Written Answers Nos. 1365-1385
1365. Deputy Ruth Coppinger asked the Minister for Health the supports available for a person (details supplied) to gain access to surgery aboard given issues that have been raised; and if she will make a statement on the matter. [39509/26]
View answerI understand the Deputy may be seeking information on the Endometriosis Surgery Abroad Interim Scheme (ESAIS) and EU Treatment Abroad Scheme (TAS). As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1366. Deputy Micheál Carrigy asked the Minister for Health the reason an adult patient with Type 1 diabetes (details supplied) has been denied access to a critical, life-sustaining insulin pump; if her attention has been drawn to the fact that this patient is experiencing severe gaps in continuity of care; the steps she will take to address the extensive administrative delays and lack of coordinated regional care hindering patients transferring international diabetes care profiles into the HSE structure; if she will outline the contingency arrangements or direct clinical intervention available to prevent adverse health outcomes for this patient; and if she will make a statement on the matter. [39543/26]
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.
1367. Deputy Shónagh Ní Raghallaigh asked the Minister for Health if she will consider adding Crohn's disease to the long-term illness scheme, given the incurable nature of the disease and significant impact on patients' lives; and if she will make a statement on the matter. [39551/26]
View answerThe Long-Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 conditions to be covered by the Scheme. Further information, including the list of conditions, can be found at:
www2.hse.ie/services/schemes-allowances/lti/about/.
Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. While there are currently no plans to extend the list of conditions, it is important to remember that the LTI Scheme exists within a wider eligibility framework.
Individuals and families in Ireland may be entitled to the following schemes:
• General Medical Services (GMS) Scheme (medical card). Eligibility for a medical card is determined by the HSE, in accordance with the provisions of the Health Act 1970 (as amended) In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness.
• In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
• Under the Drugs Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland.
The issue of granting medical card eligibility based on having a particular disability or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
1368. Deputy Shónagh Ní Raghallaigh asked the Minister for Health the financial supports available to patients with inflammatory bowel disease; and if she will make a statement on the matter. [39552/26]
View answerInflammatory Bowel Disease (IBD) is the name used for a group of disorders that cause inflammation of the intestine. It is a term used for conditions known as ulcerative colitis, Crohn's disease, and indeterminate colitis.
Crohn's and Colitis Ireland (CCI) are a proactive group looking for approved services for people living with Inflammatory Bowel Disease. They provide support services, guidance, and a shoulder to lean on for individuals and families affected by inflammatory bowel disease (IBD).
The National Clinical Programme for Gastroenterology and Hepatology was established in October 2019 as a joint collaboration between the HSE and the Royal College of Physicians of Ireland. Gastroenterology and Hepatology multi-disciplinary teams provide expertise in the diagnosis, treatment and prevention of conditions of the digestive tract, liver and pancreas, including Inflammatory Bowel Disease.
The Long-Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing sixteen conditions covered by the Scheme. These are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.
Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. While there are currently no plans to extend the list of conditions, it is important to remember that the LTI Scheme exists within a wider eligibility framework.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card under the General Medical Services (GMS) Scheme. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE.
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. The HSE will afford applicants the opportunity to furnish supporting documentation to determine whether undue hardship exists and to fully take account of all relevant circumstances that may benefit them in assessment. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
The issue of granting medical card eligibility based on having a particular disability or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
Under the Drugs Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
There has been a significant focus on improving access to and the affordability of healthcare services over the last few years. This includes reductions in the DPS threshold, expansion of access to free GP care, and the abolition of all public in-patient hospital charges for children and adults. These measures continue to create a health and social care service that offers affordable access to quality healthcare.
Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
I trust this reply is of assistance.
1369. Deputy Erin McGreehan asked the Minister for Health to set out the full process and eligibility criteria for patients accessing the Northern Ireland Planned Healthcare Scheme; and to provide the number of applications, approvals, refusals and reimbursements issued under the scheme in each of the past three years, along with any planned changes or improvements. [39553/26]
View answerThe Northern Ireland Planned Healthcare Scheme (NIPHS) has been in effective operation since 1 January 2021. This Scheme was introduced to mitigate the loss of access to care from private providers in Northern Ireland under the EU Cross Border Directive, which ceased to apply as a result of Brexit.
The current administrative scheme enables persons ordinarily resident in the State to access and be reimbursed for private healthcare in Northern Ireland by the HSE, provided such healthcare is publicly available within Ireland. Such healthcare will be reimbursed at the cost of providing that treatment in the State or the cost of same in Northern Ireland, whichever is the lesser. The HSE provides further information for patients on the HSE NIPHS website: www2.hse.ie/services/schemes-allowances/niphs/.
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1370. Deputy Erin McGreehan asked the Minister for Health to outline the process and administrative requirements for patients seeking treatment under the Cross Border Directive; and to provide the number of applications, approvals, refusals and reimbursements recorded under the scheme in each of the past three years, together with any planned changes or improvements. [39554/26]
View answerThe EU Cross Border Directive (CBD) provides rules for the reimbursements to patients of the cost of receiving treatment abroad, where the patient would be entitled to such treatment in their home Member State, and supplements the rights that patients already have at EU level. The HSE operates the EU Cross Border Directive (CBD) in Ireland. Under the terms of the CBD, patients in Ireland can seek to be referred to another EU/EEA country for medical treatment that is available in the public health service in Ireland. The patient may access the overseas service in either the public or private health sector of the country they choose to receive the service in. The patient pays for the treatment and claims reimbursement from the HSE at the cost of that treatment in Ireland or the cost of it abroad, whichever is the lesser. The HSE, in fulfilling its role as the National Contact Point (NCP) in Ireland, provides information for patients on the operation of the CBD, including on its website www2.hse.ie/services/schemes-allowances/cross-border-directive/.
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1371. Deputy Erin McGreehan asked the Minister for Health to detail the process and eligibility criteria for patients accessing treatment through the National Treatment Purchase Scheme; and to provide the number of applications, approvals, refusals and reimbursements under the scheme in each of the past three years, as well as any planned changes or improvements. [39555/26]
View answerThe National Treatment Purchase Fund (NTPF) works with public hospitals, as opposed to with patients directly, to offer and provide the funding for treatment to clinically suitable long waiting patients who are on an Inpatient/Day case or Outpatient waiting list.
The key criteria of the NTPF is the prioritisation of the longest waiting patients first. While the NTPF identifies patients eligible for NTPF treatment the clinical suitability of the patient to avail of NTPF funded treatment is determined by the public hospital.
The number of patient care episodes arranged by the NTPF in each of the last three years; 250,206 in 2023, 247,159 in 2024, and 198,289 in 2025.
The NTPF continues to support the public hospital system and under the Waiting Time Action Plan 2026, the NTPF has undertaken to deliver 143,000 episodes of patient care; 100,000 OPD appointments, 23,000 IPDC procedures and 20,000 GI Scopes.
1372. Deputy Erin McGreehan asked the Minister for Health to outline the full process and eligibility criteria for patients applying under the Treatment Abroad Scheme; and to provide the number of applications, approvals, refusals and reimbursements issued under the scheme in each of the past three years, together with any planned changes or improvements. [39556/26]
View answerThe HSE operates the EU Treatment Abroad Scheme (TAS), for persons entitled under EU Regulation 883/04. The TAS is a consultant led scheme and allows for a public consultant based in Ireland to refer a public patient who is normally resident in Ireland for treatment in the public healthcare system of another EU member state, the UK or Switzerland. Subject to the EU Regulations and Guidelines, the TAS provides for the cost of approved public treatments in another EU/EEA member state, the UK or Switzerland through the issue of form S2 (IE) where the treatment is:
• among the benefits provided for by Irish legislation;
• not available in Ireland;
• 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;
• medically necessary and will meet the patient’s needs;
• a proven form of medical treatment and not experimental or test treatment;
• provided in a recognised public hospital or other institution that will accept EU/EEA form S2 (IE) and;
• is under the control of a registered medical practitioner.
The HSE provides further information for patients on the HSE TAS website:www2.hse.ie/services/schemes-allowances/treatment-abroad-scheme.
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1373. Deputy Ivana Bacik asked the Minister for Health if she will confirm whether Action 9 of the HSE Position Paper on FASD Prevention, published in September 2022, namely "Expand availability of Drug and Alcohol Liaison Midwifery Services, with access to full range of supports (including detoxification) in pregnancy" led by HSE Acute Hospitals; National Women and Infants Health Programme; HSE Social Inclusion; HSE Mental Health which was due to be completed within three years of publication, has now been completed; and if she will make a statement on the matter. [39573/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1374. Deputy Sorca Clarke asked the Minister for Health the estimated cost to the State of progressing one clinical nurse specialist post to an advanced nurse practitioner post; the average difference in annual salary costs, associated training and education costs; and any associated implementation or backfill costs; in tabular form. [39586/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1375. Deputy Michael Cahill asked the Minister for Health to urgently examine a matter (details supplied;); and if she will make a statement on the matter. [39608/26]
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.
1376. Deputy Marie Sherlock asked the Minister for Health the estimated full year cost of abolishing all prescription charges under the GMS scheme. [39640/26]
View answer1377. Deputy Marie Sherlock asked the Minister for Health the estimated full year cost of reducing the drug payment scheme threshold to €72, €50, and €0 respectively. [39642/26]
View answerI propose to take Questions Nos. 1376 and 1377 together.
Affordable access to medicines is a priority for the Government.
Budgets 2021-2025 allocated €158 million for new drugs, and Budget 2026 allocated an additional €30 million. Since 2021, this has facilitated the introduction of 270 new medicines, 74 of which are for rare diseases.
The Year 1 cost of a new drug comes from the allocation for new medicines, but it should be noted that once these medicines are approved for reimbursement the full cost of providing them can reach multiples of this initial cost as their uptake increases.
There are a suite of measures to support individuals and households in Ireland with meeting their medicine and medical costs. Individuals and families in Ireland may be entitled to the following schemes:
• General Medical Services (GMS) Scheme (medical card). Eligibility for a medical card is determined by the HSE, in accordance with the provisions of the Health Act 1970 (as amended). In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness.
• In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
• Under the Drugs Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland.
• Individuals may also be able to claim tax relief on their medicines expenditure at the standard rate of 20%.
Details of the costs of such schemes are available at: PCRS - Reporting Menu
Establishing costs of any eligibility changes can be challenging due to a variety of reasons and will only take place in the context of budgetary decisions.
1378. Deputy Marie Sherlock asked the Minister for Health the estimated full year cost of providing reimbursement under the general medical services scheme for sublingual immunotherapy for house dust mite allergy; the number of patients estimated to be eligible for such treatment; and the specific assumptions used in calculating this estimate. [39643/26]
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.
1379. Deputy Pádraig O'Sullivan asked the Minister for Health the number of approved but unfilled posts across the HSE, by grade and health region; the way in which these compare to assessed service demand in each area; and if she will make a statement on the matter. [39646/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1380. Deputy Pádraig O'Sullivan asked the Minister for Health the monitoring and reporting mechanisms that exist under the Framework for Safe Nurse Staffing and Skill Mix; when the most recent national compliance report under the framework was published; and if she will make a statement on the matter. [39647/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1381. Deputy Pádraig O'Sullivan asked the Minister for Health the number of staff who have left employment in the HSE in each of the past three years, by grade; the number recruited in the same period; and if she will make a statement on the matter. [39648/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1382. Deputy Pádraig O'Sullivan asked the Minister for Health the total expenditure on agency staff in the HSE in 2024 and 2025; the number of unfilled permanent posts during the same period; and if she will make a statement on the matter. [39649/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1383. Deputy Pádraig O'Sullivan asked the Minister for Health whether a fully funded multiannual workforce plan exists across all health service grades; if so, when it will be published; and if she will make a statement on the matter. [39650/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1384. Deputy Pádraig O'Sullivan asked the Minister for Health the number of posts that were approved but remain unfilled or were not retained following the introduction of the Pay and Numbers Strategy in 2024; and if she will make a statement on the matter. [39651/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1385. Deputy Pádraig O'Sullivan asked the Minister for Health the assessment that has been carried out on the impact of staffing shortages on service delivery across acute, community and home care services; and if she will make a statement on the matter. [39664/26]
View answerAs this PQ refers to operational issues, I have asked the HSE to respond directly to the Deputy.
