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Tuesday, 24 Jun 2025

Written Answers Nos. 882-909

National Treatment Purchase Fund

Ceisteanna (882, 883, 884, 885, 886)

Matt Carthy

Ceist:

882. Deputy Matt Carthy asked the Minister for Health if CHI have used National Treatment Purchase Fund (NTPF) money to pay orthopaedic consultants at rates above the standard approved fees or during their contracted public working hours; if any CHI consultants were effectively double-paid that is, receiving their normal salary plus NTPF-funded fees for treating public patients, contrary to the intent that NTPF work be done in out-of-hours clinics; if any such individually negotiated pay arrangements occurred; if so, the details and justification; if any such arrangements were approved with the NTPF and HSE in advance; and if she will make a statement on the matter. [34329/25]

Amharc ar fhreagra

Matt Carthy

Ceist:

883. Deputy Matt Carthy asked the Minister for Health if those who approved arrangements (details supplied) ensured that all such work was done strictly on overtime with no clash with consultants' public duties; if all payments to consultants for these sessions processed transparently via CHI payroll in line with NTPF's rule against direct pay to consultants; who in CHI management signed off on these arrangements; if any insourcing deviated from these guidelines, if so, the reason; and if she will make a statement on the matter. [34330/25]

Amharc ar fhreagra

Matt Carthy

Ceist:

884. Deputy Matt Carthy asked the Minister for Health the internal processes that CHI have had in place from 2019 onward to oversee the use of NTPF funds and special waiting-list initiatives; if the CHI executive or board were required to sign off on decisions to use NTPF money for private or insourced clinics; If so, if those protocols followed, for example, if the CEO, CFO, or clinical directors formally approved paying consultants extra to clear lists; and if she will make a statement on the matter. [34331/25]

Amharc ar fhreagra

Matt Carthy

Ceist:

885. Deputy Matt Carthy asked the Minister for Health if she has ascertained the way in which CHI ensured that patients chosen for any NTPF-funded surgery or clinic were selected based on medical priority and waiting time; if there were instances where long-waiting children were bypassed in favour of others in NTPF sessions; if she is assured that CHI did not engage in any practice of resetting or manipulating waitlists for optics for example, removing and re-adding patients to make waits appear shorter, or cycling patients through initial consultations or diagnostics, funded by NTPF, only to place them back on the same surgical waiting list thereafter; and if she will make a statement on the matter. [34332/25]

Amharc ar fhreagra

Matt Carthy

Ceist:

886. Deputy Matt Carthy asked the Minister for Health if she has ensured that CHI utilized National Treatment Purchase Funds monies to reduce waiting times for the longest-waiting orthopaedic patients; and if she will make a statement on the matter. [34333/25]

Amharc ar fhreagra

Freagraí scríofa

I propose to take Questions Nos. 882, 883, 884, 885 and 886 together.

Insourcing initiatives of the National Treatment Purchase Fun (NTPF), targeted at the longest waiting public patients, are arranged with the management of the public hospital concerned, in line with the relevant Waiting List Management Protocols, and on the basis of a strict Memorandum of Understanding. Under the insourcing agreement, the hospital confirms that the work is undertaken outside core hours and is additional activity aimed at reducing waiting lists.

Due to concerns raised over the 2022 Internal Examination, the NTPF placed a temporary pause on all insourcing work with CHI. It initiated a comprehensive review of all insourcing work with CHI to gather the necessary assurances regarding compliance, value for money and appropriate use of NTPF funding mechanisms. On the 11th of June, the NTPF confirmed that it was immediately recommencing insourcing work with CHI after a review of the assurances given by CHI in relation to its ongoing compliance with existing NTPF protocols and procedures.

The HSE CEO is commissioning an audit of governance and equity in patient access and waiting list management at CHI. The audit aims to assess governance and equity in access to care within CHI, especially regarding the balance between public and private patient management. The outcome of this audit is expected in the coming months.

As the Deputy’s question requires operational detail, I have asked the HSE to look into these matters and provide a direct reply as soon as possible.

Question No. 883 answered with Question No. 882.
Question No. 884 answered with Question No. 882.
Question No. 885 answered with Question No. 882.
Question No. 886 answered with Question No. 882.

Organ Donation

Ceisteanna (887)

Peadar Tóibín

Ceist:

887. Deputy Peadar Tóibín asked the Minister for Health the reason the address is needed for the opt out register of the organ donation scheme (details supplied). [34339/25]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Organ Donation

Ceisteanna (888)

Peadar Tóibín

Ceist:

888. Deputy Peadar Tóibín asked the Minister for Health the number of persons who have registered their opt out register of the organ donation scheme in the first week of the portal going live. [34340/25]

Amharc ar fhreagra

Freagraí scríofa

Part 2 of the Human Tissue (Transplantation, Post-Mortem, Anatomical Examination and Public Display) Act 2024, which commenced on 17 June 2025, provides for the first time a national legislative framework for organ donation and transplant services in Ireland.

Under the legislation, all adults in Ireland are considered to have agreed to be an organ donor when they die unless they have recorded a decision not to donate on the Relevant Organ Donation Opt-Out Register or are in one of the excluded groups. It is important to reassure people that family members will always be consulted before any action is taken. This is commonly referred to as a soft opt-out system of organ donation.

Most people in Ireland are in favour of organ donation, and the new system changes the default assumption to one that matches the prevailing public attitude regarding organ donation. Meanwhile, the Register is intended to ensure that a person’s right to autonomy, self-determination and bodily integrity is respected.

The wishes of those on the Register will be respected in full, and their family will not be approached on the issue of organ donation. This objection applies to the relevant organs under the Act, namely, the liver, lung, pancreas, heart or kidney.

The Health Service Executive has responsibility for maintaining the Register. I have been informed by the HSE that, as of 12pm on Friday 20 June 2025, 29,394 persons have registered their objection to becoming an organ donor.

Dental Services

Ceisteanna (889)

Brian Stanley

Ceist:

889. Deputy Brian Stanley asked the Minister for Health the average age of children and their school class in the State when they have their first dental examination and screening under the school dental scheme; and if she will make a statement on the matter. [34347/25]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.

Departmental Investigations

Ceisteanna (890)

Matt Carthy

Ceist:

890. Deputy Matt Carthy asked the Minister for Health if she has commissioned an investigation into the response of CHI management and board to internal warnings that arose in 2022 that the allocation of €19 million of scoliosis funds were not being utilised for the intended purpose; and if she will make a statement on the matter. [34348/25]

Amharc ar fhreagra

Freagraí scríofa

Scoliosis and Spina Bifida were identified as a priority in both the 2022 and 2023 Waiting List Action Plans with €19 million of current and capital funding committed to tackle these waiting lists by creating additional capacity.

This investment funded a fifth operating theatre in Temple Street, a second MRI in Crumlin, and additional beds. The investment has supported a significant increase in the number of paediatric spinal procedures carried out in 2022 and 2023. In 2022, 509 spinal procedures were carried out, and in 2023, 464 spinal procedures were carried out, compared to 380 for the same period in 2019. This represents a 34% increase and a 22% increase respectively compared to 2019.

Following the implementation of the majority of the additional capacity, and having consulted with patient groups and clinicians, the former Minister asked the HSE to have their internal audit team review the allocation of the €19 million in the context of what it was allocated to achieve.

The report from the HSE Internal Audit was completed in October 2024 and found that the expenditure was used for the purposes intended. This report "Review on the Implementation of Scoliosis and Spina Bifida Action Plans 2022 and 2023" has since been published on the HSE website.

National Treatment Purchase Fund

Ceisteanna (891)

Matt Carthy

Ceist:

891. Deputy Matt Carthy asked the Minister for Health in response to reports that CHI orthopaedic surgeons performed hip surgeries at University Hospital Galway and Cork in recent years, who approved sending CHI orthopaedic doctors to Galway and Cork; whether this was part of an official waiting-list initiative or NTPF arrangement; if the same oversight and patient-selection standards applied there as CHI sites; whether the orthopaedic doctors concerned were paid over the accepted rates; if so, the reason; and if she will make a statement on the matter. [34349/25]

Amharc ar fhreagra

Freagraí scríofa

As the Deputy’s question relates to operational matters, I have asked the Health Service Executive to provide a direct reply as soon as possible.

Departmental Data

Ceisteanna (892)

Matt Carthy

Ceist:

892. Deputy Matt Carthy asked the Minister for Health the number of surgeries outsourced by CHI to private providers in each year since 2020, in tabular form; the total amount paid to each private provider in each year; the governance policies in place to determine each private provider; and if she will make a statement on the matter. [34350/25]

Amharc ar fhreagra

Freagraí scríofa

This Government is committed to ensuring ongoing improvements in paediatric orthopaedic services to ensure that children with scoliosis and spina bifida are treated quickly and safely.

There has been significant additional investment to help tackle waiting lists for spinal procedures. This has resulted in a significant increase in the number of spinal procedures carried out in recent years.

Several initiatives are underway to help improve access to services including a ring-fenced theatre, additional outpatient clinics, and national and international outsourcing to maximise capacity.

The Paediatric Spinal Services Management Unit, led by a Consultant Orthopaedic Surgeon, and supported by wider MultiDisciplinary Teams, ensures patients are prioritised correctly for surgery and works to reduce waiting times.

As the detail of the question posed by the Deputy relates to operational matters, I have asked the HSE to provide a direct response as soon as possible.

National Treatment Purchase Fund

Ceisteanna (893)

Matt Carthy

Ceist:

893. Deputy Matt Carthy asked the Minister for Health whether any CHI-affiliated surgeons were involved in treating CHI patients at any private providers under NTPF contracts at any stage since 2020; to provide details of each instance; whether any conflict-of-interest declarations or audits have been carried out to ensure that outsourcing decisions were made solely to benefit patients and reduce waiting times; and if she will make a statement on the matter. [34351/25]

Amharc ar fhreagra

Freagraí scríofa

Insourcing initiatives of the National Treatment Purchase Fun (NTPF), targeted at the longest waiting public patients, are arranged with the management of the public hospital concerned, in line with the relevant Waiting List Management Protocols, and on the basis of a strict Memorandum of Understanding. Under the insourcing agreement, the hospital confirms that the work is undertaken outside core hours and is additional activity aimed at reducing waiting lists.

Due to concerns raised over the 2022 Internal Examination, the NTPF placed a temporary pause on all insourcing work with CHI. It initiated a comprehensive review of all insourcing work with CHI to gather the necessary assurances regarding compliance, value for money and appropriate use of NTPF funding mechanisms. On the 11th of June, the NTPF confirmed that it was immediately recommencing insourcing work with CHI after a review of the assurances given by CHI in relation to its ongoing compliance with existing NTPF protocols and procedures.

The HSE CEO is commissioning an audit of governance and equity in patient access and waiting list management at CHI. The audit aims to assess governance and equity in access to care within CHI, especially regarding the balance between public and private patient management. The outcome of this audit is expected in the coming months.

As the Deputy’s question requires operational detail, I have asked the HSE to look into these matters and provide a direct reply as soon as possible.

Departmental Investigations

Ceisteanna (894)

Matt Carthy

Ceist:

894. Deputy Matt Carthy asked the Minister for Health whether CHI commissioned any internal investigation since 2020 into orthopaedic waiting-list practices; the details of any such investigations; whether the findings of any such investigation were shared in a timely matter with the CHI board, HSE or the Minister respectively; and if she will make a statement on the matter. [34352/25]

Amharc ar fhreagra

Freagraí scríofa

There have been a number of reviews into orthopaedic services at CHI. These include the Boston Review on Spinal Surgery for Patients with Spina Bifida (published September 2023), the HIQA Review on the use of surgical implants (published April 2025), the Developmental Dysplasia of the hip Audit (published May 2025), and the Nayagam review which is ongoing.

In response to these reviews I have moved to strengthen governance and oversight structures at CHI, by appointing two members of the HSE Board to the Board of CHI.

There has also been a strengthening of the SLA between CHI and the HSE to strengthen operational oversight. Further, there will be increased involvement and support from the Dublin Midlands REO and senior management.

Recognising the need to co-ordinate oversight of the range of matters of focus in CHI in a cohesive fashion, the HSE CEO has established the HSE CHI Improvement Steering Group. This Group will co-ordinate across a number of projects including the implementation of recommendations from completed reviews and upcoming reports.

In relation to any additional internal investigations that CHI may have commissioned over recent years, I have asked the HSE to look into these matters further and provide a direct reply to the Deputy.

Departmental Meetings

Ceisteanna (895)

Mark Wall

Ceist:

895. Deputy Mark Wall asked the Minister for Health further to Parliamentary Question No. 554 of 7 May 2025, for a list of all patient representative and civil society groups that the gender healthcare programme has organised meetings with to date; and if she will make a statement on the matter. [34360/25]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Health Service Executive

Ceisteanna (896)

Mark Wall

Ceist:

896. Deputy Mark Wall asked the Minister for Health if the clinical lead of the gender healthcare programme is engaged in clinical work at the National Gender Service; and if she will make a statement on the matter. [34361/25]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Departmental Data

Ceisteanna (897)

Michael Cahill

Ceist:

897. Deputy Michael Cahill asked the Minister for Health the number of general practitioners who retired in 2022, 2023, 2024 and to date in 2025, in tabular form; and if she will make a statement on the matter. [34365/25]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Please note that GPs are private practitioners, most of whom hold at least one contract with the HSE for the provision of medical services on its behalf, such as the GMS contract for the provision of GP services without charge to medical card and GP visit card holders. Accordingly, it may only be possible for the HSE to respond in relation to HSE contracted GPs.

Health Services

Ceisteanna (898)

Eoghan Kenny

Ceist:

898. Deputy Eoghan Kenny asked the Minister for Health to provide details on the services currently provided for adult patients with epilepsy at a hospital Cork University Hospital; the number and grade of staff that are currently attached to this service at this site; the number of current staff vacancies within this service; the number of epilepsy patients currently registered with this service; the number of patients currently awaiting first consultations; and if she will make a statement on the matter. [34369/25]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Departmental Budgets

Ceisteanna (899)

Brian Stanley

Ceist:

899. Deputy Brian Stanley asked the Minister for Health the total budget for the treatment benefit (PRSI used dental) scheme in 2024 and, separately, for 2025; and if she will make a statement on the matter. [34375/25]

Amharc ar fhreagra

Freagraí scríofa

This PQ should be directed to the Department of Social protection as the topic raised is under their remit.

Dental Services

Ceisteanna (900)

Brian Stanley

Ceist:

900. Deputy Brian Stanley asked the Minister for Health the total budget for the dental treatment services scheme in 2024 and, separately, in 2025; and if she will make a statement on the matter. [34376/25]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.

Dental Services

Ceisteanna (901)

Brian Stanley

Ceist:

901. Deputy Brian Stanley asked the Minister for Health the total budget for the school dental scheme in 2024 and, separately, in 2025; and if she will make a statement on the matter. [34377/25]

Amharc ar fhreagra

Freagraí scríofa

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.

Departmental Reviews

Ceisteanna (902)

David Cullinane

Ceist:

902. Deputy David Cullinane asked the Minister for Health when she expects to receive and to publish the review of urgent and emergency care in the midwest; the resources and WTE staff committed to the review; and if she will make a statement on the matter. [34378/25]

Amharc ar fhreagra

Freagraí scríofa

HIQA has recently updated me of a revised timeline for completion of their final report regarding the review of hospital services in the Mid West region, which is now expected to be September 2025.

Overall, the HIQA work on the review of urgent and emergency healthcare services in the Mid West region has progressed very well and the workstreams undertaken by HIQA to inform the advice to me, as Minister, are complete. A critical dependency for completion of the advice and a final report from HIQA is the input from the national and regional demand and capacity projections being undertaken by the ESRI for the Department.

The first of these three ESRI reports, on projections of national demand and bed capacity requirements for public acute hospitals, was published on 28 May 2025. The second report, on future capacity requirements for GP services, was published on 18 June 2025. The third report, on older persons care, will be published shortly. The ESRI will also publish further regional analysis over the coming months.

HIQA have updated me that, given the ESRI regional capacity projections work will not be completed until later in the summer, this will impact on the timeframe for delivery of HIQA’s final report and advice.

The revised timeline for completion of the HIQA final report will therefore be September 2025, contingent on the completion of the ESRI reports within the expected timeframe. The final report will be published.

I look forward to receiving the advice from HIQA once this important work is completed.

A new senior programme manager was appointed in HIQA to coordinate the review. Otherwise, the review has been carried out by HIQA through reallocation of existing resources.

Nursing Homes

Ceisteanna (903)

David Cullinane

Ceist:

903. Deputy David Cullinane asked the Minister for Health the number of incidents referred to An Garda Síochána by the Health Information and Quality Authority relating to nursing homes, by incident type and by registered provider for each year 2015-2025, in tabular form. [34399/25]

Amharc ar fhreagra

Freagraí scríofa

The Chief Inspector of Social Care and the Health Information Quality Authority (HIQA) is the national independent regulator of designed centres for older people including public community nursing units and private nursing homes.

Department of Health officials directed this query to HIQA who have requested more time to deal with this substantial request.

As soon as the information is to hand it will be supplied to the Deputy.

Nursing Homes

Ceisteanna (904)

David Cullinane

Ceist:

904. Deputy David Cullinane asked the Minister for Health the number of protected disclosures received by the Health Information and Quality Authority relating to nursing homes for each year 2015-2025; the action taken in each case; the time-lapse between receipt of disclosure and action taken in each case; the number which resulted in a referral to the Gardaí; and the number which resulted in prosecution, in tabular form. [34400/25]

Amharc ar fhreagra

Freagraí scríofa

The Chief Inspector of Social Care and the Health Information Quality Authority (HIQA) is the national independent regulator of designed centres for older people including public community nursing units and private nursing homes.

Department of Health officials directed this query to HIQA who have requested more time to deal with this substantial request.

As soon as the information is to hand it will be supplied to the Deputy.

Nursing Homes

Ceisteanna (905)

David Cullinane

Ceist:

905. Deputy David Cullinane asked the Minister for Health the number of compliance notices issued by the Health Information and Quality Authority relating to nursing homes, for each nursing home, for each year 2015-2025, in tabular form. [34401/25]

Amharc ar fhreagra

Freagraí scríofa

The Chief Inspector of Social Care and the Health Information Quality Authority (HIQA) is the national independent regulator of designed centres for older people including public community nursing units and private nursing homes.

Department of Health officials directed this query to HIQA who have advised the following:

“On 14 February 2025 the Health (Miscellaneous Provisions) (No. 2) Act 2024 was commenced.

Section 16 of this Act sets out the legislative framework whereby the Chief Inspector can issue a compliance notice to a registered provider of a designated centre, which includes nursing homes, if they are not in compliance with the relevant regulations (and some other legal obligations). A Compliance Notice must tell a provider in clear terms what provision they have failed to comply with and what they must do to fix it - either to do certain things or to stop doing certain things, by a specified date. It is legally binding, meaning the provider must follow it.

Compliance Notices are new (they came in on 14 February 2025) and are considered to be a middle-ground enforcement tool – more formal than a Warning Letter or a Provider Assurance Request (PAR), but less serious than using our powers under Section 51 or 59 of the Health Act 2007, as amended. This tool is useful in situations where it is very clear what is required to be done and where we can define a timeframe such as:

• Ensure all staff undergo updated safeguarding training, for example”.

Nursing Homes

Ceisteanna (906)

David Cullinane

Ceist:

906. Deputy David Cullinane asked the Minister for Health the number of closure notices issued by the Health Information and Quality Authority relating to nursing homes, for each nursing home, for each year 2015-2025, in tabular form. [34402/25]

Amharc ar fhreagra

Freagraí scríofa

The Chief Inspector of Social Care and the Health Information Quality Authority (HIQA) is the national independent regulator of designed centres for older people including public community nursing units and private nursing homes.

Department of Health officials directed this query to HIQA who have requested more time to deal with this substantial request.

As soon as the information is to hand it will be supplied to the Deputy.

Nursing Homes

Ceisteanna (907)

David Cullinane

Ceist:

907. Deputy David Cullinane asked the Minister for Health the number of times restrictions were applied on the admission of new residents to nursing homes by the Health Information and Quality Authority, for each nursing home, for each year 2015-2025, in tabular form. [34403/25]

Amharc ar fhreagra

Freagraí scríofa

The Chief Inspector of Social Care and the Health Information Quality Authority (HIQA) is the national independent regulator of designed centres for older people including public community nursing units and private nursing homes.

Department of Health officials directed this query to HIQA who have advised the following:

Year

Number*

2015

Data Not Available

2016

Data Not Available

2017

Data Not Available

2018

6

2019

2

2020

9

2021

4

2022

8

2023

17

2024

31

2025

5

* These figures reflect conditions where admissions were ceased to some or all of the designated centre.

Nursing Homes

Ceisteanna (908)

David Cullinane

Ceist:

908. Deputy David Cullinane asked the Minister for Health the number of prosecutions brought by the Health Information and Quality Authority relating to nursing homes, broken down by the relevant charges being prosecuted and the sections of Acts to which these relate, for each year 2015-2025, in tabular form. [34404/25]

Amharc ar fhreagra

Freagraí scríofa

The Chief Inspector of Social Care and the Health Information Quality Authority (HIQA) is the national independent regulator of designed centres for older people including public community nursing units and private nursing homes.

Department of Health officials directed this query to HIQA who have requested more time to deal with this substantial request.

As soon as the information is to hand it will be supplied to the Deputy.

Health Services

Ceisteanna (909)

David Cullinane

Ceist:

909. Deputy David Cullinane asked the Minister for Health further to Parliamentary Questions Nos. 527, 528, 529, 530 and 531 of 12 June 2025, if she can confirm that she is not aware of the matters raised in these questions and that the lack of response from her directly can be assumed to mean that her attention was not drawn to the subject matter in question; if this is not the case, the reason why the questions were not answered; and if this is the case, the steps she has taken to rectify the matter. [34440/25]

Amharc ar fhreagra

Freagraí scríofa

On Monday 26 May, the internal examination (2022) was provided to the Department from the HSE. I wrote to CHI on 26 May, requesting a full response to the report. I received responses advising that CHI has developed an Action Plan to implement the recommendations, and the majority of actions are complete, with work ongoing on remaining actions. I note Children’s Health Ireland's (CHI) publication of a summary of the internal examination (2022) on 16 June. I wrote to the Board again on 18 June requesting assurance that the recommendations have been addressed in full and asking the Board to report directly on the status of children that may have been impacted. I am awaiting a response to this request.

On 20 June, my Department received a copy of the 'Dickson report' and my officials are currently reviewing the report. On 25 June, my Department wrote to the HSE seeking initial assurances and additional information, while the report is being reviewed.

A succession of extant and pending reports have raised corporate and clinical governance concerns at CHI. In response to these, I have moved to strengthen governance and oversight structures at CHI by appointing two members of the HSE Board to the Board of CHI.

The service level agreement between CHI and the HSE has been strengthened in relation to operational oversight. There has also been increased involvement and support from the HSE's Dublin Midlands regional executive officer and senior management. This includes the establishment of the HSE CHI Improvement Steering Group to coordinate oversight of a range of matters of focus at CHI.

It is important that CHI is given the support and the time to continue the significant reform underway across both current services and in preparation for the new children’s hospital.

Roinn