Written Answers Nos. 495-515
495. Deputy Marie Sherlock asked the Minister for Health if her Department has researched AI therapy chatbots or mental health tools; and if her Department is exploring options for the regulation of AI tools purporting to provide therapeutic services. [68023/26]
View answerSharing the Vision's Digital Mental Health Strategy 2026-2030 aims to provide a clear vision, focus efforts, and guide implementation in digital mental health to 2030. The strategy acknowledges the use of AI chatbots, however they are not designed or developed to be used specifically as mental health interventions.
The forthcoming WHO Digital Mental Health Roadmap, being developed in collaboration with Ireland's Health Service Executive (HSE) and Department of Health, is expected to provide practical guidance, evidence-informed recommendations and international examples to support countries in developing safe, effective, equitable and inclusive digital mental health services across the life course.
The Department of Public Expenditure, Infrastructure, Public Service Reform and Digitalisation (D/PEIPSRD) has provided Guidelines for the Responsible Use of AI in the Public Service www.gov.ie/en/department-of-public-expenditure-infrastructure-public-service-reform-and-digitalisation/publications/guidelines-for-the-responsible-use-of-ai-in-the-public-service/ to assist public servants and government Departments in making informed decisions about using AI and identifying and addressing potential risks in an AI system’s lifecycle. In addition, in July 2026, HIQA published its National Guidance for the Responsible and Safe Use of Artificial Intelligence in Health and Social Care Services. www.hiqa.ie/reports-and-publications/guide/national-guidance-responsible-and-safe-use-artificial-intelligence
The new HIQA guidance is intended for all health and social care services including mental health services and is structured around four core principles: accountability, a human-rights based approach, safety and wellbeing, and responsiveness. It emphasises that robust governance arrangements, clear lines of accountability, transparency regarding the use of AI, protection of privacy and confidentiality, and ongoing monitoring of AI systems are essential safeguards. Importantly, the guidance makes clear that AI tools should support, but not replace, professional judgement and decision-making.
AI can be ethically used to improve mental health services in Ireland, to enhance digital tools and assist organisations with being more operationally efficient. The use of any AI in mental health services must be developed in line with D/PEIPSRD and HIQA guidance.
HSE-funded services, including community and voluntary based mental health organisations, should be applying these principles in line with the relevant guidance if incorporating any AI element into their operations or services.
People who are struggling with their mental health and seeking help online should always be signposted to trusted and verified supports, including online tailored supports such as My Mental Health Plan, Spunout's Navigator, Turn2me, MyMind and instant services such as Text About It.
To the extent that this relates to an operational matter, I have asked the Health Service Executive to respond directly to you as soon as possible.
496. Deputy Cian O'Callaghan asked the Minister for Health to provide the number of completed Cross-Border Directive reimbursement applications currently awaiting payment; the date of receipt of the oldest outstanding completed application; the current average and median processing time; and the number of applications outstanding for more than 30, 60, 90, 120 and 180 working days respectively. [67794/26]
View answer498. Deputy Sinéad Gibney asked the Minister for Health the case-specific information available to an applicant seeking an update on an outstanding Cross-Border Directive reimbursement application; whether applicants can be informed of the stage their application has reached; whether it has been assessed as complete; whether further information or review is required; the indicative timeframe for reimbursement; and whether consideration will be given to providing meaningful individual updates rather than general information regarding current backlogs. [67996/26]
View answer502. Deputy Sinéad Gibney asked the Minister for Health to confirm whether Cross-Border Directive reimbursement applications continue to be processed in the order in which they are received; whether there are circumstances in which a completed application received at a later date may be processed and reimbursed before an earlier completed application; and, if so, to outline those circumstances and the reason completed applications submitted in 2025 may remain outstanding while some applications submitted in January and February 2026 have subsequently been reimbursed. [67994/26]
View answer503. Deputy Cian O'Callaghan asked the Minister for Health to confirm whether Cross-Border Directive reimbursement applications continue to be processed in the order in which they are received; whether there are circumstances in which a completed application received at a later date may be processed and reimbursed before an earlier completed application; if so, to outline those circumstances and explain how completed applications submitted in 2025 may remain outstanding while some applications submitted in January and February 2026 have subsequently been reimbursed. [67788/26]
View answer504. Deputy Cian O'Callaghan asked the Minister for Health the case-specific information that is available to an applicant seeking an update on an outstanding Cross-Border Directive reimbursement application; whether applicants can be informed of the stage their application has reached, whether it has been assessed as complete; whether further information or review is required, and an indicative timeframe for reimbursement; and whether consideration will be given to providing meaningful individual updates rather than general information regarding current backlogs. [67787/26]
View answer505. Deputy Sinéad Gibney asked the Minister for Health to provide the number of completed Cross-Border Directive reimbursement applications currently awaiting payment; the date of receipt of the oldest outstanding completed application; the current average and median processing time; and the number of applications outstanding for more than 30, 60, 90, 120 and 180 working days respectively, in tabular form. [67992/26]
View answer507. Deputy Cian O'Callaghan asked the Minister for Health the assessment that has been made of the financial and healthcare impact of prolonged Cross-Border Directive reimbursement delays, including on patients servicing loans used to fund treatment and patients whose subsequent treatment has been postponed or cancelled while awaiting reimbursement; the additional staffing or resources that have been allocated to address the current backlog; the measures being taken to reduce processing times; and whether a target date has been established for returning processing times to the HSE's stated aim of reimbursement within 30 working days. [67786/26]
View answerI propose to take Questions Nos. 496, 498, 502, 503, 504, 505 and 507 together.
The Cross Border Directive allows public patients to access necessary healthcare, which they would have been entitled to access in the public healthcare service in Ireland, in another EU or EEA country. The patient pays upfront for the treatment and is reimbursed upon return to Ireland.
The HSE is responsible for the operation of the cross-border directive and has a dedicated office for that purpose.
The continued growth in use of the scheme has placed additional demands on the HSE CBD office and given rise to a build-up of applications. The increased activity is evidenced by the number of treatments reimbursed increasing by approx. 75% between 2020 and 2024.
It is important that this service operates in a responsive way and that reimbursement applications are processed within a reasonable timeframe. The HSE advises it usually aims to repay patients within 30 working days of receipt of all completed documents. The HSE advise the CBD office is currently (as of 2 September 2026) processing applications received at the end of February 2026. A 6-month delay for reimbursement is clearly unacceptable. To address this the HSE has advised my Department that additional resources are being assigned to manage this increase in demand with the aim of restoring processing times to expected levels. I have set the HSE a specific target of getting back to the 30-day target by the end of 2026.
Reimbursement is at the cost of that treatment in Ireland or the cost of it abroad. Whichever is the lesser. Reimbursement is confined to the costs of the care itself. It does not include any additional costs incurred by the patient.
In relation to the specific question regarding financial implications of the delays in reimbursement under the Cross-Border Directive is governed by European and national legislation. Reimbursement is generally limited to the eligible healthcare costs that would have been met by the public health service in Ireland. There is no provision within the scheme for the reimbursement of interest charges, borrowing costs or other consequential financial costs arising from the manner in which treatment is financed.
Furthermore, there should be no need for such a provision because reimbursement should be predictable and timely. Our priority is to ensure that the HSE’s processing of applications improves and meets with normal operations by the end of 2026. I can assure the Deputy that my department will continue to engage with the HSE to ensure that the measures identified by the HSE are being implemented to facilitate the efficient ongoing operation of the scheme.
As this is a service matter, I have also asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
497. Deputy Cian O'Callaghan asked the Minister for Health to examine the case of an advance nurse practitioner (details supplied) who is still being paid at the candidate ANP rate despite being formally registered as of June 2026. [67793/26]
View answerThe question has been referred to the HSE for direct reply to the Deputy.
499. Deputy Cian O'Callaghan asked the Minister for Health the reason a two-year waiting list for an speech and language therapist for children has been allowed to develop; the number of children that are currently waiting for a Speech and Language assessment in HSE Dublin and North East, HSE Dublin and Midlands and HSE Dublin and South-East Regions; the steps her Department are taking to address this backlog; and the number of speech and language therapists currently employed by the HSE in the Clontarf, Kilbarrack, Coolock and Coastal Children's Disability Network Teams. [67792/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
500. Deputy Cian O'Callaghan asked the Minister for Health to examine the case of a person (details supplied). [67791/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
501. Deputy Cian O'Callaghan asked the Minister for Health to examine the case of a person (details supplied) whose scheduled spinal surgery has been cancelled ten times. [67789/26]
View answerI fully acknowledge the distress and inconvenience for patients and their families when hospital appointments are cancelled, particularly in the case of clinically urgent procedures.
While every effort is made to avoid cancellation or postponement of planned procedures, the Health Service Executive (HSE) has advised that planned procedures and operations can be postponed or cancelled for a variety of reasons including capacity issues due to increased unscheduled care demand.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically aligned and prioritised way, hospitals follow HSE clinical guidelines and protocols.
Cancelled hospital procedures/appointments are, where appropriate, rescheduled as early as possible with priority given to patients requiring time-sensitive and urgent treatment. Patients that are cancelled are rescheduled with the next available appointment based on their clinical prioritisation, with urgent patients prioritised for access.
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. The Minister for Health is prohibited from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly, as soon as possible.
506. Deputy Martin Kenny asked the Minister for Health if the position of adult speech and language therapists has been filled for HSE North and North West and specifically for Leitrim and Sligo. [67990/26]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
508. Deputy Cian O'Callaghan asked the Minister for Health if she will increase the qualifying income thresholds for a medical card for those over the aged of 70. [67784/26]
View answerMedical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card. It is specific to the individual’s own financial circumstances.
Persons aged 70 or older are assessed under medical card income thresholds which are based on gross income. However, it should be noted that those aged over 70 can also be assessed under the general means tested scheme where there are particularly high medical costs. Details are available at: Medical card for over 70s : www2.hse.ie/services/schemes-allowances/medical-cards/other-types-of-medical-card/over-70s/
Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. In such circumstances, the HSE may exercise discretion and grant a medical card, for example:
• Discretionary medical cards issued to patients with significant medical expenses but who do not satisfy the means test.
• Emergency medical cards are issued to patients that are terminally ill, or are seriously ill, and in urgent need of medical care that they cannot afford.
In addition, where a person's sole household income is derived from a social protection payment, he/she will be awarded a medical card.
I can assure the Deputy that, in order to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues under review and any proposals are considered in the context of any potential broader implications for Government policy, the annual budgetary estimates process and legislative requirements arising.
509. Deputy Pádraig Rice asked the Minister for Health to clarify if staff recruited by acute hospitals to achieve baseline implementation of Phase 1 of the Framework for Safe Nurse Staffing and Skill Mix are counted separately from, or included within, each site's employment ceiling. [67781/26]
View answerThe Framework for Safe Nurse Staffing and Skill Mix (the Framework) is an evidence-based, flexible approach to determine the number of nurses and healthcare assistants to provide safe and quality care based on patient need.
Since 2020, Government has invested €56.2 million in the implementation of Phases 1 and 2 of the Framework, supporting the recruitment of an additional circa 2,000 Whole Time equivalents (WTE) registered nurses and healthcare assistants in adult in-patient wards and emergency departments nationally.
The HSE has been made significant progress in recruiting the additional staff required under the Framework and in advancing the delivery of the initial baseline implementation policy target. As of August 2026, implementation of the Framework is well advanced, with 93% of approved WTE posts filled nationally.
As detailed in the HSE’s 2026 National Service Plan, with effect from 2026, pay and staffing resources were allocated at Regional Health Area (RHA) level. Under this approach it was expected that additional resources would be allocated to the various facilities within the RHA in line with their capacity to meet identified priorities. Consequently, there are no specific employment ceilings for individual facilities, and the Framework for Safe Nurse Staffing and Skill Mix staffing requirements are not counted separately from other staff.
It should be noted that the Minister for Health in the 2026 Letter of Determination (LoD) issued to the HSE Board Chair, clearly set out that total pay budget, including basic pay, agency, overtime and allowances, remained the key tool for controlling staff growth. In these circumstances, staff ceilings should be viewed as an indicative metric and not a recruitment target.
510. Deputy Pádraig Rice asked the Minister for Health the number of funded radiographer posts from 2024, 2025 and to date in 2026 which remain vacant in Cork University Hospital; the number for which approval has been sought; the number for which approval has been granted; and of those that have been approved, the number in post. [67766/26]
View answerAs the issue raised is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
511. Deputy Matt Carthy asked the Minister for Health further to Parliamentary Question No. 1661 of 18 March 2026, to confirm that a drug (details supplied) is to be discontinued from January 2027; and the plans that are in place to replace this product which is essential for many people who are undergoing weight loss treatment. [67833/26]
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; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
512. Deputy John Connolly asked the Minister for Health for any plans the HSE have to increase the parking capacity at Merlin Park Hospital Galway. [67840/26]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
513. Deputy Marie Sherlock asked the Minister for Health to list for every section 39 organisation the share of expenditure spent on agency staff. [68025/26]
View answerAs the Deputy's question relates to an administrative issue it has been referred to the HSE for direct response.
514. D'fhiafraigh Deputy Mairéad Farrell den Aire Sláinte [68020/26]
View answerToisc gur ábhar seirbhíse é seo. D’fhiafraigh mé d’Fheidhmeannacht na Seirbhíse Sláinte freagra a thabhairt don Leas-Cheann Comhairle díreach, chomh luath agus is féidir leo.
515. Deputy Emer Currie asked the Minister for Further and Higher Education, Research, Innovation and Science for an update on the case of a student (details supplied) who has completed the academic component of a PLC course and has now received provisional results, but whose official results may not be uploaded in time to allow their qualification to be considered for the final CAO offer round on 29 September 2026; whether his Department has engaged with the relevant bodies to identify a means of ensuring the student is not disadvantaged solely as a result of the timing of the results process; and if he will make a statement on the matter. [67817/26]
View answerAs the Deputy will appreciate, assessment procedures for further Education and Training (FET) programmes and the processing of applications through the Central Applications Office (CAO) are matters for the relevant autonomous bodies and my Department does not have a direct role in these matters.
Correspondence relating to the specific case raised by the Deputy has been received by my Department. Given the individual circumstances involved, the person concerned has been provided with a direct response addressing the matters raised. A response has also issued to the Deputy's office.
Should the Deputy require any further information, my Department will be happy to provide assistance.
