Written Answers Nos. 770-791
770. Deputy Tony McCormack asked the Minister for Health when a person (details supplied) will receive an appointment for assessment with a consultant in the Mater Misericordiae University Hospital. [51108/26]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. The Minister for Health is prohibited from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly, as soon as possible.
771. Deputy Cian O'Callaghan asked the Minister for Health to provide an update on the work her Department is doing to progress the pricing and reimbursement application (details supplied) for welireg (belzutifan); and if she will make a statement on the matter. [51110/26]
Amharc ar fhreagra773. Deputy Denise Mitchell asked the Minister for Health the steps she is taking to ensure that the drug belzutifan is available and accessible to those who need it; and if she will make a statement on the matter. [51144/26]
Amharc ar fhreagra818. Deputy Barry Heneghan asked the Minister for Health the current status of the health technology assessment and reimbursement process for the medicine belzutifan for the treatment of eligible patients with Von Hippel-Lindau (VHL) syndrome; the expected timelines for completion of the assessment and any subsequent reimbursement decision; and if she will make a statement on the matter. [51420/26]
Amharc ar fhreagra819. Deputy Barry Heneghan asked the Minister for Health the steps her Department and the HSE are taking to facilitate timely access to belzutifan for eligible patients with Von Hippel-Lindau (VHL) syndrome, if approved for reimbursement; whether engagement has taken place, or is planned, with clinicians, patient representative organisations and other relevant stakeholders regarding access to this treatment; and if she will make a statement on the matter. [51421/26]
Amharc ar fhreagra820. Deputy Johnny Mythen asked the Minister for Health if belzutifan will be made be available to people suffering from Von Hippel- Lindau disease; and if she will make a statement on the matter. [51422/26]
Amharc ar fhreagra833. Deputy Naoise Ó Muirí asked the Minister for Health the status of negotiations regarding belzutifan; whether she will expedite the assessment and approval process; and if she will make a statement on the matter. [51584/26]
Amharc ar fhreagra840. Deputy Eamon Scanlon asked the Minister for Health the steps being taken to expedite the assessment and approval of belzutifan for patients with Von Hippel–Lindau (VHL) disease to ensure timely access for eligible patients; if she will engage with clinicians and patient groups regarding barriers to access; and if she will make a statement on the matter. [51615/26]
Amharc ar fhreagraI propose to take Questions Nos. 771, 773, 818, 819, 820, 833 and 840 together.
The Government recognises the importance of timely access for patients to new medicines and supporting those living with rare diseases in Ireland. Budgets 2021-2025 allocated €158 million for new drugs, and Budget 2026 allocated an additional €30 million. Since 2021, this funding has facilitated the introduction of 276 new medicines, including 75 medicines for rare diseases.
The Year 1 cost of a new drug comes from the allocation for new medicines, but it should be noted that once these medicines are approved for reimbursement the full cost of providing them can reach multiples of this initial cost as their uptake increases.
Under the Health (Pricing and Supply of Medical Goods) Act 2013, the Health Service Executive (HSE) has statutory responsibility for decisions on the pricing and reimbursement of medicines.
To commence this process, a pharmaceutical company must submit an application for a new medicine or a new use of an existing medicine, which has been granted European Medicines Agency (EMA) or Health Products Regulatory Authority (HPRA) authorisation, to the HSE’s Corporate Pharmaceutical Unit.
Applicants must continue to engage throughout the process to ensure that the necessary evidence is available for the HSE to carry out its statutory role as a decision-maker with respect to the reimbursement of new medicines, in accordance with the Act. The Act specifies nine criteria which must be considered. These include the health needs of the public and the clinical need for the medicine. All these factors, taken together, allow the HSE to make an informed decision on new medicines.
The HSE has advised that it received an application for pricing and reimbursement on the 6th March 2025 from Merck Sharp & Dohme B.V (the applicant) for belzutifan (Welireg®) indicated as monotherapy for the treatment of adult patients with von Hippel-Lindau disease who require therapy for associated, localised renal cell carcinoma (RCC), central nervous system (CNS) haemangioblastomas, or pancreatic neuroendocrine tumours (pNET), and for whom localised procedures are unsuitable.
Following a Rapid Review conducted by the National Centre for Pharamacoeconomics (NCPE), a full Health Technology Assessment (HTA) was commissioned by the HSE on the 30th April 2025.
MSD submitted the materials required for the HTA to the NCPE on the 13th of November 2025 and following ongoing engagement between the NCPE and MSD, the NCPE completed its assessment on the 25th May 2026 and submitted a HTA report with a recommendation to 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. A meeting has been scheduled between the CPU and the applicant to discuss this application. These negotiations are commercially confidential.
Once the commercial negotiations are completed, the next steps in the process involve the HSE’s Drugs Group—the national expert committee, which includes public interest members. The HSE’s Drugs Group will consider all evidence, including outputs of commercial negotiations and recommendations of the NCPE, and issue a recommendation to the HSE Senior Management Team, which holds final decision-making authority on the reimbursement of a medicine.
This application remains under consideration with the HSE and the HSE cannot make any comment on possible outcomes from the ongoing process.
772. Deputy Paul Lawless asked the Minister for Health if her attention has been drawn to the case of a person (details supplied); if this case can be reviewed with a view to securing an appointment; and if she will make a statement on the matter. [51123/26]
Amharc ar fhreagraUnder the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. The Minister for Health is prohibited from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly, as soon as possible.
774. Deputy Roderic O'Gorman asked the Minister for Health the long-term measures her Department are taking to prevent negative impacts from relocation on the health of Palestinian refugees accessing medical treatment in Dublin (details supplied); and if she will make a statement on the matter. [51150/26]
Amharc ar fhreagraI would like to thank the Deputy for the question he has raised.
In September 2024, the Government agreed that Ireland would receive up to 30 paediatric patients in response to the World Health Organisation's (WHO) request to EU Member States to respond to the growing humanitarian crisis in Gaza. Since September 2024, Ireland has evacuated 27 World Health Organisation approved paediatric patients and their 115 accompanying family members.
On arrival, all paediatric patients and their family members are initially accommodated in short-term accommodation in Dublin to support early treatment and assessment. A transition to longer-term accommodation is required for the duration of their treatment period. Families are informed of this process before arrival.
Irish Red Cross are contracted by the Department of Health to provide accommodation and social care support to the patient and their family groups. Irish Red Cross engage with the medical services and relevant advocacy groups to ensure that the accommodation is medically suitable for the primary purpose to support the WHO approved child patient.
For families who are medically cleared to relocate outside Dublin, the Children’s Health Ireland hub-and-spoke model is utilised, where a family accesses specialist treatments in Dublin and interim/ follow up medical services are accessed locally. Children’s Health Ireland provides medical clearance for the family to relocate, where a property is deemed medically appropriate.
The Irish Red Cross maintain frequent contact with the families to work through any concerns. Post-relocation Irish Red Cross continue to engage directly with the families, to address any concerns with respect to the move to Kilkenny and transport to medical appointments.
Department Officials maintain regular contact with Irish Red Cross on various matters, particularly when Departmental support is required on challenging issues in delivery of accommodation and support services to Gaza medevac patients and their families.
Irish Red Cross hold regular meetings with the families, their supporters, and Children’s Health Ireland to address any concerns. Irish Red Cross engage with local bus companies to explore adding an additional bus stops where necessary. Irish Red Cross arrange volunteers to provide transport to medical appointments for the first month after relocation, to help with their transition.
24 of the 27 Gaza Medevac Initiative patients and family groups have successfully relocated to appropriate accommodation outside Dublin. The same accommodation and treatment pathway has been used for all 27 paediatric patients and their family members who have arrived in Ireland for medical treatment since December 2024. This follows standard Irish Red Cross practice in the provision of accommodation and associated services to individuals fleeing situations of conflict
775. Deputy Sorca Clarke asked the Minister for Health the actions the Government is taking to prevent online forums or websites that encourage or facilitate suicide from being accessed in Ireland; whether legislative changes are being considered to prohibit such platforms; and if she will make a statement on the matter. [51170/26]
Amharc ar fhreagra776. Deputy Erin McGreehan asked the Minister for Health the public care available to women who wish to have their hormones tested on an asymptomatic basis; and if she will make a statement on the matter. [51178/26]
Amharc ar fhreagraThe provision of diagnostic testing within the public health service is based on clinical need and the professional judgment of the treating healthcare practitioner.
In general, blood tests, including hormone tests, are not provided as part of a routine blood testing for people who are asymptomatic and do not have an identified clinical indication. Decisions regarding laboratory investigations are made by a patient's healthcare provider, typically a General Practitioner (GP) or hospital doctor, having regard to the individual's symptoms, medical history and clinical presentation.
Where a clinician considers it appropriate, blood tests measuring hormones such as oestrogen, progesterone, testosterone, follicle-stimulating hormone (FSH) and luteinising hormone (LH) may be requested through public health service laboratory services to assist in the diagnosis, investigation or management of a medical condition. These tests are generally undertaken where there is a relevant clinical indication, rather than on an information basis alone.
Access to publicly funded diagnostic services ordinarily occurs following referral by a GP or another treating clinician.
777. Deputy John Lahart asked the Minister for Health if she will provide an update on the ongoing discussions between the HSE and clinical perfusion scientists regarding their pay scale and the measures being taken to bring the dispute to a resolution. [51190/26]
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.
778. Deputy Mairéad Farrell asked the Minister for Health to provide an update on the timeframe for filling the vacant OT position in Conamara; and if she will make a statement on the matter. [51191/26]
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.
779. Deputy Mairéad Farrell asked the Minister for Health to provide an update on the work her Department is undertaking to increase the income threshold for medical card eligibility for persons under 70 years-of-age; and if she will make a statement on the matter. [51192/26]
Amharc ar fhreagraMedical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card. It is specific to the individual’s own financial circumstances.
Persons aged 69 and under are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. Certain expenses are also taken into account. Detailed guidelines are available at: [Assessment for a medical card - HSE.ie] (www2.hse.ie/services/schemes-allowances/medical-cards/applying/assessment/) .
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. Details are available at: [Medical card for over 70s]. (www2.hse.ie/services/schemes-allowances/medical-cards/other-types-of-medical-card/over-70s/)
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.
In addition, where a person's sole household income is derived from a social protection payment, he/she will be awarded a medical card.
Over 1.56 million people now hold a Medical Card and over 800 thousand hold a GP Visit Card. This means that over 2.3m have access to free GP care.
Finally, there is a programme of work underway in my Department, as part of Sláintecare 2025+, which is reviewing the existing eligibility framework. The purpose of this review is to clearly assess what is working well and to inform future policy proposals on the eligibility framework, based on robust evidence, as we progress implementation of Sláintecare.
780. Deputy Roderic O'Gorman asked the Minister for Health the status of the review of the maternity and infant care scheme; to provide a timeline for the publication of the final report and recommendations following the work undertaken by the National Women and Infants Health Programme review group; the specific recommendations within the National Maternity Strategy (Recommendations 62 to 66) that remain outstanding or in progress; and if she will make a statement on the matter. [51195/26]
Amharc ar fhreagra781. Deputy Roderic O'Gorman asked the Minister for Health the specific stakeholders and organisations that have been consulted by the HSE during the review and development of the revised maternity and infant care scheme; if formal engagement has occurred with the IMO, ICGP and NWIHP; the extent to which advocacy, voluntary parent support, and service-user organisations have been involved in the consultation process; the mechanisms used to capture broader feedback from the public and parents; the steps being taken within the maternity system to ensure all frontline hospital and community staff are aware of and actively signposting new parents to existing voluntary community supports; and if she will make a statement on the matter. [51196/26]
Amharc ar fhreagraI propose to take Questions Nos. 780 and 781 together.
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
782. Deputy Roderic O'Gorman asked the Minister for Health the progress made by the HSE and the NWIHP to develop and fund evidence-based, equitable tongue-tie assessment and frenotomy services nationally; the plans in place to standardise regional care pathways so they mirror successful specialist clinics (details supplied); the measures being introduced to address geographic disparities in wait times and access to public infant feeding supports; and if she will make a statement on the matter. [51197/26]
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.
783. Deputy Michael Cahill asked the Minister for Health if she will clarify the ownership and governance arrangements relating to the block of private patient rooms located on the campus of University Hospital Kerry; whether these rooms constitute HSE property; the person or body that is authorised to provide private practice or private patient services within these facilities; and if she will make a statement on the matter. [51232/26]
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.
784. Deputy Pádraig O'Sullivan asked the Minister for Health further to the HSE’s confirmation that all clinical sites have been required to verify compliance with the public only consultant contract, the number of hospital sites that have returned compliance confirmations to date; the number that remain outstanding; whether the results will be published by hospital group, region or site; and if she will make a statement on the matter. [51237/26]
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.
785. Deputy Pádraig O'Sullivan asked the Minister for Health the assessment that has been carried out of consultant obstetrician and gynaecologist staffing levels and midwifery staffing levels in Irish maternity services compared with international benchmarks; whether the next National Maternity Strategy will include specific staffing and continuity-of-care targets; and if she will make a statement on the matter. [51238/26]
Amharc ar fhreagraMaternity care in Ireland is provided in line with the National Maternity Strategy, Creating a Better Future Together, 2016 - 2026.
The Strategy is built around the principle of woman-centred care.
Since 2016, €28 million has been invested in new development funding through the National Maternity Strategy, transforming our maternity services for women, babies, and families. This investment forms part of an overall €80 million invested across our maternity and gynaecology services since the start of the strategy.
This investment has provided for the recruitment of over 567 additional full time equivalent health professionals including 390.5 additional nurses and midwives and 44 additional consultants.
Proposals to progress an external, independent evaluation of the Strategy in its final year have been approved. This evaluation will provide objective, evidence-based recommendations for future policy and reform in Maternity Services.
In addition to this independent evaluation the Department will also draw on work to evaluate the Birthrate Plus model.
Recommendation 6 of the Expert Review Body (ERB) on Nursing and Midwifery focuses specifically on midwifery workforce planning and the implementation and evaluation of the Birthrate Plus model as the national standard to determine clinical midwifery staffing levels.
The Department of Health is finalising arrangements to commission an independent evaluation to examine the effectiveness of Birthrate Plus and Birthrate Plus Acuity.
In the context of the Programme for Government 2025 commitment to develop a successor strategy, the findings of this evaluation will provide a robust evidence base to inform future midwifery workforce planning.
The National Doctors Training Programme (NDTP) published a report, Obstetrics and Gynaecology Medical Workforce in Ireland 2025–2040: An Expert Informed Review in January 2026. This report was developed by NDTP in collaboration with the Institute of Obstetricians and Gynaecologists at the Royal College of Physicians of Ireland and the HSE National Women and Infants Health Programme.
This report presents data on the obstetrics and gynaecology consultant workforce across the health service, although it does not separately identify the whole-time equivalent (WTE) of consultants working exclusively in maternity services. The report also includes an international comparison of the consultant obstetrics and gynaecology workforce.
This report will also be considered as part of the development of the successor to the National Maternity strategy.
786. Deputy Peadar Tóibín asked the Minister for Health the total cost to the public health system of performing a hip replacement; and if she will provide a detailed breakdown of all associated costs, including but not limited to anaesthesia, surgical staffing, theatre use, prosthetics, pre-operative and post-operative care. [51255/26]
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.
787. Deputy Peadar Tóibín asked the Minister for Health the total cost to the public health system of performing a cardiac ablation procedure; if she will provide a detailed breakdown of all associated costs, including but not limited to anaesthesia, cardiac mapping, surgical staffing, theatre usage, equipment, and pre- and post-procedure care. [51256/26]
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.
788. Deputy Peadar Tóibín asked the Minister for Health the total cost to the public health system of performing a cataract removal procedure; and if she will provide a detailed breakdown of all associated costs, including but not limited to anaesthesia, intraocular lenses, surgical staffing, theatre use, and pre-operative and post-operative care. [51257/26]
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.
789. Deputy Peadar Tóibín asked the Minister for Health the total cost to the public health system of performing a knee replacement; and if she will provide a detailed breakdown of all associated costs, including but not limited to anaesthesia, surgical staffing, theatre use, prosthetics, and pre-operative and post-operative care. [51258/26]
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.
790. Deputy Peadar Tóibín asked the Minister for Health the total cost to the public health system of performing a bariatric gastric sleeve procedure; and if she will provide a detailed breakdown of all associated costs, including but not limited to anaesthesia, surgical staffing, theatre usage, equipment, and pre-operative and post-operative care. [51259/26]
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.
791. Deputy Albert Dolan asked the Minister for Health to review the means test thresholds for medical cards for persons aged over 70; if she will consider the introduction of universal medical card eligibility for those over 70; and if she will make a statement on the matter. [51285/26]
Amharc ar fhreagraMedical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card. It is specific to the individual’s own financial circumstances.
Persons aged 69 and under are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. Certain expenses are also taken into account. Detailed guidelines are available at: Assessment for a medical card - HSE.ie.
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. Details are available at: www2.hse.ie/services/schemes-allowances/medical-cards/other-types-of-medical-card/over-70s/
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.
In addition, where a person's sole household income is derived from a social protection payment, he/she will be awarded a medical card.
I can assure the Deputy that, in order to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues under review and any proposals are considered in the context of any potential broader implications for Government policy, the annual budgetary estimates process and legislative requirements arising.
