Written Answers Nos. 1301-1324
1304. Deputy Ken O'Flynn asked the Minister for Health the number of complaints, adverse incident reports, legal claims or clinical governance concerns associated with procedures funded under the treatment abroad scheme since 2020. [39206/26]
View answerAs this is an operational matter, I have asked the HSE to respond directly to the deputy.
1305. Deputy Ken O'Flynn asked the Minister for Health whether the Department has sought legal advice regarding governance and duty-of-care obligations arising from State-funded overseas medical procedures where no structured outcomes monitoring system exists. [39207/26]
View answer1414. Deputy Ken O'Flynn asked the Minister for Health whether any centralised framework exists governing long-term outcome monitoring for minors referred abroad for treatment or assessment under publicly funded healthcare schemes. [39773/26]
View answer1417. Deputy Ken O'Flynn asked the Minister for Health whether the Department or HSE has conducted any assessment regarding the legal, safeguarding or governance implications of overseas referrals involving minors in circumstances where no national long-term outcomes database exists. [39776/26]
View answerI propose to take Questions Nos. 1305, 1414 and 1417 together.
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1310. Deputy Ken O'Flynn asked the Minister for Health whether the Comptroller and Auditor General has ever examined category-specific overseas treatment expenditure under the treatment abroad scheme; and if so, to provide details. [39213/26]
View answerAs this is a service matter, this PQ has been referred to the HSE to respond.
1312. Deputy Ken O'Flynn asked the Minister for Health whether any national clinical governance framework exists governing referrals for overseas gender affirmation surgeries funded through the treatment abroad scheme. [39215/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1314. Deputy Ken O'Flynn asked the Minister for Health whether any post-treatment outcome monitoring or follow-up governance arrangements exist for persons funded for overseas gender affirmation surgeries under the treatment abroad scheme. [39217/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1315. Deputy Ken O'Flynn asked the Minister for Health whether the HSE has undertaken any national capacity assessment of the public pre-exposure prophylaxis (PrEP) programme since 2024; and if so, if she will provide details of the findings, including identified service gaps, unmet demand, regional pressures and recommended expansion measures. [39272/26]
View answer1316. Deputy Ken O'Flynn asked the Minister for Health the number of persons currently awaiting access to public PrEP services, by clinic and by HSE health region; and whether this figure includes informal, paused or closed waiting lists. [39273/26]
View answer1318. Deputy Ken O'Flynn asked the Minister for Health whether any risk assessment has been undertaken regarding individuals sourcing PrEP medication privately from overseas due to inability to access the public system; and if she will provide details of any such assessment. [39275/26]
View answer1321. Deputy Ken O'Flynn asked the Minister for Health how many public PrEP clinics nationally are currently closed, fully or partially, to new self-referrals; the duration of each restriction; and the reasons cited for same. [39278/26]
View answer1322. Deputy Ken O'Flynn asked the Minister for Health whether the HSE has considered establishing a temporary national bridging pathway or interim prescribing arrangement for persons unable to access public PrEP services due to capacity limitations. [39279/26]
View answer1323. Deputy Ken O'Flynn asked the Minister for Health the number of approved private or GP PrEP providers currently operating nationally and by county; and whether the HSE has assessed the financial impact on patients required to access private consultations and testing due to lack of public capacity. [39280/26]
View answer1324. Deputy Ken O'Flynn asked the Minister for Health whether additional funding, staffing or clinic capacity has been allocated in 2026 to expand access to public PrEP services; and if she will provide a breakdown of same by region and service. [39281/26]
View answer1326. Deputy Ken O'Flynn asked the Minister for Health whether any national equality-of-access assessment has been undertaken regarding geographic disparities in access to PrEP services, particularly for persons outside Dublin or without access to private care options. [39287/26]
View answer1329. Deputy Ken O'Flynn asked the Minister for Health whether the Department of Health receives routine reporting on public PrEP service capacity, waiting times, referral refusals or clinic closures; and if not, whether she intends to introduce such reporting arrangements. [39290/26]
View answerI propose to take Questions Nos. 1315, 1316, 1318, 1321, 1322, 1323, 1324, 1326 and 1329 together.
Further to previous PQs of 06/05/2026 and 18/05/2026, to which we provided comprehensive responses and to which the HSE are also responding, we can add the following information in respect of PQ39275/26 and others composited above.
We understand from HSE colleagues that excess demand of approximately 30% was estimated, prior to additional capacity coming on stream in Q3-4 2025. The training framework for GPs and other private providers has expanded the numbers of GPs and other primary care healthcare providers providing PrEP from 17 in late 2023, with more providers likely to complete training in the current year. Details of current providers, both public and private, can be accessed at: [https://www2.hse.ie/conditions/hiv/where-to-get-prep/].
Training programmes for GPs continue, with additional potential providers working towards inclusion in the programme.
Additional funding of €550,000, including 7WTE in staffing allocation in 2025 and an additional €100,000 in 2026 were provided at a national level for the PrEP programme recently. Allocations or service provision changes within individual regions are a matter for the HSE.
The HSE estimates that, following additional staffing in 4 public STI clinics and privately, through the training and recruitment of additional GPs, family planning and student health clinics to the PrEP scheme, that capacity in the wider Dublin region and, separately, in private services in many locations, has significantly improved.
However, while supply in some regions has improved, demographic increases are impacting on demand, so further assessment is required and will be progressed. According to the National Census and CSO population estimates, our population has risen by over 820,000 people since 2015, and by over 530,000 since 2019, when the PrEP scheme was launched, with a significant proportion of that increase, driven by both natural increase and migration, occurring in the 17-50 age-ranges most likely to need a wide range of sexual and reproductive health services, including, but not limited to PrEP.
Revisions in WHO eligibility criteria have also resulted in increases in the numbers of people deemed eligible for PrEP and likely to benefit from it. In summary, we have an increasingly vibrant, dynamic and diverse society that is operating at full capacity and full employment. As noted in the NSHS, we are aware of demographic change and are working to expand capacity where we can.
Work is ongoing to consolidate waiting list and unmet demand information on a nationwide and regional basis, which will feed into a Model of Care for sexual health, to be published later this year, pressures of work permitting.
In wider terms, with regard to access more generally, the Department recognises that, to work towards the goal of universal healthcare in line with Sláintecare commitments, more needs to be done. It is in this context that the Department has commenced a long-term Strategic Review of the Eligibility Framework, Phase 1 of which includes a review of the existing eligibility arrangements for health services to see how they align with current population needs. The Review includes within its scope, the commitments in the Programme for Government and National Sexual Health Strategy, 2025-35 pertaining to sexual and reproductive health services, including, but not limited to PrEP.
In terms of further detail on:
• Risk assessments for medicines sourced abroad.
• National capacity assessments.
• Temporary service gaps and closures .
• unmet demand, including by region and clinic.
• temporary bridging prescriptions or other access measures.
• HSE/DoH reporting structures.
• Equality of access assessments.
• Additional funding, staffing or clinic capacity changes.
as the detail raised in these questions are service matters, I have asked the HSE to respond directly and in more detail to the Deputy, as soon as possible.
1317. Deputy Ken O'Flynn asked the Minister for Health whether the HSE maintains any centralised record of persons unable to access public PrEP services due to capacity constraints; and if not, whether she considers the absence of such data to represent a governance or public health oversight issue. [39274/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1319. Deputy Ken O'Flynn asked the Minister for Health whether the absence of a national waiting list or central referral pathway for PrEP has been formally identified within the HSE or Department of Health as a patient safety, governance or access risk. [39276/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1320. Deputy Ken O'Flynn asked the Minister for Health whether any service-level target exists regarding maximum waiting times for access to public PrEP services; and if so, what compliance levels have been achieved during 2025 and 2026 to date. [39277/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
