Wednesday, 6 May 2026

Care Services

Questions (1006)

Seán Ó Fearghaíl

Question:

1006. Deputy Seán Ó Fearghaíl asked the Minister for Health if she will address concerns regarding access to primary care services (details supplied); and if she will make a statement on the matter. [32547/26]

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Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Regulatory Impact Assessments

Questions (1007)

Pádraig Rice

Question:

1007. Deputy Pádraig Rice asked the Minister for Health further to Parliamentary Question No. 486 of 19 March 2026, the engagements she has had with the Pre-Hospital Emergency Care Council (PHECC) since March regarding the regulatory framework; if she intends to address the shortcomings identified; if she has been provided with a copy of the PHECC’s internal discussion document; and if she will make a statement on the matter. [32560/26]

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Written answers

Minister for Health

The Department of Health maintains a close working relationship with the Pre-Hospital Emergency Care Council (PHECC) to support the continued effective regulation of the pre-hospital emergency care environment. This includes quarterly oversight meetings with PHECC in line with required governance arrangements as well as meetings on other topics. The Department continues to have ongoing engagements with PHECC and this has continued with further meetings since March.

In relation to the internal PHECC discussion document referred to by the Deputy, I refer the Deputy to the previous response outlining that PHECC had informed the Department that the document referred to him was an internal discussion document and that it was not included in the correspondence sent to the Department in September 2025.

Departmental Policies

Questions (1008)

Ken O'Flynn

Question:

1008. Deputy Ken O'Flynn asked the Minister for Health to provide a copy of any formal written policy, guideline or standard operating procedure governing eligibility decisions under the Treatment Abroad Scheme; and if none exists, to confirm this. [32561/26]

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Written answers

Minister for Health

As the Deputy will be aware, the HSE operates the Treatment Abroad Scheme (TAS) for persons entitled to treatment in another EU/EEA member state, UK or Switzerland under Regulation (EC) No. 883/2004, as per the procedures set out in Regulation (EC) No. 987/2009. Subject to the EU Regulations and Guidelines, patients may apply to the HSE TAS seeking access to public health care outside the state through the issue of form S2 (IE). The application requires the patient's referring hospital consultant based in Ireland, following clinical assessment, to certify, among other things, that the treatment is medically necessary and will meet the patient’s needs. The treatment must not be available within the State or not available within the time normally necessary for obtaining it in Ireland, taking account of the patient's current state of health and the probable course of the disease. Applications to the TAS are processed and a determination given in accordance with the statutory framework prior to a patient travelling to avail of treatment.

Information and guidelines on the EU Social Security Co-ordination governing legislative framework are available on the European Commission website:

• www.employment-social-affairs.ec.europa.eu/policies-and-activities/moving-working-europe/eu-social-security-coordination/specialised-information/eu-legislation_en .

• www.employment-social-affairs.ec.europa.eu/policies-and-activities/moving-working-europe/eu-social-security-coordination/specialised-information/official-documents_en .

The HSE is responsible for implementing the Regulations in Ireland and provides further information for patients on the HSE TAS website: www2.hse.ie/services/schemes-allowances/treatment-abroad-scheme/ .

Under 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. As the HSE holds responsibility for the management and operation of the EU Treatment Abroad Scheme (TAS), for persons entitled under EU Regulation 883/04, I have also asked the HSE to respond directly to the Deputy as soon as possible.

Departmental Funding

Questions (1009, 1011, 1024, 1026, 1027, 1030, 1031, 1052, 1053, 1054, 1055, 1056, 1058, 1062, 1063, 1065, 1066, 1067)

Ken O'Flynn

Question:

1009. Deputy Ken O'Flynn asked the Minister for Health who holds ultimate decision-making authority for approving funding under the Treatment Abroad Scheme, including whether this rests with individual consultants, HSE management, or a defined approval panel. [32562/26]

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Ken O'Flynn

Question:

1011. Deputy Ken O'Flynn asked the Minister for Health whether the Department or HSE has conducted any audit or review of approval decisions under the Treatment Abroad Scheme since 2020; if so, to provide dates and findings. [32564/26]

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Ken O'Flynn

Question:

1024. Deputy Ken O'Flynn asked the Minister for Health the title, scope, date, reporting line, and final report reference of the 2022 Comptroller and Auditor General audit of the Treatment Abroad Scheme referred to by the HSE in correspondence to this Deputy; whether the report is publicly available; and if not, whether she will arrange for a copy to be provided. [32588/26]

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Ken O'Flynn

Question:

1026. Deputy Ken O'Flynn asked the Minister for Health whether any recommendations, observations, management letters, internal control issues, expenditure concerns, or governance issues arose from the 2022 Comptroller and Auditor General audit of the Treatment Abroad Scheme; and if she will provide a summary of each such matter and the action taken. [32590/26]

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Ken O'Flynn

Question:

1027. Deputy Ken O'Flynn asked the Minister for Health whether any internal audit, external audit, Comptroller and Auditor General review, value-for-money review, or expenditure-control review of the Treatment Abroad Scheme has been completed since the 2022 audit; and if so, the date, scope, findings, and recommendations of each review. [32591/26]

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Ken O'Flynn

Question:

1030. Deputy Ken O'Flynn asked the Minister for Health whether any internal audit, external audit, or review by the Comptroller and Auditor General has examined the financial recording, traceability, and year attribution of expenditure under the Treatment Abroad Scheme since 2020; if so, to provide the findings; and if not, whether such an audit will now be commissioned. [32599/26]

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Ken O'Flynn

Question:

1031. Deputy Ken O'Flynn asked the Minister for Health whether the HSE maintains a patient-level dataset under the Treatment Abroad Scheme that links each individual approval to associated expenditure, treatment dates, and payment dates; and if not, how financial accountability and verification of expenditure is ensured. [32600/26]

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Ken O'Flynn

Question:

1052. Deputy Ken O'Flynn asked the Minister for Health to identify the specific grade, title, and role of the individual or body within the HSE that has final authority to approve or refuse applications under the Treatment Abroad Scheme; and whether this authority is exercised by a single decision-maker or a panel-based process. [32631/26]

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Ken O'Flynn

Question:

1053. Deputy Ken O'Flynn asked the Minister for Health to set out the formal governance structure underpinning decision-making under the Treatment Abroad Scheme, including any documented approval hierarchy, escalation pathways, or oversight committees. [32632/26]

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Ken O'Flynn

Question:

1054. Deputy Ken O'Flynn asked the Minister for Health whether decisions to approve funding under the Treatment Abroad Scheme are subject to any form of independent clinical review, secondary validation, or administrative appeal prior to authorisation of expenditure. [32633/26]

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Ken O'Flynn

Question:

1055. Deputy Ken O'Flynn asked the Minister for Health to detail the process by which independent medical advisors engaged by the HSE in respect of Treatment Abroad Scheme applications are selected, governed, and assessed for independence; and whether their advice is binding or advisory. [32634/26]

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Ken O'Flynn

Question:

1056. Deputy Ken O'Flynn asked the Minister for Health whether any internal audit, external audit, or examination by the Comptroller and Auditor General has been conducted on the decision-making and approval processes under the Treatment Abroad Scheme since 2020; and if so, to provide details and findings. [32635/26]

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Ken O'Flynn

Question:

1058. Deputy Ken O'Flynn asked the Minister for Health whether a standardised cost range or expected cost per patient is applied when approving applications under the Treatment Abroad Scheme; if not, how value for money is assessed at approval stage. [32650/26]

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Ken O'Flynn

Question:

1062. Deputy Ken O'Flynn asked the Minister for Health whether any internal or external audit has been carried out specifically on expenditure under the Treatment Abroad Scheme for gender affirmation procedures. [32654/26]

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Ken O'Flynn

Question:

1063. Deputy Ken O'Flynn asked the Minister for Health whether any independent clinical validation, separate from the referring consultant and MDT, is carried out by the HSE prior to approval of applications under the Treatment Abroad Scheme for surgical procedures not provided in the State. [32655/26]

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Ken O'Flynn

Question:

1065. Deputy Ken O'Flynn asked the Minister for Health whether any audit or review has been conducted on approvals granted under the Treatment Abroad Scheme for gender-related surgical procedures since 2020. [32657/26]

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Ken O'Flynn

Question:

1066. Deputy Ken O'Flynn asked the Minister for Health whether post-operative outcomes, complications, or follow-up care requirements are tracked for patients funded under the Treatment Abroad Scheme; if not, the rationale for the absence of such data. [32658/26]

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Ken O'Flynn

Question:

1067. Deputy Ken O'Flynn asked the Minister for Health whether the Department has conducted any value-for-money or clinical effectiveness assessment in respect of gender-related surgical procedures funded under the Treatment Abroad Scheme. [32659/26]

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Written answers

Minister for Health

I propose to take Questions Nos. 1009, 1011, 1024, 1026, 1027, 1030, 1031, 1052, 1053, 1054, 1055, 1056, 1058, 1062, 1063, 1065, 1066 and 1067 together.

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Departmental Schemes

Questions (1010)

Ken O'Flynn

Question:

1010. Deputy Ken O'Flynn asked the Minister for Health whether any national clinical criteria, thresholds, or evidentiary standards are formally defined for determining what constitutes a “proven treatment” under the Treatment Abroad Scheme. [32563/26]

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Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Question No. 1011 answered with Question No. 1009.

Departmental Reviews

Questions (1012)

Ken O'Flynn

Question:

1012. Deputy Ken O'Flynn asked the Minister for Health whether decisions under the treatment abroad scheme are subject to any centralised review, appeal mechanism, or consistency check across cases. [32565/26]

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Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Departmental Schemes

Questions (1013, 1028, 1061)

Ken O'Flynn

Question:

1013. Deputy Ken O'Flynn asked the Minister for Health whether any cost ceilings, budget controls, or value-for-money assessments are applied to approvals under the Treatment Abroad Scheme. [32566/26]

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Ken O'Flynn

Question:

1028. Deputy Ken O'Flynn asked the Minister for Health what formal audit schedule, risk assessment, or expenditure-control framework applies to the Treatment Abroad Scheme; who is responsible within her Department for oversight of that framework; and whether the Scheme is subject to periodic value-for-money review. [32592/26]

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Ken O'Flynn

Question:

1061. Deputy Ken O'Flynn asked the Minister for Health what internal financial controls are applied to ensure that costs claimed under the Treatment Abroad Scheme are reasonable, necessary, and proportionate. [32653/26]

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Written answers

Minister for Health

I propose to take Questions Nos. 1013, 1028 and 1061 together.

The Treatment Abroad Scheme operates within the overall health expenditure framework approved by the Oireachtas through the Estimates process and reflected in the HSE National Service Plan. The HSE is required, under the Performance and Accountability Framework agreed with my Department, to deliver all services, including the Treatment Abroad Scheme, within its overall annual budget allocation and to put in place appropriate governance, monitoring and financial controls.

While access to the Treatment Abroad Scheme is determined by individual clinical eligibility rather than fixed activity quotas, it is not exempt from budgetary oversight. Expenditure on the scheme is monitored as part of the HSE’s monthly financial reporting, and pressures arising within the scheme must be managed by the HSE within its overall annual budget allocation.

There are no financial caps applied to referrals under the Treatment Abroad Scheme. Notwithstanding that treatment costs are set by external health systems, the HSE applies statutory eligibility, prior approval, verification and audit controls, with my Department assuring value for money at system level through the budgetary and performance framework within which the HSE operates.

As the detailed operation of the Treatment Abroad Scheme, including the specific control measures in place, is an operational matter for the HSE, I have referred the Deputy’s question to the HSE for direct response.

Departmental Policies

Questions (1014)

Ken O'Flynn

Question:

1014. Deputy Ken O'Flynn asked the Minister for Health whether her Department has considered developing a national policy definition or classification framework for surgical procedures by clinical priority, medical necessity, quality-of-life impact, and elective status; and if she will make a statement on the matter. [32577/26]

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Written answers

Minister for Health

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Departmental Policies

Questions (1015)

Ken O'Flynn

Question:

1015. Deputy Ken O'Flynn asked the Minister for Health whether she accepts the HSE position that there is currently no agreed or standardised definition of a procedure that is not medically necessary; whether her Department intends to address this policy gap; and if she will make a statement on the matter. [32578/26]

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Written answers

Minister for Health

I am advised that there is no single, universally agreed definition of a medical procedure that is not deemed to be medically necessary and the net benefit arising from the adoption of such a definition would need to be clearly set out before doing so. Decisions on whether a procedure is clinically indicated are generally based on individual patient need, professional clinical judgement, relevant clinical guidelines, and evidence-based standards of care.

Responsibility for the provision and organisation of health services rests with the Health Service Executive (HSE). Clinical decision-making, including determinations regarding the appropriateness of specific procedures, is a matter for suitably qualified healthcare professionals, operating within established governance, regulatory and ethical frameworks.

My Department keeps matters of clinical governance and patient safety under ongoing review, in engagement with the HSE and other relevant bodies. Where appropriate, the development or clarification of guidance is informed by international evidence, best practice, and advice from clinical and regulatory authorities.

I will continue to keep this area under consideration and will ensure that any relevant policy issues are examined in the context of patient safety, quality of care, and the appropriate use of healthcare resources.

Departmental Circulars

Questions (1016)

Ken O'Flynn

Question:

1016. Deputy Ken O'Flynn asked the Minister for Health whether the Department has issued any guidance to the HSE on how theatre capacity should be prioritised where demand exceeds available capacity; and if she will publish any such guidance. [32579/26]

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Written answers

Minister for Health

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Departmental Data

Questions (1017)

Ken O'Flynn

Question:

1017. Deputy Ken O'Flynn asked the Minister for Health whether public hospitals are required to record the clinical priority category attached to surgical procedures when theatre time is allocated; and if not, whether her Department intends to require such data collection.; and if she will make a statement on the matter. [32580/26]

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Written answers

Minister for Health

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Departmental Inquiries

Questions (1018)

Ken O'Flynn

Question:

1018. Deputy Ken O'Flynn asked the Minister for Health whether the Department has assessed the feasibility of introducing structured data fields within hospital systems to record the clinical rationale and priority category for surgical procedures; and if she will make a statement on the matter. [32581/26]

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Written answers

Minister for Health

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Departmental Data

Questions (1019)

Ken O'Flynn

Question:

1019. Deputy Ken O'Flynn asked the Minister for Health whether her Department receives any regular reporting from the HSE on the allocation of theatre capacity by specialty, urgency category, elective status, waiting-list category, or clinical priority; and if she will provide details of the reporting received [32582/26]

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Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Departmental Data

Questions (1020)

Ken O'Flynn

Question:

1020. Deputy Ken O'Flynn asked the Minister for Health whether she is satisfied that current hospital data systems allow adequate national oversight of how scarce theatre capacity is allocated across the public health system; and if she will make a statement on the matter. [32583/26]

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Written answers

Minister for Health

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Departmental Data

Questions (1021)

Ken O'Flynn

Question:

1021. Deputy Ken O'Flynn asked the Minister for Health whether any work is underway to create a nationally consistent methodology for reporting theatre utilisation, cancellations, prioritisation, and allocation across public hospitals; and if she will provide a timeline for such work. [32584/26]

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Written answers

Minister for Health

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Healthcare Policy

Questions (1022)

Ken O'Flynn

Question:

1022. Deputy Ken O'Flynn asked the Minister for Health whether the absence of a standardised definition of medical necessity in surgical care creates a governance risk in relation to waiting lists, theatre access, and resource allocation; and if she will make a statement on the matter. [32585/26]

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Written answers

Minister for Health

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Healthcare Policy

Questions (1023)

Ken O'Flynn

Question:

1023. Deputy Ken O'Flynn asked the Minister for Health whether she will request the HSE to prepare options for improved reporting on theatre-capacity allocation, including reporting by specialty, urgency, elective status, and clinical priority; and if she will make a statement on the matter. [32586/26]

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Written answers

Minister for Health

As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Question No. 1024 answered with Question No. 1009.

Departmental Reports

Questions (1025)

Ken O'Flynn

Question:

1025. Deputy Ken O'Flynn asked the Minister for Health whether her Department received, reviewed, or was briefed on the 2022 Comptroller and Auditor General audit of the Treatment Abroad Scheme; the date on which any such briefing or report was received; and what follow-up actions were required by the Department. [32589/26]

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Written answers

Minister for Health

Since the query relates to an HSE audit, this is a service matter and I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.