Written Answers Nos. 1402-1421
1402. Deputy Ken O'Flynn asked the Minister for Health whether the HSE records instances in which persons presenting to addiction services also require mental health intervention for dual diagnosis conditions; and if she will provide the recorded figures for the past five years. [39696/26]
Amharc ar fhreagraDual diagnosis means a person experiences both a substance abuse problem and a mental health issue such as depression or an anxiety disorder.
Treatment options must address both issues, and as such the HSE have developed a Model of Care which recommends the development of 12 Adult Specialist Dual Diagnosis Teams nationally, 4 Adolescent Hub Teams, and a National Dual Diagnosis Rehabilitation Centre. To date funding of over €5 million has resulted in the roll out of the Dual Diagnosis teams. Five Dual Diagnosis teams are being recruited into and developed at present – adult teams in Limerick and Cork commenced services in 2024, and a team in Waterford is in recruitment. 2 Adolescent hub teams in Dublin have also been developed, supported by funding from HSE Social Inclusion.
Under Budget 2026, funding has been allocated for an additional Dual Diagnosis team, and a Dual Diagnosis Day Programme in Dublin.
With reference to the information requested, as this is an operational issue, I have referred it to the HSE for direct reply to you.
1403. Deputy Ken O'Flynn asked the Minister for Health whether any independent review, audit or service evaluation has been carried out into addiction service staffing adequacy within HSE South-West since 2020. [39697/26]
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.
1404. Deputy Ken O'Flynn asked the Minister for Health whether her Department maintains a central register identifying healthcare pathways or services in which no unified national audit system, outcome-monitoring framework, or standardised national dataset currently exists; and if she will provide details. [39753/26]
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.
1405. Deputy Ken O'Flynn asked the Minister for Health whether the absence of national audit or outcome-monitoring systems in any healthcare pathway has been recorded on any Departmental or HSE risk register since 2020; and if she will provide details of any such entries. [39754/26]
Amharc ar fhreagraThere is one relevant risk that is recorded on the Department’s Risk Register, and it remains under active management. This risk reflects that the National Clinical Effectiveness Committee (NCEC) has not completed certain elements of work in clinical audit in recent years, as originally set out under its terms of reference. However, this situation is due to an evolving policy and governance landscape in relation to National Clinical Audit.
Alternative structures have been put in place which strengthen the oversight and delivery of national clinical audit activity. The HSE’s National Centre for Clinical Audit (NCCA), is established and operational, and has recently launched the HSE National Strategy for Clinical Audit 2026–2030. It sets out a clear vision to embed clinical audit as a cornerstone of quality and patient safety across the integrated health and social care system. This strategy supports national, regional, and local delivery of evidence-informed clinical audit that leads to measurable improvements in patient outcomes.
The NCCA has service level agreements with several audit providers, such as National Office for Clinical Audit (NOCA) and The National Perinatal Epidemiology Centre (NPEC) to complete national clinical audits on behalf of the HSE.
In parallel, the Department is proactively progressing measures to ensure clarity and alignment of roles. An options paper is currently being prepared to support consideration at senior management level of the future role and policy focus of the NCEC, including its role in relation to National Clinical Audit.
In relation to the HSE’s risk register, the question has been referred to the HSE for direct response.
1406. Deputy Ken O'Flynn asked the Minister for Health whether any formal governance framework exists defining the respective responsibilities of the Department of Health and the HSE in circumstances where operational responsibility is delegated to the HSE but safeguarding, audit, patient-safety or oversight concerns arise. [39755/26]
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.
1407. Deputy Ken O'Flynn asked the Minister for Health whether her Department has conducted any review examining the extent to which Parliamentary Questions relating to governance, safeguarding, audit or patient-safety matters are routinely classified as "service matters" and referred to the HSE for direct reply. [39756/26]
Amharc ar fhreagra1411. Deputy Ken O'Flynn asked the Minister for Health whether any internal Departmental guidance exists governing when issues categorised as "service matters" nonetheless require direct Ministerial oversight due to governance, safeguarding or expenditure concerns. [39760/26]
Amharc ar fhreagraI propose to take Questions Nos. 1407 and 1411 together.
Dear Deputy each Parliamentary Question is assessed on its individual merits having regard to the subject matter, including any governance, safeguarding or expenditure considerations.
Where matters relate to the operational delivery of services, they are generally referred to the Health Service Executive, which has statutory responsibility for service provision, for direct reply to the Deputy.
1408. Deputy Ken O'Flynn asked the Minister for Health whether any healthcare pathways have been identified by the Department or HSE as operating without complete national outcome datasets despite involving vulnerable patients, minors, safeguarding considerations or high-cost public expenditure; and if she will provide details. [39757/26]
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.
1410. Deputy Ken O'Flynn asked the Minister for Health whether the Department considers reliance on general HSE governance structures, in the absence of pathway-specific audit systems or national datasets, sufficient to satisfy the State's safeguarding and patient-safety obligations. [39759/26]
Amharc ar fhreagraMy Department in recent years has overseen a number of initiatives and infrastructures that have been put in place to achieve greater quality in healthcare safety, general safeguarding standards and clinical excellence.
The HSE has strengthened its focus on quality and patient safety by establishing an integrated infrastructure for quality, safety, and risk management, with the goal of achieving excellence in clinical governance. The Chief Clinical Officer and his team provide system-wide oversight, ensuring safe practices are upheld and clear, high standards for quality and patient safety are consistently set and maintained.
The HSE’s National Centre for Clinical Audit (NCCA) which was established within National Quality and Patient Safety (NQPS) in 2022 represented a significant advance in HSE’s policy of safer, better healthcare.
Under the Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023, clinical audit is specifically acknowledged and safeguarded, enabling it to contribute effectively to patient safety and quality assurance.
It is the policy of the HSE that through their Incident Management Framework (IMF) all Patient Safety Incidents are identified, reported and reviewed so that learning from events can be shared to improve the quality and safety of service. These patient safety incidents require disclosure in accordance with the requirements of the HSE Open Disclosure Policy. The HSE also informs the NPSO in the Department of Health of major/significant patient/service user safety incidents and issues of concern through the communications protocol.
The Health Information and Quality Authority (HIQA) is an independent body responsible for setting standards, inspecting and monitoring health and social care services, and advising on safety and quality in Ireland. To ensure compliance, HIQA conduct inspections assessing whether service providers comply with national standards and regulation.
Safeguarding adults who may be at risk of abuse, harm, and neglect by others in the context of their interactions with the health and social care sector, is a key objective of the Department of Health, every statutory body under its aegis and every relevant service that interacts with such adults.
Currently, there are various structures and processes in place within the health and social care sector, to protect against abuse and ensure prompt action. This includes the HSE National Safeguarding Office under the governance of the Chief Social Worker, specialist Safeguarding and Protection Teams in each health region, designated Safeguarding Officers within services, specific regulatory requirements for residential care services which are inspected against by HIQA and the Mental Health Commission.
In 2024, the HSE implemented a single digital platform (Adult Safeguarding Portal) to standardise the reporting and referral of adult safeguarding concerns or allegations of abuse to Regional Adult Safeguarding and Protection Teams.
In December 2025, the Government approved Ireland’s first ever National Policy Framework for Adult Safeguarding in the Health and Social Care sector. The policy framework will extend across all public, private and voluntary health and social care services.
1412. Deputy Ken O'Flynn asked the Minister for Health whether any independent external review has examined the adequacy of national audit and oversight systems across healthcare pathways involving overseas treatment referrals, vulnerable patients or cross-border care arrangements since 2020. [39761/26]
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.
1413. Deputy Ken O'Flynn asked the Minister for Health whether the Department has identified any governance risks arising from fragmented or non-interoperable national healthcare datasets across different HSE divisions, regions or programmes. [39762/26]
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.
1415. Deputy Ken O'Flynn asked the Minister for Health whether any formal safeguarding review process applies where minors are referred outside the State for healthcare interventions under HSE-funded schemes. [39774/26]
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.
1418. Deputy Ken O'Flynn asked the Minister for Health whether any review has examined whether existing HSE governance systems are sufficient to monitor long-term psychological, safeguarding or clinical outcomes for minors referred abroad for healthcare interventions. [39777/26]
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.
1419. Deputy Ken O'Flynn asked the Minister for Health whether any national reporting mechanism exists for adverse incidents, safeguarding concerns, regret outcomes or complaints associated with minors referred abroad under publicly funded healthcare pathways. [39778/26]
Amharc ar fhreagraThe position on this matter has been addressed in replies to Parliamentary Questions number 36389 of 2026, as well as other previous Parliamentary Questions, and remains unchanged. Accordingly, there is no additional information to add at this time.
1420. Deputy Ken O'Flynn asked the Minister for Health whether any standardised post-treatment follow-up protocol applies to minors returning to Ireland following healthcare treatment, assessment or intervention abroad funded directly or indirectly by the State. [39779/26]
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.
1421. Deputy Ken O'Flynn asked the Minister for Health whether the Department or HSE maintains any national estimate of the number of minors currently engaged in overseas healthcare pathways supported directly or indirectly through public funding arrangements. [39780/26]
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.
