Written Answers Nos. 2391-2410
2391. Deputy Duncan Smith asked the Minister for Health if there are any schemes that individuals can avail of to recoup money when they have been forced to go through private healthcare providers for their medical care due to inadequate public services; and if she will make a statement on the matter. [20587/25]
Amharc ar fhreagraThe HSE funds and operates the public healthcare system in Ireland. Private Hospitals and healthcare providers are independent organisations. In general, patients use their private health insurance when accessing healthcare in the private sector, while some patients who do not have private health insurance may opt to pay privately for the treatment. Treatment accessed in the independent private healthcare system is not eligible for reimbursement by the HSE or the Department of Health.
Private health insurance in Ireland operates within a voluntary, community rated market. This means that each individual pays the same premium for a particular plan, regardless of their age, gender or health status. Individuals who hold private health insurance may be able to recoup some of the costs of private treatment, depending on the level of cover provided by their insurance policy. The community rated market is regulated by the Health Insurance Authority, which provides information to consumers to help them make informed choices about their health insurance options.
2392. Deputy Peadar Tóibín asked the Minister for Health her views on the incident that occurred in St. Joesph’s adolescent psychiatric unit; the number of children who were left without placement; the measures being taken on the issue; when it is envisioned all the children will be offered alternative placements; the steps that will be put into place to ensure that where another situation such as this arises, the most vulnerable children would not be left without a placement; and if she will make a statement on the matter. [20608/25]
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.
2393. Deputy Sorca Clarke asked the Minister for Health if she believes that it would be important to routinely collect data on the job vacancies within CAMHS to ensure the effective delivery of services; and if she will make a statement on the matter. [20632/25]
Amharc ar fhreagraThe data referred to by the Deputy is already collated as a matter of routine by the HSE and by the Department of Health.
The Mental Health Unit in the Department holds monthly performance management meetings with their counterparts in HSE National Mental Health Services to review various key performance indicators across mental health services, including staffing levels within the specialist CAMHS service.
In addition to the above, and arising from a meeting I had in early March last with the HSE CEO Bernard Gloster, I recently commenced a series of visits to all HSE Regional Health Areas to meet with the Regional Executive Officers and their staff to focus on improvements to all aspects of Youth Mental Health care. This includes CAMHS waiting lists and associated plans to reduce waiting times for accessing services. As part of these site visits, I receive further detailed information on the clinical and other staffing levels for each region, including staff vacancies relating to each individual CAMHS team.
At these meetings, I have and will continue to impress upon the Regional Executive Officers and the Integrated Health Area Managers, the importance of filling vacancies within CAMHS teams as soon as possible to ensure the effective delivery of services. To date, I have visited two of the six new HSE Health Regions - HSE South West and HSE Dublin and North East. Further visits are planned over the coming weeks.
A key objective of the recently published HSE Child and Youth Mental Health Action Plan, which is available on the HSE website, is the delivery of a comprehensive recruitment and retention approach for child and youth mental health services. The HSE will achieve this by supporting research designed to examine the current mental health needs of the population and the development of modelling tools. The latter will help to identify staffing needs based on local population and associated deprivation levels. This will include future projections to help inform improved workforce planning.
The Child and Youth Mental Health Office in the HSE will also support the new Health Regions in their workforce planning efforts, including the recruitment of clinical and administrative roles within CAMHS. The National Office will also work with HSE National HR to agree specific recruitment, retention and succession planning needs for Child and Youth Mental Health services on the back of identified workforce needs and/or gaps.
This approach will ensure investment in, and the development of, robust retention and focused recruitment strategies.
The Deputy can rest assured that I will continue to liaise closely with the HSE to undertake improvement across our mental health services, including CAMHS, in line with the HSE Service Plan 2025.
2394. Deputy Barry Heneghan asked the Minister for Health what immediate actions are being taken to address the significant disparities in mental health emergency care across hospitals, as highlighted by the Mental Health Commission’s recent report indicating that children with acute mental health crises are left in emergency departments for extended periods without appropriate care; and if she will make a statement on the matter. [20635/25]
Amharc ar fhreagra2395. Deputy Barry Heneghan asked the Minister for Health if she will outline what concrete actions are being taken to urgently address the ongoing failure to provide adequate care and follow-up for individuals in mental health crisis, who are often forced to leave overcrowded and understaffed emergency departments without a care plan and, subsequently, return in a revolving-door pattern; and if she will make a statement on the matter. [20636/25]
Amharc ar fhreagraI propose to take Questions Nos. 2394 and 2395 together.
The 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.
2396. Deputy Shónagh Ní Raghallaigh asked the Minister for Health why the bungalows in the hospital in Athy are not registered with the Residential Tenancies Board; and if she will make a statement on the matter. [20645/25]
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.
2397. Deputy Sorca Clarke asked the Minister for Health the number of women who have been diagnosed with breast cancer in the last five years. [20653/25]
Amharc ar fhreagraThe National Cancer Registry (NCRI) was established in 1991 with a statutory obligation to collect and classify information on all cancer cases that occur in Ireland and has been collecting such data since 1994.
This information will typically only be made available two to three years after the year of incidence, in keeping with international standards. This means that the data in this answer is provided for the most recent 5 years for which the NCRI have reliable data.
The number of invasive breast cancers (ICD10 C50) diagnosed in women 2018-2022 is as follows:
|
Year |
C50 Breast cancer (Female) |
|
2018 |
3552 |
|
2019 |
3552 |
|
2020 |
2927 |
|
2021 |
3779 |
|
2022 |
4054 |
|
Total 2018-2022 |
17864 |
2398. Deputy Sorca Clarke asked the Minister for Health the reason a person (details supplied) has not yet been seen by CAMHS or a psychiatrist, despite her critical condition; and when she will receive an inpatient care plan. [20666/25]
Amharc ar fhreagraAs this is a service issue I have asked the Health Service Executive to respond directly to the Deputy.
2400. Deputy Colm Burke asked the Minister for Health if she will confirm that funding will be provided in 2025 for the provision of an integrated homeless health hub in Cork city (day centre), in view of the fact that a detailed proposal has been agreed upon between her Department, the HSE, Cork City Council and the Department of Housing, Local Government and Heritage, also taking into account there are over 500 homeless people in the city who have no place to go during the day as they are required to leave homeless accommodation each morning; and if she will make a statement on the matter. [20670/25]
Amharc ar fhreagraThe Dept of Health is committed to strengthening integrated care pathways to meet the chronic health needs of people who are homeless. In line with this, the HSE capital plan 2025 will provide funding to expand healthcare facilities for people experiencing homelessness.
The HSE Capital Plan 2025 provides for a total of €1.33 billion for healthcare building and equipment that will deliver benefits all over the country. This significant investment in health infrastructure underlines the Government’s commitment to improving quality healthcare in a sustainable way.
The capital plan facilitates the development of infrastructure to support mental health service delivery, the delivery of more Primary Care Centres, HIQA Community Nursing Unit programme and community-based infrastructure to help ensure people can access appropriate care closer to home.
The HSE National Service Plan 2025 also contains a number of actions to improve and expand access to healthcare services for people experiencing homelessness.
HSE South West has developed a business case for an integrated inclusion health hub for people who are homeless in Cork City, in conjunction with Cork City Council. They have engaged with HSE Estates to assess the business case, with a view to securing funding in the capital plan.
The Dept of Health hosted a meeting with the promoters of the Integrated Inclusion Health Hub in October 2024. Officials from the Dept of Housing were also present. The Dept of Health is supportive of the proposal for the integrated inclusion health hub and is committed to working with the HSE to secure funding under the capital plan.
The IIHH would provide a centralised space in a suitable location offering a wide range of services, including access to housing supports, assertive outreach, welfare and medical care. It will also help to mitigate premature deaths among people who are homeless, with 20 such deaths recorded in the Cork region in 2020. HSE Southwest and CCC have together identified a property in the city centre which is available for a long-term lease and possible purchase. It is proposed that existing HSE services and a newly funded addiction care service will be relocated to this property, while Cork City Council commits to establish a day care service operating 7 days a week.
The proposal is aligned with the pathway to eradicate homelessness set out in Housing for All, specifically action 3.13 – strengthen integrated care pathways for people who are homeless with chronic health needs based on an inclusion health model, to achieve better health outcomes and to reduce premature death.
I am supportive of the proposal and look forward to seeing it progress under the HSE service and capital plans and with the support of the Dept of Housing.
2401. Deputy Michael Cahill asked the Minister for Health if she will examine a difference of opinions in regard to the validity of a medical card for a person (details supplied) in County Kerry; and if she will make a statement on the matter. [20677/25]
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.
2403. Deputy Michael Cahill asked the Minister for Health if she will provide a detailed response to several points raised (details supplied); and if she will make a statement on the matter. [20698/25]
Amharc ar fhreagraOn 9th April 2025 I launched the Sharing the Vision: A Mental Health Policy for Everyone Implementation Plan 2025 - 2027 at Dublin Castle. This document contained a number of commitments to enhance supports provided in Emergency Departments, such as ensuring the provision of appropriate environments for those presenting to Emergency Departments in mental health crisis, and ensuring continued investment in the National Clinical Care Programme for the Assessment and Management of Patients Presenting to Emergency Departments Following Self-Harm.
It is appropriate to ensure that those in mental health crisis have access to necessary supports in Emergency Departments should they need them.
In addition to this, I fully support the development of real alternatives to crisis support in 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 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 key part of the Crisis Resolution Model of Care will be crisis cafés, a welcoming, non-clinical, safe environment in the style of a café, where people can go at evenings and weekends. These are known as Solace cafés, and a number are now open in different locations.
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.
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.
I will continue to advance initiatives that will improve the supports available to all those in suicidal crisis.
2404. Deputy Ged Nash asked the Minister for Health if referrals to hospital emergency departments from out-of-hours services like NEDOC are not liable for a charge at accident and emergency; and if so, if she will investigate the reason a person (details supplied) is being pursued by a debt collection agency for payment of this charge; and if she will make a statement on the matter. [20722/25]
Amharc ar fhreagraThe Health (Out-Patient Charges) Regulations 2019 provide for €100 statutory charge for Emergency Department attendance and €75 statutory charge for attendance at a Minor Injury Unit subject to a number of exemptions including for those who are medical cardholders, patients who have a letter of referral from a registered medical practitioner and patients whose attendance results in admission as an in-patient.
The issue of billing for services received in an emergency department or a minor injury unit is the responsibility for the appropriate hospital. Therefore, a copy of the Deputy's question has been referred to the HSE with a request that the appropriate billing office investigate the issues raised and reply directly to the Deputy as soon as possible.
2405. Deputy Peter 'Chap' Cleere asked the Minister for Health to provide a list of all vacant healthcare posts unable to be filled in County Kilkenny; and if she will make a statement on the matter. [20727/25]
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.
2406. Deputy Peter 'Chap' Cleere asked the Minister for Health to provide a list of all vacant healthcare posts unable to be filled in County Carlow; and if she will make a statement on the matter. [20729/25]
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.
2407. Deputy Peter 'Chap' Cleere asked the Minister for Health the number of ambulance call-outs in County Carlow and County Kilkenny, for the past three years; the average arrival time for each arrival broken down monthly, in tabular form; and if she will make a statement on the matter. [20731/25]
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.
2408. Deputy Willie O'Dea asked the Minister for Health if the BreastCheck and BowelScreen programmes will be extended to the over-70s; and if she will make a statement on the matter. [20732/25]
Amharc ar fhreagraI am committed to supporting our population screening programmes, which are a valuable part of our health service, enabling early treatment and care for many people, and improving the overall health of our population.
The current Programme for Government commits to extending the BowelScreen programme and also extending the ages for the BreastCheck screening programme in line with updated standards from HIQA.
Since April 2025, BowelScreen, the national bowel screening programme, invites men and women aged between 59-70 to take the free at-home screening test. This is an important part of a phased approach to expanding the screening age, in line with available capacity and resources. Funding of €1.9m has been allocated for the expansion of BowelScreen to those aged 58 and 70 and this will be completed in 2026. When full expansion is complete, people aged 55-74 will be invited for screening.
BreastCheck, the national breast screening programme, currently invites women aged 50 to 69 years at regular periods to have a mammogram. An additional €2.9m in full-year costs has been allocated to BreastCheck for 2025 to help to future-proof the programme, allowing for increased capacity and enabling service developments to meet women's evolving needs and ensure equitable access across the entire population.
I am intent on advancing cancer screening commitments outlined in the Programme for Government, which will be facilitated through established protocols. The National Screening Advisory Committee (NSAC) is the independent expert group that considers proposed changes to Ireland’s screening programmes. NSAC assesses the evidence in a robust and transparent manner, and against internationally accepted criteria, before making recommendations to myself as Minister for Health. The rigorous processes utilised by NSAC are critical to ensure that our screening programmes are effective, quality assured and operating to safe standards, and that the benefits of screening outweigh the harms.
In this regard, I am pleased to report that NSAC is already progressing work to consider the further expansion of our cancer screening programmes and has submitted requests to the Health Information and Quality Authority (HIQA) to consider the evidence for a further expansion of the eligibility for the BreastCheck and BowelScreen programmes.
HIQA is currently focused on a Health Technology Assessment (HTA) process to examine a proposed further expansion of the age range eligibility for the BowelScreen programme to those aged 50-54 years. Work has already commenced, with a report expected to be submitted to NSAC for consideration later this year.
The evidence review for the expansion of the BreastCheck programme remains a key priority for NSAC and HIQA is expected to commence work on it later this year. The BreastCheck review will focus on two key elements, the expansion of the age range eligibility and the potential introduction of a standardised breast density measurement.
HTAs facilitate the assessment of relevant evidence and knowledge on the effects and consequences of healthcare technologies to guide decisions regarding the appropriate use of technology and efficient allocation of resources. They involve a multi-disciplinary assessment of the clinical, economic, ethical, legal and societal perspectives that may be impacted by the introduction of a new technology. They are time intensive and rigorous processes.
Finally, I would like to emphasise that population-based screening programmes are for people without symptoms. If anyone becomes aware of symptoms, or if they have concerns or worries, they should contact a medical professional.
2409. Deputy Paul Lawless asked the Minister for Health the number nationwide on the waiting list for home help; the amount her Department is spending on private agencies to provide cover; and if she will make a statement on the matter. [20735/25]
Amharc ar fhreagraAs this is an operational matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
2410. Deputy Cian O'Callaghan asked the Minister for Health if she will examine alternative options for people suffering from a mental health crisis in order that they do not need to go through the standard accident and emergency department; and if she will make a statement on the matter. [20738/25]
Amharc ar fhreagraPeople experiencing mental health distress and illness often find busy Emergency Departments - especially out-of-hours - the wrong setting for their needs, and we know this is the reason some people leave before meeting a clinician.
Minister Butler recently welcomed the report of the Chief Inspector of the Mental Health Commission into acute mental health care in hospital Emergency Departments, stating that her priority is that people in mental health crisis are provided with timely assessment and support in an appropriate environment that keeps them safe.
Minister Butler recently expressed her impatience to the HSE at the pace of change, nothing that the Mental Health Commission’s report is a timely reinforcement of the need for the department and the HSE to intensify efforts to expand access to these alternatives to Emergency Departments.
A number of initiatives have been launched since the publication of Sharing the Vision: A Mental Health Policy for Everyone to develop real alternative care pathways and therapeutic environments to reduce the number of people who have to attend Emergency Departments for acute care. This includes deliver investments and implementation of the National Clinical Care Programme for the Assessment and Management of Patients presenting to Emergency Departments following Self Harm, which relates to policy Recommendation 23.
Supports have been put in place so people presenting to emergency departments (EDs) receive a compassionate response, as well as a therapeutic assessment and intervention from a suitably trained mental health professional. This programme is delivered in all 26 adult emergency departments that are operating 24/7 and in one paediatric hospital.
The Model of Care for Self-Harm and Suicide Related Ideation was updated in 2022 and incorporates the Suicide Crisis Assessment Nurse (SCAN) service, which provides a critically important safety net for people in suicidal crisis. The ambition of the new Sharing the Vision implementation plan (2025-2027), published on 9th April 2025, is to expand these services to provide full coverage nationwide. The SCAN service provides a timely response to requests for assessment of patients in suicidal crisis from GPs, and the assessments often take place in primary care settings. In addition, Budget 2025 provided funding for a further six SCAN nurses, and work is ongoing to ensure full access to the service across the country.
The model of care for the service envisages a dedicated mental health assessment room within hospitals to provide a more appropriate environment for assessments to take place. Given most acute mental health in-patient units are co-located with our acute hospital network, it is important that people in distress are assessed in clinically appropriate environments when they present for support.
Over the course of the second implementation plan for Sharing the Vision, a new National Clinical Programme for Self-Harm and Suicide Related Ideation will be published and will include a scaling up of the Suicide Crisis Assessment Nurse service. To support this continuous service improvement, an online data capture tool will provide valuable insights into population needs, service user experiences and the effectiveness of the service.
The policy also commits to providing an alternative to emergency departments for people in a mental health crisis. The emergency department is not an appropriate environment for supporting people in distress, and work is ongoing to shift supports for those in crisis away from hospitals and into services in our communities.
The development of the new model of care for Crisis Resolution Services has been delivered, which has two components::
Crisis Resolution Teams: teams of mental health professionals who work out of hours to meet people in a crisis and provide rapid assessment and intensive intervention.
There are five pilot Crisis Resolution Teams currently operational in Sligo/Leitrim, Cork city (two teams), Waterford City and County, South Dublin/Wicklow. The Limerick Crisis Resolution Team is due to commence operations later this month (April).
Crisis Cafés: a welcoming, non-clinical safe environment in the style of a café where people can go at evenings and weekends. These are known as 'Solace' cafés, and a number are now open in different locations.
The model of care for Crisis Resolution Services was developed as a direct recommendation of Sharing the Vision (Recommendation 24). It recognises that people who are experiencing a mental health crisis need specialist services to provide timely brief intensive supports to keep people safe. Work is ongoing with the HSE to speed up the expansion of these services for people in a mental health crisis.
