Written Answers Nos. 2371-2390
2371. Deputy John Brady asked the Minister for Health the status of the National Ambulance Service Strategic Plan; if a copy of this can be made available; and if she will make a statement on the matter. [20519/25]
Amharc ar fhreagra2372. Deputy John Brady asked the Minister for Health if any draft or finalised documents for the National Ambulance Service Strategic Plan will be made available; and if she will make a statement on the matter. [20520/25]
Amharc ar fhreagra2373. Deputy John Brady asked the Minister for Health to provide a timeline for the publication of the National Ambulance Service Strategic Plan; and if she will make a statement on the matter. [20521/25]
Amharc ar fhreagraI propose to take Questions Nos. 2371, 2372 and 2373 together.
I can confirm that the HSE National Ambulance Service (NAS) are currently working on the development of a new Strategic Plan. The new Strategy will build on the achievements of its predecessor "Vision 2020" in continuing the NAS's reform from a traditional patient conveyance service to an agile and mobile urgent and emergency care service. I expect that the new NAS strategic plan will be finalised and submitted by the HSE shortly.
2374. Deputy John Brady asked the Minister for Health to provide a breakdown for posts to be delivered in the National Ambulance Service; the date by which she expects recruitment to be commenced; and if she will make a statement on the matter. [20522/25]
Amharc ar fhreagraUnder Budget 2025 the National Ambulance Service (NAS) has been allocated a total of €285 million. This year's budget includes €8m for new service developments - translating into a full year cost in 2026 of €16million - to deliver 180 additional posts. These additional posts will support:
• Essential frontline emergency services,
• Expansion of NAS alternative care pathways and further development of NAS specialist service capacity, and
• Additional capacity in the National Emergency Operations Centre.
Concerning the Deputy's specific queries, I have asked the Health Service Executive (HSE) to respond to him with any other pertinent information relating to this matter.
2375. Deputy Seán Fleming asked the Minister for Health to respond to correspondence (details supplied) regarding the drug Palforzia; and if she will make a statement on the matter. [20524/25]
Amharc ar fhreagraUnder 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 I have asked the HSE to provide an update on this matter.
The HSE has advised that it is committed to providing access to as many medicines as possible, in as timely a fashion as possible, from the resources available (provided) to it.
The HSE must robustly assess applications for pricing and reimbursement to make sure that it can stretch available resources as far as possible and to deliver the best value in relation to each medicine and ultimately more medicines to Irish citizens and patients.
HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds.
There are formal processes which govern applications for the pricing and reimbursement of medicines, and new uses of existing medicines, to be funded and / or reimbursed.
The HSE considers the following criteria prior to making any decision on pricing / reimbursement in line with the Health (Pricing and Supply of Medical Goods) Act 2013:
(1) The health needs of the public,
(2) The cost effectiveness of meeting health needs by supplying the item concerned rather than providing other health services,
(3) The availability and suitability of items for supply or reimbursement,
(4) The proposed costs, benefits, and risks of the item or listed item relative to therapeutically similar items or listed items provided in other health service settings and the level of certainty in relation to the evidence of those costs, benefits and risks,
(5) The potential or actual budget impact of the item or listed item,
(6) The clinical need for the item or listed item,
(7) The appropriate level of clinical supervision required in relation to the item to ensure patient safety,
(8) The efficacy (performance in trial), effectiveness (performance in real situations) and added therapeutic benefit against existing standards of treatment (how much better it treats a condition than existing therapies) and
(9) The resources available to the HSE.
In terms of the specific details of the application for pricing and reimbursement of Defatted powder of Arachis hypogaea L., semen (peanuts) (Palforzia®) for the treatment of patients aged 4 to 17 years with a confirmed diagnosis of peanut allergy. (Palforzia® may be continued in patients 18 years of age and older):
The HSE has advised that it received a complete application for pricing / reimbursement on the 30th March 2022 from Aimmune Therapeutics (the applicant) for Defatted powder of Arachis hypogaea L., semen (peanuts) (Palforzia®) for the treatment of patients aged 4 to 17 years with a confirmed diagnosis of peanut allergy. (Palforzia® may be continued in patients 18 years of age and older).
• The first step in the process is the submission of a Rapid Review dossier (a clinical and economic dossier) to the National Centre for Pharmacoeconomics (NCPE) for assessment. The HSE commissioned the Rapid Review process on the 1st April 2022.
• The NCPE Rapid Review assessment report was received by the HSE on the 5th May 2022. The NCPE advised the HSE that a full HTA was recommended to assess the clinical effectiveness and cost effectiveness of Defatted powder of Arachis hypogaea L., semen (peanuts) (Palforzia®) compared with the current standard of care.
• The HSE commissioned a full Health Technology Assessment on the 26th May 2022 as per agreed processes.
• The NCPE Health Technology Assessment Report was received by the HSE on the 29th November 2023. The NCPE recommended that Defatted powder of Arachis hypogaea L., semen (peanuts) (Palforzia®) not be considered for reimbursement unless cost-effectiveness can be improved relative to existing treatments (www.ncpe.ie/defatted-powder-of-arachis-hypogaea-l-semen-peanuts-palforzia-hta-id-22019/).
• The HSE Corporate Pharmaceutical Unit (CPU) is the interface between the HSE and the Pharmaceutical Industry in relation to medicine pricing and reimbursement applications. CPU met with the applicant to discuss their application for Arachis hypogaea L., semen (peanuts) (Palforzia®).
• The Drugs Group is the national committee which the HSE has in place to make recommendations on the pricing and reimbursement of medicines. The membership of the HSE Drugs Group includes public interest members. The HSE Drugs Group consider all of the evidence and make a recommendation to the HSE Senior Leadership Team. The totality of clinical and economic evidence for Defatted powder of Arachis hypogaea L., semen (peanuts) (Palforzia®) for the treatment of patients aged 4 to 17 years with a confirmed diagnosis of peanut allergy was comprehensively and extensively reviewed by the Drugs Group at the September 2024 meeting. The HSE Drugs Group recommended in favour of reimbursement of Arachis hypogaea L., semen (peanuts) (Palforzia®) subject to an improved commercial offering.
• The decision making authority in the HSE is the HSE Senior Leadership Team. The HSE Senior Leadership Team decides on the basis of all the demands it is faced with (across all services) whether it can fund a new medicine, or new use of an existing medicine, from the resources that have been provided to it in line with the Health (Pricing and Supply of Medical Goods) Act 2013.
The HSE CPU proposed a meeting with the applicant to discuss the HSE Drugs Group recommendation. The applicant communicated to the HSE CPU in October 2024 that they wished for the application for Palforzia® to be paused until the end of 2025, and on this basis requested postponement of the meeting with the HSE CPU. In summary, the HSE awaits further engagement from the applicant to progress this application. The HSE cannot make any comment on possible outcomes from the ongoing process.
2376. Deputy Erin McGreehan asked the Minister for Health to publish a national policy on adult safeguarding for the health and social care sector. [20531/25]
Amharc ar fhreagra2390. Deputy Ruth Coppinger asked the Minister for Health if she will take steps to introduce legislation for adult safeguarding; and if she will make a statement on the matter. [20580/25]
Amharc ar fhreagraI propose to take Questions Nos. 2376 and 2390 together.
Safeguarding adults who may be at risk of abuse is a key objective of my Department, every statutory body under its aegis and every relevant service that interacts with such adults. A framework of standards, policies and procedures for safeguarding adults in the health and social care sector is in place, and further measures are being developed to strengthen this framework.
The Programme for Government 2025 "Securing Ireland’s Future" includes a commitment to publish a national policy on adult safeguarding for the health and social care sector. My Department, in liaison with the Department of Children, Disability and Equality, is at an advanced stage of finalising this policy to further strengthen the existing protections in the sector.
To facilitate the development of appropriate legislation to underpin this sectoral policy, subject to its approval by the Government, the Government has included a Health (Adult Safeguarding) Bill in its current Legislation Programme. It is expected that these sectoral policy proposals will be brought before Government in the coming months, and that the preparation of related underpinning legislation will commence thereafter.
2377. Deputy John Brady asked the Minister for Health her plans to extend temporary registration licenses to stamp 4 non-EU dentists; and if she will make a statement on the matter. [20540/25]
Amharc ar fhreagraThe Dentists Act 1985 establishes the Dental Council as the regulatory body for the dental profession in Ireland. As such, issues concerning the registration of dentists are a matter for the Dental Council to consider.
Temporary registration is only available to persons not eligible for full registration. The Dental Council advises that it only grants temporary registration in limited and mainly education related circumstances. The applicants visa status is not a factor in the Dental Council’s consideration.
For all applicants for full registration, bar those granted international protection, the key criteria in determining their registration pathway is the country where the applicant undertook their dental education.
There are different registration pathways for:
• Irish graduates and graduates from countries with which we have reciprocal agreements,
• graduates from the EEA,
• graduates from the UK, and
• graduates from non-EEA countries.
Non-refugee graduates from non-EEA countries must pass the Dental Council examination.
2378. Deputy John Brady asked the Minister for Health her plans to expand access to a mentorship programme and period of adaptation to all eligible non-EU dentists residing in the State; and if she will make a statement on the matter. [20541/25]
Amharc ar fhreagraThe Dentists Act 1985 establishes the Dental Council as the regulatory body for the dental profession in Ireland. As such, issues concerning the registration of dentists are a matter for the Dental Council to consider.
The Dental Council introduced a registration pathway for refugees in response to the EU Commission’s request to assess the qualifications from refugees from the war in Ukraine. This pathway includes a mentorship programme whereby refugee dentists can practice under the mentorship of an established registered dentist. To avail of this registration pathway you must be a qualified dentist with current Temporary Protection or Refugee Status in Ireland. The Dental Council has opened this process to any refugee granted international protection in Ireland.
For applicants who qualified outside of the EU and do not have refugee status or temporary protection in Ireland, the appropriate pathway to registration is the Dental Council Examination.
The Dental Council is continually seeking to increase the capacity to take more candidates into its examination pathway. The Dental Council has increased the number of places on its examination from 11 in 2018 to over 60 in 2025 and it gives an active advantage to non-EEA qualified dentists who are already established in Ireland and who wish to sit the examination.
There are no plans to introduce an additional registration pathway or to change the existing pathways for non-EEA qualification holders.
2379. Deputy John Brady asked the Minister for Health her plans to increase the frequency and intake capacity of the Dental Council’s registration examination; and if she will make a statement on the matter. [20542/25]
Amharc ar fhreagraThe Dentists Act 1985 establishes the Dental Council as the regulatory body for the dental profession in Ireland. As such, issues concerning the registration of dentists are a matter for the Dental Council to consider.
The Dental Council advises that it is continuing to look at the potential to further increase capacity for the Dental Council examination for non-EEA dentists. For the 2024 examination, capacity was increased by 50% in co-operation with the Dublin and Cork dental schools whose support, clinical resources and expertise are a key component of the examination.
Noting that the examination provides a route to registration and practise for dentists, the Dental Council will continue to maintain a focus on competence and patient safety throughout its efforts in this area.
2380. Deputy Emer Currie asked the Minister for Health the number of children currently waiting for speech and language therapy, psychology, and occupational therapy in primary care services in CHO9; the corresponding average waiting times in weeks, in tabular form; and if she will make a statement on the matter. [20544/25]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
2381. Deputy Emer Currie asked the Minister for Health the number of clinical sessions typically offered to children and adolescents attending CHO9 primary care speech and language therapy services; whether clients are placed on a further waiting list following discharge if ongoing support is required; and if she will make a statement on the matter. [20545/25]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
2382. Deputy Emer Currie asked the Minister for Health the total number of speech and language therapists currently employed within the HSE orthodontic services in CHO9; and if she will make a statement on the matter. [20547/25]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
2383. Deputy Emer Currie asked the Minister for Health the total number of vacant speech and language therapist posts currently within CHO9; and if she will make a statement on the matter. [20548/25]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
2384. Deputy Louis O'Hara asked the Minister for Health if she intends to implement the recommendations of the Mental Health Commission’s report into the level of mental health services provided in hospital emergency departments across all health regions in Ireland; and if she will make a statement on the matter. [20549/25]
Amharc ar fhreagraThe Mental Health Commission plays an important, independent role in supporting and assisting in the development and improvement of mental health services. The Commission’s 2024 thematic report focused on mental health care in hospital Emergency Departments.
I welcome the Chief Inspector’s report and will work with the Department of Health and the HSE to expand the alternative care pathways and therapeutic environments for people presenting to emergency departments in mental health crisis.
The report of the Chief Inspector recommends improving the timeliness of mental health assessments following presentation to the emergency department, and for medical and mental health assessments to happen concurrently rather than sequentially, in line with international best practice. It is widely accepted emergency departments are an inappropriate environment for people in a mental health crisis, and that alternative care pathways and therapeutic environments should be developed.
I fully support the development of real alternatives to emergency departments and will continue to prioritise securing additional funding to continue their expansion.
Several initiatives and developments continue to be advanced to support access to services, and to ensure that people with mental health difficulties can access the emergency supports that they need. This includes:
• Prioritising ongoing work of the National Clinical Programme for Self-Harm and Suicidal Ideation in relation to the issue of assessment rooms and securing safe, dedicated spaces within all EDs for mental health assessments.
• National roll out of Suicide Crisis Assessment Nurses (SCAN), providing assessment and support to GP patients who present with suicide-related thoughts, who might otherwise be referred to the emergency department or community mental health services.
• The HSE's Child and Youth Mental Health Office Action Plan, launched in February 2025, commits to developing an Integrated Crisis Response Pathway for children and young people experiencing a Mental Health crisis across the 24/7 continuum of Care, including an improved child and youth liaison service with Emergency Departments.
• The roll out of a network of Crisis Resolution Teams, providing an extensive range of community focused mental health services, to address the needs of people requiring help with their mental health and reducing the requirement to access mental health care services at their local hospitals.
• A model of care for Liaison Psychiatry has been developed by the HSE and will be launched in Q2 2025.
• The Urgent and Emergency Care (UEC) Operational Plan reduction in cumulative daily trolley count in 2024 and key focus in the 2025 plan on expansion of all UEC services into evenings and weekends.
The recommendations of the Commission’s report are being considered by both the Department and the HSE and will be used to inform service delivery improvement programmes, including the National Clinical Programmes for Self-Harm and Suicidal Ideation and other relevant clinical programmes.
2385. Deputy Claire Kerrane asked the Minister for Health the total number of clinical status 1 calls (Echo and Delta) per the advanced medical priority dispatch system (AS1s) requiring an advanced paramedic (AP) response, total AP advised calls not receiving an AP response and the percentage of AP-advised calls not receiving an AP response for each of the 12 months for the years 2022 to 2024 and to date in 2025, in tabular form (details supplied); and if she will make a statement on the matter. [20562/25]
Amharc ar fhreagraAs this is a service matter I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
2386. Deputy Claire Kerrane asked the Minister for Health the number of patients identified with severe pain and the number of patients with a reduction in pain score of at least three points for each of the 12 months for the years 2022 to 2024 and to date in 2025, in tabular form; and if she will make a statement on the matter. [20563/25]
Amharc ar fhreagraAs this is a service matter, I referred the question to the HSE for direct reply to the deputy.
2387. Deputy Ivana Bacik asked the Minister for Health the steps her Department took to arrive at the conclusion that reimbursement was not possible in respect of HRT purchased before 1 June 2025; and if she will make a statement on the rationale for not reimbursing such purchases. [20564/25]
Amharc ar fhreagra2388. Deputy Ivana Bacik asked the Minister for Health the reason for excluding some dosages from the free HRT scheme; the reason for excluding some brands not listed on the DPS reimbursable list managed by PCRS from the free HRT scheme; an if she will amend the scheme to include all brands and all dosages, respectively. [20565/25]
Amharc ar fhreagra2389. Deputy Ivana Bacik asked the Minister for Health the number of times she has met with an organisation (details supplied); the agenda and minutes of each meeting; if she has further meetings scheduled with the organisation; ad if she will make a statement on what is proposed for discussion at further meetings. [20566/25]
Amharc ar fhreagraI propose to take Questions Nos. 2387, 2388 and 2389 together.
I recently announced that from the 1st June 2025, the provision of Hormone Replacement Therapy (HRT) products for the treatment of the symptoms of menopause will be provided free to women at the point of dispensing. The implementation of this measure will now include a dispensing fee for pharmacists. This is step forward from the Budget 2025 announcement which only covered the medication costs.
This measure is also targeted at assisting women who do not have access to a medical card or whose HRT costs fall below the current Drugs Payment Scheme threshold of €80 per month.
My Department and the Health Service Executive (HSE) has engaged extensively with the Irish Pharmacy Union (IPU) in relation to the practical rollout of this measure. In addition to several meetings at official level, I met with the IPU on two separate occasions. At the first meeting we discussed my ambitions for extending the scope of community pharmacists and the implementation of the Budget 2025 HRT measure. The second meeting focused on the practical roll-out of the HRT measure.
I regret that the implementation of this measure could not be agreed with the IPU, despite engagement over many months. However, I must follow through on the commitment made in the Programme for Government: Securing Ireland's Future.
When operational, this measure will cover any HRT medications and products which are reimbursable by the HSE, which have been prescribed for the purposes of alleviating the symptoms of menopause. The HSE can add HRT medicines to the formal reimbursement list only in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013. In line with the 2013 Act and the national framework agreed with industry, a company must apply to the HSE to have a medicine added to the reimbursement list.
Reimbursement support will commence from the 1st June 2025. A different and more complex mechanism would be needed to refund individuals for HRT costs incurred prior to that date. However, the measure as planned will now involve no costs for the prescribed HRT product at the point of dispensing in participating pharmacies.
There has also been ongoing engagement between Department officials and the IPU regarding the potential to extend the scope of practice of community pharmacists. I want to see pharmacists practising at their full potential, delivering expert professional services and expanded healthcare roles like diagnosing and prescribing for common conditions. This will enhance patient access to health care, speed up diagnoses, and improve recovery, as we also continue to expand GP services for Ireland’s growing population. I look forward to working on this with pharmacies as the year progresses.
