Written Answers Nos. 524-547
524. Deputy Pádraig Rice asked the Minister for Health if consideration has been given to establishing a scheme of financial reimbursement for women suffering with endometriosis who had to pay for previous treatment that was not offered by the State; and if she will make a statement on the matter. [66964/25]
Amharc ar fhreagraIt is recognised that endometriosis is a significant health issue for women in Ireland today and the HSE acknowledges that it is a difficult condition to diagnose and treat because of the variation of presentations which can impact the physical and mental well-being of patients. Endometriosis is a chronic disease with high recurrence rates, for which there is no definitive cure.
On 18 October I launched the National Framework for the management of Endometriosis. The Framework sets out for the first time in Ireland a defined clinical pathway for women with endometriosis, which spans primary to secondary care to specialist complex care in tertiary settings.
Most women experiencing signs and symptoms of endometriosis present to their local GP in the community. In line with clinical guidelines GPs are encouraged to initiate treatment for suspected endometriosis and may refer women with suspected endometriosis to general gynaecology services in their local hospital.
Regional Specialist Centres for moderate cases have been established in the Rotunda, the Coombe, and Limerick, with clinics under further development in Galway and the National Maternity Hospital.
Two supra-regional specialist centres, in Tallaght and Cork, have been established for the management of complex endometriosis cases.
All endometriosis sites are operational and taking referrals. Treatment including surgical intervention is being provided across the network.
Additional funding has been provided this year to expand these services through the recruitment of more personnel to provide multidisciplinary care at both supra-regional and regional level.
The Framework was officially published in October of this year. Funding of over €5 million has already been invested in specialist endometriosis services since 2021. In addition, endometriosis surgeries have been and continue to be performed in other acute gynaecology services.
The HSE has carried out an analysis of the short term and medium-term requirements to build adequate capacity, improve clinical pathways and increase expertise within our endometriosis services. The HSE’s budget for 2026 will be €27.4 billion, an increase of 6.2% on 2025. This investment will enable expansion and improvement in our health services, including endometriosis.
The Endometriosis Surgery Abroad Interim Scheme commenced from the 18 October and will operate in addition to the existing treatment abroad pathways, including the EU Treatment Abroad Scheme, the EU Cross Border Directive and Northern Ireland Planned Healthcare Schemes. The interim scheme will cover costs for the transport abroad and for healthcare provided, paid directly to the hospital.
Where a person accesses private healthcare in Ireland there is no facility for the cost of that care to be reimbursed by the public health system.
525. Deputy Ruth Coppinger asked the Minister for Health to consider providing funding for free blister packaging for patients from pharmacies; and if she will make a statement on the matter. [66968/25]
Amharc ar fhreagraThere are currently no reimbursement arrangements under the General Medical Service (GMS) Scheme or the Community Drug Schemes for the filling of blister packs (monitored dosage systems). Community pharmacies may offer, as a quality initiative, to provide a patient’s medicines in such systems and may charge for this. However, such is a pharmacy arrangement with the patient and is not a State funded service.
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.
The Community Pharmacy Agreement 2025 marks a significant milestone in the strategic collaboration between the Department of Health, the 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 designed to support the delivery of safe, equitable, and efficient healthcare, and to ensure that community pharmacists are better equipped to contribute to national health priorities through structured engagement, sustainable funding, and integrated service delivery.
Under the Agreement, a Strategic Collaboration Group will be established from early 2026 which will provide a structured forum for dialogue and joint consideration of strategic issues shaping the future of community pharmacy in Ireland.
The Agreement also includes the establishment of a rolling annual medicines optimisation programme with dedicated annual funding. The Strategic Collaboration Group will be tasked with exploring the best way to utilise this fund.
526. Deputy Ken O'Flynn asked the Minister for Health to list each voluntary hospital that has raised concerns about the deployment of the integrated financial management system; the date on which each concern was submitted to her Department or the HSE; and the categories of issues raised. [66974/25]
Amharc ar fhreagraThis is an operational matter this PQ has been referred to the HSE for direct response to the Deputy.
527. Deputy Ken O'Flynn asked the Minister for Health when she expects full deployment of the integrated financial management system across all voluntary hospitals; and the milestones that have been agreed with each hospital following her recent correspondence to them. [66975/25]
Amharc ar fhreagraAs of July 2025, IFMS has been deployed to all statutory sites – that is, all sites directly managed by the HSE – so over 80% of all health expenditure is now managed through IFMS. Planning is underway to extend IFMS to voluntary hospitals and other voluntary providers, which will cover the remaining 20% of health expenditure. Implementation in the voluntary sector is expected to begin in early 2026. As planning for this roll-out is not yet complete, I will provide a timeline for full implementation shortly.
528. Deputy Ken O'Flynn asked the Minister for Health the number of governance reviews, financial audits and compliance assessments completed by the HSE for voluntary hospitals in each of the past five years; and the date on which each review or audit was furnished to her Department under the Performance and Accountability Framework. [66976/25]
Amharc ar fhreagraAs this is a service matter I have asked the HSE to respond to the deputy as soon as possible.
529. Deputy Ken O'Flynn asked the Minister for Health to outline the financial transparency and reporting requirements that apply when her Department approves payments to non-statutory bodies; and the number of compliance checks carried out in the past three years. [66977/25]
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.
530. Deputy Ken O'Flynn asked the Minister for Health the number of instances in the past five years in which the HSE has reported governance or financial non-compliance by voluntary hospitals or HSE-funded private providers to her Department; and the actions taken in each case. [66978/25]
Amharc ar fhreagraAs this is a service matter I have asked the HSE to respond to the deputy as soon as possible.
531. Deputy Ken O'Flynn asked the Minister for Health the number of governance reviews, financial audits and compliance assessments completed by the HSE for voluntary hospitals and HSE-funded private providers in each of the past three years, the date each review was finalised, and whether the Department has received and examined these reviews as part of its oversight of the HSE under the Performance and Accountability Framework. [66980/25]
Amharc ar fhreagraAs this is a service matter I have asked the HSE to respond to the deputy as soon as possible.
532. Deputy Ken O'Flynn asked the Minister for Health if she will confirm whether her Department has requested, received or reviewed any governance, audit or compliance reports from the HSE relating to voluntary hospitals or HSE-funded private providers in the past three years, and the outcome of any such reviews. [66981/25]
Amharc ar fhreagraThe Department has not requested or reviewed and reports of this nature in the past three years. The governance and oversight of voluntary hospitals is a matter for the HSE; these hospitals operate under Service Level Agreements (SLAs) with the HSE, which set out governance and compliance requirements. The Department does not directly engage in the governance of these hospitals; the Department sets policy, determines investment, and engages with the HSE through the Performance and Accountability Framework (PAF). This framework places responsibility on the HSE to ensure robust governance and compliance arrangements for funded providers.
533. Deputy Ken O'Flynn asked the Minister for Health the process by which her Department assesses the adequacy of the HSE’s financial reporting, audit controls and compliance systems for voluntary hospitals and HSE-funded providers; and if she will provide details of any deficiencies or risks identified by her Department in each the past three years. [66982/25]
Amharc ar fhreagraThe governance and oversight of voluntary hospitals is a matter for the HSE; these hospitals operate under Service Level Agreements (SLAs) with the HSE, which set out governance and compliance requirements. The Department does not directly engage in the governance of these hospitals; the Department sets policy, determines investment, and engages with the HSE through the Performance and Accountability Framework. This framework places responsibility on the HSE to ensure robust governance and compliance arrangements for funded providers.
534. Deputy Ken O'Flynn asked the Minister for Health the number of non-statutory bodies that currently receive funding from her Department; the value of payments to each of these bodies in each of the past three years; and any compliance issues, audit flags or irregularities recorded during this period. [66983/25]
Amharc ar fhreagraDetails relating to the number of non-statutory bodies that currently receive funding from my Department, plus the annual value of payments received are as follows:
|
Description |
2022 € |
2023 € |
2024 € |
YTD 2025 € |
Totals € |
|
State Commissioned body fully funded by the DoH |
|
|
|
|
|
|
Patient Advocacy Service |
1,330,432.77 |
1,806,347.50 |
1,848,657.72 |
2,606,918.67 |
7,592,356.66 |
|
|
|
|
|
|
|
|
Non -Statutory Bodies |
|
|
|
|
|
|
International Society for Quality in Health Care |
1,393,526.28 |
1,377,000.00 |
1,681,806.00 |
4,452,332.28 |
8,904,664.56 |
|
Institute of Public Health |
210,000.00 |
157,500.00 |
210,000.00 |
362,500.00 |
940,000.00 |
|
|
|
|
|
|
|
No bodies reported that there were any compliance issues, audit flags or irregularities recorded during this period. Patient Advocacy Services, representing the views of HSE patients, is a commissioned body under the Dept of Health. It is independently audited by RBK Chartered Accountants.
535. Deputy Ken O'Flynn asked the Minister for Health to detail all mechanisms in place within her Department to verify the financial transparency and operational compliance of non-statutory bodies receiving public funds; and if she will provide a summary of the most recent compliance checks or reviews undertaken. [66984/25]
Amharc ar fhreagra553. Deputy Ken O'Flynn asked the Minister for Health to set out the audits, inspections or compliance checks carried out by her Department in the past three years relating to non-statutory bodies that receive public health funding directly from her Department, including the date of each review, the body reviewed, the methodology used, and the findings. [67013/25]
Amharc ar fhreagraI propose to take Questions Nos. 535 and 553 together.
The vast majority of payments made by my Department are to statutory bodies. Payments to non-statutory bodies represent less than 0.01% of the Department’s overall spend.
All payments made to non-statutory bodies are to the same two bodies (as specified in my previous response to PQ 66983/25) and to the Department commissioned, Patients Advisory Services each year. These bodies represent and advocate for patients, accrediting professional medical qualifications, conducting health surveys, promoting healthy living and highlighting areas for further improvement in the life expectancy of disadvantage groups, mostly on an all-Ireland basis arising from the Good Friday Agreement or other international agreements.
Department officials are in regular communication with these bodies over both their role in the health system and the nature of their spend. If there was a decision to make a health-related payment to a new non-statutory body, due diligence would naturally apply to any funding being considered, including background checks on the organisation concerned, including obtaining copies of audited financial statements.
Broadly similar procedures apply to all payments made by the Department to ensure that all payments are:
• genuine,
• subject to the principle of approval within a proper segregation of duties environment,
• for an appropriate purpose improving the overall health and well-being of our citizens, and
• tax compliant,
• within the parameters of public financial procedures.
All payments made are recorded in the Department’s Financial Management System and, as with any payments made by the Department, are subject to review by the Internal Audit Unit and the Comptroller and Auditor General. To date no significant control issues in respect of these bodies have been identified in the course of audit.
536. Deputy Ken O'Flynn asked the Minister for Health the number of governance reviews, financial audits and compliance assessments completed by the HSE for voluntary hospitals and HSE-funded private providers in each of the past three years, the date each review was finalised, and whether the Department has received and examined these reviews as part of its oversight of the HSE under the Performance and Accountability Framework. [66990/25]
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.
537. Deputy Ken O'Flynn asked the Minister for Health if her Department has requested, received or reviewed any governance, audit or compliance reports from the HSE relating to voluntary hospitals or HSE-funded private providers in the past three years; and the outcome of any such reviews. [66991/25]
Amharc ar fhreagraThe Department has not requested or reviewed and reports of this nature in the past three years. The governance and oversight of voluntary hospitals is a matter for the HSE; these hospitals operate under Service Level Agreements (SLAs) with the HSE, which set out governance and compliance requirements. The Department does not directly engage in the governance of these hospitals; the Department sets policy, determines investment, and engages with the HSE through the Performance and Accountability Framework (PAF). This framework places responsibility on the HSE to ensure robust governance and compliance arrangements for funded providers.
538. Deputy Ken O'Flynn asked the Minister for Health the process by which her Department assesses the adequacy of the HSE's financial reporting, audit controls and compliance systems for voluntary hospitals and HSE-funded providers; and if she will provide details of any deficiencies or risks identified by her Department in the past three years. [66992/25]
Amharc ar fhreagraThe governance and oversight of voluntary hospitals is a matter for the HSE; these hospitals operate under Service Level Agreements (SLAs) with the HSE, which set out governance and compliance requirements. The Department does not directly engage in the governance of these hospitals; the Department sets policy, determines investment, and engages with the HSE through the Performance and Accountability Framework. This framework places responsibility on the HSE to ensure robust governance and compliance arrangements for funded providers.
539. Deputy Ken O'Flynn asked the Minister for Health the number of non-statutory bodies that currently receive funding from her Department, the value of payments to each of these bodies in each of the past three years, and any compliance issues, audit flags or irregularities recorded during this period. [66993/25]
Amharc ar fhreagraDetails relating to the number of non-statutory bodies that currently receive funding from my Department, plus the annual value of payments received are as follows:
|
Description |
2022 € |
2023 € |
2024 € |
YTD 2025 € |
Totals € |
|
State Commissioned body fully funded by the DoH |
|
|
|
|
|
|
Patient Advocacy Service |
1,330,432.77 |
1,806,347.50 |
1,848,657.72 |
2,606,918.67 |
7,592,356.66 |
|
|
|
|
|
|
|
|
Non -Statutory Bodies |
|
|
|
|
|
|
International Society for Quality in Health Care |
1,393,526.28 |
1,377,000.00 |
1,681,806.00 |
4,452,332.28 |
8,904,664.56 |
|
Institute of Public Health |
210,000.00 |
157,500.00 |
210,000.00 |
362,500.00 |
940,000.00 |
|
|
|
|
|
|
|
No bodies reported that there were any compliance issues, audit flags or irregularities recorded during this period. Patient Advocacy Services, representing the views of HSE patients, is a commissioned body under the Dept of Health. It is independently audited by RBK Chartered Accountants.
540. Deputy Ken O'Flynn asked the Minister for Health the date on which her Department last reviewed the clinical governance structures in place for children and young people referred for gender-related assessment or treatment, and the findings of that review. [67000/25]
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.
541. Deputy Ken O'Flynn asked the Minister for Health if she will outline the changes to clinical pathways, referral criteria, risk assessment processes and external oversight arrangements that have been implemented following the publication of the Cass Review. [67001/25]
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.
542. Deputy Ken O'Flynn asked the Minister for Health the full number of children and young people referred by the HSE for gender-related assessment or treatment abroad in each of the past five years, the public cost incurred for each year, and the number of cases currently awaiting referral or approval. [67002/25]
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.
543. Deputy Ken O'Flynn asked the Minister for Health if her Department has carried out or commissioned any audit of compliance with international evidence standards, including safeguarding and mental-health assessment protocols, for gender-related care provided or funded by the State in the past five years. [67003/25]
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.
544. Deputy Ken O'Flynn asked the Minister for Health the number of individuals who have sought support for detransition or reversal of gender-related interventions in the past five years, and the governance framework in place to ensure access to appropriate clinical, psychological and safeguarding supports. [67004/25]
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.
545. Deputy Ken O'Flynn asked the Minister for Health the number of circumcisions carried out in public hospitals in each of the past five years, broken down by cases performed for medical reasons and cases performed for non-medical or cultural reasons. [67005/25]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
546. Deputy Ken O'Flynn asked the Minister for Health if she will confirm the clinical or administrative authorisation process that permits circumcisions for non-medical reasons to be carried out in public hospitals, and the criteria applied when such procedures are approved. [67006/25]
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.
547. Deputy Ken O'Flynn asked the Minister for Health the number of theatre slots allocated in each of the past five years to circumcisions undertaken for non-medical reasons, and whether her Department has assessed the impact of these procedures on access to surgery for clinically urgent cases. [67007/25]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
