Written Answers Nos. 1006-1026
1006. Deputy Ken O'Flynn asked the Minister for Health the expenditure-control arrangements, budget ceilings, approval processes and value-for-money mechanisms applied by her Department to overseas gender-related referrals for minors since 2020; and to confirm whether these arrangements have been audited. [71979/25]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1007. Deputy Ken O'Flynn asked the Minister for Health if her Department will establish a single national reporting structure for all gender-related referrals of minors, including approvals, outcomes and costs, to ensure transparent governance and accountability; and to provide the expected timeline. [71980/25]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1008. Deputy Ken O'Flynn asked the Minister for Health the reason her Department issued no updated circulars, guidance or interpretative instructions for the assessment of discretionary medical card applications for people aged over 70 since 2020, despite sustained medical inflation and rising household costs; and to outline the process used by the Department to ensure fairness and consistency during this period. [71981/25]
View answer1009. Deputy Ken O'Flynn asked the Minister for Health if her Department conducted any equality, vulnerability or impact assessment on the treatment of discretionary medical card applications for people aged over 70 during 2020 to 2025; and if not, to state the reason such assessments were not carried out. [71982/25]
View answerI propose to take Questions Nos. 1008 and 1009 together.
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 per 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. 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. Detailed guidelines are available at: www.hse.ie/eng/staff/pcrs/medical-card-and-gp-visit-card-assessment-guidelines.pdf
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 the 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.
The Deputy may wish to note that the provision of medical cards by the HSE on a discretionary basis is not specific or limited to people over 70 only and the arrangements in place are applicable to all people applying for a medical card, taking account of the specific individual circumstances of applicants who may be in excess of the income guidelines.
Information provided by the HSE indicates that there have been increases over recent years in the number of discretionary cards held by persons 70 years old and over, as outlined in the table below.
|
Date |
Number of Discretionary Cards held by 70-year-olds and over |
|
Jan 1st 2021 |
21,306 |
|
Jan 1st 2022 |
24,692 |
|
Jan1st 2023 |
28,702 |
|
Jan 1st 2024 |
32,048 |
|
Jan 1st 2025 |
35,566 |
|
Nov 1st 2025 |
38,076 |
It is important to acknowledge that the administration of medical card exists within a wider eligibility framework, and that a range of other measures have also been implemented over recent years to help increase access to and the affordability of healthcare services, 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.
• 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
• Public in-patient charges in public hospitals have been abolished.
• 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%.
I can assure the Deputy that, 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 Government policy and other issues which may be relevant.
1010. Deputy Ken O'Flynn asked the Minister for Health the work, governance structure, timelines and outputs of the Programme of Work Underway within her Department examining the medical card eligibility framework; and to specify whether this work includes an assessment of approval trends for discretionary medical cards for people aged over 70. [71983/25]
View answerA strategic review of eligibility is being undertaken as part of Sláintecare 2025+. In order to achieve the goal of universal healthcare in line with the commitments made in Sláintecare, we must first review existing eligibility arrangements and see how they align with current population needs while identifying gaps in the eligibility framework.
It is in this context that my Department has commenced a long-term project to review Ireland’s current eligibility policies, with a focus on services delivered at primary and community care level.
This overall programme of work will review the existing eligibility framework, including the provision and administration of medical cards, to clearly assess what is working well and to inform future policy proposals regarding the eligibility framework based on robust evidence.
Phase 1 of the strategic review is due to be completed in the months ahead. Phase 2 of the strategic project will examine the findings of phase 1. This will then inform the development of evidence-based policy options for a future eligibility framework to support a progressive move towards universal healthcare.
1011. Deputy Ken O'Flynn asked the Minister for Health if her Department holds trend analysis or internal reports on discretionary medical card approvals, refusals and approval rates for people aged over 70 since 2020; and to provide a summary of any findings. [71984/25]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1012. Deputy Ken O'Flynn asked the Minister for Health the Department’s policy position on the role of medical inflation, rising living costs and increased clinical need in assessing hardship for people aged over 70 who exceed the income threshold; and to confirm whether the Department plans revisions to hardship interpretation or supporting documentation requirements. [71985/25]
View answer1058. Deputy Ken O'Flynn asked the Minister for Health if her Department has undertaken any review since 2020 of the adequacy of the medical card income thresholds for persons aged 70 years and over in light of cumulative inflation and rising living costs; and the findings of any such review. [72242/25]
View answerI propose to take Questions Nos. 1012 and 1058 together.
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. 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. Detailed guidelines are available at: National Medical Card Assessment Guidelines. Furthermore, the Deputy may be aware that, since 2015, every individual aged 70 and over has automatic eligibility for a 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 and, in particular, to take full account of the 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, and that a range of other measures have also been implemented over recent years to help increase access to and the affordability of healthcare services, 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.
• 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
• Public in-patient charges in public hospitals have been abolished.
• 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%.
I can assure the Deputy that my Department keeps medical card issues under review in order to ensure the medical card system is responsive and sensitive to people's needs. There is a programme of work currently underway in my Department which is reviewing the existing eligibility framework, to clearly assess what is working well and to inform future policy proposals regarding the eligibility framework based on robust evidence. This is an important step towards delivering on universal healthcare in Ireland.
1013. Deputy John McGuinness asked the Minister for Health further to Parliamentary Question No. 634 of 23 September 2025, if an urgent response from the HSE will be provided (details supplied). [72019/25]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1014. Deputy Carol Nolan asked the Minister for Health the number of first consultations and second consultations for abortions that were provided by general practitioners, family planning clinics and women’s health clinics in 2022 and 2023; and if she will make a statement on the matter. [72028/25]
View answerAs the Deputy's question relates to a service matter, I have referred to the HSE for direct reply.
1015. Deputy Eoghan Kenny asked the Minister for Health the amount her Department has spent on translation services from a company (details supplied) for the years 2020 to 2025 to date, in tabular form; and if she will make a statement on the matter. [72070/25]
View answerMy Department has not made any payments to this company.
1016. Deputy Niall Collins asked the Minister for Health if she will extend the long Covid sick scheme; and if she will make a statement on the matter. [72078/25]
View answerAfter a hearing in the Labor Court in June, it was recommended that a final extension of the current Special Scheme to the 31st of December 2025, at which point anyone remaining on the scheme should transition to the Public Service Sick Leave Scheme. Any employee of the public health sector remaining unwell beyond that date, may utilise the full provisions of the Public Service Sick Leave Scheme which will provide further support. Employees who did not qualify for the Special Scheme but are also impacted by Long-Covid may also utilise the supports of the sick leave scheme. The sick leave scheme provides full pay for three months, followed by half pay for three months, and after that, Temporary Rehabilitative Remuneration may be applied for, which, if granted, provides up to a further 547 days of paid leave. The Critical Illness Protocol that forms part of the sick leave scheme may also provide additional supports if granted.
1017. Deputy Pearse Doherty asked the Minister for Health the assessment or consultation that was done to approve the permanent removal of dental services in Killybegs, County Donegal; the reason for removing the service; the reason another dentist could not be found in Killybegs to continue the service; if her Department will consider reversing this decision in the future given the distance people will now need to travel to Donegal town; and if she will make a statement on the matter. [72081/25]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
1018. Deputy Sean Fleming asked the Minister for Health when the practice support grant will be paid to a doctor (details supplied); and if she will make a statement on the matter. [72099/25]
View answerAs this is a service matter, I have asked the HSE to reply to the Deputy directly as soon as possible.
1019. Deputy Thomas Gould asked the Minister for Health the timeline for delivery of the new elective hospital in Cork; and when this will be fully operational. [72100/25]
View answerI have asked the HSE, as sponsoring agency with day-to-day responsibility for the delivery of the new elective treatment centres to respond to you directly in relation to the matters raised.
1020. Deputy Thomas Gould asked the Minister for Health the number of children and adults in Cork currently awaiting an appointment for audiology, by waiting time, in tabular form. [72102/25]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1021. Deputy Thomas Gould asked the Minister for Health the number of children and adults in Cork currently awaiting an appointment for ophthalmology, by waiting time, in tabular form. [72103/25]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1022. Deputy Thomas Gould asked the Minister for Health the number of children in Cork currently awaiting a scoliosis appointment longer than four months. [72104/25]
View answerAs this is a service matter I have asked the HSE to respond to the deputy as soon as possible.
1023. Deputy Thomas Gould asked the Minister for Health for an update on the proposed supervised injection facilities in Cork. [72105/25]
View answerThe independent evaluation of the national drugs strategy, Reducing Harm Supporting Recovery, assessed the expansion of harm reduction as a significant accomplishment. It found that harm reduction initiatives were a central component of the health-led approach to drug use, with a focus on reducing the adverse health and social impacts associated with drug use.
One significant harm reduction initiative is the establishment of a supervised injecting facility. Last year, the Department of Health granted a licence to operate Ireland's first supervised injecting facility to Merchants Quay Ireland and the facility opened on 22 December 2024.
I am happy to report that between launch and 11th Dec 2025, the facility has been attended by 1,390 individual clients who have made a total of 14,365 visits. Crucially, there were 236 successful interventions to prevent a fatal overdose. I provided additional funding to extend the opening hours of the facility to meet presenting demand.
The HSE is overseeing an evaluation of the 18-month pilot phase of the facility. The evaluation will inform decisions on whether to continue to licence this facility and to licence the establishment of similar facilities in other areas of need, such as Cork.
I am committed to a health led response to drug use including the provision of harm reduction initiatives based on population need.
1024. Deputy Thomas Gould asked the Minister for Health the provision of primary care centres in Blarney, Mayfield and Glanmire. [72106/25]
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.
1025. Deputy Thomas Gould asked the Minister for Health the number of GMS general practitioners in Cork, by LHO in 2020 and in 2025. [72107/25]
View answer1026. Deputy Thomas Gould asked the Minister for Health the number of GMS patients in Cork, by LHO, in 2020 and in 2025. [72108/25]
View answerI propose to take Questions Nos. 1025 and 1026 together.
As this is a service matter, I have asked the HSE to reply to the Deputy directly as soon as possible.
