This question goes to the heart of our priorities in healthcare. The goal is universal healthcare, which means affordable, accessible and high-quality care. A lot of good progress has been made in patient outcomes and clinical strategies being rolled out, including in women's healthcare, and there have been other positive initiatives. A lot of progress is being made on affordability as well. Progress is being made on access but that is the highest priority. To the Deputy's point, there are various initiatives in pl…

I am not satisfied, nor are any of us, with either the number of people waiting on trolleys or the amount of time people are waiting. There are two parts to how we will solve this. First, we need extra capacity, including more emergency medicine, consultants, nurses, healthcare assistants, beds in hospitals, home care packages and preventative measures. A lot of work is going on there and I accept, on behalf of the State, that more capacity is needed. Second, we need significant reform in how hospitals are managing…

We have some pretty clear ideas as to why not only Waterford Hospital, but also the hospitals in Portlaoise, Tullamore and others are doing better. Some of it comes down to rostering patterns, some of it to patient flow and advance triage in the emergency department, block booking of private beds and nursing home beds for discharge, strong leadership on patient flow through the hospitals and many other issues. At this stage we have a pretty good idea as to why some hospitals are doing better.

That is exactly what we are focusing on. It is incumbent on the Members of the Oireachtas to keep the focus on both. I fully accept the position of clinicians who say they need more capacity. They do. As the Deputy will be aware, we have added more community and hospital capacity than at any time since the foundation of the HSE and we will continue to do that. At the same time, we must keep focusing on different ways of working. That is the core of the new consultant contract, which we will be offering later this m…

I thank the Deputy for the question. There have been changes in the Department of Health. Broadly they have been positive. The Department is in a much better position now than it was when I was appointed to office. There is a strong culture of decision making, more openness and more stakeholder engagement. For example, we saw that in respect of the Bill that passed Committee Stage in this House last night. A strong senior team is in place and it is working well. I have seen important changes and improvements in per…

I imagine the figure of 24% relates partly to secondments and other issues connected to the fact that the Department scaled up for Covid-19 and then scaled back down again. There have been movements. Some are due to retirement and some people are moving on to other Departments, which is normal. I repeat that the Department of Health is in a much stronger position than it was two and a half years ago.

The figures I have show that the churn in the Department of Health is similar to other Departments. I am not concerned about the numbers who have left. Strong teams have been put in place. There is something for us all to reflect on. As the Deputy will be aware from her time as a Minister of State at the Department, those who work in the Department of Health are on the receiving end of relentless negativity every day, every week. At a human level it can be difficult to work in that environment day in and day out, w…

I simply do not accept the premise. The Deputy states that there is a significant issue in the Department of Health and I am telling her straight that there is not. The Department of Health is in a much more robust and healthy place than it was two and a half years ago.

Am I concerned about it? I am not

I have addressed the numbers several times now.

I am telling the Deputy that according to the Department of Public Expenditure, National Development Plan Delivery and Reform, the figures in the Department of Health are matched in other Departments. If what the Deputy is saying is true, it is true across the Civil Service. As I said, I have no doubt some of it is down to people who were on secondment because of Covid-19 and have left. For example, we have moved an entire disability team to the Minister, Deputy O'Gorman's, Department. At senior level, ten people r…

I acknowledge that the current situation for cancer services and the location of those at University Hospital Kerry is not sustainable and is not what anybody wants to see. I visited the hospital just last month and discussed this with the senior management in the hospital. The priority is that every patient in Kerry receives the best possible care in the right environment. The solution to this is the new oncology unit, which will greatly increase capacity at the hospital. The project is going through the various c…

We need to get this sorted as quickly as possible. The new unit is going to make a big difference. It will have 14-day treatment cubicles, two treatment isolation rooms and seven outpatient consultation rooms, so it is going to make a big difference in terms of the experience that patients have and, indeed, that clinicians have in providing what is world-class oncology treatment to patients. I am advised that to facilitate palliative care being reinstated, the Department has been told by the HSE that the oncology s…

We are looking at modular builds. My view is that the capital process is not working; the capital process is broken. There are internal processes within the HSE and processes between the Department of Health and the Department of Public Expenditure, National Development Plan Delivery and Reform. There are far too many layers and far too many people who can say “No” who need to say “Yes”. As an example, I was checking in recently on a very modest project that I sanctioned a year and a half ago which still has not ha…

I thank the Deputy for his question. He will be aware that I secured funding of €1.3 million in budget 2023 to provide reimbursement support for Cariban, which I think is at the heart of his question. Cariban has been available since the beginning of the year for women suffering from hyperemesis, which is a severe form of nausea and vomiting during pregnancy that affects about 1% of pregnant women. I believe the number of women who have been approved for the product is 144 as of today. This is slightly ahead of pro…

I will get the Deputy a detailed note to ensure this information is correct. My understanding is that once a woman has a prescription from her obstetrician that the repeat prescriptions can then be filled by the GP. Under the scheme introduced this year, the product is provided completely free of charge. I will, however, get the Deputy a detailed note just in case there are some nuances involved. What we should be doing now is looking to the company. Under the Health Act 2013, the onus is on the company to apply to…

I do not know if "prescriptionable" is a word. It is now and will be forever recorded as such. My understanding is that it is up to any company to apply for market authorisation and to apply to be added to the reimbursement list. I think this would be the best solution to this. We have well established processes, clinical governance, safety reviews and contract negotiations in place, which work very well. In fact, the reason we are in this situation is because Cariban is not a licensed product and this means there …

I thank the Deputy for the question. He will be aware that many of the recent medicine shortages were caused by an exceptional increase in demand for certain products to treat winter illnesses; in some cases this demand was two to three times greater than the same period in previous years. This demand was seen right across Europe and around the world. I am pleased to be able to inform the House that the level of demand for products to treat winter illnesses has levelled off and the problems with the supply for most…

The Deputy asked if Ireland was more affected than other countries. This is something we have been looking at. There are some commercial entities that have been suggesting it, linking it to them potentially getting paid more money for their products. There is no evidence to suggest that Ireland is more adversely affected by the current global medicine shortage than anywhere else. The HPRA has said we are experiencing fewer shortages than many other European countries, despite the fact that demand for some medicines…

The HPRA is doing a very good job. It is very actively engaged in this and I am open to seeing if there is a wider role it can play or more it can do. The HPRA publishes a list of shortages. It would be useful if it could show that in many of these cases, for example, it might be that the 12-pack of a medication is not available but the 24-pack is. The real squeeze is therefore substantially less than the list might suggest. We were just discussing the medicine shortages protocol. There is merit to it but there is …