Of course we will look at the organisation of services more generally. It is very important to me that every hour a therapist works delivers therapeutic services. I do not want to see therapists in cars. That is one of the reasons the Minister, Helen McEntee, is doing such strong work to make sure there are therapists based in schools, where they can have the most effective and efficient use of their time. I appreciate that is a transitional period at the moment as she moves to do that and provide services in speci…

I thank Deputy Healy-Rae for his comments on abolishing the means test for carers. We are systematically trying to get to the point where it has been abolished. I recognise the changes that have been made because what we want to see, as the Deputy said, is people staying in their own homes for as long as possible for their dignity, comfort and connection with their families and because that is the model we want to have. There is a substantial body of work on that, which the Minister of State, Deputy O'Donnell is le…

I thank all Senators who have spoken. I know that many more spoke on earlier Stages of the Bill and that there is a very strong interest among them all, correctly, in making this the easiest pathway for children to get the surgery they need when they need it. I really welcome the Bill. It is fantastic to have this collaboration here, and I totally appreciate the purpose, logic and intention behind it. At the end of the day, however, the Bill should not be necessary. Unless the surgeries are actually performed, the …

It was very important to conduct the national assessment of insourcing, which I commissioned at the beginning of April because of my concerns, and to publish it. The Deputy has had an opportunity to consider it today. We have to use every lever to implement Sláintecare, including rostering for five over seven days, the public only consultant contract and making the best case possible for as much investment in health infrastructure as this Government can do collectively. That includes elective hospitals and surgical…

This is an issue for enterprise, social protection and health. GPs are private practitioners. Many of them have contracts with the HSE to provide public services. Services provided outside of these are a private matter. The Medical Council is there to protect the public. Part of this is registering doctors as quickly as may be, and part of it is making sure that doctors operate to a very high standard. I encourage the Medical Council to reflect on the issue Deputy Feighan has correctly highlighted, recognising the …

I will repeat some of the things that have been said about recruitment. The numbers are up by 25% over that period. The pay and numbers strategy resulted in a net increase of 2,000 people into the health system, with 2,000 people who had temporary contracts made permanent, 2,000 vacancies and a net uplift of 2,000 people. I will be happy to provide the detail to the Deputy. Nevertheless, we continue to recruit. We have several thousand more people to recruit this year. We are doing our best to meet the targets. I m…

The Government remains committed to increasing capacity in the public system. The commitment is underpinned by unparalleled levels of investment as we move to universal access to health care. However, until the capacity is in place to meet the increased levels of demand, it is necessary in the interim to make use of all available capacity in the public and private systems to ensure that patients have access to the care they need. The waiting list action plan 2025 includes targeting the delivery of additional capaci…

It is an excellent question. It is exactly what I have asked Bernard Gloster to do. Of course, I have to wait for the report to be able to express my confidence in the quality of the work that has come back. The Deputy may take that as a reference example. As I said in my opening reply, if there was underutilised capacity, that is, as the report states, other people in the hospital could have held surgeries at an earlier period but did not due to the waiting list management process, that is very serious. In advance…

The Deputy raised the issue I am concerned about, namely that there are incentives to be under productive during the working week with a view to, or which have the outcome of, very busy clinics on Saturdays or bank holiday Mondays. That is exactly the sort of incentive I need to see stop. I cannot speak to the relative activity because I do not have that data. The Deputy's example is precisely the sort of example that prompted me to conduct the work on insourcing. I wish I was a couple of weeks ahead and had the da…

There are nine HSE rapid access symptomatic breast disease clinics nationally, as the Deputy knows. The HSE has set a target of 95% of urgent referrals being seen within ten working days. Non-urgent referrals should be seen within 12 weeks. The HSE national cancer control programme monitors the performance of these clinics. Last year, national compliance with targets was 76% for urgent and non-urgent referrals but I recognise the variations the Deputy described. While five centres generally met or exceeded the targ…

The Deputy is right. Yesterday I was at St. James's Hospital and it and Trinity College have become one of the accredited cancer centres of the Organisation of European Cancer Institutes. There are many accredited centres but this is at a different level. It is the most prestigious award for cancer control. The Deputy is correct that we have very good services. He asked in what world is this acceptable. There is no world in which it is acceptable and there is no world in which the Mater's figures are remotely accep…

I thank the Deputy and I agree with him on all of these points. Yesterday at the health committee we covered some of the workforce planning issues and the expansion of training places. It is also a workforce management issue and the variation between hospitals is well noted. I am told that in the Mater there have been long-standing recruitment challenges but they have been stabilised. There has been a consistently high volume of urgent referrals with difficulty in accessing radiology in St. James's Hospital. A lean…

In response to a series of reviews which raised corporate and clinical governance concerns at CHI, I have moved to strengthen governance and oversight structures at CHI in a range of different ways. This was done via the appointment of two members of the HSE board to the board of CHI on 28 May. There are more board appointments to be made. This means that all but one members of the board have been appointed since 2024. This is a different reference period to some of these activities. The service level agreement bet…

The Deputy will note the number of resignations from the board. She has identified a series of important and serious issues, most of which we knew would be coming because of the concerns raised by whistleblowers and others. Reports were correctly commissioned with HIQA by the HSE and CHI. We knew they would come but, as she pointed out, the report that was not shared with either the HSE or the Department raises very serious concerns. It comes from 2022 when it should have been shared and addressed properly but it i…

I want to be very careful of the privacy of Mikey and his family but I have met him and I have met his family. I am aware of the various issues. On foot of meeting them, I put in train a process and perhaps I might speak to the Deputy about it privately rather than on the floor of the Dáil, recognising his privacy. With regard to scoliosis and the issue of waiting times, it is a source of great frustration to me that there has been so much additional investment, both financial and personnel, into the system but we …

I thank the Deputy. The role our healthcare workers played during the pandemic cannot be overstated, particular at the very early stage of it. They went beyond the call of duty, working in front-line environments, treating Covid-19 positive patients, particularly in the early days when the control mechanisms were what they ultimately became and while the risk was extraordinarily great. In response to that, a temporary scheme was put in place for 12 months in July 2022 to support eligible staff who were impacted by …

There is no intention not to recognise that or to not be empathetic, which is why the scheme for full pay was there for five years. I am aware that the Minister for Social Protection has reviewed the EU recommendation in respect of the recognition of Covid-19, not long Covid, for an occupational illness. Following that review, it was determined that Covid-19 did not meet the requirements to be recognised as an occupational illness in the context of the occupational injuries benefit scheme and the Social Welfare Con…

Again, I recognise that the findings of the Labour Court are still awaited and I respect that. I will also reiterate the terms of the sick leave scheme. Having been on full pay for five years, the healthcare workers may receive further full pay for three months, half pay for three months, temporary rehabilitative remuneration for 547 days of paid leave and the critical illness protocol that forms part of the sick leave, which provides additional support for up to three years. I appreciate the distinction, important…

I thank the Deputy. As part of the Government’s ambulatory care policy and in advance of the new elective hospitals, the HSE is developing surgical hubs across the regions. They will play an important role in separating scheduled and unscheduled care, reducing waiting times, thereby improving access and care for patients. The programme for Government committed to delivering six new hubs and exploring the provision of an additional surgical hub for the north west. No decision has yet been made on a location for this…

I thank Deputy Ward and I assure him, representatives from Donegal, the consultants and doctors in Letterkenny and the people of Donegal more broadly that I will do precisely that. I am committed to that region. That is why I visited it a number of weeks into becoming Minister for Health in order to understand for myself. I cannot look at it on a map or look at drawings. I have to be there to understand the dynamics and to listen to people, which is precisely why I went and have tried to engage in this way. No deci…