Written Answers Nos. 2453-2472
2453. Deputy Matt Carthy asked the Minister for Health the regions in which new neurology hubs have been established in which to assist patients to have access to integrated services without requiring hospital inpatient care; and if she will make a statement on the matter. [21084/25]
Amharc ar fhreagraAs the Deputy's question relates to a service matter, I have referred the Deputies question to the HSE for consideration and direct reply to the Deputy.
2454. Deputy Matt Carthy asked the Minister for Health if it is proposed to establish a neurology hub in the Cavan Monaghan region to assist patients to have access to integrated services without requiring hospital in-patient care; and if she will make a statement on the matter. [21085/25]
Amharc ar fhreagraAs the Deputy's question relates to a service matter, I have referred the Deputy's question to the HSE for consideration and direct reply to the Deputy.
2455. Deputy Peter 'Chap' Cleere asked the Minister for Health if she will provide an update on the shortages of several HRT products for women (details supplied); and if she will make a statement on the matter. [21118/25]
Amharc ar fhreagraMy Department is aware of the stress that shortages of medicines can cause for patients and healthcare professionals alike, thusly mitigating medicine shortages and strengthening security of supply is the subject of several workstreams in my Department, the wider health service and across Europe.
Shortages are a global issue experienced by all countries regardless of size or economic status. There has been intermittent supply of some hormone replacement therapy (HRT) presentations over recent years, not just in Ireland but also in other countries, due to a significant increase in demand and manufacturing issues which are limiting the ability to meet this increased demand.
Persistent medicinal product shortages across this therapeutic area (HRT) have been managed and continue to be managed via the national Medicines Shortages Framework (MSF), coordinated by the HPRA. The MSF involves a multi-stakeholder approach to handling shortages of human medicinal products, and the HPRA engages with all such stakeholders, in all cases where this is necessary, until such a time it is established that there is sufficient supply of medicinal products to meet the demand and continuity of care. In case of shortages with a significant public health impact, the HSE can issue clinical guidance to healthcare professionals, where appropriate, to mitigate the impact of a shortage. There have been a number of such shortages where the HSE has issued clinical guidance as a mitigation measure, including HRT (see HSE Medicines Management Guidance issued in 2022: www.hse.ie/eng/about/who/cspd/medicines-management/guidance-on-shortages/prescribing-tips-and-tools-in-response-to-hrt-shortages.pdf).
The HPRA, along with other health service entities, is actively monitoring the national supply, and the current status is that HRT medicines are generally available. The HPRA has engaged with relevant suppliers to understand the reasons for current reports and to examine opportunities for regulatory flexibilities to assist meeting current demand. There are a number of medicines authorised for use in Ireland as HRT for the treatment of symptoms of menopause. In the event that patients are unable to source a medicinal product due to supply constraints, they are advised discuss possible alternatives with their healthcare professional pending the resumption of normal supply.
Sandoz Pharmaceuticals d.d., the company responsible for supplying Estradot, has notified the HPRA of a shortage of Estradot transdermal patches (37.5 microgram/ 24 hour transdermal patch, 50 microgram/ 24 hour transdermal patch, 75 microgram/ 24 hour transdermal patch, and 100 microgram/24 hour transdermal patch). These shortages are due to a manufacturing delay which is impacting multiple countries, including Ireland.
The HPRA have been notified by Sandoz Pharmaceuticals d.d of an expected return date, reported as the 6th May 2025 for 37.5 microgram/ 24 hour transdermal patch and 100 microgram/24 hour transdermal patch. The resupply of the 50 microgram/ 24 hour transdermal patch and the 75 micrograms / 24 hours, transdermal patch is anticipated by the end of the year.
The HPRA maintains a list of current and resolved shortages on its website (www.hpra.ie/find-a-medicine/for-human-use/medicine-shortages?data=eyJpZCI6bnVsbCwic2tpcCI6MCwidGFrZSI6MTAsInF1ZXJ5IjpudWxsLCJvcmRlciI6Imxhc3R1cGRhdGVkIERFU0MiLCJmaWx0ZXIiOiJBbGwifQ%3D%3D). The webpage is updated daily as the HPRA receives new information.
2456. Deputy Peter 'Chap' Cleere asked the Minister for Health the reason unlicensed products are available for 50 mg patch but are not currently covered on GMS scheme, which results in patients having to pay privately for this; and if she will make a statement on the matter. [21119/25]
Amharc ar fhreagraThe Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013.
Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority (HPRA). In line with the 2013 Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the reimbursement list.
In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact. HSE decisions on which medicines are reimbursed are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).
2457. Deputy Liam Quaide asked the Minister for Health her plans to add Addison’s disease to the long-term illness scheme; and if she will make a statement on the matter. [21120/25]
Amharc ar fhreagraThe Long-Term Illness (LTI) Scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 conditions covered by the Scheme. These are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.
Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. While there are currently no plans to extend the list of conditions, it is important to remember that the LTI Scheme exists within a wider eligibility framework.
There has been a significant focus on improving access to and the affordability of healthcare services over the last few years. This includes reductions in the Drugs Payment Scheme threshold, expansion of access to free GP care, and the abolition of all public in-patient hospital charges for children and adults. These measures continue to create a health and social care service that offers affordable access to quality healthcare.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card under the General Medical Services (GMS) Scheme. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE.
In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
Under the Drugs Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
2458. Deputy John Connolly asked the Minister for Health if the HSE National Ambulance Service will provide an ambulance service on Inis Meáin, Aran Islands; and if she will make a statement on the matter. [21123/25]
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.
2459. Deputy Barry Ward asked the Minister for Health the position regarding any plans to provide on-site health care in IPAS facilities; the actions she is taking to ensure that adequate GP facilities are available for IPAS residents while not removing existing services from any community; and if she will make a statement on the matter. [21142/25]
Amharc ar fhreagraThe Government is committed to delivering a humanitarian response to people seeking international protection. A total of €174 million has been made available for the provision of healthcare services for refugees and migrants since 2022, including €50 million for 2025.
This funding is used to deliver a suite of healthcare services that are responsive to areas of higher demand and local health service factors- this includes additional GP sessions where local capacity challenges are identified. I am committed to ensuring that healthcare services for refugees are provided in a coordinated and flexible manner.
As the Deputy’s question relates to the provision of services, I have referred the question to the Health Service Executive for direct response.
2460. Deputy John Connolly asked the Minister for Health if the drugs payment scheme can be extended to allow for the availability of the medication Ozempic for conditions other than approved indication of diabetes; and if she will make a statement on the matter. [21146/25]
Amharc ar fhreagraThe Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013. Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority (HPRA).
In line with the 2013 Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the reimbursement list. In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact. HSE decisions on which medicines are reimbursed are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).
Ozempic® (Semaglutide) is indicated for the treatment of adults with insufficiently controlled type 2 diabetes mellitus as an adjunct to diet and exercise; as monotherapy when metformin is considered inappropriate due to intolerance or contraindications; and in addition to other medicinal products for the treatment of diabetes. Ozempic® (Semaglutide) is not licensed for the treatment of weight management in a non-diabetic population.
Ozempic® (Semaglutide) was approved by the HSE in September 2018 for addition to the reimbursement list in accordance with its licensed indication (see www.ncpe.ie/semaglutide-ozempic/).
Controls are currently in place within the HSE's Primary Care Reimbursement Service (PCRS) in relation to Ozempic® (Semaglutide) to restrict reimbursement support to the approved indication. It is for this reason that reimbursement for Ozempic® (Semaglutide) is confined to those with eligibility under the General Medical Services Scheme (GMS) or the Long-Term Illness (LTI) scheme and is not made available on the Drugs Payment Scheme.
In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card under the GMS Scheme is determined by the HSE by means of a financial assessment. In certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness.
The LTI Scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made prescribing 16 conditions covered by the Scheme, including diabetes mellitus.
2461. Deputy Liam Quaide asked the Minister for Health if she has engaged with an organisation (details supplied), a service for individuals and families affected by cancer, concerning funding and supporting their need to purchase the building from which they operate; and if she will make a statement on the matter. [21161/25]
Amharc ar fhreagraThe National Cancer Strategy 2017-2026 acknowledges cancer support centres as a valuable resource, providing access to support to cancer patients and their families outside of the acute care setting. The HSE's National Cancer Control Programme (NCCP) works closely with a network of Community Cancer Support Centres, on the psycho-oncology model of care and the implementation of survivorship programmes for those living with and beyond cancer.
Community cancer support centres are voluntary and charity organisations delivering services directly to cancer patients and their families. These centres provide a range of services, including information and advice about cancer, psychological and emotional support, and survivorship programmes to patients during and after their cancer treatment and are invaluable to those they support. These services can be availed of free of charge and in local communities.
In 2024, €3 million and, in 2025, €5.5 million in funding has been allocated to the NCCP Alliance of Community Cancer Support Centres and Services. The Alliance is a HSE initiative which aims to develop a collaborative framework for community-based cancer support centres and services. The NCCP operates an activity-based funding model for organisations who have joined the Alliance. Community cancer support centres are encouraged to engage with the NCCP and the Alliance to explore opportunities for funding.
In relation to funding for a new premises, the centre in question should contact the Integrated Healthcare Area in its local Health Region regarding the matter of capital funding.
2462. Deputy Catherine Ardagh asked the Minister for Health the number of public health nurses in each local health centre and primary care centre in the CHO7 area with a month-by-month breakdown of the total from 1 January 2023 to 1 January 2025, in tabular form; and if she will make a statement on the matter. [21162/25]
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.
2463. Deputy Catherine Ardagh asked the Minister for Health the immediate steps she and her senior officials are taking to ensure that public health nursing staffing levels in the Dublin 12 area are returned to a level that can meet demand and deliver child health and development assessments again; and if she will make a statement on the matter. [21163/25]
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.
2464. Deputy Robert O'Donoghue asked the Minister for Health if her Department will revise the current means testing system for medical cards to formally include the "cost of disability" as an allowable expense category in determining eligibility for the medical card. [21164/25]
Amharc ar fhreagraMedical 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.
Persons aged 70 or older are assessed under medical card income thresholds which are based on gross income. The weekly gross medical card income thresholds for people aged 70 and over are currently €550 per week for a single person and €1050 for a couple.
Persons under 70 are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. Certain expenses are also taken into account. Examples of allowable expenses include rent, mortgage, certain insurance costs, childcare, maintenance, nursing home net costs which help to increase the amount a person can earn and still qualify for a medical card. Detailed guidelines are available at: www2.hse.ie/services/schemes-allowances/medical-cards/applying/assessment/).
The issue of granting medical cards on the basis of illness or a disability was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
However, 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. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.
Since December 2018, the medical card earnings disregard for people in receipt of Disability Allowance was increased from €120 to €427 per week and applies to the assessment process for single people and to family assessments. This significant policy change gave effect to an important recommendation of the Make Work Pay for People with Disabilities report. This substantial increase in allowable earnings acknowledges that a Medical Card is a particularly significant support and ensures that people with disabilities can continue to be supported to access care when needed.
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.
2465. Deputy Barry Ward asked the Minister for Health the actions she is taking to ensure that adequate dental facilities are available for IPAS residents while not removing existing services from any community; and if she will make a statement on the matter. [21167/25]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
2466. Deputy Erin McGreehan asked the Minister for Health the measures being taken to routinely collect data on addiction service waiting lists, ensuring that services are adequately resourced to meet demand. [21169/25]
Amharc ar fhreagraAs the issue of waiting lists is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
To support the strategic approach to the regional planning of drug services, the Department is completing an audit of drug services. Phase 1 of the audit was the development of an interactive map to facilitate access to over 400 publicly funded drug treatment and family support services (www.drugsandalcohol.ie/services_map). Phase 2 of the audit is identify and rank needs, using a variety of data sources and research. This includes the latest available data from the CSO, NDTRS and the HRB, surveys, commissioned reports/research and evaluation studies.
2467. Deputy Ken O'Flynn asked the Minister for Health if she will provide a full report on the current status of podiatry services in Cork city and North Cork; the number of staff currently working in podiatry services in these areas, including administrative and clinical roles; the number of staff currently on maternity leave, sick leave, or other forms of extended leave; the number of vacant posts across both areas; the current waiting times for podiatry appointments; the total backlog; the average length of time patients are waiting to be seen; and the reasons for the delays in service delivery. [21179/25]
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.
2468. Deputy Holly Cairns asked the Minister for Health if provision can be made for people living with lifelong disabilities, including polio survivors, who face unavoidable costs that are not currently recognised as allowable expenses in the medical card means test; and the steps proposed to reflect these realities in eligibility assessments. [21183/25]
Amharc ar fhreagraEligibility for a Medical Card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970 (as amended). The HSE assesses each medical card 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 under 70 are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. Certain expenses are also taken into account. Examples of allowable expenses include rent, mortgage, certain insurance costs, childcare, maintenance, nursing home net costs which help to increase the amount a person can earn and still qualify for a medical card. Detailed guidelines are available at: www2.hse.ie/services/schemes-allowances/medical-cards/applying/assessment/.
Persons aged 70 or older are assessed under medical card income thresholds which are based on gross income. The weekly gross medical card income thresholds for people aged 70 and over are currently €550 per week for a single person and €1050 for a couple. Furthermore, the Deputy may be aware that, since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card. 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 costs, e.g., medication, nursing home fees.
Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card - in particular, to take full account of 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.
Where a person's sole income is derived from a social protection payment, even where this is more than the current means threshold, 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.
2469. Deputy Martin Daly asked the Minister for Health if there are plans to provide transport for vulnerable patients who lack personal support networks when travelling to Northern Ireland for medical treatment (details supplied); and if she will make a statement on the matter. [21190/25]
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.
2470. Deputy Niamh Smyth asked the Minister for Health if her Department will review the case of a person (details supplied) and expedite this appointment; and if she will make a statement on the matter. [21191/25]
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.
2471. Deputy Ruairí Ó Murchú asked the Minister for Health if she will review and revise the medical card means-testing system to assess income after deduction of essential disability-related expenses, in order to more accurately reflect disposable income and improve fairness in eligibility decisions; and if she will make a statement on the matter. [21215/25]
Amharc ar fhreagraMedical 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.
Persons aged 70 or older are assessed under medical card income thresholds which are based on gross income. The weekly gross medical card income thresholds for people aged 70 and over are currently €550 per week for a single person and €1050 for a couple.
Persons under 70 are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. Certain expenses are also taken into account. Examples of allowable expenses include rent, mortgage, certain insurance costs, childcare, maintenance, nursing home net costs which help to increase the amount a person can earn and still qualify for a medical card. Detailed guidelines are available at: www2.hse.ie/services/schemes-allowances/medical-cards/applying/assessment/).
The issue of granting medical cards on the basis of illness or a disability was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
However, 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. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.
Since December 2018, the medical card earnings disregard for people in receipt of Disability Allowance was increased from €120 to €427 per week and applies to the assessment process for single people and to family assessments. This significant policy change gave effect to an important recommendation of the Make Work Pay for People with Disabilities report. This substantial increase in allowable earnings acknowledges that a Medical Card is a particularly significant support and ensures that people with disabilities can continue to be supported to access care when needed.
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.
