Written Answers Nos. 340-359
340. Deputy Pádraig Rice asked the Minister for Health the number of regional sustainability officers in the HSE, by region and grade, in tabular form; the number that are on permanent contracts; and the number that are on agency contracts. [70703/25]
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.
341. Deputy Pádraig Rice asked the Minister for Health the status of the vendors shortlist for electronic health records; the number of vendors on the shortlist; if any vendors have been ruled out;; and if she will make a statement on the matter. [70704/25]
Amharc ar fhreagraVendors have not yet been shortlisted. The scale of the National Electronic Health Record programme is such that it comes under Government Infrastructure Guidelines which means it requires Government consent to proceed to pre tender stage. The Department are seeking that consent currently. That will enable the HSE to proceed with shortlisting and, subject to approval of the pre tender business case, then proceeding with the next stage in procurement.
342. Deputy Pádraig Rice asked the Minister for Health in relation to electronic health records, the market studies and due diligence that has been carried out to date to inform the procurement process; and if she will make a statement on the matter. [70705/25]
Amharc ar fhreagraExtensive work has been done in this area given the scale of the programme and the long term implications associated with how the health service goes about selecting the optimal process for market engagement and ultimately selecting the best products and vendors.
Through the departments close working with leaders in digital health in all other EU member states, we have learned a lot about what worked well and what was not good. We have also leveraged our contacts in digital health globally and in the UK to inform both our Digital for Care strategic framework and to inform direction for the EHR and market engagement.
The HSE have also taken on board advice and guidance from their EHR strategic partner and industry insights companies such as Gartner, who are independent of any vendor and therefore can provide unbiassed advice. Important also to note that the HSE have their own experience of vendor engagement with EHR systems which will be factored into the process.
Finally, DPER will be establishing an external Peer Review Group for the programme and we understand, this will be chaired by the former senior leader in public procurement.
343. Deputy Pádraig Rice asked the Minister for Health the hospitals in which electronic health records are already in operation that her Department or the HSE has visited to garner learnings about the system and the specific providers; the learnings taken from these visits; and if she will make a statement on the matter. [70706/25]
Amharc ar fhreagraWhilst all hospitals have major systems such as Patient Administration Systems, Laboratory Systems, Imaging Systems, Pharmacy systems and a selection of specialist/ departmental systems in place, Electronic Health Record systems are only deployed in the following hospitals: St James Hospital; All major maternity hospitals Cork University Maternity, Rotunda (Dublin), National Maternity Hospital (Holles St), The Coombe (Dublin), Limerick University Maternity (plus the maternity unit in Kerry); New National Rehabilitation Hospital; New National Forensics Hospital; New National Childrens Hospital. Private hospitals are also actively deploying EHR systems at the moment.
Not all EHR systems are from the same vendor and the hospital types also vary which provides excellent resource and experience for the HSE to draw upon, both in relation to the products available, the vendors and how they operate and the operational impact for the service. Combined with learnings from international experience, we can confirm that the HSE are factoring all of this into their planned approach for wider deployment of electronic health records in the future.
344. Deputy Pádraig Rice asked the Minister for Health the hospitals in which electronic health records are already in operation that her Department or the HSE has visited to garner learnings about the system and the specific providers; the learnings taken from these visits; and if she will make a statement on the matter. [70707/25]
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.
345. Deputy Pádraig Rice asked the Minister for Health the steps being taken to address concerns related to vendor lock-in and interoperability risks with respect to electronic health records; and if she will make a statement on the matter. [70708/25]
Amharc ar fhreagraI can assure the Deputy that we are very mindful of the risks associated with 'vendor lock in' when it comes to the implementation of electronic health records. We are seeing a gradual shift in the market towards more open standards but for major vendors they are still operating is a way that makes this challenging. Important regulator developments such as the European Health Data Space and the Health Information Bill will require specific categories of data to conform to standards and for specific interoperability requirements to be met by all EHR vendors for their products to be certified for sale and use in Europe. Additionally, we are starting to see consensus on major interoperability standards emerge, with increased momentum behind adoption globally. For instance FHIR and OpenEHR are gaining real traction now and indeed the National Shared Care Record that the HSE are developing is based on these standards.
As we approach the market for electronic health record systems in 2026, technical specifications that form part of the requirements that get published will need to address this issue. However, experience to date would suggest that this will still represent an ongoing risk if any of the large EHR providers is selected.
Ireland is not facing this challenge alone. We are now very well connected with counterparts internationally so that we can more easily speak with one voice to industry.
346. Deputy Pádraig Rice asked the Minister for Health the reason a Voluntary Ex-Ante Transparency (VEAT) notice was chosen instead of a competitive tender to extend the National Laboratory Information System (MedLIS) contract, given that the original 2015 agreement had failed to deliver any live sites after seven years; and if she will make a statement on the matter. [70709/25]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
347. Deputy Pádraig Rice asked the Minister for Health to explain the lack of progress from 2015 to 2019, on the National Laboratory Information System (MedLIS) project; her response to the fact that almost four years after the Voluntary Ex-Ante Transparency (VEAT) notice, only one hospital is partially live; if the HSE conducted any market analysis before awarding hosting services directly to the vendor; and if she will make a statement on the matter. [70710/25]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
348. Deputy Pádraig Rice asked the Minister for Health the current total projected cost, not spend to date, of the National Laboratory Information System (MedLIS) project, including all CCNs and extensions, compared to the original €33 million contract; and if she will make a statement on the matter. [70711/25]
Amharc ar fhreagraAs this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.
349. Deputy Pádraig Rice asked the Minister for Health the current vendor-stated product lifecycle status of the cellular pathology and microbiology modules in the National Laboratory Information System (MedLIS) project; the hospital sites that have completed user acceptance testing for these modules and the outcomes; the feedback received from clinical and laboratory end-users on the suitability of these modules for real-world workflows; if an independent clinical safety assessment been carried out on these modules; and if she will make a statement on the matter. [70712/25]
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.
350. Deputy Pádraig Rice asked the Minister for Health to provide a full risk register for the National Laboratory Information System (MedLIS), including risks associated with module lifecycle, site readiness, and clinical safety concerns; and if she will make a statement on the matter. [70713/25]
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.
351. Deputy Pádraig Rice asked the Minister for Health the reason reimbursement for continuous glucose monitors is only available to patients with type 1 diabetes who have required insulin from the outset; if reimbursement will be extended to patients diagnosed with type 2 diabetes who subsequently require insulin or develop type 1 diabetes later in life; and if she will make a statement on the matter. [70714/25]
Amharc ar fhreagraUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for decisions on the pricing and reimbursement of medicines and medical devices; therefore, I have asked the HSE for an update in this matter.
The HSE has advised that the Health Information and Quality Authority (HIQA) Rapid Health Technology Assessment (HTA) of Continuous Glucose Monitoring (CGM) in Adults with Type 1 Diabetes Mellitus was published on 29th September 2023. The published document can be found at: www.hiqa.ie/reports-and-publications/health-technology-assessment/rapid-health-technology-assessment-continuous.
The HSE has also advised that in line with the advice from HIQA and due to the budget impact associated with CGM sensors, the HSE established a single national reimbursement application system for all CGM sensors on the reimbursement list on 01/12/2023.
Reimbursement support for CGM sensors at this point in time is based on the HIQA HTA and is for patients with type 1 diabetes mellitus regardless of age, who have required insulin from the outset. Reimbursement does not extend to other cohorts such as people with type 2 diabetes who require insulin, or patients previously diagnosed with type 2 diabetes which is now classified as type 1 diabetes based on laboratory investigations such as C-peptide measurement or diabetes-specific autoantibodies. To date, a HTA of CGM sensors for people with type 2 diabetes mellitus or other types of diabetes excluded from the HTA referenced above, such as latent autoimmune diabetes in adults (LADA), type 3c diabetes, monogenic forms of diabetes etc. has not been undertaken. Therefore, there is limited information to support the extension of reimbursement to this cohort, including cost-effectiveness assessment and budget impact of same.
An application for reimbursement support of CGM sensors can be submitted for any patient, and each application is reviewed centrally by the HSE-Medicines Management Programme (MMP) on a case-by-case basis.
If a prescriber wishes, the outcome of a negative decision can be appealed directly via email to the HSE Medicines Management Programme at mmp@hse.ie, or a new application can be submitted via the online application system. Appeals must be made by the patient’s clinician and should include any additional information to support the unmet clinical need for CGM sensors.
Appeals are reviewed on a case-by-case basis, reviewing the information provided in the initial online application and the information in the appeal submission to the HSE Medicines Management Programme. The final reimbursement recommendation is communicated back to the clinician via email or the online application system.
352. Deputy Pádraig Rice asked the Minister for Health her plans to increase capacity at University College Cork's Dental School following the decision not to build a new dental school; if she will reverse the decision not to move forward with the new build; and if she will make a statement on the matter. [70715/25]
Amharc ar fhreagraThe Deputy should note that my officials are continuing to collaborate with the Department of Further and Higher Education, Research, Innovation and Science with a view to examining the expansion of dental training places in University College Cork (UCC).
As part of this engagement, my Department has received a strong proposal from UCC requesting €4.7 million in capital funding to establish a new dental community-based training facility in Cork. This would enable the training of additional undergraduate students in a primary care setting, benefiting both Irish and EU students.
While the proposal is promising, it currently delivers limited increases in domestic student places. Discussions are currently ongoing between my Department and the Department of Further and Higher Education to further maximise the benefits this proposal will bring with a view to expanding Irish and EU places to help meet the required oral healthcare workforce capacity in Ireland.
My Department proactively engaged with UCC throughout 2024 regarding the construction of a new dental school and hospital in Cork. Several options were considered and my Department offered €25 million in capital funding to assist in fitting out a new dental school and hospital which was estimated to cost in excess of €74 million. A decision was made by UCC not to proceed with the new dental school and hospital, but instead to refurbish the existing Cork University Dental School and Hospital, and to develop a new primary care dental facility in Cork. This refurbishment, at a total cost of €15m, is being co-funded by my Department and UCC.
Work is ongoing through the appropriate processes to explore all options to support UCC to deliver on its remit regarding both education and healthcare service provision.
353. Deputy Pádraig Rice asked the Minister for Health to respond to a recent article regarding a public-private partnership to deliver seven new nursing homes (details supplied); the status of each nursing home; and if she will make a statement on the matter. [70717/25]
Amharc ar fhreagraAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
354. Deputy Pádraig Rice asked the Minister for Health to provide an update on commencement of section 232 of the Assisted Human Reproduction Act 2024 (details supplied); the engagements her Department has had with the Department of Justice, Migration and Home Affairs on this matter; and if she will make a statement on the matter. [70718/25]
Amharc ar fhreagraSection 232 of the Health (Assisted Human Reproduction) Act 2024 will amend section 20 of the Children and Family Relationships Act 2015. This will allow for a declaration of parentage to be obtained in circumstances where a donor assisted human reproduction (DAHR) procedure did not take place in a clinical setting and in cases where a known donor was used, providing that the donor consents to the granting of the declaration. This will apply to DAHR procedures which have taken place prior to the commencement of the Children and Family Relationships Act 2015, i.e. prior to 4th May 2020.
As these amendments concern procedures before the District and Circuit Court, it was necessary that the relevant Rules of Court were updated to reflect the changes to be introduced, and before Section 232 of the 2024 Act can be commenced. Officials in my Department worked with colleagues in the Courts Service in the preparation of updated Rules of Court for the District and Circuit Courts.
The updated Rules for the Circuit Court were approved at the meeting of the Circuit Court Rules Committee on 24th October 2025. The District Court Rules Committee approved the updated Rules of Court for the District Courts at its meeting of 11th November 2025.
The changes recently approved by both Committees are now being submitted for concurrence by the Minister for Justice, Home Affairs and Migration. My officials are continuing to liaise with officials from that Department in this regard.
Following concurrence from the Minister for Justice, Home Affairs and Migration, it will be possible to commence section 232 of the Assisted Human Reproduction Act 2024 Act. I am keen to do this as soon as is practicable thereafter.
355. Deputy Pádraig Rice asked the Minister for Health further to Parliamentary Question Nos. 690 and 691 of 2 December 2025, her plans with respect to the strategic collaboration group to be established in early 2026; the proposed membership of this group; if it will include representation for vulnerable groups, in particular those impacted by changes to phased dispensing; and if she will make a statement on the matter. [70725/25]
Amharc ar fhreagraThe Community Pharmacy Agreement will be implemented on a phased basis and will be supported by regular structured engagements between the Department of Health (DoH), Health Service Executive (HSE) and the Irish Pharmacy Union (IPU).
The continuation of a high-level, enduring strategic relationship is designed to support the shaping and implementation of pharmacy’s role in a more integrated, efficient, and patient-centred health system.
Under the Agreement a Strategic Collaboration Group will be established which will provide a structured forum for dialogue and joint consideration of strategic issues shaping the future of community pharmacy in Ireland. This Strategic Collaboration Group will consist of representatives from the IPU, the HSE and the DoH.
356. Deputy Michael Cahill asked the Minister for Health to provide a detailed breakdown of dental treatments provided through PRSI stamps and the medical card; and if she will make a statement on the matter. [70735/25]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
357. Deputy Naoise Ó Muirí asked the Minister for Health for an update on a matter (details supplied); and if she will make a statement on the matter. [70754/25]
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.
358. Deputy Naoise Ó Muirí asked the Minister for Health for an update on a matter (details supplied) regarding insulin delivery systems. [70755/25]
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.
359. Deputy Albert Dolan asked the Minister for Health her response to the newly published report “Unseen and Unregulated: TFA, the ‘forever chemical’ in Europe’s Cereals” (details supplied), which identifies widespread contamination of cereal-based foods across Europe, including samples purchased in Ireland; her intentions to assess the implications for Irish consumers. [70791/25]
Amharc ar fhreagra360. Deputy Albert Dolan asked the Minister for Health if her Department has carried out an assessment of the potential health risk to children from trifluoroacetic acid exposure in cereal-based foods. [70792/25]
Amharc ar fhreagra361. Deputy Albert Dolan asked the Minister for Health if she will allocate funding for Irish research into trifluoroacetic acid in food and the environment, given the absence of a national exposure assessment. [70793/25]
Amharc ar fhreagra362. Deputy Albert Dolan asked the Minister for Health if she will instruct the Food Safety Authority of Ireland to immediately begin national testing of cereal-based foods for trifluoroacetic acid, given the widespread contamination reported across Europe. [70794/25]
Amharc ar fhreagraI propose to take Questions Nos. 359, 360, 361 and 362 together.
I am aware of recent discussion regarding Trifluoroacetic Acid (TFA) in cereal-based foods, including the report “Unseen and Unregulated: TFA, the ‘forever chemical’ in Europe’s Cereals”, which presents findings across 16 European countries. The Food Safety Authority of Ireland (FSAI) has advised that it will review this report and, as part of that process, will engage as necessary with EU counterparts, including the European Food Safety Authority (EFSA). EFSA published a draft statement in 2025 on consumer health-based guidance values for TFA, and the final EFSA risk assessment is expected in 2026.
TFA can be present in the environment from multiple sources, including the atmospheric transformation of certain refrigerant gases and the use of some pesticide substances. Pesticides that could potentially give rise to TFA are already included in the European regulatory review programme established under Regulation (EC) No. 1107/2009. The scientific review is managed by EFSA and includes input from the European Chemicals Agency (ECHA) where appropriate. EFSA and ECHA are currently completing a body of work regarding toxicological reference values for TFA and on the formation of TFA from pesticide use in the environment. It is important that all relevant information is considered in detail so that harmonised, coordinated action can be taken by European Member States regarding pesticide regulation. Ireland will continue to be guided by the scientific opinions and conclusions of EFSA and ECHA. Protection of human health is always the foremost concern.
With respect to monitoring, foods are routinely tested for the presence of certain contaminants under Regulation (EU) 2023/915. TFA is not currently included among those regulated chemical contaminants. In parallel, FSAI is assessing whether targeted national testing for TFA is practical and scientifically warranted at this time, taking into consideration available national or international research, current laboratory capacity, and the absence (pending EFSA’s final opinion) of an established health-based guidance value.
Regarding public health concerns, EFSA has been formally mandated by the European Commission to define a health-based guidance value for TFA for use in assessing potential risks for consumers via dietary intake. EFSA published a provisional value in July 2025, based on detailed analysis of technical data from a wide range of sources, and will finalise its scientific opinion in 2026 following public consultation. Based on EFSA’s published information—which is the most reliable scientific information currently available—the levels of TFA reported in some cereal-based foods do not indicate a health risk for children.
In addition to EFSA’s work, the European Commission has formally requested further scientific advice from ECHA and the World Health Organisation (WHO) to inform a harmonised EU approach and assist Member States in implementing coordinated measures. The outcomes of these processes will guide my Department.
