Written Answers Nos. 115-139
122. Deputy Brian Brennan asked the Minister for Health to provide an update on the progress of the expert panel established to address unnecessary hip dysplasia surgeries on children; the current status of reviews for families impacted; and if she will make a statement on the matter. [28455/26]
View answerMy immediate priority following the publication of the Thomas Audit in May of last year was to ensure that there was clinical follow-up and care for patients who have undergone pelvic osteotomy surgery. Multi-disciplinary team (MDT) clinics have been underway since June of last year. Just over 1,600 patients have had clinical reviews as part of this process.
In relation to retrospective reviews to determine the indications for surgery, an External Expert Panel (EEP) has been established by the HSE. The EEP will assess the appropriateness of the original clinical decision-making for pelvic osteotomy procedures performed in CHI Temple Street and Cappagh Kids between January 2010 and March 2025.
Dr Kishore Mulpuri, a world-renowned Consultant Paediatric Orthopaedic Surgeon from Canada, has been appointed to chair the EEP review. Dr Mulpuri will be joined by 14 international paediatric orthopaedic surgeons. The inaugural meeting of the EEP members took place in February.
There has been ongoing active collaboration with Patient Advocates and the Hip Dysplasia Advocacy Group. These advocates are involved in developing and finalising the terms of reference for the review. The terms of reference are expected to be published before the end of this month.
Correspondence will issue to all stakeholders (including families and surgeons involved in the review) once the terms of reference are published. The formal reviews of the cases by the panel will commence shortly.
126. Deputy Pa Daly asked the Minister for Health her plans to reduce bed days lost in University Hospital Kerry. [28492/26]
View answerOn 18 of April, there were 23 instances of Delayed Transfers of Care in University Hospital Kerry. Of these, eleven were awaiting transfer to residential care. Other instances were due to individual circumstances, including complex care needs, legal complexity and non-compliance cases.
The Government is committed to continued investment in healthcare infrastructure to support the highest quality care for our older population and its projected requirements in the South West region.
The Community Nursing Unit programme is a major capital infrastructure project which plans for the refurbishment of up to 90 of our public CNUs and Community Hospitals. The programme includes the delivery of a 130-bed Community Nursing Unit in Killarney, Co. Kerry. The application for the registration of the CNU has been submitted to HIQA and the HSE South West is actively engaging with them to facilitate its opening as soon as possible. Once HIQA registration is secured, the new unit will open on a phased basis with a planned transfer of residents from St. Columbanus and the District Hospital to the new building.
Older Persons Services in the South West will further be enhanced by the opening of two new CNUs in Cork in 2026. St. Finbarr’s in Cork City will have a total of 105-beds and Midleton CNU will have a total of 50-beds.
Bed days lost within the hospital may arise when people are medically fit to leave hospital, but other factors prevent the transfer of their care. These delayed transfers of care can arise from varied factors, including availability of care in the community. Hospitals work closely with patients and their families to ensure their care is progressed in the most appropriate setting.
130. Deputy David Cullinane asked the Minister for Health when changes will come into effect for the fair deal nursing home loan to extend the interest-free repayment period to 18 months; and if she will make a statement on the matter. [28496/26]
View answerThe Department of Health acknowledges that some applicants have, through no fault of their own, inadvertently incurred interest on the Ancillary State Support, commonly referred to as the nursing home loans due for repayment. This is due primarily to delays caused by the probate process.
Currently the nursing home loan must be repaid at least 12 months from the date the applicant leaves the nursing home, usually upon the death of the applicant, otherwise interest will accrue at the prescribed rate.
The Department of Health, following collaboration with the HSE and the Office of the Revenue Commissioner, agreed to extend the repayment period for Ancillary State Support under the Nursing Homes Support Scheme Act 2009 from 12 months to 18 months for those families whose relatives passed away while in Long Term Residential Care.
The primary reason for this request is that the Probate Office is now taking on average 5-6 months to process probate applications. The consequence of this is that it can be very difficult for the Accountable Persons for Nursing Home Loan clients to repay the loan within the 12 month period before interest is chargeable. Once Probate is granted the Executor must distribute the Estate and the property which the charge is held on, must be placed for sale and sold. This can take a number of months and conveyancing of a property can take a long number of weeks, even when all the administration is in order.
This amendment responds to the increasing number of cases in which families are unable to meet the 12-month deadline due to delays in selling the family home. Extending the repayment period would make the NHSS more practical for families, reduce the need for extensions and reduce the administrative burden on the HSE and Revenue. The Department are in discussions with Revenue regarding the progression of this change as quickly as possible.
The Nursing Home Loan, also known as Ancillary State Support (ASS) is an optional feature of the Nursing Home Support Scheme (NHSS) available to participants who own property/land-based assets in the State. It is a loan advanced by the HSE to help people meet the portion of their contribution to the cost of care that is based on property/land-based assets, most typically against the personal residence. This loan is advanced during their time on the scheme, unless the property is sold during that period.
Payment of ASS by the HSE results in the creation of a charge (a simple type of mortgage) in favour of the HSE against the interest of the applicant and his/her partner in the asset(s). The HSE will notify the Property Registration Authority of the charge who will register it against the specified asset(s).
It is advisable to seek independent legal advice before applying for a Nursing Home Loan, however there is no requirement to do so. A Nursing Home Loan may be applied for at any time.
It should be noted that the initial loan amount can increase as it is subject to adjustment at the relevant Consumer Price Index (CPI) amount applicable at the time the loan deferral period ends. This adjustment based on CPI applies in all cases and should not be confused with interest accrued due to late repayment of the loan amount to Revenue.
131. Deputy Ruairí Ó Murchú asked the Minister for Health whether the recommendations of the 2009 Vaccine Damage Steering Group report have been implemented; and if she will make a statement on the matter. [28205/26]
View answerAs the Deputy will be aware, the development of a vaccine damage scheme is a long-standing Government commitment and it remains a priority for my Department.
The 2009 Vaccine Damage steering group recommended the establishment of a vaccine damage redress scheme. It recommended ex-gratia support for rare serious adverse reactions and also emphasised maintaining public confidence in vaccination programmes, which would be achieved through appropriate recognition of such outcomes.
The Deputy will be aware that the Government has established a number of vaccination programmes, including those based on the principle of “community immunity” which require high uptake to be effective. It has also recommended vaccination for specific cohorts during public health emergencies to mitigate the overall impact of the disease.
Notwithstanding appropriate design, manufacture and administration, vaccines can, in very rare cases, cause adverse reactions. Where the State actively promotes vaccination to enhance community immunity and safeguard health and social care services, I believe that a moral duty of care arises towards those individuals who experience those rare adverse reactions.
In this regard, my officials have undertaken substantial work to develop a model for a vaccine damage scheme, and that work is continuing to refine and strengthen the proposal. Once this process is complete, I intend to bring the model to Cabinet for discussion and consideration, subject to the finalisation of the necessary policy work, in advance of the summer recess.
132. Deputy Naoise Ó Cearúil asked the Minister for Health the workforce development plan referenced in the AI for care strategy, including the way clinicians, allied health professionals and administrative staff will be supported to build the digital and AI competencies required for safe adoption; and if she will make a statement on the matter. [28369/26]
View answerThe AI for Care Strategy 2026–2030 identifies the need to develop the workforce to ensure safe adoption and use of artificial intelligence across the health sector. The AI strategy identifies four domains where AI is relevant for health: AI for Clinical Care, AI for Operations, AI for Research & Innovation, and AI for Public Health.
In this context, the HSE has introduced the ‘Digital Health Learning Passport’ to support staff as digital technology becomes an integral part of healthcare delivery.
Three initial modules of the 'Digital Health Learning Passport' were launched in February 2026 and are accessible to all staff. These initial modules cover (1) AI in Healthcare; (2) Digital Health Clinical Safety; and (3) Digital Health Literacy.
These modules help staff develop a better understanding of digital and AI-enabled healthcare tools and support safer, more effective patient care, with a strong emphasis on safety, risk assessment and responsible system use.
The AI in Healthcare module in particular provides a clear and practical introduction to artificial intelligence, explaining core concepts, describes healthcare applications and governance arrangements, with an emphasis on continuous human oversight being central throughout.
The recently established Centre of Excellence for ‘AI and Automation' at the HSE continue to engage staff through CPD events across clinical, finance and radiology services. This work complements initiatives that support clinical staff through relevant colleges and professional bodies.
This approach will be reinforced through guidance on the safe and responsible use of AI in health and social care that is currently being developed by HIQA and will be published later this year, following a public consultation that is currently taking place.
Our approach is also aligned with Ireland’s obligations under the EU AI Act, including requirements on human oversight and staff competence.
Let me be clear: AI is intended to support staff and strengthen care, not replace clinical or professional judgement. I am confident this approach equips our workforce, safeguards patients and enables innovation that improves care.
133. Deputy Barry Ward asked the Minister for Health the actions she has taken to ensure that the Public Health (Single-Use Vapes) Bill 2025 will be future proofed against developments in technology and attempts to find loopholes that would allow the sale of disposable nicotine vaping in other forms; and if she will make a statement on the matter. [27964/26]
View answerThe Public Health (Single-Use Vapes) Bill will apply to any vape that is single-use. This includes devices which are not refillable, have a battery which cannot be recharged or a coil which cannot be replaced. Vapes must be refillable and rechargeable by the user in the normal course of use, and any replacements required must be separately available for purchase.
This legislation ensures that products on the market are intended to be reused and have the functional capability to be reused. Devices with non-operational charging ports, or pods which cannot actually be refilled or replaced would be contravening the law. It will be for the enforcement authority to ensure compliance with this.
It is worth stating that this law should not be seen in isolation. It is part of a suite of measures being proposed to reduce the appeal and accessibility of vapes to young people. This includes restrictions on flavours, appearance, packaging and retail display and advertising under the Public Health (Tobacco Products and Nicotine Inhaling Products) (Amendment) Bill. A vaping prevention campaign from the HSE aimed at young people and their guardians is also underway, and funding of €200,000 was given to continue this as part of Budget 2026. As with tobacco, we must approach the issue from a range of angles to achieve our objective.
134. Deputy Marie Sherlock asked the Minister for Health for an update on the current staffing levels, per job type, at the two supra-regional endometriosis centres respectively per number of WTE posts, filled posts and current vacancies; the current waiting times for a first outpatient appointment at each centre; and if she will make a statement on the matter. [28378/26]
View answerLast October, I launched the National Framework for the Management of Endometriosis. I also mandated an action plan to accelerate development of our endometriosis services. This includes the successful recruitment of additional colorectal surgeons in Cork and Tallaght. This will serve to facilitate and increase capacity for more complex surgical treatments. I am fully committed to the continued expansion of these essential services.
Further investment and expansion of these specialist services is provided for in the HSE’s 2026 National Service Plan. This includes an additional 65 WTE allocated to endometriosis services. The HSE has advised that this recruitment may take up to 18 months.
Over €5 million was invested in endometriosis services between 2021 and 2025. From this, two supra-regional specialist centres in Cork and Tallaght have been established. These centres provide for the management of complex endometriosis cases.
Cork’s endometriosis service currently has 5.5 Whole Time Equivalent (WTE) staff.
• 1.5 Consultants
• 1.0 Specialist Registrar
• 0.5 Senior Psychologist
• 0.5 Clinical Specialist Physiotherapist
• 1.5 Clinical Nurse Managers
• 0.5 Grade IV.
A further 5.1 WTE staff are being actively recruited;
• 2.1 Consultants
• 2.0 Healthcare Assistants
• 0.5 Clinical Specialist Dietitian
• 0.5 Senior Physiotherapist.
Tallaght’s endometriosis service has 10.1 WTE staff. All 10.1 posts are filled.
• 3.3 Consultants
• 1.5 Clinical Nurse Specialist
• 1.0 Clinical Specialist Physiotherapist
• 1.0 Specialist Registrar
• 1.0 Grade IV
• 1.0 Health Care Assistant
• 0.5 Clinical Nurse Manager 2
• 0.5 Clinical Specialist Dietitian
• 0.3 Staff Nurse.
The health system does not collect the data necessary to calculate the average waiting time. The waiting time of patients who have already received their care is not recorded.? All referrals to a supra regional centre will have already been assessed by a specialist consultant.
There were 499 women waiting for a first appointment at a supra regional centre in February.
• 79% of women in Cork were waiting within the Sláintecare wait time target of 12 weeks. Most women are waiting no more than 6 months.
• 17% of women in Tallaght were waiting within the Sláintecare wait time target of 12 weeks. Most women are waiting no more than 9 months.
The Tallaght centre manages higher volumes of complex cases. An additional 0.5 WTE colorectal surgeon was recruited in April. This resource will help to reduce waiting times for women waiting on complex surgeries.
135. Deputy David Cullinane asked the Minister for Health her plans for expanding the adult vaccination programme; and if she will make a statement on the matter. [28498/26]
View answerIreland has a robust and effective immunisation programme that operates over the life span, with vaccinations offered from infancy through to old age.
• Vaccination across the life course supports a healthier adult population, promotes healthy aging and helps protect against serious illness.
• Pneumonia, flu and COVID-19 vaccines are currently available to certain groups of adults, who are most vulnerable to a severe outcome from these diseases, as part of the immunisation programme.
• The pneumococcal vaccine protects against pneumococcal disease which can lead to pneumonia, sepsis or meningitis.
• The Influenza Vaccination Programme ensures that those most vulnerable to the effects of influenza have access to the flu vaccine, free of charge. For winter 2024, the flu vaccination programme was expanded to also include those aged 60 to 64 in the older age category. Ireland has one of the highest flu vaccine uptake rates for older adults in Europe, reaching nearly 75% in the 2024/25 Flu season, which is the target set for this group by the WHO.
• For last season, over a million people were protected from serious complications of seasonal flu infection and almost 50,000 more children were protected than the previous year. We achieved above-target levels of vaccination coverage for our most vulnerable older adults, those aged 80 years and over and those in long-term care facilities, at around 91% and 83% vaccine coverage respectively.
• The COVID-19 Vaccination Programme currently offers a free COVID-19 booster vaccine to people who are aged 80 years and older, immunocompromised and those living in residential care facilities. People aged 70 to 79 years who did not get a COVID-19 vaccine in the last 12 months are also eligible. A good uptake is crucial to get maximum effect.
• In addition the RSV Infant Pathfinder Programme provided immunisation to 88% of newborn babies and 52% of babies who were aged 6 months and under at the start of the RSV season. This meant that more infants were protected from RSV infection during the winter season when the infection is in high circulation.
• Vaccines deliver their best public health impact when uptake is high, protecting individuals, their families and their communities. Therefore, I urge everyone eligible, and particularly older adults, to take up every opportunity to protect themselves by getting vaccinated.
• In relation to vaccines, such as the shingles vaccine and the RSV vaccine for adults, that are not part of the National Immunisation Programme, work is underway in relation to assessing the potential for their inclusion in the Programme.
• A Health Technology Assessment on RSV immunisation for infants and adults will provide advice to my department to inform a policy decision on the most appropriate RSV Immunisation Strategy for infants and adults aged 65 and older.
• The introduction of the shingles vaccine 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.
137. Deputy Shane Moynihan asked the Minister for Health the measures being taken to address the increasing prevalence of myopia, and particularly its presentation among teenagers following completion of school vision screening programmes; and if she will make a statement on the matter. [28448/26]
View answerMyopia, more commonly known as short or near sightedness, is a condition that is increasing in prevalence among young children and teenagers both globally and in Ireland.
In the first instance, research indicates that daily outdoor activities, and managing children’s screen time and sleep time, may be beneficial to slowing the progression of myopia.
The Health Service Executive (HSE) provides optical services free of charge to pre-school children and national school children referred from child health service and school health service examinations who are discovered to have sight problems. These children are referred to the appropriate service for treatment. In such circumstances, these services will continue to be provided until the child has reached the age of 16. Furthermore, under the Community Ophthalmic Services Scheme (COSS), medical card holders or their dependents (aged over 12 years) can receive eye exams from local eye care professionals and receive optical appliances as needed free of charge.
If a child is discovered to have sight problems during these screenings, they can also get free treatment via a Modernised Paediatric Care Pathway under which a Consultant Medical Ophthalmologist leads an Integrated Eye Care Team of nurses, orthoptists, optometrists and technicians. These teams facilitate assessment, diagnoses, management and treatment, enabling most patients to be seen in their own locality.
Significant investment has been made in developing and strengthening these Integrated Eye Care Teams, of which there are 10 across the 6 Health Regions. These Teams are also facilitating large-scale transfer of care from hospital outpatient departments to community settings, with a substantial proportion of referrals assessed, treated, and discharged outside the acute system. Evidence from several regions indicates that 60–70% of paediatric ophthalmology referrals can be safely managed in community settings once these Teams and pathways are in place.
138. Deputy Aisling Dempsey asked the Minister for Health her plans to further increase medical card income limits; and if she will make a statement on the matter. [28388/26]
View answerI want to assure the House that my Department keeps medical card issues under ongoing review.
By way of context, under the Health Act 1970, eligibility for a medical card is primarily based on a financial assessment carried out by the HSE. The HSE assesses each application against a qualifying financial threshold. In practical terms, this is the amount of money an individual can earn in a week and still qualify for a card, and it is specific to the applicant’s own financial circumstances.
For people under 70, eligibility is assessed under the general means-tested medical card thresholds. These are based on an applicant’s household net income, taking account of specified expenses. For those aged 70 and over, eligibility is assessed under medical card income thresholds that are based on gross income.
It is also important to note that the HSE may exercise discretion and grant a medical card in difficult circumstances, including where an applicant would otherwise exceed the relevant threshold.
Over 1.5 million people now hold a Medical Card. A further almost 800 thousand hold a GP Visit Card. That means that about 2.3m have access to free GP care
Finally, there is a programme of work underway in my Department, as part of Sláintecare 2025+, to review the existing eligibility framework. The purpose of this review is to clearly assess what is working well and to inform future policy proposals on the eligibility framework, based on robust evidence, as we progress implementation of Sláintecare.
139. Deputy Cathy Bennett asked the Minister for Health the reason the free contraception scheme excludes women older than 35 years-of-age. [28449/26]
View answerThe Free Contraception Scheme is delivered by over 2,450 GPs and 1,900 pharmacies, nationwide. Approximately €44m has been allocated to support the scheme in 2026.
The Scheme is currently open to women aged from 17 to 35 inclusive. There is no public health reason to limit eligibility by age, up to age 55 (after which, prescription of contraception is not typically clinically recommended).
Phased introduction of the scheme was recommended for other, practical reasons.
Our Public Spending Code recommends pilot testing or phasing of demand-led schemes, in order to manage costs. Free contraception was therefore introduced for younger age cohorts first – they are at higher risk of unplanned pregnancy and less likely to be financially independent.
GP capacity to fit coils and implants, which requires specialist training, was estimated at 1,000 appropriately trained GPs in 2019 (Report of the Working Group on Access to Contraception, 2019). The phased approach has allowed support for increasing training and service delivery capacity; the Irish College of General Practitioners, who are funded to provide relevant training to GPs, advise that approximately 185 certificates for GP training in appropriate administration of coils and/or implants have been issued since 2024 alone.
Further capacity is necessary; in addition to their contraceptive function, coils and implants are used to treat menstrual symptoms such as irregular periods and heavy bleeding, which become more common in peri-menopause. The Healthy Ireland Survey, 2025, found that demand for coils and implants rises in women over 35. Legislation to enable pharmacy prescription of short-acting contraception under defined circumstances is in preparation and should free up GP capacity.
The Programme for Government, the National Sexual Health Strategy, the Sláintecare 2025+ Plan and the Women’s Health Action Plans all commit to further phased expansion of the scheme, up to age 55 in due course. Decisions relating to further expansion of the scheme must be considered through the Estimates process each year.
