I find myself in agreement with all of the five points Deputy Daly made, such that I do not believe it is necessary to repeat them. I look forward to working with him on the practical points he has made, particularly in relation to the out of hours framework, the premises structure, what we might do and how we might think about that, and the development of that in terms of a tax-efficient way of encouraging activity. The Deputy correctly recognised the public-private element to it. I must also recognise it from the…

Let me be very clear in relation to the recruitment. Any delay should only be in actually finding the consultant orthodontist and bringing them into the system. That does take time because people have to leave posts and so on but there should not be any delay at a HSE level recognising the level of need I have described to the Deputy and have described more broadly. In relation to GPs generally, we have expanded the training programmes and the numbers again and again. We do want them to work. We cannot force them t…

I thank the Deputy. I am fully committed to ensuring sufficient health care capacity across every part of Ireland. I compliment the work done in the midlands between the triangle of hospitals between Mullingar, Portlaoise and Tullamore, which are all performing at an exceedingly high standard in relation to all aspects of care, both emergency and scheduled. However, we need further development of the elective care capacity in the midlands. The HSE capital plan sets out a range of investments for the midlands, inclu…

I take this opportunity to compliment Midland Regional Hospital in Tullamore and its excellent manager, Louisea Burke, on delivering consistently predictable urgent and emergency care. While it is not easy, they do it with an extraordinary focus on patient care. Mr. Bernard Gloster, CEO of the HSE, visited the hospital recently to compliment them in that regard. Often we attend hospitals where there is a problem but not often enough do we attend hospitals to compliment them on their excellent work. Tullamore hospit…

I was just reflecting on how Birr primary care centre has evolved since we saw it last summer. I am looking forward to visiting it in quarter 3 of 2026 when it will be operational to see how magnificent it is. For anyone who has not seen it, it is absolutely huge. It will be an enormous addition to primary care for the people of Offaly generally. Of course, it will have extensive GP practices and a pharmacy. It will also provide space for a National Ambulance Service base. It is extraordinary and it will add enormo…

The HSE contracts GPs to provide medical services on its behalf, including GP services under the general medical services, GMS, contract. Over 3,200 GPs hold at least one contract with the HSE, which is a 9% increase compared with January 2020. As GPs are private practitioners, they determine the location from which they provide GP services. Increasing GP capacity is a priority for the Government. As I said in response to Deputy Daly, we have significantly increased the new entrant places. Additionally, we are tryi…

I agree with the Deputy. The difficulty, again, is that private GP practices determine their location. That is a challenge. The Deputy is right; we need to try to focus on the primary care centres and enable more GPs to come into the public practice. It is a particularly frustrating area because, of course, plans were advanced for primary care centres, which required planning permission to turn a facility into a primary care centre. They have not progressed, however. We are looking at the bigger one to serve Leixli…

The Deputy is right; we have a challenge in this regard. On the one hand, we cannot tell private GP practices where they should locate. That is a matter for them to determine. At the same time, we want to ensure they locate in areas of need, such as the Deputy’s constituency. He has suggested looking at some measures to create different incentives for GPs to either join a practice or physically extend a practice and how the State could offer the best support to them to do that. This is something the Deputy has ment…

Haemochromatosis is a hereditary condition, common in Ireland, characterised by an over-absorption of iron from the gastrointestinal tract. Excess iron accumulates in organs including the liver, pancreas and heart, causing damage. I am informed that Ireland has been confirmed as having the highest rate of haemochromatosis worldwide. I am advised by the HSE that the Irish Haemochromatosis Association receives €55,000 in funding from the Health Service Executive each year to support engagement, raise awareness, suppo…

I do not know what the reasons for that are and why Ireland has the highest rate of it. I would be quite interested to find that out. As the Deputy says, this is a condition that can be managed well, particularly at a primary care level. It is the most common genetic disease here, with one in 83 people genetically predisposed to develop the condition. The symptoms are sort of non-specific and include non-specific fatigue and joint pain. The diagnosis is very variable. However, it can be treated well and effectively…

I thank the Deputy for sharing his own experience and perspective because that helps to tell the story of how common this is and what the impact is. We support the Irish Haemochromatosis Association and World Haemochromatosis Awareness Week, which takes place from 1 to 7 June every year. The association also runs the GP practice nurse training and education programme. To the extent we can do so, we will get behind that world awareness programme every year in the first week of June, a lovely week of the year, to dri…

The Healthy Ireland framework provides a number of strategies to ensure everyone in Ireland can enjoy good health as they age, including the national physical activity framework and the obesity policy and action plan. One in three older women and one in five men are affected by osteoporosis. In 2023, the Department published healthy eating guidelines for adults aged 65 and over, which emphasise the importance of a healthy diet for older adults to maintain muscle mass and bone strength to support independent living.…

The element of preventative care is crucial from the perspective of diet, lifestyle management and the ways in which people exercise. The gym membership piece is interesting but exercise is available in lots of different ways. I am seeing different forms of community exercise groups. There is a fantastic facility in a GAA centre in south Sligo and in other places. What you are doing is turning up as part of a community and going through the different machines. Whether people are post-hospital or post-diagnosis, usi…

We met women with endometriosis at the beginning of September 2025 and this scheme was put in place six weeks later. It was put in place for a specific reason, which was that we wanted to make access to surgeries as easy as possible. There are already two schemes, which are the cross-border directive and the treatment abroad scheme. In many ways those required women to pay upfront when what we wanted to do was pay the upfront cost for them. I understand we set up a dedicated two-year scheme to keep it in line with …

When a new scheme is established, it must be done in a legally robust way. It is necessary to identify a reason these clinicians and not those clinicians are included. For example, the European Endometriosis League, EEL, and the British Society for Gynaecological Endoscopy, BSGE, criteria were picked. All of those clinics that were on those very defined lists automatically came onto the scheme. The clinics that the Deputy is referring to in Athens and Romania were not among those accredited by the EEL or BSGE. We s…

We have to keep it clinically safe as well and within the rules for the future.

If I were to come back and give the Deputy the specific reasons there might be a concern about one clinic, she might take a different view. Perhaps we might have that conversation privately, because I suspect she does not have the complete information that I have, which is not a fair balance. We might perhaps speak about that separately. She is correct that in the past there was a reluctance to refer patients abroad because clinicians did not know where they were referring them to. That is a cultural issue as much …

But the Deputy did. Let me just be careful. We have clinicians who have been taking their own time to go and see others through surgeries so that they might learn more. We have developed different education pathways and fellowships over the past number of months, particularly with clinicians who really wanted to do better in Ireland and access the opportunity to do better in Ireland. I want to support those clinicians who are taking those steps. On Friday, the Royal College of Physicians is hosting its first confer…

As the Deputy will be aware, primary care psychology provides a broad range of supports and treatment for mild to moderate mental health conditions. HIs concern is particularly the south Lee area, so I might get to that. Currently 2,445 children and young people under the age of 18 are waiting to access primary care psychology in the south Lee area, with 198 waiting for between 26 and 39 weeks, and 1,792 waiting longer than 52 weeks. That is an aberration and should not be the case. It simply has to be improved. Se…

I am sorry. I did not hear the Deputy.