Written Answers Nos. 195-220
195. Deputy Ken O'Flynn asked the Minister for Health if she will provide the guidelines issued by her Department to the HSE on the use of sex and gender terminology in medical information leaflets and online publications; and if she will direct the HSE to publish those guidelines in full. [52375/25]
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.
196. Deputy Ken O'Flynn asked the Minister for Health if she accepts that she bears ultimate responsibility for the accuracy and content of health information issued by the HSE, including its publications on menopause; and if she will confirm that such accountability cannot be delegated to the HSE. [52376/25]
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.
197. Deputy Pádraig Rice asked the Minister for Health if she has received a business case from a group (details supplied); the status of her Department’s consideration of same; if she has engaged with the group concerned since receiving its business case; and if she will make a statement on the matter. [52393/25]
Amharc ar fhreagraI am fully committed to ensuring and supporting patients' central role in working with the public health service to develop health policy and in designing and reforming health services. Patient representatives participate in a number of committees and working groups across the Department of Health, the HSE and health agencies and make a significant contribution to the strategic decision-making work of those committees and groups.
Additional Grant Funding was provided to the 221+ Cervical Check Patient Support Group for a period of eighteen months (to June 2026). This funding is to support the Group's work in assisting patients and next of kin of those directly affected by the CervicalCheck issues through the provision of information, advice, and support.
My Department is currently engaging with 221+ Cervical Check Patient Support Group around funding arrangements for next year. As the Deputy would be aware, decisions on funding are taken as part of the Budget/Estimates process, and any relevant funding requests will be considered as part of that process.
198. Deputy Michael Healy-Rae asked the Minister for Health the measures which will be taken to ensure protections remain in place for persons who rely on phased systems for medication dispensing, ahead of the planned removal of phased dispensing under the Community Pharmacy Agreement Act 2025; and if she will make a statement on the matter. [52446/25]
Amharc ar fhreagraThe Community Pharmacy Agreement 2025 does not remove phased dispensing.
Phased dispensing was introduced in 1996 for patient safety reasons. The supply of medication in instalments can support patients prescribed certain high-risk medications who are at risk of medication misadventure if these medications were to be supplied on a monthly basis, as is the norm under the community drug schemes. Where a phased dispensing claim is submitted, the current requirement is that an item must be dispensed across multiple supply occasions. Community pharmacies receive additional payments in respect of phased dispensing.
Monitored Dosing Systems are systems that enable the individual medicine doses to be organised according to the prescribed dose schedule. These are sometimes referred to as blister packs. The State has never agreed to fund Monitored Dosing Systems.
However, a practice has built up whereby the use of Monitored Dosing Systems are charged as if for phased dispensing. The State has never agreed to this. Phased claiming was never intended to be used to submit claims in lieu of the provision of Monitored Dosing Systems.
Whilst Monitored Dosing Systems may have a role for some patients there is significant uncertainty around the robustness of the evidence supporting its use. The National Centre for Pharmacoeconomics carried out an evidence assessment which indicated that the evidence was, at best, equivocal to support such a programme.
Significant expenditure is therefore being incurred where it was never intended by the State. It has been agreed to introduce improved controls in this regard and to limit the use of phased dispensing to specified high risk drugs, where a patient safety concern may exist.
This is being done in a way which puts patient safety first and allows the State to repurpose €20m of funding to be used to implement new patient-centred services.
It remains open to pharmacies to charge patients for the use of Monitored Dosing Systems as a private service.
199. Deputy Shane Moynihan asked the Minister for Health if she has had engagements with the HSE in relation to the recruitment of the six WTE public health nursing posts in the Dublin Midlands region as allocated under budget 2025; and if she will make a statement on the matter. [52447/25]
Amharc ar fhreagraThe recruitment of staff for new initiatives in 2025 is based on funding and staffing limits agreed as part of the 2025 Budget process, and is carried out in line with the approach detailed in the HSE's Pay and Numbers Strategy for 2025.
This includes the recruitment of six Public Health Nurses for the Dublin Midlands area, who, as reported by the HSE in their published Census October 2025 have all been onboarded.
200. Deputy Shane Moynihan asked the Minister for Health the steps her Department is taking in conjunction with the HSE to address ongoing recruitment challenges for public health nurses in the Dublin Midlands region; and if she will make a statement on the matter. [52448/25]
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.
201. Deputy Shane Moynihan asked the Minister for Health if she plans to expand the public health nurse sponsorship programme for 2026 given the ongoing recruitment challenges being experienced; and if she will make a statement on the matter. [52449/25]
Amharc ar fhreagraPublic Health Nurses (PHN) are employed by the HSE to deliver safe, quality and person-centred community nursing care across a person's life. There are known challenges with the recruitment and retention of Public Health Nurses, particularly within parts of Dublin. This Government remains committed to providing continued investment in the nursing and midwifery workforce and ensuring that public health nursing is available for those who need this care.
There are 160 Post graduate education places available across 3 Higher Education Institutes (HEIs) in the Student Public Health Nursing programme. Places are filled based on the number of PHN vacancies and predicted vacancies that exist each year. To date there has not been a need to increase the number of post graduate places available as the number of vacancies and predicted vacancies has not exceeded the number of places available.
In 2024, to attract more nurses to specialise as Public Health Nurses, agreement was reached to allow existing Staff Nurses / Enhanced Staff Nurses who wished to enter the Public Health Nurse Sponsorship Programme to remain on the existing point of their current salary scale. The Public Health Nurse salary scale was also merged with the Clinical Nurse/Midwife Manager 2 grade along with the extension of the salary scale to one further point and the addition of a Long Service Increment.
As of August 2025, there are 1,520 WTE Public Health Nurses employed in the HSE. This is an increase of 49 WTE since August 2024. An additional 26.7 WTE PHN posts were provided for in Budget 2025. Candidates on the Public Health Nursing Sponsorship Programme have been selected and commenced their Student Public Health Nurse roles in September 2025. The sponsorship programme runs for 1 academic year starting in September each year.
202. Deputy Shane Moynihan asked the Minister for Health if she has considered introducing a counselling and psychotherapy funding model under the medical card through accredited private therapists; and if she will make a statement on the matter. [52450/25]
Amharc ar fhreagraBetter access to talk therapies for people experiencing mental health difficulties is a priority for myself as Minister, the Government, and the HSE.
I recently launched free counselling supports for men, supported by recurring annual funding of €2m. The supports are available via GPs and are being actively promoted through a national campaign targeting men The initiative will provide over 15,000 free counselling sessions to men and establishes accessible supports over the phone and in-person.
The funding is targeted at assisting with stigma reduction and to actively encourage men who otherwise would not usually avail of counselling to seek help with their mental health, to assist men in accessing mental health services, and to provide much-needed support for men experiencing a mental health crisis.
Funding is also being provided to specifically enhance mental health supports for young Traveller men through a partnership with Exchange House, as well as to support general population mental health promotion initiatives including the Minding Your Wellbeing for Men programme.
This initiative is embedded within Ireland’s approach to mental health policy implementation. Both Sharing the Vision – A Mental Health Policy for Everyone, and Connecting for Life, Ireland’s national strategy for suicide prevention, emphasise that talk therapies should be considered a first-line treatment option for most people who experience mental health difficulties.
More broadly, the HSE is also working to establish a therapeutic interventions service improvement programme board (TISIP). The programme board will provide consolidated leadership and governance for therapeutic interventions across the whole health system, with the aim of increasing capacity, and facilitating access to, high quality integrated supports and services for all who require them.
Finally, medical card holders have access to free counselling from the HSE’s National Counselling Service, through the Counselling in Primary Care service (CiPC), with referral from their GP.
203. Deputy Marie Sherlock asked the Minister for Health when a person (details supplied) will receive an appointment to see a neurologist in Beaumont Hospital; and if she will make a statement on the matter. [52457/25]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. The Minister for Health is prohibited from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
204. Deputy Paul McAuliffe asked the Minister for Health the supports available for persons who suffer from idiopathic pulmonary fibrosis and require oxygen 24/7; and if she will make a statement on the matter. [52464/25]
Amharc ar fhreagraAs the matter raised is a service delivery matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
205. Deputy Grace Boland asked the Minister for Health the plans to increase funding for community-based mental health services that support school-aged children; and if she will make a statement on the matter. [52479/25]
Amharc ar fhreagraIt is a priority for me, and for Government, to ensure that children who need services can access them and access them on time. This is in line with our national mental health policy Sharing the Vision, our suicide reduction strategy Connecting for Life, and the HSE Annual Service Plan 2025.
The various and obvious benefits of a Prevention and Early Intervention approach, including financial, have long been recognised by the mental health system and these are also clearly reflected in our on-going policy implementation and service developments. The concepts of Prevention and Early Intervention are a core Domain of our national mental health policy Sharing the Vision 2020-2030, and implementation of this is progressing very well.
For example, recommendation 10 of Sharing the Vision states that a protocol should be developed between the Department of Education and Skills and the HSE on the liaison process that should be in place between primary/post-primary schools, mental health services and supports such as NEPS, GPs, primary care services and specialist mental health services. This is needed to facilitate referral pathways to local services and signposting to such services, as necessary. A Working Group was established to progress recommendation 10 and improve liaison processes and information sharing between schools and mental health services. The Working Group met for the first time in January 2022 until it completed its work in December 2024. The Department of Education are currently working with the HSE to implement the protocol.
The Department of Health and the HSE are always conscious of the need to achieve the best possible service delivery, and financial outcomes, for the significant investment across the Mental Health care programme. Year-on-year funding for mental health services increased from €1.3 billion announced in Budget 2024 to almost €1.5 billion in 2025. This represents a 10.7% annual increase. CAMHS nationally receives approximately €167 million annually, with a further €110 million provided to NGOs, many of which focus on youth mental health. Under Budget 2025, an additional €2.9 million will support CAMHS to increase core staffing, develop a new CAMHS Emergency Liaison Service and expand CAMHS Hubs to improve crisis cover for services.
CAMHS is a secondary care specialist service for those aged up to 18 years, who have a moderate to severe mental health difficulty. Access to CAMHS is on the basis of prioritised clinical assessment, in line with the CAMHS Operational Guidelines which are available on the HSE website. All referrals to CAMHS are assessed by a multidisciplinary team. Approximately 2% of the population require support from this specialist service with over 90% of mental health needs requiring treatment in a primary care setting.
I established the National Office for Child and Youth Mental Health in the HSE to improve leadership and all aspects of care across youth mental health. The Office published its new Youth Mental Health Action Plan in February last. This ambitious plan for comprehensive reform across all youth mental health services, including the specialist CAMHS service, will deliver services which are safer, effective, easier to access and which offers appropriate support at all levels when needed.
The three-year Plan sets out a clear roadmap for the Department and HSE to ensure children and families have equitable and timely access to high-quality mental health care, including better links with Primary Care and Disability Services, and greater use of e-mental health responses. My aim is that services will be better connected and easier to navigate, with increased focus on the rights of young people and their families. The development of a Single Point of Access for all child and youth mental health referrals in partnership with disabilities, primary care, and voluntary and statutory agencies is a key priority within the new Action Plan.
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, to identify areas where increased activity is needed, and also areas of innovative and positive service delivery. This includes improving access and reducing CAMHS waiting lists particularly for those waiting over 12 months. I have stressed also, the importance of filling all approved posts for each CAMHS team to ensure the effective delivery of services.
As the Deputy will appreciate, any increase in funding for community-based mental health services for children and young people can only been considered in the context of agreeing the overall Mental Health Budget under the 2026 Annual Estimates process.
206. Deputy Grace Boland asked the Minister for Health the supports which are available for parents and guardians of students experiencing mental health challenges; the way in which these are communicated to families; and if she will make a statement on the matter. [52480/25]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible. I understand that, from further clarification received from the Deputy, that this question relates to supports available to primary and secondary school children and their families.
207. Deputy Grace Boland asked the Minister for Health the way in which her Department is ensuring mental health supports are available to students from diverse backgrounds; and if she will make a statement on the matter. [52481/25]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
208. Deputy Grace Boland asked the Minister for Health the current policy regarding the availability of weight loss medications, for persons on low incomes, including those with medical cards; the plans to expand access to these medications for persons who do not have diabetes but are struggling with obesity; and if she will make a statement on the matter. [52482/25]
Amharc ar fhreagra209. Deputy Grace Boland asked the Minister for Health the steps being taken to ensure equitable access to clinically approved weight loss drugs for lower-income earners; and if she will make a statement on the matter. [52483/25]
Amharc ar fhreagra210. Deputy Grace Boland asked the Minister for Health for an update on the HSE’s assessment of the inclusion of weight loss medications for non-diabetic patients on the reimbursement list for medical card holders; the timeframe for a decision on this matter; and if she will make a statement on the matter. [52484/25]
Amharc ar fhreagra211. Deputy Grace Boland asked the Minister for Health whether her Department has considered the potential impact on health inequalities if weight loss drugs remain inaccessible to lower-income groups; the measures being explored to address this issue; and if she will make a statement on the matter. [52485/25]
Amharc ar fhreagraI propose to take Questions Nos. 208 to 211, inclusive, together.
Under the Obesity Policy and Action Plan (OPAP), Ireland put in place a comprehensive, cross-Government strategy to address obesity and overweight. Since 2016 significant progress has been made in delivering on the Ten Step Programme of OPAP and to drive policy initiatives and actions, ranging from health promotion and education initiatives and obesity prevention measures through to establishing services to treat and manage obesity within the health care system.
The current OPAP runs through to the end of 2025 and a successor Obesity Policy and Action Plan will be due at the beginning of 2026. The Department is in the process of preparing the next OPAP. The Department have held a number of focus groups, workshops and interviews with various key stakeholders throughout the year.
The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. Under the 2013 Act, reimbursement is for licensed indications which have been granted market authorisation either by the European Medicines Agency (EMA) or by the Health Products Regulatory Authority (HPRA).
Controls are in place within the HSE on claiming processes to ensure that only HSE approved indications are reimbursed across a range of medicines. Controls are currently in place for the Glucagon-like peptide-1 (GLP-1) receptor agonists to restrict reimbursement support to the HSE approved indication of Diabetes. This includes Victoza® (liraglutide), Ozempic® (semaglutide) and Trulicity® (Dulaglutide). Therefore, these products are not reimbursed under the Drugs Payment Scheme (DPS) and are confined to those persons with full General Medical Services (GMS/Medical Card) and Long-Term Illness (Diabetes Mellitus) eligibility.
Diabetes is one of the Long-Term Illness (LTI) conditions for which eligible LTI persons can access their medicines to treat their Diabetes free of charge. Patients diagnosed with Diabetes Mellitus are entitled to be registered under the LTI Scheme.
Mounjaro® (tirzepatide) and Wegovy® (semaglutide) are not reimbursable under Community Drug Schemes or any arrangement as they are undergoing formal pricing and reimbursement assessments.
Liraglutide (Saxenda®) 6 mg/ml solution for injection in pre-filled pen is the only product currently approved under Community Drug Schemes (GMS/Drugs Payment Scheme (DPS)) for weight management with a managed access system in place.
The HSE introduced a managed access protocol (MAP) for liraglutide (Saxenda®) in January 2023. The aim of the MAP is to provide patients with an initial body mass index (BMI) greater than or equal to 35 kg/m2, with prediabetes and high-risk for cardiovascular disease, with access to reimbursement support for liraglutide (Saxenda®) for weight management. Liraglutide (Saxenda®) is a glucagon-like peptide-1 analogue and is indicated as an adjunct to a reduced-calorie diet and increased physical activity for weight management in adult patients.
212. Deputy Tom Brabazon asked the Minister for Health if she is aware that patients referred by their GPs for blood tests through the system (details supplied) are experiencing delays of up to two and a half months to secure an appointment, while many GP practices offer to conduct blood tests more quickly but at a cost to the patient; if she will explain the reason a service funded by the HSE out of taxpayers’ money is operating in such a way that patients who cannot afford to pay privately face prolonged delays; and the steps she will take to ensure that free, public blood test services are delivered in a timely and efficient manner. [52490/25]
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.
213. Deputy David Cullinane asked the Minister for Health the number of bed days lost due to delayed transfer of care, for each location, to end of September for each of the years 2023 to 2025, in tabular form [52519/25]
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.
214. Deputy David Cullinane asked the Minister for Health the number of extreme and major incidents reported to the national quality and patient safety directorate in the first nine months of each year 2023 to 2025, by location, in tabular form; and the percentage of category one incidents out of the total number of incidents reported. [52520/25]
Amharc ar fhreagraAs this is an operational matter for the Health Service Executive (HSE), the HSE has been asked to reply directly to the Deputy.
215. Deputy David Cullinane asked the Minister for Health the weighted average wait time for persons first access to outpatient departments as of 30 September for each year from 2023 to 2025, in tabular form. [52521/25]
Amharc ar fhreagra216. Deputy David Cullinane asked the Minister for Health the weighted average wait time for persons for an elective procedure as of 30 September for each year from 2023 to 2025, in tabular form. [52522/25]
Amharc ar fhreagraI propose to take Questions Nos. 215 and 216 together.
It is acknowledged that many patients are still waiting too long for hospital appointments and treatments. I am conscious of the burden that this places on patients and their families.
A multi-annual approach through a series of Waiting List Action Plans has been adopted to address this issue. Commencing in late 2021, these plans encompass short-term actions to increase capacity and activity in the short and immediate term, and longer-term reform measures to sustainably reduce both hospital waiting lists and waiting times.
I published the Waiting List Action Plan (WLAP) for 2025 on February 12th, representing the Government’s commitment to reducing waiting times for patients and improving access to hospital care.
In keeping with this commitment, significant funding of €420m was allocated to the Waiting List Action Plan for 2025, €190m for the HSE and €230m for the National Treatment Purchase Fund (NTPF).
With the 2025 plan, we are continuing to build upon the progress delivered to date under the multi annual action plan approach, progressing towards the ultimate vision of a public healthcare service in which everyone has timely access to high-quality scheduled care, where and when they need it.
This year’s WLAP focuses on reducing waiting times for scheduled care and sets out key targets aimed at achieving this objective, including reducing the weighted average wait time for scheduled care to 5.5 months.
The weighted average waiting time is an approach to capture the “average” waiting time and takes account of both how long people are waiting i.e. the time band that people are waiting in, and the number of people waiting within each time band. The more people within a given time band, the more “weight” that time band has when calculating the average waiting time across all time bands.
In relation to the particular queries raised, as weighted average wait times are calculated by the Health Service Executive I have asked them to respond directly to the Deputy as soon as possible.
217. Deputy David Cullinane asked the Minister for Health the number of persons waiting more than four weeks for access to an urgent colonoscopy as of 30 September for each year 2023 to 2025, in tabular form. [52523/25]
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.
218. Deputy David Cullinane asked the Minister for Health the rate of new cases of hospital acquired infections, by infection type, by location, as of 30 September for each year 2023 to 2025, in tabular form [52524/25]
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.
219. Deputy David Cullinane asked the Minister for Health the rate of medication incidents as reported to NIMS by 1,000 beds, by location, as of 30 September, for each year 2023 to 2025, in tabular form [52525/25]
Amharc ar fhreagraAs this is an operational matter for the Health Service Executive (HSE), the HSE has been asked to reply directly to the Deputy.
220. Deputy David Cullinane asked the Minister for Health the status of each patient safety review commissioned regarding Portiuncula Hospital maternity and neonatal services, in tabular form; the responsible person for each review; and the completion date of each review or timeline for completion, where not completed. [52526/25]
Amharc ar fhreagraAs this is an operational matter for the Health Service Executive (HSE), the HSE has been asked to reply directly to the Deputy.
