Written Answers Nos. 298-318
298. Deputy Barry Ward asked the Minister for Health the research carried out by her Department into the cost of further expansion of the medical card to all people over the age of 70; her views on the merits of this proposition; and if she will make a statement on the matter. [66439/25]
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 aged 69 and under 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. 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 medical costs. Furthermore, the Deputy may be aware that, since 2015, every individual aged 70 and over has automatic eligibility for a GP visit card.
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.
I can assure the Deputy that my Department keeps medical card issues under review in order to ensure the medical card system is responsive and sensitive to people's needs. There is a programme of work currently underway in my Department which is reviewing the existing eligibility framework, to clearly assess what is working well and to inform future policy proposals regarding the eligibility framework based on robust evidence. This is an important step towards delivering on universal healthcare in Ireland
299. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) has not been seen by mental health services; and if she will make a statement on the matter. [66473/25]
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.
300. Deputy Roderic O'Gorman asked the Minister for Health if she is aware that pharmacists are warning customers that the free blister packing service that they offer will be discontinued soon; her views on this development; and if she will make a statement on the matter. [66475/25]
Amharc ar fhreagraThe Community Pharmacy Agreement 2025 was published on the 18th of September 2025, following the successful conclusion of negotiations with the Irish Pharmacy Union (IPU). The Agreement is supported by a €75 million new investment across 2025 and 2026.
The Agreement marks a significant milestone in the strategic collaboration between the Department of Health, the Health Service Executive (HSE), and the IPU. It sets out a comprehensive and ongoing pathway to modernise and expand the role of community pharmacy in Ireland’s healthcare system.
The Agreement is available on the Department of Health’s website at the following link: www.gov.ie/en/department-of-health/publications/community-pharmacy-agreement-2025/.
It is important to note that the 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 monthly, 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 in the pharmacy 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.
Phased dispensing support is currently available for medical card holders under the General Medical Services (GMS) Scheme for the following reasons:
Reason 1 - at the request of a patient's physician.
Reason 2 - due to the inherent nature of a medicinal product i.e. product stability and shelf life.
Reason 3 - where a patient is commencing new drug therapy with a view to establishing patient tolerance and acceptability before continuing on a full treatment regime.
Reason 4 - in exceptional circumstances where the patient is incapable of safely and effectively managing the medication regimen.
Under the Community Pharmacy Agreement 2025, from January 2026, phased dispensing under reason 1 and 4 will be limited to a defined set of high-risk medication classes. These are:
• Psychotropics;
• Opioids;
• Codeine; and
• Pregabalin and gabapentin.
The approved list of medications under these classes will be provided by the HSE in due course.
For reasons 1 and 4, by focusing phased dispensing reimbursement on the medication categories on the approved list, phased dispensing payments can be targeted to medications with the highest risk or potential for misuse.
Phased dispensing fees will remain payable as per current arrangements under reasons 2 and 3 and will not be subject to the approved list.
The salient point here is that appropriate phased dispensing is not being removed in this Agreement.
The introduction of improved controls around phased dispensing 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
301. Deputy Barry Heneghan asked the Minister for Health the current waiting list for audiology services, by age, assessment type and procedures, and the length of time individuals have been waiting, in tabular form; and if she will make a statement on the matter. [66491/25]
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
302. Deputy Ken O'Flynn asked the Minister for Health the reason the HSE is unable to provide national-level expenditure data for chronic pain management services, as indicated in recent correspondence to this Deputy; the actions her Department is taking to ensure full financial reporting and service oversight for chronic pain services across all hospital groups and community healthcare organisations; the date on which her Department last sought national data from the HSE on expenditure and activity relating to chronic pain; and the timeline for the introduction of comprehensive national reporting, including for community based non-pharmacological interventions such as physiotherapy, CBT, mindfulness supports and graded exercise programmes. [66509/25]
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
303. Deputy Ken O'Flynn asked the Minister for Health the current national waiting times for access to chronic pain management services at primary, secondary and tertiary levels; the number of patients currently waiting for chronic pain assessment and treatment in each hospital group; the longest wait recorded; and the reforms being implemented by her Department to reduce delays in line with the Sláintecare commitment to timely access. [66510/25]
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
304. Deputy Ken O'Flynn asked the Minister for Health the number of whole-time equivalent chronic pain specialists currently employed across the HSE, broken down by hospital group; the number of vacancies; the number of unfilled consultant posts in pain medicine; and the steps being taken by her Department to address workforce shortages in chronic pain services in 2025 and 2026. [66511/25]
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
305. Deputy Ken O'Flynn asked the Minister for Health the number of community-based chronic pain management programmes currently operating nationwide; the budget allocation for each; the extent to which the iPainCentre pilot evaluation has informed national service planning; and whether her Department will commit to a national roll-out of community-based pain clinics as part of the 2026 National Service Plan. [66512/25]
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
306. Deputy Colm Burke asked the Minister for Health the total number of locum consultants who are currently employed by the Health Service Executive, by the hospitals that they are employed in, the category of healthcare they are providing, and the time period that they are in post; and if she will make a statement on the matter. [66518/25]
Amharc ar fhreagraAs this is a service matter I have asked the HSE to respond to the deputy as soon as possible
307. Deputy Ken O'Flynn asked the Minister for Health to set out the number of occupational therapy posts currently unfilled in each area of Cork, broken down by network, grade and whole-time equivalent, and to provide the date by which her Department expects all posts to be filled. [66519/25]
Amharc ar fhreagraAs this is a service matter I have asked the HSE to respond to the deputy as soon as possible
308. Deputy Ken O'Flynn asked the Minister for Health to confirm the formal targets held by her Department for reducing occupational therapy waiting times in Cork, and to specify the date by which these wait times will fall below 12 weeks in each network. [66520/25]
Amharc ar fhreagraAs this is a service matter I have asked the HSE to respond to the deputy as soon as possible
309. Deputy Ken O'Flynn asked the Minister for Health to outline the funding allocated for occupational therapy services in Cork in 2026, including new development posts, replacement posts, and resources for waiting list initiatives. [66521/25]
Amharc ar fhreagraThe additional funding for current expenditure in Budget 2026 for the Health Vote is €1.5 billion, bringing the total current allocation to €25.8 billion. This includes funding to maintain existing levels of service and for new service developments, including funding for the recruitment of 3,300 additional whole time equivalent staff in 2026.
The HSE is in the process of preparing its National Service Plan for 2026, setting out how the HSE will operationalise the Department’s priorities funded in Budget 2026, including the key priorities of improved access, quality and safety for those who use our services and value for money for the public more broadly.
The National Service Plan will include HSE plans, targets and timelines for specific measures to be progressed in 2026. Further information on the specific measures to be progressed in 2026, along with the associated funding and staffing, will be available when the National Service Plan has been completed and approved
310. Deputy Ken O'Flynn asked the Minister for Health the number of occupational therapists who left HSE posts in Cork in 2024 and 2025, and to give the reasons recorded for exit. [66522/25]
Amharc ar fhreagraAs this is a service matter I have asked the HSE to respond to the deputy as soon as possible
311. Deputy Ken O'Flynn asked the Minister for Health to confirm whether her Department has carried out any assessment of unmet need for occupational therapy in Cork, including expected demand growth for 2026 and 2027; and to publish the findings. [66523/25]
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
312. Deputy Ken O'Flynn asked the Minister for Health the average waiting time for a speech and language therapy appointment in Cork by network, and to set out plans to reduce waiting lists. [66524/25]
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
313. Deputy Ken O'Flynn asked the Minister for Health the average waiting time for a physiotherapy appointment in Cork by network, and the expected date by which waiting times will fall below 12 weeks. [66525/25]
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
314. Deputy Ken O'Flynn asked the Minister for Health the number of vacant community health posts across Cork, by discipline, by grade and whole-time equivalent; and to provide recruitment timelines for each. [66526/25]
Amharc ar fhreagraAs this is a service matter I have asked the HSE to respond to the deputy as soon as possible
315. Deputy Ken O'Flynn asked the Minister for Health to set out the current vacancy rate within the South South-West Hospital Group and Cork Kerry Community Healthcare, by hospital, service, grade and specialty; and to provide the total number of approved posts versus filled posts as of the most recent reporting period. [66533/25]
Amharc ar fhreagraAs this is a service matter I have asked the HSE to respond to the deputy as soon as possible
316. Deputy Ken O'Flynn asked the Minister for Health further to Parliamentary Question No. 2004 of 4 November 2025, the number of staff recruited in 2024 and to date in 2025 within the South South-West Hospital Group and Cork Kerry Community Healthcare under each of the recruitment and retention initiatives referenced, including graduate retention, nurse and healthcare assistant campaigns, Health and Social Care Professional retention, agency conversions to permanent contracts, and targeted recruitment campaigns, and to provide the outcomes for each initiative. [66534/25]
Amharc ar fhreagraAs this is a service matter I have asked the HSE to respond to the deputy as soon as possible
317. Deputy Ken O'Flynn asked the Minister for Health to detail the total number of agency staff currently working within the South South-West Hospital Group and Cork Kerry Community Healthcare; the number offered conversion to permanent HSE contracts in 2024 and 2025; the number who accepted; and the number of posts that remain dependent on agency staff. [66535/25]
Amharc ar fhreagraAs this is a service matter I have asked the HSE to respond to the deputy as soon as possible.
318. Deputy Ken O'Flynn asked the Minister for Health to outline the number of apprentices currently in place in Social Work and Social Care Work within the South South-West region; the planned intake for 2025 and 2026; any planned expansion of apprenticeships into additional roles; and the projected contribution of these apprenticeship schemes to reducing vacancies in the region. [66536/25]
Amharc ar fhreagraAs this is a service matter I have asked the HSE to respond to the deputy as soon as possible
