Written Answers Nos. 445-452
445. Deputy Peadar Tóibín asked the Minister for Health whether the planned statutory inquiry into CHI will include all matters previously examined in internal or external reviews; and to provide copies of those reviews to ensure full transparency in the development of the Terms of Reference. [50333/26]
Amharc ar fhreagraI appointed Mr Remy Farrell, Senior Counsel as the independent facilitator for the Children’s Health Ireland Inquiry into Spina Bifida and Complex Scoliosis Services Scoping Exercise. I remain committed to supporting the facilitation process and encourage all stakeholders to engage fully with the facilitator as his work continues.
The scoping exercise is considering existing information, consulting with stakeholders, seeking to avoid duplication with other relevant reports or statutory processes and will make recommendations regarding the scope, breadth and format of an inquiry and the content of potential terms of reference.
Work commenced on Tuesday 3 March 2026 initially running for up to 16 weeks. The Facilitator wrote to me last week requesting an extension to conduct his scoping exercise, in particular, to attempt to further reengage with stakeholders. I granted this request until 18th August.
There have been calls for access to a number of reports. Officials in me Department have engaged with the facilitator on the necessary material required for his scoping exercise. My Department has provided him with a number of publicly available reports as part of his work including the completed Boston Report, HIQA Review, DDH Audit and most recently the HSE audit on governance and equity in patient access and waiting list management. The facilitator has reached out to CHI with regard access to other reports commissioned by them.
Once the scoping exercise is complete, further Government approval will be sought for the final terms of reference. The inquiry will form a part of the wider reflection on paediatric services in CHI.
446. Deputy Peadar Tóibín asked the Minister for Health to provide copies of the recent HSE internal reviews into CHI which identified systemic failures in waiting list management; and to outline the actions that have been taken in response to the findings. [50334/26]
Amharc ar fhreagraI acknowledge the challenges families have faced regarding paediatric services.
The HSE Internal Audit Report and the Narrative Review relating to equity in access and waiting list management in Children’s Health Ireland (CHI) were published by the HSE on 15 June 2026 and are available online. While the Internal Audit Report found no clear evidence of inequity in access to care, both Reports outline important findings in governance, waiting list management, and patients’ experiences, with necessary recommendations to address concerns and improve paediatric services for children and young people.
I met with the HSE and CHI on 11 June and I expect every effort to be made to ensure that the actions informed by these reports, and previous reports, are implemented without delay for the benefit of children and young people.
The HSE has advised that actions in response to both reports are being implemented and there is clear progress already being made in strengthening governance and management. The HSE is also committed to ensuring that the matters raised in these reports are considered across the Regions to inform enhancement of services nationally.
I remain committed to the improvement of services for children and young people.
448. Deputy Conor Sheehan asked the Minister for Health if there are guidelines governing the amount a GP can charge a medical card patient for completing a form (details supplied) [50337/26]
Amharc ar fhreagraGPs are private practitioners. Most GPs hold contract(s) with the HSE for the provision of certain health services without charge, such as for the provision of GP care to medical card and GP visit card holders under the GMS contract.
Under the terms of the current GMS contract, GPs are required to provide eligible patients, persons who hold a medical card or GP visit card, with ''all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess". Eligible persons are not subject to any co-payments or other charges in respect of such services including GP consultations.
The HSE reimburses GPs for medical services provided under the GMS contract to medical and GP visit card holders. The contract stipulates that fees in respect of certain medical certificates which may be required, for example, "under the Social Welfare Acts or for the purposes of insurance or assurance policies or for the issue of driving licences" are not covered by the contract.
The provision of services outside the terms of the GMS contract, and the fees charged for same, are a matter of private contract between the GP and their patient.
Where a Department or authority requires the inclusion of a medical report as part of a submission/claim, that requirement is governed by the Department or authority concerned.
449. Deputy Michael Cahill asked the Minister for Health to review medical grounds and award a medical card to a Kerry family (details supplied); and if she will make a statement on the matter. [50356/26]
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.
450. Deputy Michael Cahill asked the Minister for Health to urgently assist a family with care needs (details supplied) in County Kerry; and if she will make a statement on the matter. [50417/26]
Amharc ar fhreagraAs this is a service matter, I have asked the HSE to respond to the deputy directly, as soon as possible.
451. Deputy Joe Cooney asked the Minister for Health if her Department has undertaken an assessment of providing free access to the shingles vaccine to those with a medical card; and if she will make a statement on the matter. [50423/26]
Amharc ar fhreagraThe HSE Primary Care Reimbursement Service does not supply vaccines or provide reimbursement support for vaccines through community pharmacies under the Statutory Drug Schemes.
When the public health imperative to support particular vaccines to defined cohorts becomes national policy, vaccines are directly procured by the HSE and supplied through the national vaccine distribution arrangements to GPs and pharmacies for eligible cohorts.
Therefore, the Shingles vaccine is not reimbursed under Community Drug Schemes including both the General Medical Services and Drugs Payment Scheme.
The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). NIAC considers the prevalence of the relevant disease in Ireland as well as international best practice in relation to immunisation when developing its advice.
The current NIAC guidelines state that the shingles vaccine may be considered for those aged 65 years and older, due to the greater burden and severity of disease in this age group and in those aged 18 years and older at increased risk of shingles.
The Health Information and Quality Authority (HIQA) has carried out a Health Technology Assessment (HTA) on the herpes zoster vaccine which protects against shingles. A HTA is a multidisciplinary research process that collects and summarises information about a health technology. HIQA’s HTA examined the evidence on the clinical effectiveness and safety of shingles vaccines. The cost effectiveness and budget impact were also reviewed, along with the ethical, social and organisational implications of including the vaccine in the adult immunisation schedule.
HIQA published this HTA on 19 July 2024. The HTA found that adding the shingles vaccine to the routine immunisation schedule, at the vaccine price at the time, for all adults aged 65 years and over would not be cost effective and would be associated with a substantial budget impact.
While the vaccine is considered safe and effective, its protective effect diminishes over time. HIQA also noted the substantial budget impact associated with vaccination. If made available to everyone aged 65 and older, vaccination would cost €218 million over five years.
Whilst the HTA found that the introduction of the shingles vaccine was not cost effective based on the cost of the vaccine, it found that it could be cost effective for vaccination of those at 75 years and 80 years if the cost of the vaccine was reduced by 80%.
Given that the healthcare budget is finite and decisions regarding increased spending relating to a change in one area could impact the provision of other health technologies and treatments within the healthcare system, the cost-effectiveness must be considered in any decision-making process.
The Department considered the findings of this HTA in 2024 and determined that the introduction of the vaccine could be reconsidered when the cost effectiveness of the vaccine is confirmed as being more favourable.
The introduction of the shingles vaccine to the immunisation schedule in Ireland is again being actively considered for a cohort of immunocompromised individuals, in line with NIAC advice and cognisant of the cost effectiveness of market pricing and available funding.
452. Deputy Ryan O'Meara asked the Minister for Health for an update on the extension of the free contraceptive scheme to all ages; and if she will make a statement on the matter. [50433/26]
Amharc ar fhreagraThe Free Contraception Scheme (FCS) for women ordinarily resident in Ireland, was launched in 2022. Its remit has been expanded gradually from 17-25 initially to include women aged from 17 to 35 inclusive currently. Approximately €45m is allocated to support the scheme in 2026 and approximately 2,450 GPs, primary care, family planning and student health centres and just over 1,900 community pharmacies are participating in the scheme currently, countrywide.
The scheme covers the cost of consultations with GPs, primary care, student health and family planning centres and prescriptions for the wide range of contraceptive options available on the HSE Reimbursement List, including long-acting reversible contraception (LARCs: injections, intra-uterine devices and systems (coils) and implants) and emergency contraception in addition to the contraceptive Pill, patch and ring. LARC fittings, removals, injections and check-ups are also free of charge under the scheme.
Access to free contraception is also available on an emergency basis through the National Women and Infants Health Programme (NWIHP), enabling maternity units, hospitals, postnatal clinics, and Sexual Assault Treatment Units (SATUs) to provide free contraception to patients who might have difficulty accessing the scheme through primary care. NWIHP advise that at least 3,000 women accessed free contraception through their services in 2025. Similar supports for accessing contraception are in place with the Women’s Health Service, which supports people working in the sex trade. The Women’s Health Service supported over 330 women in 2025.
The Report of the Working Group on Access to Contraception, published in 2019 and available on the Department’s website, laid the foundations for the introduction of the Free Contraception Scheme. In addition to recommending the phased introduction of free contraception, the report also noted that policy proposals must also focus on accessibility, education and workforce capacity as well as cost.
In this regard, another initiative to expand capacity within the FCS is to make additional services available through pharmacies. The landmark Community Pharmacy Agreement, launched in 2025, supports expanding pharmacy services, delivering safe, efficient and accessible healthcare, across Ireland. The Common Conditions Scheme, allowing access to treatment for 8 common conditions through pharmacies, was publicly launched in January 2026.
The Agreement supports pharmacy prescription of contraception, under defined clinical circumstances, for which some legislation, the Health (Miscellaneous Provisions) Act of 2024 (the 2024 Act), is already in place.
In order to enable pharmacy provision of contraception to be delivered free of charge under the FCS, the legal framework for the FCS must be amended to include prescribing pharmacists. The Health (Provision of Contraception Prescribing Service in Retail Pharmacy Businesses) Bill 2026 has just been published on the Oireachtas website and may pass through the Houses before the summer recess. If so, it is envisaged that the service may be launched before the end of 2026, following subsequent secondary legislation and once training, clinical protocols and contracts for the service are in place.
This service may free up capacity within GPs for the delivery of more complex services, including the higher volumes of long acting reversible contraception (coils and implants) that may be needed by women aged 36 and over. Work is ongoing within NWIHP develop and finalise a scheme to train more staff in the acute sector to fit LARCs, and the ICGP’s LARC training scheme continues to train more GPs.
Research has been undertaken recently to support monitoring of the scheme. The Healthy Ireland Survey, 2025, published last November, examined contraceptive choices, noting a rise in the use of LARCs, especially hormonal coils, after the age of 35. The Survey also shows that awareness of the scheme was high in age-groups eligible to access it (86% in 18-25 and 74% in 26-34 year-olds). The Survey can be accessed at: www.gov.ie/en/healthy-ireland/publications/healthy-ireland-survey-2025/
Qualitative research was published in April, 2026, in partnership with the National Women’s Council of Ireland and TCD, supported by the Women’s Health Fund, to assess awareness of, and access to the scheme amongst key groups. The current age limits and GP access were identified as significant barriers, along with issues affecting specific cohorts of the population. The Report can be accessed here: www.nwci.ie/learn/publication/an_investigation_into_womens_experiences_of_the_free_contraception_scheme
The Programme for Government, Securing Ireland’s Future, the National Sexual Health Strategy, 2025-2035, the Sláintecare 2025+ Plan and the Women’s Health Action Plans all commit to further sequential expansion of the scheme, such that it encompasses the full reproductive age-range within the lifetime of this Government. However, any decision relating to further expansion of the scheme must be considered through the Estimates process in advance of the annual Budget each year.
While contraception provided through the FCS is very effective at preventing unplanned pregnancy, hormonal contraception does not protect against sexually transmitted infections (STIs). The National Condom Distribution Scheme supports both STI prevention and accessible contraception.
Free condoms can be accessed through the national network of STI clinics, participating charities and NGO partners and on participating 3rd level campuses. Since 2023, free condoms have also been supplied with orders for free home STI testing kits. The NCDS is open to those aged 17 and above. Over 1.2m condoms were distributed in 2025.
The NCDS is being expanded on a phased basis to pharmacy consulting rooms, to further enable contraception availability through pharmacies. Efforts to make NCDS condoms available through more GP consulting rooms are also ongoing.
