Written Answers Nos. 395-401
395. Deputy Eamon Scanlon asked the Minister for Health the way in which she will ensure more senior staff are rostered in emergency departments during weekends and public holidays for better decision-making; and if she will make a statement on the matter. [48083/26]
View answerThe Minister for Health is fully committed to the implementation and enforcement of the Public Only Consultant Contract so that its full benefits are realised for patients and the wider health system. There has already been strong national uptake of the contract, with 3,483 consultants signed up as of 26 June 2026, including 1,266 new entrants and 2,217 consultants who have switched from older contracts.
While the uptake of POCC has been strong, the focus is now on optimising the benefit for the contract and ensuring the level of activity in the evenings and weekends continues to improve. Strong uptake and increased staffing alone are not enough. The contract must also deliver stronger consultant presence on site, including in the evenings and at weekends, so that patients see the benefit in practice.
The POCC allows for consultants to be rostered from 8am-10pm Monday to Friday and 8am-6pm on Saturdays. Around one-third of consultants are now rostered for extended working day arrangements and 11% for Saturday working. These figures are improving, but remain too low and vary significantly by region.
The HSE Chief Clinical Officer has written to clinical directors requiring a review of current rosters to ensure extended hours and Saturday working are scheduled and staffed in line with clinical service need. This follows previous direction from the HSE CEO on implementation of the contract. The HSE has governance and programme structures in place to strengthen oversight, reporting and accountability, and that work now needs to translate into more consistent extended-day and weekend rostering across the system.
The Government’s objective is clear: the Public Only Consultant Contract must mean more timely care, more senior decision makers on site, better access to services outside traditional hours, and fuller delivery for public patients.
396. Deputy Paula Butterly asked the Minister for Health if she will bring forward regulations to require nursing homes to adopt mandatory minimum patient-to-staff ratios given the current regulatory framework does not set any specific staffing levels and instead only obliges providers to ensure that the number and skill mix of staff is appropriate having regard to the needs of the residents; and if she will make a statement on the matter. [30589/26]
View answer400. Deputy Paula Butterly asked the Minister for Health if there are any minimum staff-to-resident ratios recommended or applied in practice across nursing homes (details supplied); the extent to which such requirements are standardised across public and private facilities; if she is considering the introduction of explicit minimum staffing ratios in order to ensure consistent standards of care; and if she will make a statement on the matter. [47225/26]
View answerI propose to take Questions Nos. 396 and 400 together.
Currently providers must ensure that staffing levels, skill mix and supervision arrangements are appropriate to residents' assessed needs and set out these arrangements in the centre's Statement of Purpose. HIQA assesses compliance with these requirements through registration and inspection processes. While the obligation to provide appropriate staffing is enforceable, the current framework does not prescribe minimum staffing ratios or an objective national benchmark for assessing staffing adequacy.
The Framework for Safe Nurse Staffing and Skill Mix (The Framework) provides an evidence-based flexible approach to determine the number of nurses and healthcare assistants required to provide safe and quality care based on patient need. Framework development to date has comprised three phases.
Phase 1 focused on Adult General and Specialist Medical and Surgical Care Settings and has been national policy since 2018. Phase 2, focused on Adult Emergency Care Settings, and was adopted as national policy in 2022.
Phase 3 extended the Framework into Community settings and comprises three distinct stages: (i) Long-Term residential care settings for older persons; (ii) Community care settings; and (iii) Step-down and Rehabilitation settings.
The Framework was implemented and rigorously tested and evaluated in eight long term residential care settings nationally, including public, private and voluntary care settings. These sites were selected to reflect the sector’s diversity in terms of geography, size and governance arrangements. Following the conclusion of the pilot testing, the Research Team presented the findings to the Taskforce and submitted a Final Evaluation Report.
Based on the evidence and recommendations contained in the Final Report, policy development is at an advanced stage and is expected to be completed in 2026. This timeframe for testing and developing Phase 3(i) of the Framework is in line with the previous two phases of Framework development.
When published, the policy will provide, for the first time, an objective and evidence based approach for all nursing homes nationally to determine their nursing staffing levels and skill mix required based on resident need and the opportunity to enhance and strengthen the role that the regulator can play in objectively monitoring the implementation of the Framework on a national basis.
397. Deputy Paula Butterly asked the Minister for Health in light of a surge in the number of people seeking treatment for cocaine addiction and Ireland being the second highest country in the EU for cocaine use, if she will support a cross-departmental approach to address this issue. [45624/26]
View answerThe European Drug Report 2026: Trends and Developments (www.euda.europa.eu/publications/european-drug-report/2025_en), has reported that cocaine use remains high across Europe, with approximately 4.3 million European adults (15–64 years) reporting use in 2025.
The growth in cocaine use is part of a volatile and global drugs market, with increased sources of supply of drugs across European countries. Ireland is an integral part of this drugs market.
The National Drug Treatment Reporting System (NDTRS), shows an increased uptake of drug treatment services in 2025. The NDTRS shows a record figure of 15,422 cases presenting for treatment for problem drug use, representing an increase of 16% on 2024, and a 73% increase in the annual number of cases entering treatment since the commencement of the current national drugs strategy in 2017.
This increase in treatment numbers reflects ongoing increases in investment by the Govt.
Cocaine was the most commonly treated main problem drug in 2025, accounting for 42.4% of all cases. The number of cocaine related treatment episodes increased by 23.6% compared with 2024.
The Government has responded to the increased use of cocaine by investing in treatment services. In all, there are over 460 services providing treatment across the country. These services can be accessed through a map of all services provided by the Health Research Board.
In 2022 and 2023, the Department of Health provided €1.35m on a recurring basis to the HSE to expand drug services for people with problematic cocaine use.
In 2025, approx. €170 million was provided by the Department of Health and the HSE for drug services. This is an increased investment of €54 million since 2017 and has resulted in greater availability of drug treatment services for those who need them.
My department is also investing in preventative initiatives that seek to reduce the extent of cocaine use. In particular, the HSE is developing a digital self-help project to support people to reduce their drug and alcohol use.
I am currently finalising the national drugs strategy, which will set out an integrated, equitable and evidence-led response to drug use, including cocaine. It will also prepare and respond effectively to a volatile and dynamic global drugs market, working with EU members states, Europol and the EU Drugs Agency and the Europol.
398. Deputy Paula Butterly asked the Minister for Health if she will commit to establishing a sexual assault treatment unit (SATU) in County Louth, given the current absence of such a facility in the region and the significant travel burden placed on victims of sexual violence; and if she will make a statement on the matter. [46797/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
399. Deputy Paula Butterly asked the Minister for Health if she will consider extending the upper age of eligibility for CAMHS from 18 to 21 years to ensure continuity of care during the transition to adult mental health services (details supplied); and if she will make a statement on the matter. [47224/26]
View answerAll aspects of mental health care, including the specialist CAMHS service, are being enhanced in line with implementation of our mental health policy Sharing the Vision 2020-2030, our new suicide reduction policy Connecting for Life 2026-2035 and the annual HSE Service plans.
Government has provided record funding of nearly €1.6 billion for mental health in 2026. CAMHS receives approximately €191 million annually, an increase of almost 40% over the past four years. A further €127 million is provided to NGOs, many of which focus on young people. Under Budget 2026, €10 million was provided to improve youth mental health services, including CAMHS.
As the Deputy will be aware, HSE mental health supports range from Prevention and Early Intervention to the specialist CAMHS service, which is for those under age 18 with moderate to high mental health difficulties. Access is based on clinical assessment, in line with the CAMHS Operational Guideline (the CAMHS COG is on the HSE website). For young people attending CAMHS, if they still need psychiatric support as they turn 18, they move to the Adult Mental Health Team in their area. This transition begins about six months before their 18th birthday. During this time, CAMHS shares detailed notes and information with the adult team so that care can continue smoothly.
If a patient is doing well and no longer shows moderate to severe symptoms, they are discharged back to their General Practitioner. If they later need mental health support again, their General Practitioner can refer them to the Adult Mental Health Team.
By way of background context, a Youth Mental Health Transitions Specialist Group was established by the HSE in September 2021 at the request of Sharing the Vision National Implementation and Monitoring Committee to progress Recommendation 36 of Sharing the Vision. This recommendation states: “Appropriate supports should be provided for on an interim basis to service users transitioning from CAMHS to Adult Mental Health Services (AMHS). The age of transition should be moved from 18 to 25, and future supports should reflect this.”
The specialist group focused its work into two separate, but interrelated workstreams: Development of an enhanced Transitions Plan to support individuals moving from CAMHS to AMHS at 18 years and the development of a Reconfiguration Plan, including prioritised and phased recommended actions, in order to plan for the provision of age appropriate specialist mental health services up to age 25. Quantitative and qualitative data and narratives from young people who have accessed CAMHS and made the transition to AMHS was an invaluable source of information to assist with developing the recommendations.
Surveys and Focus groups were undertaken with young people drawn from a pool of respondents as part of the work of the Group, to enable a deeper understanding of how respondents felt and how they perceived the transition experience. Many felt they were battling to access the service in CAMHS and that they then faced a second battle when they went to AMHS. The lack of perceived linkage between the two services served to reinforce this perception. The stated difficulties were retelling their story, dealing with a new team and new location. The outputs of the Specialist Group have been considered and incorporated into the HSE Child and Youth Mental Health Action Plan 2025-2027, which is now being implemented.
It is acknowledged that those who transition from CAMHS to AMHS are a particularly vulnerable group in terms of their age and a risk of disrupted care. The transition to adulthood is an extremely challenging period of life in which young people are maturing physically, personally, mentally and socially. Irish research also suggests that despite having ongoing mental health needs, many young people are not being referred, or are refusing referral, to adult services.
The Enhanced Transition Plan highlights several key considerations for the HSE Child and Youth Mental Health Office (CYMHO) which has key responsibility for implementation of relevant recommendations. The Enhanced Transition Plan sets out three overarching principles and three recommendations to improve transition from CAMHS to AMHS, with detailed implementation goals and actions underpinning these, with progression over this year and 2027. The Enhanced Transition Plan and the CYMHO Action Plan 2025-2027 are available online.
In light of the above, and the many other initiatives being progressed to improve more integrated mental health care overall including transition from CAMHS to AMHS, there are no plans to undertake the specific approach suggested by the Deputy. Examples of other key initiatives to improve access to CAMHS and to reduce waiting lists include a new Single Point of Access for youth mental health care and greater use of electronic health records.
I will continue to work closely with the HSE to ensure that all aspects of youth mental health care are improved over this year and beyond.
401. Deputy John Paul O'Shea asked the Minister for Health if she will provide an update on actions taken to accelerate the development of endometriosis services in Cork; and if she will make a statement on the matter. [47580/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
