Healthcare Policy
Seanad Éireann — 2026-06-17
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Mary Butler (FF), Waterford

I thank Senator Cosgrove for raising this matter, which I am taking on behalf of my colleague, the Minister for Health, Deputy Jennifer Carroll MacNeill.
It is something I am very familiar with because my husband has the exact same diagnosis. It is amazing how lived and living experience can come into a lot of the stuff we deal with every day. To look at the Senator, we would never in a million years think she is dealing with a condition that can be very debilitating at times, when the knees start rubbing off each other.
As provided for under the 2019 GMS GP agreement, the GP-led chronic disease management, CDM, programme was rolled out to adult medical card and GP visit card holders on a phased basis from 2020. The specified chronic conditions included in the programme under the 2019 agreement were type 2 diabetes, asthma, chronic obstructive pulmonary disease and cardiovascular disease. The 2023 GMS GP agreement then expanded the CDM programme to include adult GMS patients with hypertension and all women diagnosed with gestational diabetes or pre-eclampsia.
Under the CDM treatment programme, eligible patients are supported in managing their chronic conditions. Each patient receives two scheduled reviews a year with the GP, each preceded by a practice nurse visit. These reviews include patient education, preventative care, medication review, physical examinations, scheduled investigations and individual care planning. Furthermore, patients with an undiagnosed chronic disease or those who are at high risk of developing a chronic disease are identified on an opportunistic basis, for example, when a patient attends the GP for another issue. This is the issue raised by the Senator. Those who are not diagnosed but are at a high risk of cardiovascular disease or diabetes are entered into a preventive programme. The programme has shown very high uptake, with almost all eligible GPs having signed up to provide the CDM programme and provide improved patient care. An Irish College of General Practitioners audit of CDM patient records showed a notable reduction in emergency department attendance and inpatient admissions, as well as a reduction in use of GP out-of-hours services, while the third HSE report on the treatment programme showed patient improvements in biometric and lifestyle risk factors, including blood pressure, vaccine status, smoking and vaping habits, and weight and BMI.
It is understood that approximately 500,000 people in Ireland live with osteoarthritis. The causation of the condition is complex, and treatment can also be quite complex for patients. Self-management, including maintaining an optimum weight and being physically active, is now viewed as critical in managing the condition. I will take on board what the Senator has said about the GLA:D programme and alternative response group education, and also the national strategy with regard to treatment plans and lifestyle education. Some people are very good at doing that themselves, but others will need support. Self-management support and advice on exercise and muscle strengthening is available through the HSE.
Consideration can be given to future expansions of the CDM programme to include additional conditions. However, this would require rigorous clinical assessment to determine whether the condition concerned is suitable for inclusion in the treatment programme, including whether it would be of added benefit to eligible patients who already receive GP care under the GMS scheme. The inclusion of additional conditions would also require engagement with the relevant stakeholders, including the GPs delivering the service. Any service expansion must also be considered in the context of GP capacity to deliver the service. It should be noted that an expansion of the CDM programme is already planned for this year to include further conditions under the various CDM programmes, including chronic kidney disease at stages 4 and 5 under the treatment programme.

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Source: Houses of the Oireachtas. Licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). The Official Report is revised after first publication; the fetch timestamp below identifies the version quoted.

Record URI: https://data.oireachtas.ie/akn/ie/debateRecord/seanad/2026-06-17/debate/main
Retrieved: 2026-08-14T04:55:04+00:00
Sitting date: 2026-06-17