Written Answers Nos. 492-511
492. Deputy Peadar Tóibín asked the Minister for Health whether her Department has evaluated the overall effectiveness of the NIRP since it became operational in 2018; and if so, to publish or summarise the outcomes. [33542/26]
View answerThe new National Policy Framework for Adult Safeguarding in the Health & Social Care Sector was published in December 2025, following Government approval.
The framework recognises the important role of adult safeguarding learning reviews as part of our overall system of adult safeguarding. Specifically, it acknowledges the role that the National Independent Review Panel (NIRP) has undertaken since its establishment by the HSE in 2017.
The framework includes commitments to introduce a new standardised approach for adult safeguarding learning reviews, building on and strengthening the current NIRP process.
Forthcoming legislation will place the NIRP on a statutory footing and will require that all adult safeguarding incidents that reach a defined criteria must be referred to the NIRP for review. The legislation will provide:
• That the NIRP will operate independently,
• For an expansion of the NIRP’s remit to enable it to review adult safeguarding incidents across all health and social care services,
• Clear criteria for when adult safeguarding incidents must be referred to NIRP, and by whom,
• That the NIRP can review adult safeguarding incidents that do not meet the mandatory criteria, on the basis of a clear referral process which will be developed,
• For powers of access to information and to interview relevant persons, and
• That the primary focus of reviews is learning and system improvement.
As the day-to-day operation of the NIRP is an operational matter, the question has also been referred to the HSE for direct reply.
493. Deputy John Connolly asked the Minister for Health further to Parliamentary Question No. 1964 of 18 March 2026, relating to omaveloxolone skyclarys®, whether any interim arrangements are available or under consideration whereby, in circumstances where a family is willing to travel abroad, a patient could be facilitated in accessing this treatment while the drug remains under assessment by the HSE; whether the National Treatment Purchase Fund, or any other State mechanism, can be used to enable access to omaveloxolone (skyclarys®) in another jurisdiction pending completion of the assessment and reimbursement process; and if she will make a statement on the matter. [33553/26]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for decisions on the pricing and reimbursement of medicines and medical devices; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
494. Deputy Ken O'Flynn asked the Minister for Health whether the dispatch-time KPIs relating to allocation within 60 seconds (PURPLE) and 180 seconds (RED) are subject to any mandatory compliance thresholds, enforcement mechanisms, or escalation protocols where breached; and if so, to provide details. [33563/26]
View answer495. Deputy Ken O'Flynn asked the Minister for Health what operational or clinical actions are triggered when a 999 call exceeds the defined allocation time thresholds, and whether such breaches are recorded, reviewed, or reported. [33564/26]
View answer496. Deputy Ken O'Flynn asked the Minister for Health whether the National Ambulance Service maintains any documented decision-making framework governing prioritisation where no ambulance resource is immediately available [33565/26]
View answer497. Deputy Ken O'Flynn asked the Minister for Health whether delays in ambulance allocation beyond defined KPI thresholds are recorded as risks within the HSE Enterprise Risk Register or National Ambulance Service risk frameworks. [33566/26]
View answer498. Deputy Ken O'Flynn asked the Minister for Health whether any audit, internal review, or external evaluation has examined compliance with ambulance allocation time targets since 2020. [33567/26]
View answer499. Deputy Ken O'Flynn asked the Minister for Health the number and proportion of emergency calls in 2024 and 2025 that exceeded the defined allocation time thresholds of 60 seconds (PURPLE) and 180 seconds (RED). [33568/26]
View answerI propose to take Questions Nos. 494, 495, 496, 497, 498 and 499 together.
As this is a operational matter, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
500. Deputy Cathy Bennett asked the Minister for Health the number of paramedic vacancies that currently exist within the National Ambulance Service; and if she will make a statement on the matter. [33588/26]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
501. Deputy Cathy Bennett asked the Minister for Health the reason candidates on panel NRS14276 have not yet been assigned posts with the National Ambulance Service; when those candidates can expect to be placed; and if she will make a statement on the matter. [33589/26]
View answerAs this is an operational matter, I have asked the HSE to respond directly to the Deputy.
502. Deputy Cathy Bennett asked the Minister for Health whether delays in placing qualified paramedics are affecting ambulance availability, staffing levels, and response capacity; and if she will make a statement on the matter. [33590/26]
View answerAs this is a operational matter, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
503. Deputy Emer Currie asked the Minister for Health to provide an update on the shingles vaccine being made available for a cohort of immunocompromised individuals; to outline when a decision will be made on this issue; and if she will make a statement on the matter. [33635/26]
View answerThe immunisation programme in Irelandis informed by 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.
504. Deputy Ken O'Flynn asked the Minister for Health in light of confirmation that no structured national data collection system currently exists in respect of gender-related healthcare services, whether her Department has conducted any formal risk assessment regarding the operation of such services in the absence of comprehensive national data; and if so, to provide details of that assessment, including date, scope and findings. [33656/26]
View answer505. Deputy Ken O'Flynn asked the Minister for Health whether she accepts that the absence of a national dataset capturing referral numbers, treatments, outcomes and associated costs for minors accessing gender-related healthcare represents a governance gap; and if so, the steps being taken at Departmental level to address this. [33657/26]
View answer506. Deputy Ken O'Flynn asked the Minister for Health to specify the current governance and accountability framework at departmental level for oversight of gender-related healthcare services for minors, including the identification of the office or official with ultimate responsibility for policy and clinical oversight. [33658/26]
View answer508. Deputy Ken O'Flynn asked the Minister for Health whether she has sought or received any assurance from the HSE that adequate clinical governance, audit, and safeguarding mechanisms are currently in place for gender-related healthcare services for minors; and if so, to outline the basis of such assurances. [33660/26]
View answer510. Deputy Ken O'Flynn asked the Minister for Health whether her Department has undertaken any evaluation of the financial governance arrangements associated with gender-related healthcare services for minors, including expenditure tracking, cost controls, or value-for-money assessment; and if so, to provide details. [33662/26]
View answer511. Deputy Ken O'Flynn asked the Minister for Health whether she considers it appropriate that gender-related healthcare services for minors are currently operating in the absence of a completed national model of care, national audit structures, and comprehensive data collection systems; and if so, the basis for that position. [33663/26]
View answer526. Deputy Ken O'Flynn asked the Minister for Health whether she is satisfied that the absence of a national audit or review of gender healthcare referral pathways since 2023 is consistent with her Department’s obligations in respect of clinical governance and patient safety; and if she will make a statement on the matter. [33738/26]
View answer527. Deputy Ken O'Flynn asked the Minister for Health whether her Department has directed the HSE to establish structured national data collection systems in respect of gender healthcare referrals and outcomes, including those funded through the treatment abroad scheme; the timeline for same; and if she will make a statement on the matter. [33739/26]
View answer533. Deputy Ken O'Flynn asked the Minister for Health whether she accepts that the absence of structured data collection, national audit, and a defined clinical governance framework represents a policy gap in the oversight of gender healthcare services; and if she will make a statement on the matter. [33745/26]
View answerI propose to take Questions Nos. 504, 505, 506, 508, 510, 511, 526, 527 and 533 together.
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.
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.
Developing a model of care for Gender Healthcare Services is a complex process and the HSE and my department are working 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.
507. Deputy Ken O'Flynn asked the Minister for Health whether her Department has issued any interim policy direction, guidance, or governance framework to the HSE in respect of gender-related healthcare services for minors pending completion of the proposed national model of care; and if so, to provide details. [33659/26]
View answerAs 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.
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. If specialised gender assessment and support is required, children are then referred by a CAMHS consultant to the NHS Children and Young People’s Gender Service in the U.K. under the Treatment Abroad Scheme (TAS) for a multidisciplinary assessment. 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.
Developing a model of care for Gender Healthcare Services is a complex process and the HSE and my department are working 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.
509. Deputy Ken O'Flynn asked the Minister for Health whether any performance indicators, outcome measures, or clinical quality metrics are currently required or monitored at national level in respect of gender-related healthcare services for minors; and if not, the reason for same. [33661/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
