Malcolm Byrne
Question:1038. Deputy Malcolm Byrne asked the Minister for Health the supports which are available for pre and post-natal exercise programmes. [9464/26]
View answerHealth Services
Questions (1038)
Written answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Healthcare Policy
Questions (1039)
Ken O'Flynn
Question:1039. Deputy Ken O'Flynn asked the Minister for Health the governance framework under which funding for chronic pain services is currently allocated, given that the HSE has confirmed that funding decisions are made at regional level without national expenditure data; when this decentralised approach was approved by her Department; and the oversight mechanisms her Department has in place to ensure consistency and equity of access to chronic pain services nationwide. [9472/26]
View answerWritten answers
Funding for chronic pain services forms part of the wider HSE budget for acute and community services. Since the establishment of the HSE Health Regions, the allocation of funding for individual service areas, including chronic pain services, is now made at regional level. This reflects the broader move towards devolved decision-making under Sláintecare, enabling Health Regions to prioritise resources in line with local population needs and service configurations. This approach is consistent with the shift to regional autonomy and was approved and communicated to the HSE in the Letter of Determination for 2026, which issued to the HSE in October 2025.
Equity of access is supported through national clinical programmes, national waiting-list oversight, and performance monitoring across Health Regions under the Performance and Accountability Framework. These mechanisms allow the Department and the HSE to monitor delivery against the National Service Plan, identify variation between regions, ensure consistency of service provision, and intervene where necessary to address access issues.
Health Services
Questions (1040)
Ken O'Flynn
Question:1040. Deputy Ken O'Flynn asked the Minister for Health if she accepts that the absence of national-level expenditure data for chronic pain services represents a gap in financial oversight; when her Department last formally requested national expenditure data from the HSE for chronic pain services; and the actions she is taking to ensure that comprehensive national financial reporting is put in place. [9473/26]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Health Services
Questions (1041)
Ken O'Flynn
Question:1041. Deputy Ken O'Flynn asked the Minister for Health the date by which her Department will require the HSE to implement mandatory national reporting on chronic pain services, including expenditure, activity, and outcomes across all health regions; and whether this reporting will be standardised and published as part of the National Performance Report. [9474/26]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Healthcare Policy
Questions (1042)
Ken O'Flynn
Question:1042. Deputy Ken O'Flynn asked the Minister for Health whether her Department has specified, or intends to specify, a minimum national dataset for chronic pain services, including waiting times, consultant capacity, referral pathways, and treatment modalities; and when such standards will be issued to the HSE. [9475/26]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Healthcare Policy
Questions (1043)
Ken O'Flynn
Question:1043. Deputy Ken O'Flynn asked the Minister for Health what assessment her Department has made of regional variation in access to specialist chronic pain services following the establishment of the six health regions; and the measures she will take to prevent inequitable access to care based on geographic location. [9476/26]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Health Strategies
Questions (1044)
Ken O'Flynn
Question:1044. Deputy Ken O'Flynn asked the Minister for Health whether she intends to ring-fence funding within chronic pain services for older adults, in light of evidence showing high prevalence of untreated chronic pain in this cohort; and if not, how her Department will ensure that the needs of older people with chronic pain are prioritised consistently across all health regions. [9477/26]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Hospital Overcrowding
Questions (1045)
Ken O'Flynn
Question:1045. Deputy Ken O'Flynn asked the Minister for Health whether the Health Service Executive records the actual duration of trolley waits exceeding 24 hours for emergency department patients; if not, whether such information is captured within hospital patient administration or emergency department information systems but not collated centrally; when the Minister became aware that maximum trolley wait times are not recorded or reported; and whether he considers the absence of this data compatible with effective patient safety oversight and hospital performance management. [9478/26]
View answerWritten answers
The Minister would like to thank the deputy for his question and assure him that the HSE and the Department of Health have targets set to minimise the amount of time patients spent in Emergency Departments across our health system.
The Health Service Executive (HSE) records the number of patients waiting more than 24 hours for an inpatient bed as part of its daily 8am snapshot (TrolleyGAR).
While patient-level data, including the specific time from registration to admission (Patient Experience Time or PET), is captured within individual hospital administration systems, the primary metrics reported centrally are median wait times and the total number of 24-hour PET breaches.
The Unscheduled Emergency Care Plan 2025-2026 sets out key performance indicators that set focused targets to meet the rising number of patients presenting at Emergency Departments.
The Patient Experience Time (PET) target is set at 97% of all attendees are see within 24 hours and for the over 75s cohort that target is set at 99%.
There was a 16% decrease in the number of patients that exceeded the 24hr breach threshold in 2025 compared to 2024. Similarly, there was a 16% decrease in the same category for over 75s over the same timeframe.
It is unacceptable for any patient to have to wait over 24hrs for care and progress has been made year on year to reduce instances of this occurring. A strong operational grip with a particular focus on patient flow is the key to achieving the PET KPIs.
This is being aided by the continuing rollout of the Public Only Consultant Contracts. As of late 2025, 3,261 consultants (66%) have signed up to the Public Only Consultant Contract (POCC) ensuring senior decision-makers are on-site during evenings and weekends to facilitate flow.
Hospital Services
Questions (1046)
Ken O'Flynn
Question:1046. Deputy Ken O'Flynn asked the Minister for Health what national information systems are used by the Health Service Executive to record emergency department patient flow and trolley wait times; whether those systems are technically capable of recording precise wait durations beyond 24 hours; and if so, the reason such data is not routinely extracted, analysed, or published on a hospital-by-hospital basis. [9479/26]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Hospital Services
Questions (1047)
Ken O'Flynn
Question:1047. Deputy Ken O'Flynn asked the Minister for Health whether he has issued, or intends to issue, any direction to the Health Service Executive to begin recording and publishing maximum trolley wait times by hospital for emergency department patients; if not, the reason for this decision; and whether he will commit to implementing such reporting as part of national urgent and emergency care oversight. [9480/26]
View answerWritten answers
The Minister would like to thank the deputy for his question and assure him that the HSE and the Department of Health have targets set to maximise the efficient use of all resources available to the HSE.
The HSE uses the 8 am daily trolley count (TrolleyGAR) as its primary public metric, which provides a point-in-time snapshot of patients awaiting an inpatient bed after a decision to admit has been made.
The HSE Urgent and Emergency Care Plan Operational Plan 2025-2026 (UEC Plan) presents a comprehensive framework designed to promote collaboration and integration across the healthcare system. Central to this plan are the national priorities and actions, which are divided into two categories:
National Priorities• : Universal actions and priorities, focused on achieving operational excellence, optimising resources, and reducing delayed transfers of care (DTOC) nationally.
Operational Actions: • Specific and detailed actions designed to support and enable regions in meeting UEC KPI targets.
The delivery of UEC Plan is being measured against the following four KPIs:
Trolleys• : The Average Monthly Trolley Count at 8am 280.
DTOC• : Total number of Delayed Transfers of Care (DTOC) 300.
24hr PET• ( 75 Years) < 24hrs; 99%.
24hr PET • (All Attendees) <24hrs; 97%.
Progress is being made in reducing the numbers of patients waiting more than 24hrs. In 2025 there was a 16% decrease in number of 24hr breaches for all patients and also for patients over 75s compared to 2024.
Progress on UEC activity and performance is reported as follows:
• Daily UEC situational analysis reports to the UEC Oversight Group and the DoH, covering acute ED demand, and general acute and critical care bed demand and availability;
• Weekly PMO and monthly UEC reports providing updates on UEC Plan actions and comparisons of current activity and performance to previous weeks and years at both national and site levels;
• The Monthly National Performance Report (NPR) and Regional Performance Reports (RPRs) providing updates on regional performance, including performance against regional UEC targets to the SLT, CEO, Board and Health Minister;
• Quarterly Red, Amber, Green (RAG) reports submitted by the Health Regions to the National HSE UEC Oversight Group, providing status updates on the implementation of national priorities and 2025 operational actions.
The Government is investing in the Demand and Capacity Visualisation Platform (HPVP), which provides senior management with real-time data on activity, bed-flow blockages, and waiting lists across the hospital network to support operational grip.
Furthermore, the HSE is establishing centralised operational hubs to provide a shared view of real-time capacity to support decisions regarding patient flow and active surge management.
Hospital Services
Questions (1048)
Ken O'Flynn
Question:1048. Deputy Ken O'Flynn asked the Minister for Health whether he accepts that the failure to identify and monitor the longest emergency department trolley waits limits the ability of the Health Service Executive and the Department of Health to detect extreme delays that may present patient safety risks; and the alternative safeguards are relied upon in the absence of maximum trolley wait-time data. [9481/26]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Hospital Services
Questions (1049)
Ken O'Flynn
Question:1049. Deputy Ken O'Flynn asked the Minister for Health whether his Department has examined emergency department wait-time reporting standards in comparable health systems; whether the non-recording of maximum trolley wait durations aligns with international best practice; and if not, what steps are planned to address this gap. [9482/26]
View answerWritten answers
The Department of Health, HSE and HIQA through the guises of the Health Technology Assessment continually seek out ways and means to improve the performance of our health system. We proudly work with our partners in the Europe Union through the European Union Health Initiative.
The European Health Union Initiative aims to strengthen health cooperation among EU member states, enhance preparedness for health crises, and ensure equitable access to healthcare for all Europeans.
The Health Information Quality Authority (HIQA) explore advances in health policy and technology through Health Technology Assessment (HTA). The HTA operates under the following frameworks to deliver the best advances in healthcare.
HTAR (HTA Regulation) (https://health.ec.europa.eu/health-technology-assessment/regulation-health-technology-assessment_en) is an EU regulation designed to improve the availability for EU patients of innovative technologies in the area of health, such as medicines and certain medical devices. The regulation provides a transparent and inclusive framework by establishing a Coordination Group of HTA national or regional authorities. This Regulation replaces the voluntary network of national authorities (HTA Network), and the EU-funded project-based cooperation (Joint Actions EUnetHTA) with a permanent framework for joint work. The HTAR will also reduce duplication of efforts for national HTA authorities and industry, facilitate business predictability and ensure the long-term sustainability of EU HTA cooperation. HIQA is an active participant in HTAR-related work, contributing to process and methodological guidance and, once commenced, to joint clinical assessments.
HTAi (www.htai.org/) is the global scientific and professional society for those who produce, use, or encounter HTA. Its members include researchers, agencies (including HIQA), policy-makers, industry, academia, health service providers, and patients and or consumers. HIQA hosted the annual scientific meeting of HTAi in Dublin in June 2010 which was attended by over 1,200 delegates.
INAHTA (International Network of Agencies in HTA) (www.inahta.org/) is a collaboration of 52 HTA agencies, including HIQA, from more than 50 countries around the world. The network aims to accelerate exchange and collaboration among agencies and promotes information sharing to prevent duplication of activities.
[]HAG (Head of Agencies Group) (https://htahag.eu/) is a network of health technology assessment agencies from across Europe. The group is a HTA-focused collaborative network for high level strategic exchange and discussion. It has a keen focus on supporting the development of joint HTA at an EU level and advising policy-makers and relevant EU and national institutions on matters regarding HTA, particularly cooperation in HTA.
The Unscheduled Emergency Care Plan 2025-2026 had key performance indicators that set focused targets to meet the rising number of patients presenting at Emergency Departments.
The Patient Experience Time (PET) target is set at 97% of all attendees are see within 24 hours and for the over 75s cohort that target is set at 99%.
There was a 16% decrease in the number of patients that exceeded the 24hr breach threshold in 2025 compared to 2024. Similarly, there was a 16% decrease in the same category for over 75s over the same timeframe.
The Department is implementing several initiatives to improve data visibility and operational oversight, to help address gaps in wait-time information:
• Demand and Capacity Visualisation Platform (HPVP): This platform provides real-time data and trends across EDs and bed management to identify "bed-flow blockages" and support "operational decisions regarding patient flow".
• Centralised Operational Hubs: The UEC Operational Plan 2025 calls for hubs to provide a "shared view of real-time capacity" for all teams, which is intended to support active surge management and reduce long wait times.
• Digital Health Transformation: The rollout of the National Shared Care Record and the HSE Patient App aims to consolidate healthcare information and improve the aggregation of health data across the system.
• Productivity Reporting Model: A new dynamic reporting model is being developed to measure and monitor progress against activity targets at the national, regional, and site levels.
It is unacceptable for any patient to have to wait over 24hrs for care and progress has been made year on year to reduce instances of this occurring. A strong operational grip with a particular focus on patient flow is the key to achieving the PET KPIs.
Question No. 1050 answered with Question No. 1017.
Question No. 1051 answered with Question No. 1017.
Question No. 1052 answered with Question No. 1017.
Question No. 1053 answered with Question No. 1017.
Question No. 1054 answered with Question No. 1017.
Healthcare Policy
Questions (1055)
Ken O'Flynn
Question:1055. Deputy Ken O'Flynn asked the Minister for Health whether she accepts that responsibility for national policy, safeguarding standards, and governance frameworks for services involving children rests with her Department rather than with clinical programmes established by the Health Service Executive; and how that responsibility is exercised in the context of gender identity services for minors. [9488/26]
View answerWritten answers
The Model of Care for Paediatric Health Care Services was approved and published by the HSE in 2016; it strongly advocates for an integrated networked structure of healthcare services for children and young people supporting the delivery of care as close to a child’s home as is safely possible, aligned with Sláintecare.
The new National Children’s Hospital Ireland (NCHI) is a key enabler of this Model of Care, acting as the hub of the national network of paediatric services, with robust links to regional and local paediatric acute units to deliver acute paediatric care close to home for children where clinically appropriate. In addition to the NCHI, regional paediatric care is available from three centres at Galway, Limerick, and Cork, and local paediatric care is available from 14 units around the country.
The Deputy will be aware, as set out in the Programme for Government 2025, that Government is committed to ensuring a transgender healthcare service that is based on clinical evidence, respect, inclusiveness and compassion.
It is in this context that the HSE has established a National Clinical Programme for Gender Healthcare to develop an updated clinical Model of Care with the aim of designing clinical pathways to deliver safe and effective health and social care for those seeking gender affirming healthcare services. This work will also inform an implementation plan for its delivery.
Developing a model of care for Gender Healthcare Services is expected to be a complex process and the HSE and my department will work closely together to support the process, ensure transparency and keep the patient at the centre of the process.
It is important that the HSE is given time to develop a model of care that is based on the best clinical evidence and that will deliver the best outcomes for persons with gender incongruence or dysphoria.
In the context of current services, there is no specialist gender service for children and young people (under the age of 16), the current pathway for children and young people is to attend their GP who may refer the patient to their local CAMHS service.
The HSE National Clinical Programme for Gender Healthcare will include a clinical framework for the clinical support and management of children and young people in primary, secondary and specialist care settings, and matters such as the collection of clinical data will be considered in the development of this model of care.
Healthcare Policy
Questions (1056)
Ken O'Flynn
Question:1056. Deputy Ken O'Flynn asked the Minister for Health whether her Department has assessed the evidence base underpinning current or proposed models of care for gender identity services for children and young people; whether international reviews or guidance were considered in that assessment; and whether any such assessment has been formally documented. [9489/26]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Health Service Executive
Questions (1057)
Ken O'Flynn
Question:1057. Deputy Ken O'Flynn asked the Minister for Health whether her Department receives routine reports from the Health Service Executive on governance, safeguarding, activity levels, and outcomes relating to gender identity services for minors; and if not, the steps she intends to take to ensure appropriate ministerial oversight of services involving children. [9490/26]
View answerWritten answers
My Department relies upon the Code of Practice for Governance of State Bodies for governance and safeguarding issues and ensures that all aegis bodies are in compliance with this Code.
Officials in my Department that have oversight of aegis body responsibilities present to the Departmental Corporate Governance Committee on a two-year cycle. This ensures that aegis bodies are reviewed regularly and that my Department holds all aegis bodies accountable to high standards.
As the Deputy will be aware and as set out in the Programme for Government 2025, this Government is committed to ensuring a transgender healthcare service that is based on clinical evidence, respect, inclusiveness and compassion.
It is in this context that my Department has provided funding to the HSE in 2024, 2025 and this year for the establishment and development of the National Clinical Programme for Gender Healthcare. This programme is developing an updated clinical Model of Care with the aim of designing clinical pathways to deliver safe and effective health and social care for those seeking gender affirming healthcare services. This work will also inform an implementation plan for its delivery.
Hospital Waiting Lists
Questions (1058)
Ken O'Flynn
Question:1058. Deputy Ken O'Flynn asked the Minister for Health the mean and median waiting time, by hospital group, for a first outpatient assessment in publicly funded chronic pain services at end-December 2025; and the number of persons on those waiting lists in each hospital group. [9503/26]
View answerWritten answers
It 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 Time Action Plan (WTAP) for 2026 on January 30th, as part of this Government’s ongoing commitment to improving access to hospital care and reducing waiting times for patients.
The multi-annual Action Plan approach was implemented in September 2021 to sustainably reduce and reform hospital waiting lists and waiting times. Significant progress has been made under this approach in reducing the length of time patients are waiting.
With the 2026 plan, we will continue to build upon the progress delivered to date under the multi annual action plan approach, moving 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.
National waiting list information by hospital, specialty, and time band is published monthly by the 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.
The specific information requested by the Deputy which is not readily available on the NTPF website is set out in the attached spreadsheet.
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 mean and median average waiting times provided to my Department by the NTPF and set out in the attached, are in respect of how long patients on lists have been waiting.
Hospital Waiting Lists
Questions (1059)
Ken O'Flynn
Question:1059. Deputy Ken O'Flynn asked the Minister for Health the number of persons waiting longer than six months and longer than twelve months, by hospital group, for a first outpatient assessment in publicly funded chronic pain services at end-December 2025. [9504/26]
View answerWritten answers
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.