Written Answers Nos. 504-522
504. Deputy Colm Brophy asked the Minister for Health to provide an update on the National Stroke Strategy; the level of funding that has been provided to the strategy; and if he will make a statement on the matter. [45895/24]
Amharc ar fhreagraThe HSE National Stroke Strategy 2022-2027 aims to modernise and reform stroke services in line with Sláintecare policy and address the challenges facing Ireland from population ageing and the predicted increase in the total number of strokes right across Europe, including Ireland. The strategy provides a blueprint for required investment in stroke services over the five-year period from 2022-2027 and is based on a required overall investment of approximately €36m.
The government is fully committed to supporting improvements and advances in stroke services. Prior to Budget 2025, a total of €7.3m has been allocated to fund the HSE National Stroke Strategy which was allocated for the extension of the GP contract to cover opportunistic screening of High blood pressure in over 18- year-olds with a medical or GP visit card.
Separately, approval in 2023 enabled 11.5 WTEs to be progress through recruitment to support the implementation of the strategy.
In Budget 2025 I secured €5.0m for the HSE National Stroke Strategy bringing the total funding allocated to date to €12.3m. This new funding will support the expansion of early supported discharge teams and access to acute stroke units to support stroke services through the provision of additional consultants, psychologists and a range of health and social care professionals.
I remain fully committed to supporting this key clinical strategy. My officials are working closely with the HSE to ensure its successful implementation to prevent new cases of stroke and improve outcomes for those who experience a stroke.
505. Deputy Colm Brophy asked the Minister for Health to provide an update on the National Sexual Health Strategy; the level of funding that has been provided to the strategy; and if he will make a statement on the matter. [45896/24]
Amharc ar fhreagraSexual health is a priority for the Department of Health; the National Sexual Health Strategy 2015-2020 (NSHS) was developed as a core policy under the Healthy Ireland Framework and is a priority under the Healthy Ireland Strategic Action Plan, 2021-2025. Implementation of the Strategy is led by the HSE Sexual Health Programme (formerly the Sexual Health and Crisis Pregnancy Programme (SHCPP)). The first Strategy was extended until the end of 2022 as a result of the Covid-19 pandemic.
An independent Review of the Strategy, by Crowe Ireland, was published in March 2023. The Review identified 56 Priority Actions, of which 49 were assessed as having been successfully progressed. It also sets out 32 indicative recommendations to build on achievements, and to optimise development of a new Strategy.
The following priorities have been identified for the new National Sexual Health Strategy:
• Supporting sexual health across the lifecourse
• Implementing a Model of Care for sexual health services, with a key focus on prevention; diagnosis, treatment, information and surveillance for STIs, including HIV;
• Building capacity and meeting demand for HIV prevention and treatment, including PrEP and PEP;
• Expanding capacity and further developing the home STI testing service and STI testing and treatment more widely, bearing in mind the increase in STI transmission rates, internationally;
• Improving Sexual health information, education and supports, including awareness of consent;
• Further developing and expanding the Free Contraception Scheme for women and the National Condom Distribution Service, to support better access to contraception and STI prevention, also recognising the key role of hormonal contraception in treating adverse period symptoms;
• Supporting sexual health related research;
• Working in partnership across Government, supporting other relevant policy areas, including women’s, men’s and LGBTI+ health, DSGBV prevention, recognising the needs of marginalised groups, using a socially inclusive approach and focusing on the sexual health-related elements of these areas of work;
• Supporting our international commitments concerning sexual health.
The budget for the Strategy will be determined each year for the following year, via the annual Estimates process leading to the annual Budget. For 2025, in order to expand sexual health services and provide additional supports to our rapidly growing population, we have been allocated additional funding of €600,000, through Budget 2025, to further support delivery of the PrEP scheme, bringing the total allocation for PrEP to €5.9m. This additional funding is comprised of €0.2m for additional PrEP drug costs, and €0.4m for additional staffing in the public STI clinics from July 2025, increasing capacity for in-person appointments.
Furthermore, an additional €0.6m has been allocated to support the free home STI testing scheme; given increasing demand for the service. This brings funding for home STI testing to €4.82m in 2025.
Approximately €0.2m has been allocated to support the free contraception scheme, enabling expert advice to be applied to the inclusion of free contraception in the forthcoming expansion of pharmacy services, and supporting forthcoming public information campaigns in 2025 regarding those changes. In summary, an additional €1.4m has been allocated to support sexual health in 2025.
Following the advice of experts on the NSHS Drafting Committee, the new Strategy has now undergone an additional round of stakeholder consultation and feedback, which is now complete. The Strategy is in the final stages of development; it is envisaged that it will be launched in early 2025.
506. Deputy Colm Brophy asked the Minister for Health the estimated cost of abolishing prescription charges; and if he will make a statement on the matter. [45897/24]
Amharc ar fhreagraPrescription charges were introduced in the Health (Amendment) (No. 2) Act 2010. On 1 November 2020, prescription charges were reduced as follows:
• For those aged over 70, €1 per item with a maximum charge of €10 per month.
• For those aged under 70, €1.50 per item with a maximum charge of €15 per month.
The estimated full year cost of abolishing all prescription charges is €94.5m.
This costing does not take account of changes in demographics or in eligibility numbers (i.e., changes in the number of medical card holders). It also does not take account of how a reduction in prescription charges may impact on claimant behaviour.
507. Deputy Colm Brophy asked the Minister for Health to provide an update on progress to finalise an updated national carers’ strategy; and if he will make a statement on the matter. [45898/24]
Amharc ar fhreagraFamily carers are key enablers of Government policy to support people to live with dignity and independence in homes and communities of their choosing for as long as possible by providing vital care to some of our most vulnerable citizens. The essential role that family carers play in the provision of care in Ireland is fully recognised and appreciated by me and my Department. Every day, family carers through their selfless hard work, knowledge and compassion enhance the quality of life of the most vulnerable in our society.
Government policy on family carers is set out in the 2012 National Carers' Strategy, which provides the strategic direction for future policies, services and supports provided by Government departments and agencies for carers. The Strategy is designed around a core vision which recognises and respects carers as key care partners who are supported to maintain their own health and well-being, care with confidence and participate as fully as possible in economic and social life. Oversight of the Strategy is led by my department, with individual Government departments leading on action areas under their remit.
Before commencing work on updating the National Carers' Strategy, consideration is being given regarding the approach and the breadth of stakeholder consultation. A review of the Strategy, carried out by Care Alliance Ireland and University College Cork in 2021, found that over 90% of carers felt the actions in the Strategy were still relevant and wanted them retained.
In March, I established with Minister Humphreys an interdepartmental working group examining supports for family carers. Membership of the group includes my department, the Department of Social Protection and the Department of Children, Equality, Disability, Integration and Youth.
The interdepartmental working group will report its findings to me and the Ministers for Social Protection and Children, Equality, Disability, Integration and Youth once finalised.
508. Deputy Colm Brophy asked the Minister for Health for an update on the Programme for Government commitment to develop and deliver a ‘carer’s guarantee’ that provides a core basket of services to carers, given that an organisation (details supplied) states that the current funding falls short by €3.1 million to deliver the original proposals in full; and if he will make a statement on the matter. [45899/24]
Amharc ar fhreagraFamily carers are key enablers of Government policy to support people to live with dignity and independence in homes and communities of their choosing for as long as possible by providing vital care to some of our most vulnerable citizens. The essential role that family carers play in the provision of care in Ireland is fully recognised and appreciated by me and my Department. Every day, family carers through their selfless hard work, knowledge and compassion enhance the quality of life of the most vulnerable in our society.
Annually recurring funding of €2 million has been provided since Budget 2021 under the National Carers’ Strategy to improve equity of access to supports for carers across the country. In Budget 2025, additional recurring funding of €600,000 has been allocated to further support family carers under the Carers’ Guarantee. This brings to €2.6m the total amount of annually recurring funding provided to deliver the Carers' Guarantee.
This funding is an important step towards delivering on the Programme for Government commitment to develop a Carers’ Guarantee, providing a more standard package of supports to family carers in every region, in tandem with the community and voluntary sector. From 2025, €2.44 million of this funding will be provided to Family Carers Ireland, an increase of over 25% on previous funding levels, to deliver a mix of community and individual supports across five areas of activity:
• community carer supports;
• intensive and emergency supports;
• education and training;
• Family Carers Ireland’s freephone careline; and
• psychosocial supports.
The remaining funding will be allocated to Care Alliance Ireland to deliver a professionally moderated online support group for family carers. The service promotes supports to assist family carers in carrying out their caring roles, thus allowing care recipients to be maintained in their own homes and communities.
509. Deputy Colm Brophy asked the Minister for Health the funding allocated to each local drug and alcohol taskforce for each of the years 2011 to 2025; and if he will make a statement on the matter. [45900/24]
Amharc ar fhreagra510. Deputy Colm Brophy asked the Minister for Health to provide a breakdown of the total staff recruited under the enhanced community care; the number to be provided; the expected delivery date; and if he will make a statement on the matter. [45903/24]
Amharc ar fhreagraAs this is an operational matter, I have asked the HSE to respond to the Deputy Directly.
511. Deputy Colm Brophy asked the Minister for Health for an update on his commitment to standardising the opening hours of all injury units; and if he will make a statement on the matter. [45904/24]
Amharc ar fhreagraThe development of Injury Units is a strategic initiative for this Government to assist with alleviating pressures in Emergency Departments.
A National Injury Unit review was undertaken by a HSE Working Group in 2023. The recommendations from this review were:
- to expand all existing acute hospital governed IUs to operate from 8am to 8pm, and,
- to expand geographical coverage and prioritise locations for the provision of IUs.
Resources are provided under the National Service Plan 2024 to standardise all IUs to open from 8am to 8pm by quarter 4 of 2024.
In relation to the specific question regarding the status of the standardisation of existing IUs, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
512. Deputy Colm Brophy asked the Minister for Health the total investment in the National Ambulance Service in each of the years 2011 to 2025 inclusive; and if he will make a statement on the matter. [45905/24]
Amharc ar fhreagra513. Deputy Colm Brophy asked the Minister for Health the staff numbers in the National Ambulance Service in each of the years 2011 to 2025 inclusive; and if he will make a statement on the matter. [45906/24]
Amharc ar fhreagra514. Deputy Colm Brophy asked the Minister for Health the investment in the National Ambulance Service fleet in each of the years 2011 to 2025 inclusive; and if he will make a statement on the matter. [45907/24]
Amharc ar fhreagraI propose to take Questions Nos. 512, 513 and 514 together.
As these are service matters, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
515. Deputy Colm Brophy asked the Minister for Health to provide an update on the National Strategy for Accelerating Genetic and Genomic Medicine in Ireland and the National Genetics and Genomics Workforce Plan, to outline what additional resources are required to fully resource the Strategy and workforce plan; and if he will make a statement on the matter. [45908/24]
Amharc ar fhreagraThe National Genetics and Genomics Office (NGGO) has developed a 5-year plan to expand genetic and genomic testing in Ireland and has mapped out key objectives which will be implemented from 2025 – 2029.
Within the NGGO’s six priority deliverables for 2024, I am happy to update on progress as follows: Under Priority Deliverable 1, “Development of a national genomic test directory for rare and inherited diseases”, the first version of the test directory is near completion and should be operational by Quarter 2 of 2025.
In relation to Priority Deliverable 2, “Development of a national genetic and genomic workforce plan”, the HSE’s National Doctors Training and Planning (NDTP) division is in the process of updating its Clinical Genetics Workforce Review which will be published in Q4, 2024. The NGGO’s Workforce Plan will be completed in the fourth quarter of this year.
Under Priority Deliverable 3, “Continued communications and PPI activity, progression of communications research, and development of proposed new information materials for clinicians and patients”, a Communications and PPI Working Group has been established.
Within Priority Deliverable 4, “Continued development of equitable national genetics and genomics services, including clinical genetics services, genomics laboratory capabilities and associated bioinformatics”, my Department is engaging on an ongoing basis with the NGGO on long-term infrastructural developments.
Under Priority Deliverable 5: “Develop a national genetic and genomic data and technology roadmap”, project planning is currently in-progress.
Lastly, in relation to Priority Deliverable 6, “Continue to collaborate with research initiatives including Genomic Data Infrastructure and Genome of Ireland, and internationally through participation in the 1+Million Genome (1+MG) European project”, my Department and the NGGO has ongoing representation on the 1+MG workstreams, engaging with international experts working in the field.
I also note that the increase in additional resources for the upcoming year is not available at present as the HSE National Service Plan is in development, therefore confirmation cannot be made at this time.
The Government and I remain fully committed to developing robust patient and family centred genetics and genomics service in Ireland and increasing genomic laboratory capabilities for the betterment of patient diagnostics and care.
516. Deputy Colm Brophy asked the Minister for Health the estimated cost of extending the Laura Brennan HPV Catch-Up Vaccination Programme to all those under 25 who missed out on the HPV vaccination at school; and if he will make a statement on the matter. [45909/24]
Amharc ar fhreagraThe immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The committee's recommendations are based on the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation. It makes recommendations on vaccination policy to my Department.
The ages at which vaccines are recommended in the immunisation schedule are selected, where possible, in order to give each child the best possible protection against vaccine preventable diseases.
The HPV vaccine is intended to be administered, if possible, before a person becomes exposed to HPV infection. The HPV vaccine is currently offered, free of charge, to boys and girls in first year of secondary school and is administered through the School Immunisation Programme. It is critical that the HPV vaccine is administered early and before any likely exposure to HPV.
NIAC guidance does not recommend administering the HPV vaccine to all unvaccinated adults.
All women under the age of 30 years old have had an opportunity to be vaccinated within the HSE vaccination programme when they were in secondary school, and those under 25 years had an additional opportunity to receive this vaccine in 2023.
It is not possible to estimate the cost outlined as there is no fee agreement in place with GPs to administer the HPV vaccine to unvaccinated adults.
517. Deputy Colm Brophy asked the Minister for Health the estimated cost of abolishing all charges for children attending emergency departments; and if he will make a statement on the matter. [45910/24]
Amharc ar fhreagra518. Deputy Colm Brophy asked the Minister for Health the estimated cost of providing all prescription drugs free of charge; and if he will make a statement on the matter. [45911/24]
Amharc ar fhreagraThe Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines and medical items, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. To be reimbursable by the State, prescribed medicines must be on the formal reimbursable list, in accordance with the 2013 Act.
A further difficulty to accurately cost for providing all prescription drugs free of charge is that the HSE does not have data on prescriptions provided to private patients.
Therefore, the costing is based on the abolition of prescription charges under the General Medical Services (GMS) Scheme and the reduction of the Drugs Payment Scheme (DPS) threshold to €0.
The estimated full year cost of abolishing all prescription charges under the GMS Scheme is €94.5m.
The estimated full year cost of reducing the DPS threshold to €0 is €243.8m.
Therefore, the estimated full year cost of providing all prescription drugs free of charge is €338.3m
The above costing does not take account of changes in demographics or how the abolition of all charges may impact claimant behaviour.
519. Deputy Colm Brophy asked the Minister for Health the cost increasing pharmacy fees by 10%; and if he will make a statement on the matter. [45912/24]
Amharc ar fhreagraIt is estimated that increasing pharmacy fees by 10% would cost a minimum of €565m per annum.
520. Deputy Colm Brophy asked the Minister for Health the cost of expanding the Structured Chronic Disease Management Programme to two more conditions. [45913/24]
Amharc ar fhreagra521. Deputy Colm Brophy asked the Minister for Health the cost of making the current Structured Chronic Disease Management Programme universal. [45914/24]
Amharc ar fhreagraI propose to take Questions Nos. 520 and 521 together.
Under the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. The General Practitioner (GP) Chronic Disease Management (CDM) Programme commenced in 2020 and has been rolled out on a phased basis to adult GMS (Medical Card and GP Visit Card) patients over a 4-year period.
Under the Opportunistic case finding programme, cases are identified on an opportunistic basis i.e. when a patient attends for another issue, risk criteria are applied and appropriate tests/assessments carried out to identify those with chronic disease or those at high risk of chronic disease. The Opportunistic Case Finding Programme identifies those at high risk of cardiovascular disease or diabetes for entry to the CDM Prevention Programme and those with previously undiagnosed chronic disease(s) are enrolled in the CDM Treatment Programme.
The CDM programme is an entirely new healthcare service in Ireland that has brought the care for chronic disease further into the community and it aims to reduce hospital attendance.
Further expansion of the programme, to include additional conditions or to include non-GMS patients, would require rigorous clinical assessment and engagement with stakeholders, including the GPs delivering the service.
The additional cost of an expansion of the CDM Programme would depend on the outcome of the relevant clinical assessment and engagement with stakeholders.
