Written Answers Nos. 631-647
631. Deputy Ken O'Flynn asked the Minister for Health whether the average time taken to fill funded vacant posts, from approval to commencement in post, is monitored at national level; if so, the most recent national figure; and if not, whether she will introduce a national time-to-fill benchmark as a matter of policy [13741/26]
Amharc ar fhreagraThe role of the Minister for Health is primarily to deal with legislation, policy, overall budgetary allocation, and corporate governance. The HSE is a separate entity to the Department of Health and as such, the HSE has responsibility for matters relating to the staff within their employ or staff going through the process of recruitment with the HSE's National Recruitment Service.
The Department have asked the HSE to respond to the Deputy directly on this matter.
632. Deputy Ken O'Flynn asked the Minister for Health to provide the number of funded vacant whole-time equivalent posts in each of the six health regions as of the most recent reporting date; and the corresponding vacancy rate expressed as a percentage of funded workforce [13742/26]
Amharc ar fhreagraAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy as soon as possible.
633. Deputy Ken O'Flynn asked the Minister for Health to state the total expenditure on agency staffing in each Health Region in 2024 and 2025 to date; and whether her Department has undertaken any analysis correlating agency expenditure with funded vacancy levels [13743/26]
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.
634. Deputy Ken O'Flynn asked the Minister for Health to outline the recruitment control measures introduced in 2023 and 2024; the policy rationale for those measures; and whether any impact assessment was undertaken regarding their effect on vacancy levels, service delivery, or patient waiting times [13744/26]
Amharc ar fhreagraThe role of the Minister for Health is primarily to deal with legislation, policy, overall budgetary allocation, and corporate governance. The HSE is a separate entity to the Department of Health and as such, the HSE has responsibility for matters relating to the staff within their employ or staff going through the process of recruitment with the HSE's National Recruitment Service.
The Department have asked the HSE to respond to the Deputy directly on this matter.
635. Deputy Ciarán Ahern asked the Minister for Health if she is aware that there are delays of up to ten working days arising in providing access to IT accounts for HSE staff returning to work after periods of statutory leave; the details of the average wait time for the provision of access to IT accounts for all grades of staff returning from statutory leave, in tabular form; and if she will make a statement on the matter. [13759/26]
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.
636. Deputy Ken O'Flynn asked the Minister for Health the current number of medicines listed as being in short supply on the national medicines shortage list maintained by the Health Products Regulatory Authority; the number of these classified as critical or without a clinically equivalent alternative; the average duration of shortages recorded in each of the past three years; and the steps being taken at Departmental level to reduce recurrence and duration of shortages [13762/26]
Amharc ar fhreagraIn European law, pharmaceutical companies and wholesalers should ensure an appropriate and continuous supply of the medicines they market. Companies should notify the HPRA of medicines shortages or potential shortages impacting the Irish market. The HPRA maintains a list of current shortages on its website and is in regular contact with suppliers in relation to these shortages, with a view to minimising their duration and impact on patients. The webpage of the HPRA is updated daily as the HPRA receives new information related to ongoing and newly notified shortages. Shortages when published remain active until supply returns to an acceptable level to meet demand, irrespective of whether there is a suitable alternative supply available that is meeting that demand.
Addressing medicines shortages is complex and requires input from multiple stakeholders. A Medicines Shortage Framework (MSF) has been in place since 2018 when the Department requested that the HPRA assume responsibility for its coordination. Since its inception, the framework has been of enormous benefit nationally. It has served to avoid the occurrence of potential medicine shortages and, where they have occurred, ensured appropriate mitigation is in place.
As of 18th February 2026, there were 415 notified shortages published on the HPRA website. It is acknowledged that medicine shortages, when they occur, can be a challenge for patients and healthcare professionals. Each medicine shortage does not represent a defined risk to patients, and not all medicines shortages have the same potential impact on patients. In the case of medicines that are used most often in Ireland, there are typically multiple forms, strengths, brands, and generic medicines available from various sources.
Where some individual medicines are in short supply, alternative options such as alternative strengths, brands, and generic medicines remain available to ensure continuity of treatment. When a notification of a shortage is submitted to the HPRA an impact assessment is carried out and combines two main considerations - the availability of therapeutic alternatives and the expected impact on patient. In some cases where the medicine initially prescribed for the patient is unavailable, patients may be switched to a suitable therapeutic alternative following appropriate consultation with a healthcare professional. Regardless of patients being treated with suitable alternatives – a different brand for example – the shortage of each individual medicine will remain listed until supply returns to an acceptable level. The notification form also provides for a proposal from the MAH to handle a shortage, which may range from minimal activity in the case of low impact shortages, to a detailed management plan for high impact shortages.
For the notified shortages currently published (as of 18th February 2026) the impact assessment recorded was either a potential low impact or medium impact for ~80% of the cases. This means that in the majority of cases the required interventions to support continuity of care can be straightforward to administer in the clinical setting, such as that outlined already e.g. switching brands, or taking two tablets to administer the prescribed dose instead of one tablet (when using a different strength is an available mitigation measure).
Based on an analysis of data reported by companies to the HPRA related to shortages reported from January to May 2025, it takes an average (median) of 30 days for normal supply to resume from the date of market impact (unavailability). It is acknowledged that there is variance in the data, and individual supply interruptions can extend over a prolonged period on occasion.
Several initiatives have been taken over recent years at a European level to improve security of supply and address supply chain vulnerabilities that are common to multiple markets. These include an expansion of the mandate of the European Medicines Agency (EMA) to optimise the management and prevention of shortages at European level. In the proposed revision of the EU Pharmaceutical legislation the European Commission has proposed further strengthening measures and specific initiatives, such as the introduction of the Union list of critical medicines and the requirement for medicine suppliers to have in place shortage prevention plans (‘SPP’). Such measures are anticipated to further improve supply chain resilience and promote continuity of supply. The HPRA is committed to continuing its active involvement at European level to maximise the effectiveness of this work. There is also ongoing work nationally, with the introduction of new legislation, that will strengthen the capacity of the Medicines Shortage Framework (MSF) to prevent and mitigate shortages. This includes the introduction of mandatory notifications of shortages to the HPRA as well as facilitating the introduction of national stock monitoring systems. Such advancements should afford greater response capacity, with more forewarning of pending issues in supply, with actions that can then be taken in a timelier manner.
The companies who supply medicines and wholesale distributors, in particular, are key stakeholders in the supply chain that have more visibility of stock levels than others. These stakeholders must report potential shortages at an early stage. If action is taken at an early stage to avoid the shortage or any impact on patients and healthcare professionals, then no other action is required under the framework. Timely notifications are essential to have effective mitigation measures put in place with the view to avoiding any clinical impact and/or support continuity of care for patients reliant on these medicines. The HPRA routinely highlights to industry the importance of early notification.
637. Deputy Ken O'Flynn asked the Minister for Health whether her Department maintains a formal medicines supply resilience strategy addressing strategic stockholding, diversification of supply chains, early warning mechanisms and substitution protocols; if so, when it was last reviewed; and if she will outline the key policy measures currently in force [13763/26]
Amharc ar fhreagraMy Department is aware of the stress that shortages of medicines can cause for patients and healthcare professionals alike, and mitigating medicine shortages and strengthening security of supply is the subject of several workstreams in my Department, the wider health service and across Europe.
Medicine shortages are a feature of modern health systems worldwide which have been exacerbated by recent worldwide events. It is a global health problem, not unique to Ireland, and increases in demand for medications and medicines shortages have been observed in the UK, throughout the EU and across the world in recent months, and there is no evidence that shortages disproportionately impact patients in Ireland compared to other countries.
To address these challenges in Ireland, a Medicines Shortages Framework, operated by the Health Products Regulatory Authority (HPRA) on behalf of the Department of Health, has been established. This aims to help prevent potential shortages from occurring and to reduce the impact of shortages on patients by co-ordinating the management of potential or actual shortages across the health service as they arise. The HPRA maintains a list of current and resolved shortages on its website. The webpage is updated daily as the HPRA receives new information.
Additionally, within my Department a number of working groups have been established to specifically deal with medicine shortages. The Medicines Criticality Assessment Group (MCAG) is a collaborative working group of relevant government, regulatory and healthcare agency bodies that is convened by the Department of Health and chaired by the Health Service Executive (HSE) to facilitate ad hoc rapid assembly of nominated representatives to assess and address emerging human medicinal product (prescription and non-prescription) supply issues. MCAG was established in 2018 as part of a whole of government response to Brexit and has since evolved to its current form.
Following notification of a supply issue from a relevant health service stakeholder (DOH, HSE, HPRA and/or PSI) that is requiring more extensive and more immediate cross health-service input and is considered necessary to effectively prevent and/or mitigate a high impact supply issue, the Secretariat liaises with the Chair of the Group to convene an MCAG. This group will assist in the development of clinical guidance for mitigation of impact of specific medicinal product supply issues, as necessary, and where appropriate to do so. This workstream will be led by relevant HSE clinical personnel who will hold responsibility for final output.
The Strategic Medicines Access and Availability Group (SMAAG) is a working group established by the Department of Health in November 2025 to help shape national policy on medicines shortages, access and availability. The group will investigate, examine and pursue all appropriate measures that could improve the availability of medicines in Ireland by strategically addressing medicines shortages and gaps in availability, encourage an increase in the number of authorised and marketed medicines in Ireland and reduce our national reliance on Exempt Medicinal Products(EMPs).
In addition to this, there are legislative initiatives in development within the Department, via the Health (Miscellaneous Provisions) Act 2024, including Medicine Substitution Protocols, and reporting requirements for actors in the medicines supply chain. The Medicine Substitution protocols will act as an authorisation for registered pharmacists to supply an alternative medicinal product, for the medicinal product that is in short supply, without the need for a further prescription. The Department is liaising with relevant leads in the HSE to progress this, including an assessment of any potential patient safety risks.
638. Deputy Ken O'Flynn asked the Minister for Health whether her Department receives routine structured reports from the Health Products Regulatory Authority and the HSE regarding medicines shortages affecting chronic disease management, including respiratory conditions; the frequency and format of such reports; and how this information informs policy and budgetary planning [13764/26]
Amharc ar fhreagraMy Department is aware of the stress that shortages of medicines can cause for patients and healthcare professionals alike, and mitigating medicine shortages and strengthening security of supply is the subject of several workstreams in my Department, the wider health service and across Europe.
Medicine shortages are a feature of modern health systems worldwide which have been exacerbated by recent worldwide events. It is a global health problem, not unique to Ireland, and increases in demand for medications and medicines shortages have been observed in the UK, throughout the EU and across the world in recent months, and there is no evidence that shortages disproportionately impact patients in Ireland compared to other countries.
To address these challenges in Ireland, a Medicines Shortages Framework, operated by the Health Products Regulatory Authority (HPRA) on behalf of the Department of Health, has been established. This aims to help prevent potential shortages from occurring and to reduce the impact of shortages on patients by co-ordinating the management of potential or actual shortages across the health service as they arise. The HPRA maintains a list of current and resolved shortages on its website. The webpage is updated daily as the HPRA receives new information. As at 18 February 2026 415 notified medicines shortages were listed on the HPRA medicine shortages page: www.hpra.ie/find-a-medicine/for-human-use/medicine-shortages
The Medicines Criticality Assessment Group (MCAG) is a collaborative working group of relevant government, regulatory and healthcare agency bodies that is convened by the Department of Health and chaired by the Health Service Executive (HSE) to facilitate ad hoc rapid assembly of nominated representatives to assess and address emerging human medicinal product (prescription and non-prescription) supply issues. MCAG was established in 2018 as part of a whole of government response to Brexit and has since evolved to its current form.
Following notification of a supply issue from a relevant health service stakeholder (DOH, HSE, HPRA and/or PSI) that is requiring more extensive and more immediate cross health-service input and is considered necessary to effectively prevent and/or mitigate a high impact supply issue, the Secretariat liaises with the Chair of the Group to convene an MCAG. This group will assist in the development of clinical guidance for mitigation of impact of specific medicinal product supply issues, as necessary, and where appropriate to do so. This workstream will be led by relevant HSE clinical personnel who will hold responsibility for final output.
639. Deputy Ken O'Flynn asked the Minister for Health whether automatic reimbursement mechanisms are in place under community drug schemes to ensure that where a reimbursable medicine is unavailable due to shortage, clinically appropriate substitute medicines are reimbursed without additional administrative burden on patients or prescribers; and if not, whether she will introduce such a mechanism [13765/26]
Amharc ar fhreagraMy Department is aware of the stress that shortages of medicines can cause for patients and healthcare professionals alike, therefore mitigating medicine shortages and strengthening security of supply is the subject of several workstreams in my Department, the wider health service and across Europe.
Unfortunately, medicine shortages are a feature of modern health systems worldwide. There are a multitude of reasons why a medicine may not be available including: shortages of raw materials; manufacturing difficulties; or product recalls due to potential quality issues.
Ireland has a multi-stakeholder Medicines Shortages Framework in place operated by the Health Products Regulatory Authority (HPRA) on behalf of the Department of Health. This framework aims to help prevent potential shortages from occurring and to reduce the impact of shortages. Stakeholders include the HPRA, the Department, the HSE, healthcare professionals, manufacturers, wholesalers, patient representative groups and marketing authorisation holders. Details of this framework can be found at medicine shortages on the HPRA website: www.hpra.ie/find-a-medicine/for-human-use/medicine-shortages?data=eyJpZCI6bnVsbCwic2tpcCI6MCwidGFrZSI6MjUsInF1ZXJ5IjpudWxsLCJvcmRlciI6InByb2R1Y3RuYW1lIiwiZmlsdGVyIjoiQWxsIn0%3D
In European law, pharmaceutical companies and wholesalers should ensure an appropriate and continuous supply of the medicines they market. Companies are required to notify the HPRA of medicines shortages or potential shortages impacting the Irish market.
The HSE has advised that medicines not on the formal Reimbursement List are considered on an individual patient basis. Community pharmacy contractors can contact PCRS Pharmacy Function Unit regarding reimbursement support. Individual applications can also be submitted by the dispensing pharmacy to PCRS.IndividualRequest@hse.ie.
Community pharmacy contractors can also submit queries relating to reimbursement of Exempt Medicinal Products (EMPs) to PCRS.ExemptMed@hse.ie
640. Deputy Ken O'Flynn asked the Minister for Health whether her Department has undertaken any assessment of the patient safety, treatment interruption or cost implications arising from medicines shortages in the past three years; if so, the findings of that assessment; and if not, whether such an assessment will now be commissioned [13766/26]
Amharc ar fhreagraMy Department is aware of the stress that shortages of medicines can cause for patients and healthcare professionals alike, and mitigating medicine shortages and strengthening security of supply is the subject of several workstreams in my Department, the wider health service and across Europe.
Medicine shortages are a feature of modern health systems worldwide which have been exacerbated by recent worldwide events. It is a global health problem, not unique to Ireland, and increases in demand for medications and medicines shortages have been observed in the UK, throughout the EU and across the world in recent months, and there is no evidence that shortages disproportionately impact patients in Ireland compared to other countries.
To address these challenges in Ireland, a Medicines Shortages Framework, operated by the Health Products Regulatory Authority (HPRA) on behalf of the Department of Health, has been established. This aims to help prevent potential shortages from occurring and to reduce the impact of shortages on patients by co-ordinating the management of potential or actual shortages across the health service as they arise. The HPRA maintains a list of current and resolved shortages on its website. The webpage is updated daily as the HPRA receives new information. As at 18 February 2026 415 notified medicines shortages were listed on the HPRA medicine shortages page - [Medicine shortages ]www.hpra.ie/find-a-medicine/for-human-use/medicine-shortages?data=eyJpZCI6bnVsbCwic2tpcCI6MCwidGFrZSI6MjUsInF1ZXJ5IjpudWxsLCJvcmRlciI6InByb2R1Y3RuYW1lIiwiZmlsdGVyIjoiQWxsIn0%3D
Within my Department a number of working groups have been established to specifically deal with medicine shortages. The Medicines Criticality Assessment Group (MCAG) is a collaborative working group of relevant government, regulatory and healthcare agency bodies that is convened by the Department of Health and chaired by the Health Service Executive (HSE) to facilitate ad hoc rapid assembly of nominated representatives to assess and address emerging human medicinal product (prescription and non-prescription) supply issues. MCAG was established in 2018 as part of a whole of government response to Brexit and has since evolved to its current form.
Following notification of a supply issue from a relevant health service stakeholder (DOH, HSE, HPRA and/or PSI) that is requiring more extensive and more immediate cross health-service input and is considered necessary to effectively prevent and/or mitigate a high impact supply issue, the Secretariat liaises with the Chair of the Group to convene an MCAG. This group will assist in the development of clinical guidance for mitigation of impact of specific medicinal product supply issues, as necessary, and where appropriate to do so. This workstream will be led by relevant HSE clinical personnel who will hold responsibility for final output.
The Strategic Medicines Access and Availability Group (SMAAG) is a working group established by the Department of Health in November 2025 to help shape national policy on medicines shortages, access and availability. The group will investigate, examine and pursue all appropriate measures that could improve the availability of medicines in Ireland by strategically addressing medicines shortages and gaps in availability, encourage an increase in the number of authorised and marketed medicines in Ireland and reduce our national reliance on Exempt Medicinal Products (EMPs).
641. Deputy Ken O'Flynn asked the Minister for Health whether her Department has issued formal policy guidance to the Health Service Executive or to the National Centre for Pharmacoeconomics regarding the appropriate time horizon to be applied in health technology assessments where medicines are intended to reduce the long-term incidence of chronic diseases such as type 2 diabetes and cardiovascular disease; and if she will make a statement on the matter. [13785/26]
Amharc ar fhreagraThe HSE is committed to providing access to as many medicines as possible, in as timely a fashion as possible, from the resources available (provided) to it.
The HSE robustly assesses applications for pricing and reimbursement to make sure that it can stretch available resources as far as possible and to deliver the best value in relation to each medicine and ultimately more medicines to Irish citizens and patients.
HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds.
There are formal processes which govern applications for the pricing and reimbursement of medicines, and new uses of existing medicines, to be funded and / or reimbursed.
The HSE considers the following criteria prior to making any decision on pricing / reimbursement in line with the Health (Pricing and Supply of Medical Goods) Act 2013:
(1) The health needs of the public,
(2) The cost effectiveness of meeting health needs by supplying the item concerned rather than providing other health services,
(3) The availability and suitability of items for supply or reimbursement,
(4) The proposed costs, benefits, and risks of the item or listed item relative to therapeutically similar items or listed items provided in other health service settings and the level of certainty in relation to the evidence of those costs, benefits and risks,
(5) The potential or actual budget impact of the item or listed item,
(6) The clinical need for the item or listed item,
(7) The appropriate level of clinical supervision required in relation to the item to ensure patient safety,
(8) The efficacy (performance in trial), effectiveness (performance in real situations) and added therapeutic benefit against existing standards of treatment (how much better it treats a condition than existing therapies) and
(9) The resources available to the HSE
The National Centre for Pharmacoeconomics (NCPE) is an independent Health Technology Assessment (HTA) agency, responsible for evaluating the clinical and cost-effectiveness of drug treatments for the Health Service Executive (HSE) in collaboration with the HSE Corporate Pharmaceutical Unit (HSE CPU). The NCPE give advice to help the HSE provide the most effective, safe and cost-effective (value for money) treatments for patients.
The HSE Drugs Group is a national committee that makes recommendations on the pricing and reimbursement of drugs in Ireland using the criteria set out in the 2013 Act. These criteria are not weighted.
The decision-making authority in the HSE is the HSE Senior Leadership Team.
642. Deputy Ken O'Flynn asked the Minister for Health whether her Department requires that lifetime modelling of avoided downstream healthcare costs, including reduced hospital admissions, surgical interventions, dialysis, and long-term disability supports, be incorporated as standard practice in value-for-money assessments conducted under the Health (Pricing and Supply of Medical Goods) Act 2013; and if she will make a statement on the matter. [13786/26]
Amharc ar fhreagra643. Deputy Ken O'Flynn asked the Minister for Health whether her Department has undertaken any review of the balance between short-term budget impact considerations and long-term prevention-based savings in medicines reimbursement decisions under the Health (Pricing and Supply of Medical Goods) Act 2013; and whether any policy changes are under consideration in this regard. [13787/26]
Amharc ar fhreagra645. Deputy Ken O'Flynn asked the Minister for Health whether any internal Departmental policy documents, circulars, or guidance notes exist concerning the incorporation of long-term prevention outcomes in medicines reimbursement decisions under the Health (Pricing and Supply of Medical Goods) Act 2013; and whether she will arrange for any such documents to be published. [13789/26]
Amharc ar fhreagraI propose to take Questions Nos. 642, 643 and 645 together.
Under 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 it is committed to providing timely access to as many medicines as possible within the resources available to it. To ensure public funds deliver maximum value, all applications for pricing and reimbursement are assessed through a robust, evidence-based process grounded in objective scientific and economic principles.
The HSE considers the following criteria prior to making any decision on pricing / reimbursement in line with the Health (Pricing and Supply of Medical Goods) Act 2013:
(1) The health needs of the public,
(2) The cost effectiveness of meeting health needs by supplying the item concerned rather than providing other health services,
(3) The availability and suitability of items for supply or reimbursement,
(4) The proposed costs, benefits, and risks of the item or listed item relative to therapeutically similar items or listed items provided in other health service settings and the level of certainty in relation to the evidence of those costs, benefits and risks,
(5) The potential or actual budget impact of the item or listed item,
(6) The clinical need for the item or listed item,
(7) The appropriate level of clinical supervision required in relation to the item to ensure patient safety,
(8) The efficacy (performance in trial), effectiveness (performance in real situations) and added therapeutic benefit against existing standards of treatment (how much better it treats a condition than existing therapies) and
(9) The resources available to the HSE
The National Centre for Pharmacoeconomics (NCPE), an independent HTA agency, supports the HSE in this process by evaluating the clinical and cost-effectiveness of new medicines, new indications, and high-cost or uncertain treatments. All medicines undergo a Rapid Review with those requiring further assessment progressing to a full Health Technology Assessment (HTA). Full HTAs provide detailed analyses of clinical evidence, safety, cost-effectiveness, and budget impact. These evaluations inform the HSE as it assesses reimbursement applications using the statutory criteria above.
Once the assessment is complete the NCPE then provide a recommendation to the Corporate Pharmaceutical Unit in the HSE.
The HSE Corporate Pharmaceutical Unit (CPU) is the interface between the HSE and the Pharmaceutical Industry in relation to medicine pricing and reimbursement applications.
The Drugs Group is the national committee which the HSE has in place to make recommendations on the pricing and reimbursement of medicines. The membership of the HSE Drugs Group includes public interest members. The HSE Drugs Group considers all of the evidence and makes a recommendation to the HSE Senior Leadership Team.
The decision making authority in the HSE is the HSE Senior Leadership Team. The HSE Senior Leadership Team decides on the basis of all the demands it is faced with (across all services) whether it can fund a new medicine, or new use of an existing medicine, from the resources that have been provided to it in line with the Health (Pricing and Supply of Medical Goods) Act 2013.
644. Deputy Ken O'Flynn asked the Minister for Health whether her Department has assessed the extent to which population-level disease prevention benefits are reflected in cost-effectiveness evaluations carried out by or on behalf of the Health Service Executive; and whether she intends to issue policy guidance clarifying how such prevention benefits are to be weighted in future reimbursement decisions. [13788/26]
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.
646. Deputy Ken O'Flynn asked the Minister for Health whether her Department receives annual or quarterly statistical reports from the Health Service Executive on discretionary medical card approvals and refusals granted under the General Medical Services scheme in respect of persons aged over 70; and if she will make a statement on the matter. [13798/26]
Amharc ar fhreagra647. Deputy Ken O'Flynn asked the Minister for Health whether the data provided to her Department by the Health Service Executive on discretionary medical card decisions is disaggregated by age cohort, geographic region, and outcome; and if she will outline the categories of data routinely received. [13799/26]
Amharc ar fhreagra659. Deputy Ken O'Flynn asked the Minister for Health whether her Department receives, holds, or reviews aggregated data from the Health Service Executive or the Primary Care Reimbursement Service on the exercise of discretion in medical card eligibility decisions following a means assessment; the total number of applications in which discretion was considered in each of the years 2020 to 2025; the number granted on a discretionary basis; the number refused following discretionary consideration; whether such data is disaggregated by age cohort including persons aged over 70; whether the Department analyses trends or regional variation in discretionary decision-making; and the policy, audit, or governance mechanisms in place to ensure national consistency in the exercise of discretion under the general medical services scheme. [13884/26]
Amharc ar fhreagra660. Deputy Ken O'Flynn asked the Minister for Health whether any formal reporting framework exists between the Health Service Executive and her Department in respect of discretionary medical card decisions; the frequency of any such reporting; whether performance indicators, audit reviews, or internal compliance checks are conducted in relation to discretionary refusals; and if she will outline the Department’s role in supervising the exercise of discretion under the general medical services scheme. [13885/26]
Amharc ar fhreagraI propose to take Questions Nos. 646, 647, 659 and 660 together.
Eligibility for a medical card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970. The Act obliges the HSE to assess whether a person is unable, without due hardship, to arrange general practitioner and other medical services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure.
Persons aged 70 or older are assessed under medical card income thresholds which are based on gross income. 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 and, in particular, to take full account of the 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.
Regarding the arrangements in place within the Department to monitor medical card trends, officials from my Department engage in monthly Performance Report meetings with the HSE Primary Care Reimbursement Service. I can assure the Deputy that, to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues under review and any changes are considered in the context of Government policy and other issues which may be relevant.
Regarding the specific data requested on the discretionary medical card assessment process, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
