total number of inspection reports, compliance notifications, and regulatory breach findings relating to private subcontracted disability service providers that her Department has received from HIQA in each of the past five years; and the categories of breaches notified to the Department during that period. [68897/25]
View answer418. Deputy Ken O'Flynn asked the Minister for Children, Disability and Equality the number of cases in the past five years where her Department directed remedial actions, imposed additional conditions, or required enhanced governance measures in relation to private subcontracted disability service providers following HIQA inspections, and to specify the type of remedial actions directed. [68898/25]
View answer419. Deputy Ken O'Flynn asked the Minister for Children, Disability and Equality her Department’s internal process for reviewing HIQA inspection reports relating to private subcontracted disability service providers, including the tracking of compliance deadlines, escalation procedures for repeated breaches, and the number of cases escalated to senior management or to the Minister in each of the past five years. [68899/25]
View answerI propose to take Questions Nos. 417, 418 and 419 together.
The Health and Information and Quality Authority (HIQA) is an independent statutory authority under the aegis of the Department of Health, which was established to drive continuous improvement in Ireland’s health and personal social care services, to monitor the quality of these services and promote person-centred care for the benefit of the public.
The Health Act 2007 provided for the establishment of HIQA, its inspection and regulation of designated centres and the framework for registration of these designated centres. Since November 2013, all designated centres for people with disabilities, both children and adults, must be registered with HIQA.
The Health Act 2007 (amended) and the associated regulations set out the framework for the regulation of designated centres for people with disabilities and include the requirements that providers must meet in order to ensure safe, good quality care and support to people with disabilities who live under their care.
While reporting to the Minister for Health with adherence to the Code of Practice for the Governance of State Bodies 2016, HIQA engages with the Minister for Children, Disability and Equality on matters relating to disability services.
There is ongoing, regular engagement as required between HIQA and the Department of Children, Disability and Equality on a range of matters related to the provision of high-quality and safe care within designated centres for people with disabilities services in Ireland, including the notification of Inspection reports by HIQA to officials within the Department.
HIQA engages directly with service providers to ensure compliance with the regulatory framework for designated centres for people with disabilities services, taking a graduated and proportionate response to areas requiring improvement. The Health Act 2007 (as amended) empowers the Chief Inspector, a statutory officer within the Authority, to carry out this function through the processes of registration, continual monitoring and inspection and, where necessary, the application of its powers of enforcement. HIQA carries out inspections to assess compliance with the Health Act 2007 (as amended), and relevant regulations.
Where HIQA finds that the quality of support is insufficient or inadequate, the inspection and monitoring of centres by inspectors ensures that providers are required to take action to rectify issues in relation to the safety and quality of life for people with disabilities in order to bring the centre back into compliance, within an agreed timeframe.
HIQA’s mandate extends across a specific range of public, private and voluntary sector services. It is important to note that all providers of designated centres, whether they are a public or private provider, or a voluntary body must meet the requirements of the Health Act 2007 (as amended).
In addition to monitoring the progress of registered providers’ compliance plans as required, HIQA holds powers of enforcement under Section 64 of the Health Act 2007, which enables it to cancel the registration of a designated centre to operate as a service provider, where it has significant concerns about the quality of governance and oversight in the services concerned. Such centres may then be taken over by the HSE as a provider of last resort and a list of same can be found on HIQA’s Section 64 register, at www.hiqa.ie/areas-we-work/disability-services.
The Health Service Executive (HSE) directly provides and commissions a range of services for people with disabilities, including residential and respite services. Where areas of non-compliance are identified within designated centres, the HSE works closely with the service to monitor the implementation of the Compliance Improvement Plan through the HSE Governance process.
When engaging with any ‘For Profit’ agency, the HSE reviews the capacity and capability of that company to provide the services which are outlined within a Service Arrangement and reviews its relationship with each agency through regular service review meetings and submission of relevant documentation.
The purpose of regulation for designated centres is to safeguard people who are receiving residential services. Regulation provides assurance to the public that people living in designated centres are receiving services and supports that meet the requirements of National Standards, which are underpinned by regulations.
Please see below the number of inspections carried out in designated centres for people with disabilities, over the last 5 years:
|
Number of inspections for designated centres for persons with a disability |
|
|
2021 |
1220 |
|
2022 |
1329 |
|
2023 |
1268 |
|
2024 |
1042 |
|
2025 |
1012 (As of 1 November 2025) |
Over the past number of years, HIQA has noted that they have seen an increase in compliance levels, particularly in 2024, where it found that providers have strengthened their governance and management arrangements. This in turn, has had a positive impact on all other regulations assessed.
HIQA inspection reports are published and publicly available for examination on the HIQA website, www.hiqa.ie.
420. Deputy Ciarán Ahern asked the Minister for Health the number of speech and language therapists, occupational therapists and psychologists, both adult and paediatric, working in Ballyboden Primary Care Centre in each of the past three years, in tabular form; and if she will make a statement on the matter. [68614/25]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
421. Deputy Barry Heneghan asked the Minister for Health further to Parliamentary Question No. 828 of 25 February 2025, when and by whom the decision was taken to exclude medical scientists who retired before 1 January 2024 from receiving the Labour Court recommended pay parity increases; and if she will make a statement on the matter. [68866/25]
View answer422. Deputy Barry Heneghan asked the Minister for Health further to Parliamentary Question No. 828 of 25 February 2025, if she will review the implementation of the Labour Court recommendation on pay parity for medical scientists to ensure that those who retired before 1 January 2024 including those who returned to support the health service during Covid-19 and the cyberattack are treated fairly; and if she will make a statement on the matter. [68868/25]
View answerI propose to take Questions Nos. 421 and 422 together.
Firstly, I would like to acknowledge the dedication and professionalism of all Medical Scientists throughout the country, including those who have retired from the profession after years of commitment.
Following talks at the Workplace Relations Commission back in May and June of 2022, agreement was reached to conduct an independent assessment of the role, responsibilities and pay of medical laboratory scientist grades. This assessment was undertaken by an independent assessor and the final report issued in January 2023. It was confirmed that medical laboratory scientists were performing the same duties as biochemists.
This long-standing matter was resolved through the Labour Court, which examined all relevant issues including the review of the grades involved. The Labour Court determination was explicit that the claim relating to pay parity was effective from 1 January 2024.
The implementation of the binding determination of the Labour Court is set out in the Public Service Agreement 2024 - 2026. Circular 2/2024 instructed HSE management and HR personnel to implement the terms of the Labour Court recommendation from the effective date of 1 January 2024 to all staff in position from that date. Only relevant employees in post on 1 January 2024 or after, were eligible to receive the benefit of the recommendation. Those who retire beyond 1 January 2024, will receive the benefit of recommendation.
423. Deputy Marie Sherlock asked the Minister for Health the total number of people on ophthalmology waiting lists in all hospitals offering ophthalmology services by length of time on such wait lists, and the average wait time someone can be expected to be seen in each of those hospitals if a referral is put in now, in tabular form; and if she will make a statement on the matter. [68542/25]
View answerIt is acknowledged that many patients are still waiting too long for hospital appointments and treatments. I am conscious of the burden that this places on patients and their families.
I published the Waiting List Action Plan (WLAP) for 2025 in February, representing this Government’s continued commitment to reducing waiting times for patients and improving access to hospital care. This year's plan sets out four overarching targets focused on reducing waiting times.
With the multi annual action plan approach, we are progressing towards the ultimate vision of a public healthcare service in which everyone has timely access to high-quality scheduled care, where and when they need it.
My Department is engaging with the HSE and National Treatment Purchase Fund to develop the action plan for 2026, building on the progress delivered to date, renewing the focus on improving waiting times for patients, and considering the learnings from the challenges that arose in 2025.
In relation to the particular query raised, adult and child waiting list information by hospital, specialty, and time band is published monthly by the National Treatment Purchase Fund (NTPF) on its website: www.ntpf.ie/home/nwld.htm .
The information is now being made available through an interactive visual tool which provides users with a much-improved way of accessing and analysing waiting list information.
It should be noted that the health system does not collect the data necessary to calculate the average time to treatment of patients who have already received their care. The NTPF collects data on patients on a waiting list at a point in time.
The NTPF has provided my Department with the attached information which shows the mean & median average waiting times for patients on OPD and IPDC ophthalmology waiting lists by hospital at end October.
424. Deputy Ryan O'Meara asked the Minister for Health the length of time a child (details supplied) will be waiting for a psychologist assessment, to which they have been referred; and if she will make a statement on the matter. [68550/25]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
425. Deputy Cathal Crowe asked the Minister for Health the campaigns her Department is running to encourage graduating medical professionals to stay and work in the Irish healthcare system; the campaigns which are being run to entice Irish medical professionals living abroad to return to work for the HSE; her plans to future proof supply of medical staff in the health system; and if she will make a statement on the matter. [68551/25]
View answerSignificant progress has been made by the Department of Health working in collaboration with the Department of Further and Higher Education and the Higher Education Sector to increase the number of student training places for the health, disability, and education sectors. Over 1,100 additional student places in medicine, nursing and other health related disciplines will be created in 2025 and 2026 to support the workforce needs in these sectors. Further work is underway with DFHERIS and the higher education sector to increase the domestic supply of doctors, nurses and midwives, pharmacists, dentists, and health and social care professionals.
Dedicated medical workforce planning is undertaken within the HSE to ensure that the supply of medical staff meets the future needs of the health service. Medical Interns form the entry point and pipeline for postgraduate training, and the HSE works to ensure that intern numbers are aligned with future training capacity. The HSE provides an intern place for all eligible CAO-entry graduates from Irish medical schools, who submit an eligible application, recognising the significant State investment in their medical education and training. Since 2020, the number of intern posts has increased by approximately 20%, supporting the expansion of the overall medical training pipeline. Over the same period, the number of doctors in postgraduate training programmes has increased by approximately 30%, with further growth planned through the conversion of suitable non-training NCHD posts to training NCHD posts, and continued alignment with national workforce planning projections.
Medical workforce retention data from the annual Medical Recruitment and Retention Report published by the HSE National Doctors Training and Planning (NDTP) unit shows that, typically, medical Interns leave Ireland following the intern year and return two to three years later to take up postgraduate training. The overall retention rate of medical interns is high with 80% of interns from the 2015 to 2019 cohorts returning to Ireland to take up an NCHD post in our health service. The NDTP data also indicates substantial improvements in the retention of doctors who have completed Higher Specialist Training. Of the 2019 cohort who completed Higher Specialist Training (HST), 78% were reported to be working in Ireland in either a public or private post in 2023. This increased to 82% in 2024. This happened in the context of large increases in the number of consultants posts available between 2021 and 2023 in Ireland.
Attracting and retaining Irish trained healthcare workers is an ongoing focus for the HSE, which includes initiatives such as:
• Targeted attraction and engagement strategies of Irish graduates who have travelled overseas.
• Further expansion of the HSE Career Hub, which currently engages with over 56k members weekly, providing job notifications, candidate support material, relocation supports, and providing engaging information on promotional pathways, to support both retention and recruitment.
• Collaboration with education and regulation partners, in a series of engagement initiatives with students, new graduates and those trained overseas to navigate and ease their recruitment and professional registration journey.
• Increased visibility of the HSE, as an employer of choice at career events, both nationally and internationally, including attendance at international career events to attract home Irish trained Doctors to consultant posts.
• Retention of existing workforce is a primary focus of the HSE. This is supported by a number of initiatives, including the recent launch of the retention toolkit which provides practical guidance and good practice on pre and post survey implementation stages. The toolkit includes signposting to a suite of resources to help identify and implement initiatives that foster a positive work environment, enhance employee engagement, and reduce turnover based on the survey findings. It is intended to be adaptable to the diverse needs of services and teams across the health and social care sector.
426. Deputy Cathy Bennett asked the Minister for Health the number of paramedics and ENT's, including advanced paramedics in counties Monaghan and Cavan, respectively, in each of the years 2019 to date in 2025, in tabular form; and if she will make a statement on the matter. [68558/25]
View answer427. Deputy Cathy Bennett asked the Minister for Health the average ambulance response time in County Monaghan in each of the years 2019 to date in 2025, in tabular form; and if she will make a statement on the matter. [68559/25]
View answerI propose to take Questions Nos. 426 and 427 together.
As this is a service matter, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
428. Deputy Robert Troy asked the Minister for Health if she will reexamine the decision to cease the phased dispensing reimbursement service for certain medications in community pharmacies (details supplied). [68566/25]
View answer429. Deputy Robert Troy asked the Minister for Health if she will reexamine the decision to cease the phased dispensing reimbursement service for certain medications in community pharmacies (details supplied) which cannot be prescribed on a phased basis. [68567/25]
View answer443. Deputy Pa Daly asked the Minister for Health if she will explain the rationale for the planned increase to blister pack preparation charges under the new HSE–community pharmacy contract; if she will urgently review this policy in light of the disproportionate impact on older patients and those with chronic conditions; and if she will make a statement on the matter. [68616/25]
View answer444. Deputy Pa Daly asked the Minister for Health if she will consider introducing an exemption or subsidy for medical card holders and older patients who rely on blister packs, given the significant financial burden of the proposed price increase effective from 1 January 2026; and if she will make a statement on the matter. [68617/25]
View answer448. Deputy John Connolly asked the Minister for Health further to Parliamentary Question No. 1825 of 4 November 2025, the steps her Department expects pharmacies to charge for this service; the supports or alternatives available for low-income individuals who require blister packs for safe medication management but cannot afford the additional cost (details supplied); and if she will make a statement on the matter. [68663/25]
View answer510. Deputy Michael Cahill asked the Minister for Health if she will urgently address a matter (details supplied) and remove all charges for blister packs for the elderly; and if she will make a statement on the matter. [68890/25]
View answerI propose to take Questions Nos. 428, 429, 443, 444, 448 and 510 together.
The Community Pharmacy Agreement 2025 was published on the 18th of September 2025, following the successful conclusion of negotiations with the Irish Pharmacy Union (IPU). The Agreement is supported by a €75 million new investment across 2025 and 2026.
The Agreement marks a significant milestone in the strategic collaboration between the Department of Health, the Health Service Executive (HSE), and the IPU. It sets out a comprehensive and ongoing pathway to modernise and expand the role of community pharmacy in Ireland’s healthcare system.
The Agreement is available on the Department of Health’s website at the following link: www.gov.ie/en/department-of-health/publications/community-pharmacy-agreement-2025/.
It is important to note that the Community Pharmacy Agreement 2025 does not remove phased dispensing.
Phased dispensing was introduced in 1996 for patient safety reasons. The supply of medication in instalments can support patients prescribed certain high-risk medications who are at risk of medication misadventure if these medications were to be supplied monthly, as is the norm under the community drug schemes. Where a phased dispensing claim is submitted, the current requirement is that an item must be dispensed in the pharmacy across multiple supply occasions. Community pharmacies receive additional payments in respect of phased dispensing.
Monitored Dosing Systems are systems that enable the individual medicine doses to be organised according to the prescribed dose schedule. These are sometimes referred to as blister packs. The State has never agreed to fund Monitored Dosing Systems.
However, a practice has built up whereby the use of Monitored Dosing Systems are charged as if for phased dispensing. The State has never agreed to this. Phased claiming was never intended to be used to submit claims in lieu of the provision of Monitored Dosing Systems.
Whilst Monitored Dosing Systems may have a role for some patients there is significant uncertainty around the robustness of the evidence supporting its use.
The National Centre for Pharmacoeconomics carried out an evidence assessment which indicated that the evidence was, at best, equivocal to support such a programme.
Significant expenditure is therefore being incurred where it was never intended by the State. It has been agreed to introduce improved controls in this regard and to limit the use of phased dispensing to specified high risk drugs, where a patient safety concern may exist.
Phased dispensing support is currently available for medical card holders under the General Medical Services (GMS) Scheme for the following reasons:
Reason 1 - at the request of a patient's physician.
Reason 2 - due to the inherent nature of a medicinal product i.e. product stability and shelf life.
Reason 3 - where a patient is commencing new drug therapy with a view to establishing patient tolerance and acceptability before continuing on a full treatment regime.
Reason 4 - in exceptional circumstances where the patient is incapable of safely and effectively managing the medication regimen.
Under the Community Pharmacy Agreement 2025, from January 2026, phased dispensing under reason 1 and 4 will be limited to a defined set of high-risk medication classes. These are:
• Psychotropics;
• Opioids;
• Codeine; and
• Pregabalin and gabapentin.
The approved list of medications under these classes will be provided by the HSE in due course.
For reasons 1 and 4, by focusing phased dispensing reimbursement on the medication categories on the approved list, phased dispensing payments can be targeted to medications with the highest risk or potential for misuse.
Phased dispensing fees will remain payable as per current arrangements under reasons 2 and 3 and will not be subject to the approved list.
The salient point here is that appropriate phased dispensing is not being removed in this Agreement.
The introduction of improved controls around phased dispensing is being done in a way which puts patient safety first and allows the State to repurpose funding to be used to implement new patient-centred services.
It remains open to pharmacies to charge patients for the use of Monitored Dosing Systems as a private service.
The Agreement is designed to support the delivery of safe, equitable, and efficient healthcare, and to ensure that community pharmacists are better equipped to contribute to national health priorities through structured engagement, sustainable funding, and integrated service delivery.
Under the Agreement, a Strategic Collaboration Group will be established from early 2026 which will provide a structured forum for dialogue and joint consideration of strategic issues shaping the future of community pharmacy in Ireland.
The Agreement also includes the establishment of a rolling annual medicines optimisation programme with dedicated annual funding. The Strategic Collaboration Group will be tasked with exploring the best way to utilise this fund.
430. Deputy Jen Cummins asked the Minister for Health her plans to cover newer and more effective MS medications that are not yet included in the reimbursement lists to make it easier for patients with MS on lower incomes to access more effective treatments. [68569/25]
View answer431. Deputy Jen Cummins asked the Minister for Health her plans to review the inclusion of all clinically proven MS medications under both the drug payment scheme and the medical card. [68570/25]
View answerI propose to take Questions Nos. 430 and 431 together.
The State recognises the importance of timely access to new and innovative treatments for patients with Multiple Sclerosis (MS).
The Programme for Government contains a suite of measures on medicines which my officials will seek to progress over the lifetime of this government.
Supported by 158 million euros of funding, in the last four years, the State has delivered access to 243 new medicines. One hundred and one (101) of these were for cancer and 67 of these were for rare diseases. Budget 2026 allocated €30 million for new drugs from €217 million in additional funding for medicines.
It should be noted that once new medicines are approved the full cost of providing them as their uptake increases can reach multiples of their initial cost.
The OECD reports that Ireland has the second highest rate of state coverage of pharmaceutical expenditure in Europe.
The HSE has statutory responsibility for medicine pricing and reimbursement decisions, under the Health (Pricing and Supply of Medical Goods) Act 2013. Reimbursement is for licenced indications which have been granted marketing authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority (HPRA).
Once a company responsible for the commercialisation of a new medicine receives marketing authorisation, it can apply for reimbursement in the country (or countries) of its choice. The timing of company applications for new medicine reimbursement in different countries can vary for several reasons, not least the available market share in each country.
Ireland, by virtue of its size and market share, may not always be prioritised by a company in the first stages of marketing a new product.
Ireland is open for business and actively encourages all Marketing Authorisation holders of new medicines to apply for pricing and reimbursement in Ireland as soon as marketing authorisation is granted by the European Medicines Agency.
The Government has introduced a suite of new measures to enhance capacity in the HSE’s pricing and reimbursement system including 34 additional staff and a medicines application tracker to increase transparency of the process.
Access to medicines requires industry and the State to work together, through timely assessment, and reasonable pricing with fully completed HTAs (Health Technology Assessments) which will ultimately benefit patients.
432. Deputy Sorca Clarke asked the Minister for Health the current national and regional data on delayed recall appointments within the HSE including appointments issued to patients following hospital discharge for X-rays, ultrasounds, and consultant-requested follow-up assessments; the average waiting time for such recall appointments; and the steps the HSE is taking to reduce delays that can negatively impact patient outcomes, particularly for cardiology, prostate care, and ongoing medical needs of older persons. [68574/25]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
433. Deputy Sorca Clarke asked the Minister for Health the number of hospital and outpatient appointments that were missed, cancelled, or scheduled but not fulfilled in the past 12-months; the breakdown by specialty (including cardiology, urology, and geriatric medicine); the reasons recorded by the HSE for these missed or unfulfilled appointments; and the measures being introduced to improve communication with patients so that they do not miss appointments owing to delayed or unclear notifications. [68575/25]
View answerIn relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
434. Deputy Malcolm Byrne asked the Minister for Health to provide details of dentists in the north Wexford area who accept medical cards; the average length of time waiting for treatment; the measures being put in place to address this challenge; and if she will make a statement on the matter. [68577/25]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
435. Deputy Malcolm Byrne asked the Minister for Health to provide details of dentists in the Arklow and south Wicklow area who accept medical cards; the average length of time waiting for treatment; the measures being put in place to address this challenge; and if she will make a statement on the matter. [68578/25]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
436. Deputy Malcolm Byrne asked the Minister for Health to provide an update on the long awaited primary care centre planned for Gorey, County Wexford. [68579/25]
View answerAs the Health Service Executive (HSE) holds responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have asked the HSE to respond to the Deputy directly, as soon as possible.
437. Deputy Malcolm Byrne asked the Minister for Health the incentives which are in place to encourage the establishment of new general practitioner practices. [68580/25]
View answerGPs 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.
General practitioners who hold a GMS contract are reimbursed for the services they provide to medical card and GP visit card holders on behalf of the HSE. GMS GPs are remunerated through capitation payments and fee-per-item payments for certain services, and also receive a range of practice supports.
Under the GMS scheme, GPs are paid a subsidy towards the cost of employing a practice nurse and/or a practice secretary. The rate payable depends on the GP's GMS panel size and the level of experience of the nurse or secretary. A practice manager subsidy is also available. The GP Agreement 2023 increased the existing subsidy rates for practice staff and introduced a new grant support for additional practice staff capacity as well as a practice staff maternity leave support
GPs working in rural areas who meet the qualifying criteria qualify for an annual rural support allowance. The 2019 GP Agreement increased the practice support package for rural GP practices by 10% and introduced a €2 million annual support for GP practices in disadvantaged urban areas. Practices in receipt of rural practice supports attract the maximum allowable rates for practice staff support subsidies and locum contributions for leave taking. Contributions are also made under the GMS scheme towards locum costs for various GP leave arrangements.
A financial support specific for the establishment of practices is not provided under the GMS scheme.
My Department and the HSE are undertaking a Strategic Review of General Practice. The review, with input from key stakeholders, is examining the broad range of issues affecting general practice and will set out the measures necessary to deliver a more sustainable general practice into the future. Under this review, consideration is to be given to the development of the support model necessary to underpin the provision of sustainable GP services.
It is worth noting that some GP practices operate from HSE Primary Care Centres (PCCs). PCCs are modern, purpose-designed buildings that provide a single location for a primary care team to work from. There are 180 PCCs currently operational.
