Written Answers Nos. 880-905
880. Deputy Ken O'Flynn asked the Minister for Health whether her Department has undertaken or commissioned any cost-effectiveness analysis comparing high-dose influenza vaccines with standard dose influenza vaccines for adults aged 65 years and over for the 2026/2027 influenza season; if so, the date on which that analysis was completed; whether it informed procurement planning for that season; and if she will make a statement on the matter. [16702/26]
View answer881. Deputy Ken O'Flynn asked the Minister for Health whether her Department has formally requested the National Immunisation Advisory Committee to review high-dose influenza vaccines since 1 January 2025; if so, the date of that request; whether a written record of the request exists; and whether any further review is currently under consideration. [16703/26]
View answerI propose to take Questions Nos. 880 and 881 together.
The National Immunisation Programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The committee's recommendations are based on the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation. NIAC make recommendations on vaccination policy to my Department. NIAC revise recommendations on an ongoing basis to allow for the introduction of new vaccines in Ireland, to incorporate findings from horizon scanning and to keep abreast of changes in the patterns of disease. NIAC continuously monitor global developments in the field of immunisation. The immunisation schedule, therefore, continues to be amended over time based on emerging evidence. NIAC's annual workplan aims to address as many immunisation topics as possible whilst also remaining agile to address unanticipated events. The influenza chapter of the Immunisation Guidelines for Ireland is updated annually to incorporate the annual WHO recommendations for flu vaccine composition for the northern hemisphere. In 2025, the chapter was also updated to reflect the replacement of quadrivalent vaccines by trivalent vaccines. An evidence review of newer and enhanced influenza vaccines, which is a substantial piece of work was not feasible in 2025 due to competing priorities for which there were immediate clinical and operational needs. A formal review of recommendations for use of enhanced influenza vaccines was prioritised for the 2026 workplan. In January 2026, NIAC formally commenced a review of recommendations regarding the use of newer and enhanced influenza vaccines (adjuvanted, high-dose, cell-based and recombinant vaccines) in eligible populations. Work on the evidence review process will continue over the coming months and will inform the influenza season 2027/2028. I understand that no high dose influenza vaccine (HD-IIV) has been centrally authorised by the European Medicines Authority but that certain countries have authorised these vaccines at a national level. The HSE is responsible for the implementation of the Influenza Vaccination Programme, in line with Department of Health policy and funding, which includes procurement of the vaccine in line with EU and National Procurement rules. Every year the WHO reviews global surveillance data and recommends the specific influenza strains that manufacturers should include in that season’s vaccine based on the flu strains that are considered most likely to circulate. The HSE will carry out a procurement process in relation to the flu vaccine specific to the flu season 2026/2027. It is expected that NIAC recommended enhanced flu vaccines will be included in this procurement process. Only when that process is complete, will it be known what vaccines will be available for the coming flu season.
882. Deputy Ken O'Flynn asked the Minister for Health whether her Department receives regular reports from the Health Service Executive on the number, duration of vacancy, and disposal status of residential properties owned by the HSE; the frequency of such reporting; and whether any performance indicators apply to the timely disposal of surplus residential assets. [16750/26]
View answerThe Health Service Executive is responsible for the management of the public healthcare property estate. The HSE has a significant property portfolio extending to circa 4,300 buildings across circa 2,400 locations throughout the country. The health estate is varied and complex, ranging from small health centres in rural locations to very large acute hospitals.
My Department receives regular reports from the HSE on the disposal of HSE's surplus assets and meets with the HSE on a quarterly basis on land and property matters.
The HSE must follow the official process for the disposal of properties by State bodies and agencies. When a HSE property has been vacated by a service it is necessary to establish if it is surplus to HSE requirements and to be disposed of. If the property is to be disposed of, the protocol for disposal is set out in the "HSE Protocol for the Acquisition and Disposal of Property", the steps summarised as follows:
• Offer the property to the LDA via written notification.
• Should the LDA not choose to take up the property, under DPER Circulars 11/2015 & 17/2016 the HSE must then offer the property to other State Stakeholders via the State Property Register.
• Should no other State Stakeholders take up the property, the HSE then places the property for sale on the open market.
The HSE actively manages its property portfolio, which changes constantly, including the disposal of surplus assets. These disposals are subject to robust governance arrangements as set out in the HSE Protocol for the Acquisition and Disposal of Property to ensure value for money is achieved.
883. Deputy Ken O'Flynn asked the Minister for Health whether any target timelines exist, at Departmental or HSE level, for the disposal of residential properties deemed surplus to requirements; if not, whether she intends to introduce such timelines in light of properties vacant for periods exceeding ten years. [16751/26]
View answerAs the Health Service Executive is responsible for the management of the public healthcare estate, I have asked the HSE to respond to you directly in relation to this matter.
884. Deputy Ken O'Flynn asked the Minister for Health whether her Department requires the HSE to centrally record and report the annual holding costs associated with vacant residential properties, including insurance, security, and maintenance; and if not, whether she considers this consistent with public financial management best practice. [16752/26]
View answerThe acquisition and disposal of property within the HSE is governed by the “HSE Protocol for the Acquisition and Disposal of Property”, which sets out the organisational governance and legislative/regulatory context for property transactions on behalf of the HSE.
The HSE adheres to its statutory obligations as set out under Department of Public Expenditure and Reform Circulars 11/15 Protocols for the Transfer and Sharing of State Property Assets & 17/16 Policy for the Property Acquisition and for Disposal of Surplus Property.
The current version of the HSE Protocol for the Acquisition and Disposal of Property was published in 2022, with updates having issued where required to reflect changes to the organisational structure or governance processes. The HSE is currently reviewing the Protocol and will be updating this as required.
The HSE continues to actively manage their portfolio, including the disposal of properties identified as surplus assets.
885. Deputy Ken O'Flynn asked the Minister for Health whether the Department has conducted, since 2020, any review of the HSE Protocol for the Acquisition and Disposal of Property as published in 2022, with particular regard to disposal timelines and value-for-money safeguards; and if she will provide details of any such review. [16753/26]
View answer886. Deputy Sorca Clarke asked the Minister for Health for an update and projected timeline on the integrated mother and baby unit and child and adolescent mental health services inpatient facility at Saint Joseph's Hospital, Limerick. [16844/26]
View answerThe Specialist Perinatal Mental Health Services (SPMHS) is now available in all 19 maternity hospitals nationwide, providing support to pregnant women and women with a baby up to one year old, with an existing or new mental health problem. Funding of €5 million annually has established 6 consultant led multidisciplinary teams across major maternity hospitals (Coombe, NMH, Rotunda, Galway, Cork, Limerick), and 13 spoke sites staffed by perinatal mental health midwife posts. There are now over 75 funded posts in SPMHS nationally. Under Budget 2026, I secured an additional €640,000 to recruit two additional consultant psychiatrists for the Programme’s busiest sites, the Rotunda and Holles Street, to meet growing demand for the service. The HSE are progressing a review of the Model of Care for SPMHS, with a Steering Group due to be established shortly and a refreshed model published later this year. The key objective of this refresh is the provision of equivalent service to the major hospital sites as for the other 13 spoke sites, and this will be the focus of this second phase of the Model of Care. A key priority under this Model of Care is to develop a Perinatal Mother and Baby Unit (PMBU). Work is ongoing by the HSE to progress the development of an PMBU for Ireland, an inpatient mental health service with relevant maternity support to allow women to stay with their babies during their mental health treatment. To meet the needs of new mothers with moderate to severe mental illness, the PMBU must be sited at a location with access to a maternity hospital as well as an acute mental health unit. This will ensure there is always mental health and maternity expertise available. As such, it is envisaged that the PMBU will be developed on the grounds of St Vincent’s University Hospital in Dublin, and a feasibility study is currently underway to determine a location within the campus, with the study due to conclude shortly. The outcome of the study will form the basis for the next key decisions on the project. HSE Mid-West have included the development of a six-bed Perinatal Mental Health Unit for new mothers and their babies in Limerick to service pregnant and new mothers in the West of the country. This new Unit will be integrated with 4 dedicated CAMHS beds for the region. With reference to the information requested as this is an operational issue, I have referred it to the HSE for direct reply to you.
887. Deputy Sorca Clarke asked the Minister for Health for an update on the eating disorder specialist hub at Mount Carmel Campus; and if she will make a statement on the matter. [16845/26]
View answerThe National Clinical Programme on Eating Disorders has progressed well with the total number of 16 eating disorder teams under the Model of Care now fully funded. This includes 11 teams now operational and a further 5 teams in recruitment and development, as per the Model of Care. The HSE spends over €14 million on eating disorders services annually. Over 110 dedicated eating disorder clinicians from the National Clinical Programme are now working on the teams across the country, treating people with eating disorders every day. Enhancement for specialist mental health services including eating disorders is a key priority for myself as Minister, the Government as a whole, and the Health Service Executive (HSE). HSE data from the National Clinical Programme for Eating Disorders for 2025 shows increases in activity across referrals, assessments, diagnoses and access to treatment. In 2025, over 900 referrals were received, 600 assessments were completed, with a 13% increase in the number of people starting treatment for an eating disorder. 75% of patients were assessed within eight weeks. Our current focus is on completing and implementing the existing Model of Care and supporting the rollout of additional teams. Once this is complete, an evaluation will be undertaken, after which the Model of Care will be reviewed by the HSE. The HSE report on inpatient bed capacity required for eating disorders was forwarded to my Department for consideration in July 2025. Accordingly, the recommendations for enhanced bed capacity for eating disorders have now been included in the National Development Plan. In addition, as Minister I secured funding from Budget 2026 for two new eating disorder teams, a CAMHS team to serve the South east, and an Adult team to serve counties Galway and Roscommon. This will assist more people with an eating disorder requiring access to specialist eating disorder mental health services. I was very pleased to formally open the specialist eating disorder hub at Riverside House, Mount Carmel last October. The state-of-the-art centre was developed with an investment of €5 million from the capital mental health budget, and the new day programme there represents huge progress for our eating disorder services, as it offers a viable and effective alternative to inpatient care. This investment reflects my strong commitment to early intervention and expanding access to specialist community services, ensuring people get the right care, in the right place, at the right time. As this is a service matter, for a more detailed response I have referred it to the HSE for direct reply to you.
889. Deputy Joanna Byrne asked the Minister for Health the number of newly qualified general practitioners who took up work in County Louth and East Meath in 2025 and to-date in 2026. [16852/26]
View answer891. Deputy Joanna Byrne asked the Minister for Health the number of general practitioners who have retired in 2025 and 2026 in County Louth and East Meath. [16854/26]
View answer892. Deputy Joanna Byrne asked the Minister for Health the number of general practitioners currently registered and operational in County Louth and East Meath. [16855/26]
View answer893. Deputy Joanna Byrne asked the Minister for Health the average number of patients per head currently registered with general practitioners in County Louth and East Meath. [16856/26]
View answerI propose to take Questions Nos. 889, 891, 892 and 893 together.
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible. Please note that GPs are private practitioners, most of whom hold on an individual basis one or more contracts with the HSE for the provision of medical services on its behalf, such as the GMS contract for the provision of GP services without charge to medical card and GP visit card holders. Accordingly, it may only be possible for the HSE to respond in relation to individual HSE contracted GPs.
890. Deputy Joanna Byrne asked the Minister for Health the number of persons in County Louth and east Meath who were unable to find a general practitioner to register with and who made contact with the HSE seeking assistance for each of the years 2020 to 2025 and to-date 2026. [16853/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
894. Deputy Joanna Byrne asked the Minister for Health if there are any plans to extend the number of general practitioners and access to GP’s in County Louth and East Meath. [16857/26]
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 any area.
Under the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. As of February, there are 2,600 GPs contracted to provide services under the GMS Scheme. A further 637 GPs do not hold a GMS contract but hold some other contract(s) with the HSE for the delivery of health services. Where a vacancy arises in a practice with a GMS contract, the HSE becomes actively involved in the recruitment process to find a replacement GP.
As per the Programme for Government, the Government is committed to increasing the GP workforce. Work is ongoing in this regard, to increase the number of GPs practicing across the country and thereby improve access to GP services for all patients.
Over €340 million in additional annual investment in general practice has been provided under the 2019 and 2023 GP GMS Agreements. The Agreements provide for increased GP capitation fees, increased and new supports for practices, as well as new fees for additional services. Specific supports are available for eligible practices in rural areas and in areas of urban social deprivation. These measures make a career in general practice here more attractive. The 2023 Agreement also provided for the expansion of GP visit card eligibility in 2023 to all children under 8 years of age and all those who earn up to the median household income.
The annual intake of doctors into the GP training programme has been increased by approximately 80% from 2019 to 2024, with 350 new entrant training places made available in 2024 and again in 2025. The number of new entrant training places is to increase again this year by 50 places to 400. As a result, the number of GP graduates has increased in recent years and will continue to increase in the coming years.
In addition, recruitment of GPs from abroad is ongoing under the International Medical Graduate (IMG) Rural GP Programme. As of end of Q3 2025, there were 115 IMG GPs within the programme placed in general practice and a further 39 had completed the 2-year programme. The placement of IMG GPs is targeted to rural and underserved areas.
Of note, a Strategic Review of General Practice is currently underway. The review is examining the issues effecting general practice, including issues related to GP capacity, and will consider possible mechanisms to attract GPs to rural and underserved areas. When completed the review will set out recommended actions for a more sustainable general practice.
895. Deputy Robert Troy asked the Minister for Health if an appointment for a person (details supplied) will be expedited. [16869/26]
View answerUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. The Minister for Health is prohibited from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual. In 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.
896. Deputy Pearse Doherty asked the Minister for Health when a patient in Letterkenny University Hospital will be transferred to Beaumont Hospital for an urgent surgical procedure (details supplied); and if she will make a statement on the matter. [16870/26]
View answerThe Minister for Health is precluded from intervening in individual cases. As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
897. Deputy Louise O'Reilly asked the Minister for Health is she can outline the options for people living in Rush, Lusk, Skerries, Balbriggan and surrounding villages/areas who need access to a GP outside normal business hours; and if she will make a statement on the matter. [16875/26]
View answerAs this is a service matter, I have asked the HSE to reply to the Deputy directly as soon as possible.
898. Deputy Louise O'Reilly asked the Minister for Health if the D Doc or other out-of-hours GP service will be extended to Balbriggan; and if she will make a statement on the matter. [16876/26]
View answerAs this is a service matter, I have asked the HSE to reply to the Deputy directly as soon as possible.
900. Deputy Pearse Doherty asked the Minister for Health the steps her Department is taking to increase GP recruitment and retention in areas of population growth, including Lifford, County Donegal; the supports available for those currently on GP waiting lists, or who have to wait long periods for access to a GP; and if she will make a statement on the matter. [16881/26]
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.
Under the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. Currently there are 2,600 GPs contracted to provide services under the GMS Scheme. A further 637 GPs do not hold a GMS contract but hold some other contract(s) with the HSE for the delivery of health services.
Where a vacancy arises in a practice with a GMS contract, the HSE becomes actively involved in the recruitment process to find a replacement GP for the panel concerned. While recruitment is ongoing, the HSE put a locum or other suitable arrangement in place to provide continuity of care. As of January, there were 19 GMS vacancies across the country, less than 1 percent of the total number of GMS panels.
Under the terms of the GMS contract, the HSE has the power to assign a medical card or GP visit card holder to a GP's GMS patient list where that person is unable to find a GP to accept them as a patient, in accordance with the terms of the GMS contract. People who do not hold a medical card or GP visit card access GP services on a private basis and can make enquiries directly to any GP practice they wish to register with.
Work is ongoing to increase the number of GPs practicing in the State and thereby improve access to GP services for all patients across the country.
Over €340 million in additional annual investment in general practice has been provided under the 2019 and 2023 GP GMS Agreements. The Agreements provide for increased GP capitation fees, increased and new supports for practices, as well as new fees for additional services.
The annual intake of doctors into the GP training programme has been increased by approximately 80% from 2019 to 2024, with 350 new entrant training places made available in 2024 and again in 2025. The number of new entrant training places is to increase again next year by 50 places to 400. As a result, the number of GP graduates has increased in recent years and will continue to increase in the coming years.
In addition, recruitment of GPs from abroad is ongoing under the International Medical Graduate (IMG) Rural GP Programme. As of end of Q3, there are 115 IMG GPs within the programme currently placed in general practice and a further 39 have completed the 2-year programme. The placement of IMG GPs is targeted to rural and underserved areas.
901. Deputy Aengus Ó Snodaigh asked the Minister for Health to review a decision to refuse a person (details supplied) access to CAMHS. [16883/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
902. Deputy Niamh Smyth asked the Minister for Health if she will consider turning a project (details supplied) into an adult service once the permanent home is up and running for children in Monaghan Town; if she will provide an update on the new respite centre for children in Monaghan Town; and if she will make a statement on the matter. [16906/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
903. Deputy Peter 'Chap' Cleere asked the Minister for Health if she will consider providing the shingles vaccine for free for persons over 65 years-of-age; and if she will make a statement on the matter. [16923/26]
View answerThe immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). NIAC considers the prevalence of the relevant disease in Ireland as well as international best practice in relation to immunisation when developing its advice.
The current NIAC guidelines state that the shingles vaccine may be considered for those aged 65 years and older, due to the greater burden and severity of disease in this age group and in those aged 18 years and older at increased risk of shingles.
The Health Information and Quality Authority (HIQA) has carried out a Health Technology Assessment (HTA) on the herpes zoster vaccine which protects against shingles. A HTA is a multidisciplinary research process that collects and summarises information about a health technology. HIQA’s HTA examined the evidence on the clinical effectiveness and safety of shingles vaccines. The cost effectiveness and budget impact were also reviewed, along with the ethical, social and organisational implications of including the vaccine in the adult immunisation schedule.
HIQA published this HTA on 19 July 2024. The HTA found that adding the shingles vaccine to the routine immunisation schedule, at the vaccine price at the time, for all adults aged 65 years and over would not be cost effective and would be associated with a substantial budget impact.
While the vaccine is considered safe and effective, its protective effect diminishes over time. HIQA also noted the substantial budget impact associated with vaccination. If made available to everyone aged 65 and older, vaccination would cost €218 million over five years.
Whilst the HTA found that the introduction of the shingles vaccine was not cost effective based on the cost of the vaccine, it found that it could be cost effective for vaccination of those at 75 years and 80 years if the cost of the vaccine was reduced by 80%.
Given that the healthcare budget is finite and decisions regarding increased spending relating to a change in one area could impact the provision of other health technologies and treatments within the healthcare system, the cost-effectiveness must be considered in any decision-making process.
My Department considered the findings of this HTA in 2024 and determined that the introduction of the vaccine could be reconsidered when the cost effectiveness of the vaccine is confirmed as being more favourable.
I can confirm that the introduction of the shingles vaccine to the immunisation schedule in Ireland is again being actively considered for a cohort of immunocompromised individuals, in line with NIAC advice and cognisant of the cost effectiveness of market pricing and available funding.
904. Deputy Ciarán Ahern asked the Minister for Health the reason the National Ambulance Service has asked a cohort of recently qualified paramedics to sign temporary contracts and apply for permanent jobs, rather than automatically transition into permanent positions as they have done historically; and if she will make a statement on the matter. [16926/26]
View answerThe National Ambulance Service (NAS) is committed to continued expansion of its frontline workforce in 2026 through a series of planned new developments, and graduates completing the Paramedic programme this year will all be eligible to apply for permanent roles.
Each year, the NAS undertakes a competitive recruitment process to select a cohort of Student Paramedics to complete the Bachelor of Science (Honours) in Paramedic Studies and progress to registration with the Pre-Hospital Emergency Care Council (PHECC). The 2025 campaign generated significant interest, attracting more than 1,000 applications. This structured education and training pathway provides the HSE with a sustainable pipeline of newly qualified and registered Paramedics.
Graduates play a vital role in maintaining workforce capacity by filling vacancies arising from retirements and promotions, as well as supporting the creation of new posts linked to new service development under the National Service Plan. It is essential that NAS can prioritise the placement of these graduates to fill vacant or new development roles in areas prioritised for expansion, based on service activity and with the greatest operational need.
The HSE met with trade unions on the 6th of February to advise them of the challenges they face in progressing Year 3 Paramedics to permanent posts under the current processes. During this engagement, NAS outlined three specific elements of the existing process that require amendment to ensure that vacant, funded positions can be filled in a timelier manner. These changes are necessary to enable the successful Year 3 cohort to apply for available funded positions as they arise.
To ensure continuity of service delivery during this recruitment process, temporary contract extensions have been put in place for current graduates. All access to permanent employment within NAS is governed by the HSE’s employment and expenditure controls applicable in any given year.
905. Deputy Ciarán Ahern asked the Minister for Health whether there is a risk some newly qualified paramedics will not be hired by the National Ambulance Service as a result of the service’s new application process; and if she will make a statement on the matter. [16927/26]
View answer
