I thank Deputy Ward and I hear what he is saying about his experience of the HSE. That is important. It is also important to reflect on local hospital management and their responsibility to advance cases on behalf of the hospital. When I met Deputies from Donegal, I went through the projects that had been advanced and supported. I recognised there was, in my view, insufficient surgical ask by the local hospital management. While I am not trying to deflect from the surgical hub issue in any sense, it is also importa…

I will answer on HIQA specifically and ask the Minister of State, Deputy O'Donnell, for his perspective as well. HIQA plays a crucial role in ensuring high-quality and safe care for patients using our health and social care services. The Government strongly supports HIQA in maintaining and strengthening its critical regulatory role. While it provides an important role, it also needs improvement. A number of changes to both primary and secondary legislation have been made in recent years to expand and reinforce HIQA…

It is exceptionally important to acknowledge that our focus here is on HIQA, but HIQA did not do and did not enable what happened in the nursing homes. I want to take a moment to reflect on the fact that the provider and the individuals involved are ultimately responsible. We will also work with HIQA but let us first and foremost direct our ire at the providers of the nursing homes.

I recognise the importance of timely access for patients to medicines, including new medicines. Supported by €128 million of funding, in the past four years the State has delivered access to 194 new medicines. Of these, 74 were for cancer and 49 were for rare diseases. Budget 2025 allocated €30 million for new medicines, to come from efficiencies to be identified by the HSE. The Government has introduced a suite of new measures to enhance capacity in the HSE’s pricing and reimbursement system, including 34 addition…

I want to put a little bit of context on this. The State spent more than €3 billion in 2023 providing medicines to patients. We sometimes forget that €3 billion of the health spend goes to providing medicines. That is appropriate but it is a major budgetary consideration as well. With the early access programmes, we have to get the balance right between being able to get access to the drugs and also being able to work out how that programme intersects with the State's ability to negotiate the right price for the dr…

I will do so, Deputy.

I agree completely with the Deputy. However, my immediate priority is to ensure that there is clinical follow-up and care for patients who have undergone pelvic osteotomy surgery in accordance with the recommendations of the Thomas audit report. I am very aware that there are families around Ireland who are receiving letters and follow-up to say that surgery was not necessary on their child. I cannot imagine the distress that those families experience when they receive that sort of communication. I have spoken to f…

My practice, as much as I possibly can, is to meet people. Like Deputy Clarke, I have met parents and seen the distress. I have parents in my constituency in this situation. There is no difference between our experiences of this. I cannot believe the distress being experienced by the parents of the 71 children. We are already identifying children. Parents are being told through this initial clinical follow-up that their child did not need this. I will now update the Deputies on the expert review process to follow. …

I do not know the exact details of the Deputy's constituent's case but for any child now indicated for surgery, the assessment is done in a very different way from how it happened before. Any such assessment is done by a multidisciplinary team, including a doctor. It is a cross-site piece of work including a physiotherapist assessment. It is not, as had been the case, that an individual consultant makes decisions in his or her own bubble. This is a multidisciplinary team. The Deputy's constituent or any Deputy's co…

The GP chronic disease management programme commenced in 2020 and has been rolled out on a phased basis over four years to adults with either a medical card or, for GMS patients, a GP visit card. The aim of the programme is to prevent and manage chronic diseases. Since 2020, over 680,000 patients have been registered on the programme, including those who have exited the programme. Some 91% of patients now receive routine care in community settings, reducing their reliance on hospitals. An ICGP study found that for …

That is right. It impacts early detection as well. As populations age - which ours is doing - the prevalence of chronic conditions, including multimorbidity, rises. Early protection through the chronic disease management programme prevents the need for more intensive hospital-based treatments. Since 2020, 51% of the new chronic disease diagnoses have been made through elements of this programme. It is not just treating more effectively; it is diagnosing more effectively and being able to divert attention to prevent…

I can update the Deputy on the orthodontic waiting lists. As of April 2025, the HSE employs 14 consultant orthodontists and 36 specialist orthodontists nationally. There are almost 35 oral healthcare vacancies at the moment which the HSE is working to fill, including three specialist orthodontist whole-time equivalents, and a further 2.22 dental nurse whole-time equivalents. There are staffing challenges within orthodontic services in the Dublin and north-east region. At present, both specialist orthodontists posts…

I totally recognise that and I commit today to writing to the Deputy with a full answer on these points. However, as regards the waiting list initiative, there is €8.4 million for this year, provided on an ongoing basis this year to address the primary care waiting lists for children, including in orthodontics. The funding is ongoing rather than one-off and is provided to try to reduce the waiting lists and address increased demand for those services. In the area of orthodontics in 2025, €1.35 million is to be inve…

General practice plays a vital role in our health service but we need more GPs to improve access to services in some areas. To meet that need, the programme for Government has committed to increasing the number of practising GPs through a combination of increased training places and international recruitment. In part, to attract doctors to practice as GPs here, the Government has significantly increased expenditure on general practice, primarily through the 2019 and 2023 GP agreements. The agreements provide for in…

What we are talking about is the continued need to expand GP services, as we have pushed more and more services into the community and that is where we want services, such as the chronic disease management programme we discussed, to be delivered. It is the case that the number of GPs is increasing, albeit at different rates in different regions, but we have a particular challenge in rural Ireland. That is one of the reasons there is now a dedicated programme in the University of Galway. It is a specific rural GP pr…

I agree on the delivery of primary care centres. It is difficult for me to speak in general terms about GPs or other medical staff leaving because there will always be a case of someone who has done that. It is not the general trend of what we are seeing. There is clearly work here. There is the opportunity to set up a business and work in one's own practice. There is the opportunity to work in HSE primary care centres and other more directly employed opportunities, that is to work in different ways and there is cl…

The Government is fully committed to the ongoing development of regional hospitals, including Cavan and Monaghan which operate as a single hospital entity, with integrated managerial and clinical governance systems, care pathways and support functions. Since July 2020, significant resources have been invested to meet the needs of patients using Cavan and Monaghan hospitals. The total budget for Cavan Monaghan General Hospital has increased by 30% from €115 million in 2020 to €149 million in 2025. Staffing has incre…

Waiting times at Cavan Monaghan are improving a lot. Some 35% of outpatient appointments occurred within Sláintecare wait times compared with 25% in the same period last year, which is an improvement that needs to continue. Some 58% of inpatient day cases occur within the Sláintecare wait times, as do 95% of GI scopes, which is an improvement on 87% last year, and 94% to 100% of those waiting for outpatient, inpatient or day case, and GI scope appointments are waiting 12 months or less. I see progress there. The ap…

I am sure the Deputy has discussed this in detail with the management group already. I wonder what response he got directly. As I said, staffing at-----

Deputy Carthy is the local representative in Monaghan so I assume he has discussed this in detail with hospital management.