Written Answers Nos. 422-442
422. Deputy Ken O'Flynn asked the Minister for Children, Disability and Equality the mechanism that exist to ensure that the digitisation of public services across Government does not result in persons who are older, disabled, digitally excluded or unable to use online systems being denied equal access to State services, supports or entitlements; and whether she has sought a Government-wide review of this issue. [67683/26]
Amharc ar fhreagraAs the Deputy will be aware, responsibility for developing policy on the digitisation of public services across Government, including consideration of any mechanism or Government-wide review of the kind referred to in the question, is a matter for the Department of Public Expenditure, Infrastructure, Public Service Reform and Digitalisation.
The Department of Children, Disability and Equality contributes to the development and delivery of relevant whole-of-Government policies through joint implementation arrangements, cabinet coordination and participation in cross-departmental strategies.
The Department recognises that digital services may not be suitable for everyone, including some older people, people with disabilities and those experiencing digital exclusion. Accordingly, the Department itself in conducting its remit supports the continued availability of alternative access channels where required, including telephone, postal and in-person options, alongside digital services.
For example, under the Mother and Baby Institutions Payment Scheme, applications can be made online or by post, with paper application forms available through Citizens Information Centres or on request.
The Department will continue to engage constructively with relevant Departments to support accessible and inclusive public services.
423. Deputy Ken O'Flynn asked the Minister for Children, Disability and Equality the guidance her Department has issued to public bodies concerning their obligations under the Public Sector Equality and Human Rights Duty when introducing or expanding digital-only services; whether equality and human-rights assessments are required before such services replace existing non-digital access; and if not, the reason. [67680/26]
Amharc ar fhreagraUnder the Public Sector Equality and Human Rights Duty, as set out in section 42 of the Irish Human Rights and Equality Commission Act 2014, all public bodies in Ireland have responsibility to promote equality, prevent discrimination and protect the human rights of their employees, customers, service users and everyone affected by their policies and plans.
The Irish Human Rights and Equality Commission (IHREC) is Ireland’s national human rights and equality institution and has been given responsibility under the Act to monitor and provide information, guidance and education to public bodies on understanding and meeting their statutory obligations under section 42. IHREC has developed guidance and training materials for public bodies in this regard..
I understand that IHREC’s guidance indicates that a public body can undertake an Equality and Human Rights Impact Assessment (EHRIA) in advance of any change to policy or method of service delivery that would impact on the accessibility of a public service. An EHRIA may be an appropriate means of identifying the potential impacts of any changes in the way in which services are delivered.
Further information is available on IHREC’s website at www.ihrec.ie/public-sector-duty.
As IHREC is an independent body, I have no role in the development or oversight of this guidance.
424. Deputy Ged Nash asked the Minister for Children, Disability and Equality the number of registered childminders in their own home, by county, in each of the years 2023 to 2025 and to date in 2026. [67905/26]
Amharc ar fhreagraAs the subject matter of the Deputy's question relates to an operational matter for Tusla, I have referred the matter to them for a direct reply.
425. Deputy John Paul O'Shea asked the Minister for Children, Disability and Equality as part of the HSE’s National Service Plan 2026 to outline the location by county and by town/village of the proposed new 152 created residential placements for people with disabilities (details supplied). [67851/26]
Amharc ar fhreagra426. Deputy John Paul O'Shea asked the Minister for Children, Disability and Equality for a breakdown of all 9,000 residential places for people with disabilities by county and by town/village in that county. [67850/26]
Amharc ar fhreagraI propose to take Questions Nos. 425 and 426 together.
I wish to thank the Deputy for raising this question. As this question refers to service matters, I have asked the Health Service Executive (HSE) to respond to the Deputy directly.
427. Deputy Marie Sherlock asked the Minister for Children, Disability and Equality the share of expenditure spent on agency staff for every section 39 organisation. [68024/26]
Amharc ar fhreagraThe Department of Children, Disability and Equality provides funding to the, HSE, to deliver specialist disability services either directly or via Section 38 and Section 39 voluntary sector organisations.
While the Department sets the strategy, policy direction and the overall allocation for the disability sector, funding allocations to individual service providers, is an operational matter for the HSE as the funding authority, on behalf of the State. As this question refers to operational matters, I have asked the Health Service Executive (HSE) to respond to the Deputy directly.
428. Deputy Naoise Ó Muirí asked the Minister for Children, Disability and Equality to provide an update on the development of Shaping the Future Phase 2; and when it will be published in 2026. [67979/26]
Amharc ar fhreagraShaping the Future: The Early Years Action Plan, Phase 1 report (published last December) sets out measures to achieve key Programme for Government commitments on the affordability, quality, and accessibility of early learning and care (ELC) and school-age childcare (SAC). Two of the main objectives of Shaping the Future are to reduce parental fees to a maximum of €200 per month over the lifetime of the Government and to increase the supply of places, strengthening supply-side funding to support services’ sustainability and staff wages, while introducing State-led facilities to complement other measures to increase capacity.
The Action Plan adopts a phased approach that enables action to be taken in 2026 while allowing adequate time for a broad public consultation and analysis on longer-term actions.
The consultation process, which has taken place throughout this year, has had a number of channels designed to facilitate the participation of a wide range of stakeholders. The final stage (a national forum that took place on 23rd September) built on insights from surveys, local consultation events, and stakeholder engagement and will help inform future policy direction. Results of this consultation, and additional analysis, will inform Phase 2 of Shaping the Future.
Phase 2, which will be published later this year, will set out actions to be undertaken from 2027 through to the end of 2029.
A number of steps have already been taken in 2025 and 2026 to reduce the costs of ELC and SAC for parents. 2026 actions include further reduction in some of the highest fees paid by parents by lowering the maximum fees that Core Funding Partner Services can charge. These latest maximum fee caps, which apply to all Core Funding Partner Services, place a limit on the maximum fees that can be charged. Under the new maximum fee caps, the highest possible cost for a typical full day place of 45 hours per week is dropping from around €198 per week to €183.70 per week, with the universal subsidy under the National Childcare Scheme. Higher subsidies are available for many parents, depending on their level of income and the age and number of children in their family.
In addition, from September 2026, out of pocket costs for lower-income families have been reduced through changes to the National Childcare Scheme. These measures include:
- An increase to the lower (base) income threshold of the income-assessed subsidy from €26,000 to €34,000, which aimed to ensure that families with incomes below the relative income poverty line receive the maximum subsidies.
- An increase to the upper income threshold (income limit) of the income-assessed subsidy from €60,000 to €68,000, to extend income-assessed subsidies to more families.
- An increase to the multiple child deduction (MCD) component of the income-assessed subsidy for families with two children under the age of 15 from €4,300 to €5,500, and for families with three or more children under the age of 15 from €8,600 to €11,000.
In Budget 2027 I hope to build on these steps as we continue the journey towards the objective of reducing parental fees to a maximum of €200 per month.
429. Deputy Colm Burke asked the Minister for Children, Disability and Equality to confirm that home support will be provided for a person (details supplied) in the week where they are not currently receiving home support, given that they receive this care the three other weeks of the month. [67704/26]
Amharc ar fhreagraAs this question refers to service matters, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible.
430. Deputy Seán Kyne asked the Minister for Health her plans to publish the Heads of a Bill on adult safeguarding; whether the published framework for adult safeguarding in the health and social care sectors will inform the legislation; and her views on whether the elderly and those with disabilities are vulnerable to threats and that safeguarding legislation is required. [67697/26]
Amharc ar fhreagra"A National Policy Framework for Adult Safeguarding in the Health and Social Care Sector” was published in December 2025.
The policy framework will extend across all public, private and voluntary health and social care services and will cover all adults at risk in those settings. Adults at risk are defined as “persons aged 18 years or older who need help to protect themselves or their interests at a particular time, whether due to circumstances or personal characteristics, and may be at risk of experiencing harm by another party.”
It is now widely accepted that a more robust legislative underpinning is required to enhance
and strengthen adult safeguarding in the sector. Included in the policy framework are a range of both legislative and non-legislative measures that will significantly expand and strengthen existing supports and protections for adults at risk of harm across the health and social care sector. The Government has also approved the development of legislation to underpin these commitments. Key legislative commitments include:
• The Health Service Executive (HSE) will have responsibility for leading and coordinating adult safeguarding across the sector and will have statutory functions, duties, and powers to underpin this role.
• Current safeguarding structures within the HSE will be strengthened and legislation will provide that they will operate independently in the performance of their functions.
• New powers of entry for safeguarding and protection teams and powers to obtain court protection orders.
• The Health Information Quality Authority's (HIQA’s) remit will be extended to include independent oversight and monitoring of adult safeguarding services for the health and social care sector delivered by the HSE.
• New obligations for service providers including undertaking risk evaluations, developing, and publishing adult safeguarding statements and ensuring staff are appropriately trained.
• The introduction of mandatory reporting in specified circumstances.
• The National Independent Review Panel (NIRP) process for adult safeguarding learning reviews for serious incidents will be strengthened and placed on a statutory footing.
• Strengthened cooperation between service providers and relevant state agencies.
The Department of Health is actively working on preparing a General Scheme of a Health (Adult Safeguarding) Bill and it is expected to be published this year.
431. Deputy Robert Troy asked the Minister for Health if she will clarify the roll out of insulin pumps at the diabetic clinic based at the midlands regional hospital Mullingar; if the clinic currently has the capacity to roll out pumps; and the steps being taken to provide the necessary resources. [67693/26]
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.
432. Deputy Robert Troy asked the Minister for Health if she will clarify the position of the diabetic clinic at the Midlands regional Hospital Mullingar; if the clinic will be closing temporarily from 1 October 2026; if so, the provisions being made for those who have scheduled appointments post this date; if she will further clarify the current staffing levels at this diabetic clinic; and if positions remain to be filled. [67692/26]
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.
433. Deputy Conor Sheehan asked the Minister for Health the timeline for the implementation of the newly approved Huntington’s Disease Care Pathway, following the approval notification issued by the Huntington's Disease Association of Ireland on 28 August 2026. [67691/26]
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.
434. Deputy Pádraig Rice asked the Minister for Health the policy in Ireland on umbilical cord donation for stem cell collection and treatment; and if her Department has considered the creation of a public cord blood bank. [67690/26]
Amharc ar fhreagraIreland does not currently operate a national umbilical cord blood bank. Umbilical cord blood contains stem cells which may be used in the treatment of certain conditions, including some blood disorders and cancers. While cord blood is a source of stem cells, it is not the sole source, and bone marrow and peripheral blood stem cell transplants are recognised as established treatments.
Decisions regarding stem cell transplantation services and the sourcing of stem cell donations are matters for the HSE, informed by clinical expertise, service requirements and patient need. Patients in Ireland requiring stem cell transplantation may access suitably matched stem cell donations through existing national and international arrangements.
There are currently no proposals before my Department regarding the establishment of a national cord blood bank in Ireland. Any proposal in this area would require careful consideration of clinical need, operational and regulatory requirements, resource implications, international best practice and the available evidence base, informed by the advice of the relevant clinical and service planning experts.
435. Deputy Conor Sheehan asked the Minister for Health the steps being taken to address the severe delays in neurology review appointments for degenerative conditions, with specific reference to cases where patients with Huntington’s disease have had long waits to see their neurologist; and the specific measures within the new care pathway to reduce these waiting lists. [67689/26]
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.
436. Deputy Keira Keogh asked the Minister for Health for an update on the Tobacco Free Ireland Policy Review; and if she will make a statement on the matter. [67688/26]
Amharc ar fhreagraThe Tobacco Free Ireland policy review is currently at an advanced stage, with a view to publish a new strategy in Q1 2027. It will consider all available options to provide a pathway to eliminate the harm caused by tobacco use by preventing initiation and increasing cessation, and to prevent children and young people from using nicotine products.
437. Deputy Paul Nicholas Gogarty asked the Minister for Health if she will provide new funding to Diabetes Ireland to employ two psychologists to further support delivery of its Mental Health and Wellbeing Programmes to people living with diabetes and their parents/carers. [67685/26]
Amharc ar fhreagra442. Deputy Paul Nicholas Gogarty asked the Minister for Health if she plans to begin the implementation of the National Diabetes Strategy by providing funding to create a Regional Diabetes Clinical Lead post in each HSE Health Region in the upcoming budget. [67678/26]
Amharc ar fhreagraI propose to take Questions Nos. 437 and 442 together.
The Diabetes Policy and Services Review: A Strategy for Better Care was launched on the 21st of May.
assets.gov.ie/static/documents/a41e7d5d/Diabetes_Policy_and_Services_Review_-_A_Strategy_for_Better_Care.pdf
This is Ireland’s first national strategy for diabetes, marking a major milestone in diabetes care in Ireland. It provides a detailed assessment of our current diabetes services and sets out series of recommendations and actions to improve diabetes care delivery. The recommendations cover four key themes:
• Service Development
• Affordability and Access to care
• Better support for people living with diabetes
• Digital Healthcare
The recommendations are marked in the strategy as either short, medium or long-term goals. Short-term refers to recommendations which can be implemented within three years. Medium term recommendations can be implemented within five years, and long-term recommendations are those that will take longer than five years to fully implement.
The HSE is currently working to develop an implementation plan to ensure that the recommendations are followed through at national level and throughout the Health Regions.
Discussions relating to the 2027 Estimates process are underway and will not be concluded until closer to the date of the Budget. The HSE National Service Plan will be published after the budgetary process concludes.
Under the new HSE regional structure, the Department allocates the overall HSE budget and staffing ceiling. The detailed operational decisions on how those resources are deployed within and across Health Regions are a matter for the HSE.
While annual policy priorities and performance expectations are set out in the National Service Plan, the HSE, and specifically the REOs, are accountable for delivering these priorities in their Regions within their budget allocations. The Department does not specify funding or staffing line?by?line for individual services. Instead, the Department sets the overall budget and required outputs, and the HSE is responsible for prioritising its resources to meet the agreed targets.
438. Deputy Paul Nicholas Gogarty asked the Minister for Health if she will sanction a HIQA Health Technology Assessment on the effectiveness and long term health benefits of continuous glucose monitoring (CGM) for people with other types of diabetes, such as type 2 diabetes, cystic fibrosis-related diabetes, type 3c diabetes and so on, using daily insulin injections (basal-bolus) to potentially expand access to CGM based on clinical need rather than a type of diabetes. [67684/26]
Amharc ar fhreagraContinuous glucose monitoring (CGM) systems provide an alternative approach to self-monitoring of blood glucose (using blood glucose test strips with an associated blood glucose meter). These CGM systems comprise of sensors, transmitters and a mechanism to display the results (readers/receivers or smart device application).
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. The HSE has advised that the HIQA Rapid HTA of Continuous Glucose Monitoring in Adults with Type 1 Diabetes Mellitus was published on 29th September 2023.
The HTA recommended the establishment of a single managed access programme for all CGM systems for all individuals with type 1 diabetes mellitus regardless of age, noting that such a system would need clearly defined criteria for access. Following on from the recommendations in this HTA, the HSE-MMP, in conjunction with the HSE-PCRS, and with the support of the HSE Chief Clinical Officer, introduced an online reimbursement application system for all CGM sensors on 1st December 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.
To date, a HTA of CGM sensors for people with type 2 diabetes mellitus or other types of diabetes has not been undertaken in Ireland. Therefore, there is limited information to support the extension of reimbursement to these patient groups, including cost-effectiveness assessment and budget impact of same.
The HSE has identified preferred CGM products based on cost-effectiveness to manage this expenditure.
On the 21st of May, The Diabetes Policy and Services Review: A Strategy for Better Care was launched by the Minister for Health.
This is Ireland’s first national strategy for diabetes. It sets out recommendations for action in relation to type 1 diabetes, type 2 diabetes, diabetes in pregnancy and paediatric diabetes. The strategy marks a major milestone in diabetes care in Ireland, representing the development of a unified approach to the delivery of diabetes care.
439. Deputy Paul Nicholas Gogarty asked the Minister for Health if she will make continuous glucose monitoring (CGM) available to women with type 2 diabetes (approximately 300 women per year) for the duration of their pregnancy to minimise the health risks for mother and baby. [67682/26]
Amharc ar fhreagra443. Deputy Paul Nicholas Gogarty asked the Minister for Health if she will remove the specific criteria of 'insulin initiation from the start' that is preventing approximately 500-700 people with a clinical diagnosis of type 1 diabetes from accessing continuous glucose monitoring (CGM), which clinical evidence and recommendations overwhelmingly supports as first-choice glucose monitoring treatment for all people with type 1 diabetes. [67679/26]
Amharc ar fhreagraI propose to take Questions Nos. 439 and 443 together.
Continuous glucose monitoring (CGM) systems provide an alternative approach to self-monitoring of blood glucose (using blood glucose test strips with an associated blood glucose meter). These CGM systems comprise of sensors, transmitters and a mechanism to display the results (readers/receivers or smart device application).
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. The HSE has advised that the HIQA Rapid HTA of Continuous Glucose Monitoring in Adults with Type 1 Diabetes Mellitus was published on 29th September 2023.
The HTA recommended the establishment of a single managed access programme for all CGM systems for all individuals with type 1 diabetes mellitus regardless of age, noting that such a system would need clearly defined criteria for access. Following on from the recommendations in this HTA, the HSE-MMP, in conjunction with the HSE-PCRS, and with the support of the HSE Chief Clinical Officer, introduced an online reimbursement application system for all CGM sensors on 1st December 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.
To date, a HTA of CGM sensors for people with type 2 diabetes mellitus or other types of diabetes has not been undertaken in Ireland. Therefore, there is limited information to support the extension of reimbursement to these patient groups, including cost-effectiveness assessment and budget impact of same.
The HSE has identified preferred CGM products based on cost-effectiveness to manage this expenditure.
The Diabetes Policy and Services Review: A Strategy for Better Care was launched on the 21st of May. It provides a detailed assessment of our current diabetes services and sets out series of recommendations and actions to improve diabetes care delivery. This includes access to diabetes technology based on clinical need, such as continuous glucose monitoring.
The HSE is currently working to develop an implementation plan for the strategy, in cooperation with my Department, to ensure that the recommendations are followed through at national level and throughout the Health Regions.
440. Deputy Paul Nicholas Gogarty asked the Minister for Health if she will provide new funding to provide a new registered advanced nurse practitioner post in each young adult diabetes clinic in all level 4 hospitals to support the further development of each local service. [67681/26]
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.
441. Deputy Johnny Guirke asked the Minister for Health if she is aware of an incident (details supplied); and the measures she will take to increase ambulance personnel and vehicle capacity in County Meath. [67722/26]
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.
