Written Answers Nos. 622-645
622. Deputy Brian Stanley asked the Minister for Health to outline and clarify charges regarding GMS patients for routine blood tests; and the steps her Department are taking to make sure people are not being improperly charged for routine tests. [66895/26]
View answerGPs are private practitioners, most of whom hold a GMS contract with the HSE for the provision of GP services without charge to medical card and GP visit card holders.
Under the terms of the GMS contract, GPs are required to provide eligible patients with ''all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess". Persons who hold a medical card or a GP visit card are not subject to any co-payments or other charges in respect of such services.
The issue of GPs charging GMS patients for phlebotomy services is complex given the numerous reasons and circumstances under which blood tests are taken. Clinical determinations as to whether a blood test should be taken to either assist in the diagnosis of illness or the treatment of a condition are made by the GP concerned. There is no provision under the GMS GP contract for persons who hold a medical card or a GP visit card to be charged for clinically necessary blood tests.
Blood tests undertaken in the context of the GP Chronic Disease Management programme are covered by the fees paid to GPs by the HSE for this care.
Where a patient who holds a medical card or GP visit card believes they have been incorrectly charged for routine phlebotomy services (i.e. a blood test to either assist in the diagnosis of illness or the treatment of a condition) by their GP, or has been charged for a blood test provided under the Chronic Disease Management programme, then that patient should report the matter to their HSE Local Health Office. The local management, upon being notified of potential inappropriate charging of a GMS patient, shall contact the GP concerned and carry out an investigation into the complaint and will, where appropriate, arrange for a refund of charges incorrectly applied by that GP.
Fees charged by GPs outside the terms of the GMS contracts (and other HSE GP held contracts) are a matter of private contract between clinician and patient.
623. Deputy Pádraig O'Sullivan asked the Minister for Health if consideration is being given to providing dedicated funding for mental health and wellbeing supports for people living with diabetes, and their parents or carers where appropriate, including through programmes delivered by Diabetes Ireland. [66886/26]
View answer627. Deputy Barry Heneghan asked the Minister for Health her plans to begin the implementation of the National Diabetes Strategy by providing funding to create a regional diabetes clinical lead post in each HSE Health Region including in North Dublin in the upcoming budget. [66992/26]
View answer661. Deputy Peter 'Chap' Cleere asked the Minister for Health her plans to begin the implementation of the National Diabetes Strategy by providing funding to create a Regional Diabetes Clinical Lead post in each HSE Health Region in the upcoming budget; and if she will make a statement on the matter. [67181/26]
View answer673. Deputy Colm Burke asked the Minister for Health for an update on the development and implementation of the National Diabetes Strategy; and the funding has been provided to commence implementation of priority actions under the strategy. [67243/26]
View answerI propose to take Questions Nos. 623, 627, 661 and 673 together.
The assets.gov.ie/static/documents/a41e7d5d/Diabetes_Policy_and_Services_Review_-_A_Strategy_for_Better_Care.pdf.was launched on the 21st of May.
This is Ireland’s first national strategy for diabetes, marking a major milestone in diabetes care in Ireland. It provides a detailed assessment of our current diabetes services and sets out series of recommendations and actions to improve diabetes care delivery. The recommendations cover four key themes:
• Service Development
• Affordability and Access to care
• Better support for people living with diabetes
• Digital Healthcare
The recommendations are marked in the strategy as either short, medium or long-term goals. Short-term refers to recommendations which can be implemented within three years. Medium term recommendations can be implemented within five years, and long-term recommendations are those that will take longer than five years to fully implement.
The HSE is currently working to develop an implementation plan to ensure that the recommendations are followed through at national level and throughout the Health Regions.
Discussions relating to the 2027 Estimates process are underway and will not be concluded until closer to the date of the Budget. The HSE National Service Plan will be published after the budgetary process concludes.
Under the new HSE regional structure, the Department allocates the overall HSE budget and staffing ceiling. The detailed operational decisions on how those resources are deployed within and across Health Regions are a matter for the HSE.
While annual policy priorities and performance expectations are set out in the National Service Plan, the HSE, and specifically the REOs, are accountable for delivering these priorities in their Regions within their budget allocations. The Department does not specify funding or staffing line by line for individual services. Instead, the Department sets the overall budget and required outputs, and the HSE is responsible for prioritising its resources to meet the agreed targets.
624. Deputy Marie Sherlock asked the Minister for Health the number of invoices for €100 issued in respect of ED attendances without a GP referral letter; and the number paid for each of the years between 2019 and to date in 2026. [66879/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
625. Deputy Catherine Callaghan asked the Minister for Health if she will provide an update on the progress of the Full Health Technology Assessment (HTA) for a drug (details supplied) for the treatment of eosinophilic oesophagitis, which was commissioned by the HSE on 25 June 2024, when the assessment is expected to be completed and whether consideration is being given to making this drug available under the Medical Card Scheme, Drugs Payment Scheme or other community drug reimbursement arrangements, given its importance for patients living with this chronic condition. [67023/26]
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.
626. Deputy Barry Heneghan asked the Minister for Health if she will remove the specific criteria of “insulin initiation from the start” that is preventing approximately 500-700 people with a clinical diagnosis of type one diabetes from accessing continuous glucose monitoring, which clinical evidence and recommendations overwhelmingly supports as first-choice glucose monitoring treatment for all people with type one diabetes. [66993/26]
View answer660. Deputy Peter 'Chap' Cleere asked the Minister for Health if she will remove the specific criteria of 'insulin initiation from the start' that is preventing approximately 500-700 people with a clinical diagnosis of type one diabetes from accessing continuous glucose monitoring , which clinical evidence and recommendations overwhelmingly supports as first-choice glucose monitoring treatment for all people with type one diabetes; and if she will make a statement on the matter. [67184/26]
View answer674. Deputy Colm Burke asked the Minister for Health whether additional funding is being considered to expand access to continuous glucose monitoring technology for people with diabetes who are currently outside the HSE reimbursement criteria. [67242/26]
View answer676. Deputy Colm Burke asked the Minister for Health whether consideration will be given to providing access to continuous glucose monitoring systems for all people with Type 1 diabetes on the basis of current clinical need and specialist recommendation, rather than the circumstances or timing of their original diagnosis. [67239/26]
View answer677. Deputy Colm Burke asked the Minister for Health whether she will review the current eligibility criteria for reimbursement of continuous glucose monitoring systems for people with clinically diagnosed Type 1 diabetes, particularly the requirement that a person must have required insulin from the outset; whether consideration will be given to ensuring that people whose diagnosis was delayed, atypical or initially incorrect are not excluded from access to CGM technology. [67237/26]
View answerI propose to take Questions Nos. 626, 660, 674, 676 and 677 together.
Continuous glucose monitoring (CGM) systems provide an alternative approach to self-monitoring of blood glucose (using blood glucose test strips with an associated blood glucose meter). These CGM systems comprise of sensors, transmitters and a mechanism to display the results (readers/receivers or smart device application).
Under 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. The HSE has advised that the HIQA Rapid HTA of Continuous Glucose Monitoring in Adults with Type 1 Diabetes Mellitus was published on 29th September 2023.
The HTA recommended the establishment of a single managed access programme for all CGM systems for all individuals with type 1 diabetes mellitus regardless of age, noting that such a system would need clearly defined criteria for access. Following on from the recommendations in this HTA, the HSE-MMP, in conjunction with the HSE-PCRS, and with the support of the HSE Chief Clinical Officer, introduced an online reimbursement application system for all CGM sensors on 1st December 2023.
Reimbursement support for CGM sensors at this point in time is based on the HIQA HTA and is for patients with type 1 diabetes mellitus regardless of age, who have required insulin from the outset.
To date, a HTA of CGM sensors for people with type 2 diabetes mellitus or other types of diabetes has not been undertaken in Ireland. Therefore, there is limited information to support the extension of reimbursement to these patient groups, including cost-effectiveness assessment and budget impact of same.
The HSE has identified preferred CGM products based on cost-effectiveness to manage this expenditure.
The Diabetes Policy and Services Review: A Strategy for Better Care was launched on the 21st of May. It provides a detailed assessment of our current diabetes services and sets out series of recommendations and actions to improve diabetes care delivery. This includes access to diabetes technology based on clinical need, such as continuous glucose monitoring.
The HSE is currently working to develop an implementation plan for the strategy, in cooperation with my Department, to ensure that the recommendations are followed through at national level and throughout the Health Regions.
628. Deputy Ryan O'Meara asked the Minister for Health if Our Lady of Lourdes Hospital, Drogheda, held interviews with new graduate nurses for nursing posts this year; if a panel was formed; if so, when was it formed, the number on the panel; and when will offers be made to panelists. [66989/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
629. Deputy Seán Kyne asked the Minister for Health the number of total knee replacement surgeries carried out at Galway University Hospital in 2025 and to date in 2026 in tabular form; and if she will make a statement on the matter. [66988/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
632. Deputy Holly Cairns asked the Minister for Health to provide a breakdown of the staffing capacity of each adult ADHD service; by LHO, in tabular form. [66976/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
634. Deputy Holly Cairns asked the Minister for Health to provide a breakdown of staffing capacity across all Adult ADHD services in Cork and Kerry; to provide detail on any unfilled roles within the service; and to provide an update on the recruitment of each unfilled role, by LHO, in tabular form. [66973/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
635. Deputy Noel McCarthy asked the Minister for Health the floor area of a now disused building (details supplied); and the intended use of the building since its residents were relocated. [67034/26]
View answerAs the Health Service Executive is responsible for the management of the public healthcare property estate, I have asked the HSE to respond directly to you in relation to this matter.
636. Deputy Eamon Scanlon asked the Minister for Health the status of plans to develop a day-care oncology unit in the space designated beneath the new 42-bed ward currently under construction at Sligo University Hospital; and the funding that has been allocated or is proposed for the fit-out of this facility. [67026/26]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
637. Deputy Robert Troy asked the Minister for Health if an appointment can be expedited for a patient (details supplied) given the very serious and urgent medical circumstances. [67057/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
638. Deputy Michael Collins asked the Minister for Health the steps taken to implement the findings of the Health Research Board annual bulletin on people engaging with disability services, produced using the National Ability Supports System data, in relation to the provision of accommodation for adults with intellectual disabilities; the number and percentage of the total adult population with an intellectual disability in the State represented in the annual bulletin in each year; the number of service providers, by Section 38, Section 39 and HSE-operated statutory services (details supplied) in each of the years from 2022 to 2025 to date in 2026. [67045/26]
View answerThis PQ is not for the Department of Health. We respectfully request that this Parliamentary Question be redirected to the Department of Children, Disability and Equality as the matters raised fall under their remit.
639. Deputy Jen Cummins asked the Minister for Health Who will be getting the shingles vaccine for free. [67101/26]
View answerThe immunisation programme in Ireland is 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 National Immunisation Programme does not currently provide the shingles vaccine.
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 in line with NIAC advice and cognisant of the cost effectiveness of market pricing and available funding.
640. Deputy Conor Sheehan asked the Minister for Health If her Department has reviewed the findings of the 2015 independent report into Midwest public orthodontic services; if she will verify allegations that children suffered clinical damage due to systemic oversight failures highlighted in that unpublished report; and the clinical audit structures currently in place to protect children undergoing public orthodontic treatment. [67099/26]
View answer641. Deputy Conor Sheehan asked the Minister for Health if she will report on the status of the independent review completed in February 2015 by two UK-based professors into public orthodontic services in the Midwest region; the reasons this report has not been published by the HSE to date despite previous commitments to do so; and if she will state when the report will be published. [67098/26]
View answerI propose to take Questions Nos. 640 and 641 together.
I assume the report the Deputy is referring to is the Orthodontic Lookback Review commissioned by the HSE in 2015 following receipt of a ‘statement of concern’ in relation to an orthodontic service serving the Greater Dublin Area between 1999 and 2002. This review was, in effect, a scoping report commissioned to advise the HSE on what actions should be taken to determine if there was a risk of harm to patients in this case.
In response to the 2015 HSE Report, the HSE commenced an audit process in 2016 to review the records of patients treated with braces in the service between 1999 and 2002. The audit phase reviewed records of over 7,500 patients of which 16 patients met the threshold for recall by the HSE.
The HSE were successful in contacting the majority of these patients and Open Disclosure meetings took place over the period from January 2020 to August 2021. The patients were offered a dental assessment as per the terms of reference and as appropriate, treatment plans were initiated in accordance with clinical need and the informed wishes of the patients. The HSE published the Report of Look-back Review into Orthodontic Services (Dublin Mid-Leinster, 1999-2002) in August 2022.
Waiting lists vary regionally and according to the complexity of the condition. There are generally longer waiting lists for the least complex care. The HSE has put in place a number of measures to address waiting times in orthodontic services. These include treatment waiting list initiatives, services improvement initiatives and access to orthodontic services outside the jurisdiction.
The Government has invested significantly in orthodontic waiting list initiatives, including €20m between 2022 and 2025. To date 2026, through these initiatives, 5,683 Grade 4 patients have been provided with care via private capacity. For orthodontic patients who require jaw surgery, this investment has enabled a surgical initiative, benefitting 237 patients to date.
Any decision regarding publication of the HSE 2015 lookback report is a matter for the HSE.
642. Deputy Paul Donnelly asked the Minister for Health the number of orthopaedic outpatient clinics that are held at Beaumont hospital each week; the hours each clinic is available; the names of consultants and or registrars that are present at each of those clinics, in tabular form. [67074/26]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
643. Deputy Ryan O'Meara asked the Minister for Health the engagement she has had with the HSE and relevant bodies regarding concerns raised in relation to the lack of permanent posts being offered to new nursing and midwife graduates in a number of HSE regions; and the efforts been made on the matter. [67105/26]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
644. Deputy Maurice Quinlivan asked the Minister for Health her views on the issues of staffing and capacity at the University Maternity Hospital Limerick (UNMHL) where patients have faced consecutive days of necessary and scheduled C-Sections being cancelled. [67104/26]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
645. Deputy Gary Gannon asked the Minister for Health the eligibility criteria for HSE-funded nurse-prescriber training in mental-health services; whether nurses employed by Section 39 organisations providing HSE-funded inclusion-health services are eligible to access such training; if not, whether eligibility will be extended to these organisations; and the estimated cost of doing so. [67067/26]
View answerAs this is an operational matter, this PQ is referred to the HSE for direct response to the deputy.
