Written Answers Nos. 651-667
651. Deputy Sean Fleming asked the Minister for Health when planning and design will commence for a project and the estimated time for completion of this project (details supplied); and if she will make a statement on the matter. [73408/25]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
652. Deputy Michael Cahill asked the Minister for Health to expedite a fair deal appeal (details supplied) as this family cannot afford the costs of same; and if she will make a statement on the matter. [73409/25]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
653. Deputy Michael Healy-Rae asked the Minister for Health if supports will be allocated to home carers for changes that must be made in line with HIQA's draft national standards for home supports services (details supplied); and if she will make a statement on the matter. [73425/25]
View answerThe 2025 Programme for Government includes the commitment to “Design a Statutory Homecare Scheme to allow people to stay in their own home for as long as possible.” Work is ongoing within the Department of Health to progress this commitment.
A necessary pre-condition for any statutory scheme is to ensure that the sector is regulated. The Department is therefore developing a regulatory framework for all home support providers. This will consist of primary legislation for the registration of providers, secondary legislation in the form of regulations (minimum requirements), and HIQA national quality standards.
The Health (Amendment) (Home Support Providers) Bill 2025 will introduce, for the first time, the registration and regulation by HIQA and the Chief Inspector of Social Service of all home support providers in Ireland. The objective of the proposed registration system is to improve the safety and quality of home support services by ensuring that registered home support providers do not operate below the standard set by Ministerial regulations and will ensure that the public can be confident that the services provided are of a high standard and will bring Ireland in line with best international practice.
The Health (Amendment) (Home Support Providers) Bill 2025 has now been published on the Oireachtas website and will be brought before the Oireachtas shortly for consideration.
The provisions within the Bill will amend HIQA’s powers to include setting standards in relation to the safety and quality of home support services provided by registered home support providers. Draft standards for home support providers have been submitted by HIQA to the Minister for Health and are currently being reviewed by officials to ensure alignment with the Bill. The Department will continue to work closely with stakeholders, including HIQA, the HSE and representative groups as the Bill progresses through both Houses of the Oireachtas and during the implementation phase.
654. Deputy Máire Devine asked the Minister for Health for assistance in relation to a hospital discharge (details supplied). [73430/25]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
655. Deputy Sean Fleming asked the Minister for Health the alternative options for a health centre which is being explored by the HSE in respect of the improvement works or an extension (details supplied); and if she will make a statement on the matter. [73431/25]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
656. Deputy Louise O'Reilly asked the Minister for Health to provide a breakdown of the wait times to see a consultant at all HSE fertility hubs across the country, in tabular form; the measures taken to ensure the waitlists for childless couples in particular do not increase; and if she will make a statement on the matter. [73432/25]
View answerAs the Deputy's question relates to service matters, I have referred it to the HSE for direct reply.
657. Deputy Louise O'Reilly asked the Minister for Health if she is aware of any scheme or funding stream for the provision of guide dogs for a visually impaired person living in a rural area who is no longer working but who still wants to be able to leave the house and cannot do so safely without the assistance of a guide dog; and if she will make a statement on the matter. [73439/25]
View answerThe matter raised by the Deputy is a matter for the Department of Children, Disability and Equality.
658. Deputy Naoise Ó Muirí asked the Minister for Health if phased dispensing will still be provided free of charge for patients at the request of their physician; whether the HSE expects this to take place for many existing patients; when the approved list of medications will be provided in these cases; and if she will make a statement on the matter. [73443/25]
View answerPhased dispensing support is currently available for medical card holders under the General Medical Services (GMS) Scheme for the following reasons:
1. at the request of a patient's physician.
2. due to the inherent nature of a medicinal product i.e. product stability and shelf life.
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.
4. in exceptional circumstances where the patient is incapable of safely and effectively managing the medication regimen.
Under the Community Pharmacy Agreement 2025, 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 can be found in the following HSE circular: www.hse.ie/eng/staff/pcrs/circulars/pharmacy/pharmacy-circular-019-25-phased-dispensing.pdf
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.
These changes, which were due to come into effect in January 2026, have now been paused till later in quarter 1 of 2026.
659. Deputy Aidan Farrelly asked the Minister for Health to provide a schedule of campaigns over the last five years aimed at attracting medical professionals working abroad to come back to work in Ireland; the duration of the campaigns; the format they took; the total expenditure associated with each; a schedule of external parties used in respect of the campaigns; and the jurisdictions in which campaigns were run.; and if she will make a statement on the matter. [73449/25]
View answerAs this is a recruitment/staffing matter we have asked the HSE to respond directly to the Deputy.
660. Deputy Michael Healy-Rae asked the Minister for Health further to Parliamentary Question No. 264 of 3 December 2025, if measures will be taken with the changes in prices of blister packs from January 2026 to counter the impact for vulnerable patients (details supplied); and if she will make a statement on the matter. [73451/25]
View answerMonitored Dosage Systems (MDS), known as “blister packs” or compliance aids, are systems that enable the individual medicine doses for any medication to be organised according to the prescribed dose schedule. These are ordinarily provided once a month and packaged to indicate when medication should be taken.
The State has never agreed to fund this and there has never been a fee associated with MDS under the Pharmacy contract. This has always been the case and has been repeated in several HSE circulars to pharmacists.
The State has not imposed a new charge on MDS, also known as “blister packs”. This remains a private service provided by pharmacies. It is also understood that different approaches are taken by community pharmacies in respect of funding the use of MDS for medical card holders.
- Some have been blister packing their patient’s medicines for free,
- Some have been charging the patient privately for providing that service, and,
- Some have submitted claims for phased dispensing to the HSE when in reality they were using MDS. The State has never agreed to this last practice, and it is inappropriate claiming to do so.
The new Community Pharmacy Agreement 2025, which was negotiated by the Department of Health, the Health Service Executive, and the Irish Pharmacy Union, was published in September 2025. The Agreement reiterated the long-standing position of the State that MDS, were not reimbursable under the General Medical Services (GMS) Scheme, or any other State scheme.
Under the landmark agreement, a new Strategic Collaboration Group will be established in early 2026 to provide a structured forum for joint consideration of strategic issues shaping the future of community pharmacy in Ireland. A key pillar of this is a dedicated fund allocated to progressing opportunities to improve or expand community pharmacy services in relation to medicines optimisation. This new structured collaborative process will help to design and deliver evidence-informed high impact medicines optimisation services to patients and support future opportunities for service investment.
661. Deputy Shane Moynihan asked the Minister for Health the number of registered nursing homes by county (and if possible, local electoral area) in each year between 2013 and 2023, split by sector (HSE, private and voluntary); the number of beds in these nursing homes by county (and if possible, local electoral area) in each year between 2013 and 2023, split by sector (HSE, private and voluntary); and the occupancy rates of these beds by county (and if possible, local electoral area) in each year between 2013 and 2023, split by sector (HSE, private and voluntary). [73452/25]
View answerThe Chief Inspector of Social Care and the Health Information Quality Authority (HIQA) is the national independent regulator of designated centres for older people including public community nursing units and private/voluntary nursing homes.
Department of Health officials directed this query to HIQA who have requested more time to deal with this substantial request.
As soon as the relevant information is compiled it will be provided to the Deputy.
662. Deputy Michael Cahill asked the Minister for Health to put a system in place whereby any incremental rise in the old-age pension is matched by a similar rise in the qualifying income for the medical card, as it cannot be allowed to continue that any rise in the old-age pension, the right to which has been earned over a lifetime, should be the cause of disqualifying a person close to the threshold from being entitled to a medical card; and if she will make a statement on the matter. [73463/25]
View answerMedical 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. Details are available at: www2.hse.ie/services/schemes-allowances/medical-cards/other-types-of-medical-card/over-70s/
In response to the Deputy’s query regarding State pension payment increases, it is important to note that where a person's sole income is derived from a social protection payment, he/she will be awarded a medical card.
In addition, 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.
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.
663. Deputy Donna McGettigan asked the Minister for Health the estimated price, per patient, of the standard flu vaccine and of the enhanced flu vaccine; if she will introduce a policy of offering both and allowing patients decide if they want to pay the extra cost of the enhanced vaccine; and if she will make a statement on the matter. [73478/25]
View answerThe Influenza Vaccination Programme provides a free flu vaccine to those most vulnerable to the effects of the flu. Every year the WHO reviews global surveillance data and recommends the specific influenza strains that manufacturers should include in the season's vaccines based on the flu strains that are considered most likely to circulate. Vaccine production takes several months and this allows the manufacturers sufficient time to have vaccine available in time for the start of the flu season. All licensed influenza vaccines included for the 2025/2026 season comply with WHO and NIAC recommendations.
In 2024, HIQA carried out a Health Technology Assessment, or HTA, on enhanced flu vaccines. The HTA noted that studies on the effectiveness of enhanced flu vaccines are limited due to the small number of studies and a paucity of data over multiple seasons. Due to the variability of seasonal influenza, a single study may misrepresent the 'on average' vaccine effectiveness.
Based on the limited data available, the HTA found that switching from a standard to an enhanced flu vaccine for those aged 65 and older would likely reduce the burden of flu. Whether such a switch would represent a good use of public monies would depend on the price of these enhanced vaccines compared with the standard flu vaccine.
Overall, ECDC reported low to moderate relative vaccine effectiveness for the adjuvanted influenza vaccine against laboratory confirmed influenza and against laboratory confirmed influenza related hospitalisation. They concluded that the evidence of the relative vaccine effectiveness of enhanced influenza vaccines compared to standard vaccines is still limited and that further studies are needed to allow more substantial conclusions on the potential benefits of enhanced influenza vaccines.
It should be noted that the UK is experiencing a significant influenza A wave with medium-level impact in terms of hospitalisations up to 29 November 2025. This is in context of a programme using enhanced influenza vaccines. Australia also offered enhanced influenza vaccines and experienced a severe flu season.
In Ireland amongst both hospitalised influenza cases with severe acute respiratory infection and ICU admissions due to influenza this season, where influenza vaccination status was known, 73% had not received the current season influenza vaccine.
For those in recommended groups, the influenza vaccine currently offered as part of the Influenza Vaccination Programme reduces the risk of serious illness and death from influenza. Ensuring high vaccine coverage is the key public health intervention that is required. While Ireland performs well compared to other countries in Europe, achieving high vaccine coverage in older age groups, it is essential that all those in recommended groups continue to be supported and encouraged to avail of the influenza vaccine.
The HSE was asked to commence a tender process to determine if the enhanced vaccines could be purchased at a price that was cost effective and from within their existing budget. The HSE carried out an analysis of the tenders received and on 4 February 2025, advised the Department that neither of the enhanced vaccines for older people met the criteria set out in the HTA for net monetary benefit compared to standard flu vaccine and was over twice the price of the standard flu vaccine.
The HIQA HTA estimates increasing costs of procurement of the enhanced influenza vaccines at between approximately 4 and 19 million euros/year. Actual costs are commercially confidential and are not known until tenders are evaluated each year.
The healthcare budget is finite. Decisions regarding increased spending in one area could impact the provision of other health technologies and treatments within the healthcare system. Therefore, cost-effectiveness must be considered in any decision-making process. The introduction of an enhanced vaccine can be reconsidered when the cost effectiveness is more favourable.
664. Deputy Pádraig Rice asked the Minister for Health to provide further details with respect to a person’s new role within the HSE (details supplied); if they retain the salary from their previous role; to provide details of the renumeration attached to their new role; to provide a description of their new role and her responsibilities; and if she will make a statement on the matter. [73486/25]
View answerAs this is a service matter I have asked the HSE to respond to the Deputy as soon as possible.
665. Deputy Pádraig Rice asked the Minister for Health the annual cost to the State of reimbursement for monitored dosing systems, or blister packs; and if she will make a statement on the matter. [73487/25]
View answerMonitored Dosage Systems (MDS), known as “blister packs” or compliance aids, are systems that enable the individual medicine doses for any medication to be organised according to the prescribed dose schedule. These are ordinarily provided once a month and packaged to indicate when medication should be taken.
The State has never agreed to fund this and there has never been a fee associated with monitored dosage systems under the Pharmacy contract. This has always been the case and has been repeated in several HSE circulars to pharmacists.
The State has not imposed a new charge on MDS, also known as “blister packs”. This remains a private service provided by pharmacies. It is also understood that different approaches are taken by community pharmacies in respect of funding the use of MDS for medical card holders.
- Some have been blister packing their patient’s medicines for free,
- Some have been charging the patient privately for providing that service, and,
- Some have submitted claims for phased dispensing to the HSE when in reality they were using MDS. The State has never agreed to this last practice, and it is inappropriate claiming to do so.
As I stated in the Dáil on 16 December 2025, further analysis is required to determine to what extent the phased dispensing arrangements - which is funded for medical card holders under certain criteria - have been used in lieu of the provision of MDS (known as blister packing), a practice that would be classed as inappropriate claiming.
666. Deputy Pádraig Rice asked the Minister for Health further to Parliamentary Question No. 458 of 6 November 2025, the status of the estimated 390 posts required to achieve baseline implementation of Phases 1 and 2 of the Framework for Safe Nurse Staffing and Skill Mix; the number still outstanding; the timeline for completion of recruitment; and if she will make a statement on the matter. [73488/25]
View answerAs the Deputy will be aware, the Framework for Safe Nurse Staffing and Skill Mix is a systematic, evidence-based approach to determine safe staffing levels and skill mix for nursing and healthcare assistant roles. It is determined by patient need and demonstrates impact through the measurement of a range of outcomes. Phase 1 focused on Adult General and Specialist Medical and Surgical Care Settings and Phase 2 focused on Adult Emergency Care Settings. National implementation of these policies is a priority and has received significant Government investment since 2020.
The HSE CEO mandated that baseline implementation of both phases of the Framework be achieved by 31 December 2025 and this is on target to be achieved.
Prior to this, progress had been made with over 1,700 additional Registered Nurses (RNs) and Healthcare Assistants (HCAs) successfully recruited to deliver baseline implementation of the Framework across all in-patient wards and Emergency Departments nationally.
Since September 2025, further progress has been made with the recruitment of the additional 390 RNs and HCAs required to achieve baseline implementation. The HSE has advised that these remaining additional posts are progressing in line with the direction from the CEO, with recruitment at various stages of the process.
667. Deputy Pádraig Rice asked the Minister for Health further to Parliamentary Question No. 2883 of 29 July 2025, if she stands by her statement that alcohol health information labelling will be implemented in 2028; how this tallies with recent reports (details supplied); and if she will make a statement on the matter. [73489/25]
View answerI refer the Deputy to the amending Commencement Order for section 12 of the Public Health (Alcohol) Act 2018 here: www.irishstatutebook.ie/eli/2025/si/422/made/en/print, and to the amended Regulations under section 12 here: www.irishstatutebook.ie/eli/2025/si/423/made/en/print. The Deputy will note that both, by law, will come into effect on 3 September 2028.
