Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I thank the Deputies for their questions. Deputy Durkan raised the operation and layout of emergency departments. I very much agree with him that staff work very hard in emergency departments and are often subject to abuse and even violence from a minority of patients and their visitors and that is never acceptable. The NTPF is used to commission private healthcare for public patients and it generally works very well. However, patients do have the right to seek healthcare in Northern Ireland or in the EU and have the costs reimbursed. Ultimately, it is their choice. It would be better to use the capacity we have here in our private sector rather than people going abroad but they have that right under EU law. We also have an arrangement with Northern Ireland and people avail of that, particularly for cataracts.

Regarding the recruitment freeze and embargo, provision has been made for the HSE to increase its staff this year. It can hire an additional 2,000 staff. Since 2020, we have seen a recruitment surge. We have 8,000 more nurses and midwives than we had in 2020 and there are 3,000 more doctors and dentists. The HSE can hire an additional 2,000 staff but it needs to be done in a proper way.

Deputies Moynihan and Murphy asked about drugs policy. I met the chairman of the Citizens' Assembly on Drug Use last week. There were three takeaways for me from what he said. The first is that we need an Irish model; we should not just try to copy models in other countries. The assembly has made a lot of recommendations and it is not just about decriminalisation. He does not want all the focus to be on that. If it is going to be examined by an Oireachtas committee, it should be a special committee, not the health or justice committees because it is relevant to both areas and indeed other areas like education. Our intention is to refer the report to a special Oireachtas committee. The Minister, Deputy Naughton, will bring a memo to Cabinet about that next week. One of the issues the special Oireachtas committee will have to tease is what decriminalisation really means in Ireland in a legal context. Does it mean that is not an offence at all? Does it meant that it is a non-indictable offence? Does it mean that it is an offence without a penalty? Is there something like penalty points or does it actually mean that a certain amount of each particular substance would not be illegal to possess? All of this has to be teased out by the committee. It was not teased out by the assembly. In fairness to the members, they are not legal experts or legislators. With that in mind, we are proposing a timed amendment of nine months to the Private Members' Bill.

Deputy Boyd Barrett mentioned a particular medication or cream that I am not familiar with. I do not know why it was taken off the GMS and the DPS. There may well be a good reason and there may not be. If the Deputy can pass me a note with the name of the medicine, I will check up on it because I am sure the issue will come up again.

Deputy Tóibín asked about access to GP services. We have increased the number of training places dramatically. There are now more doctors qualifying as GPs than there are retiring. It does not take six, seven or eight years. If people train as a GP, in their third year of training they are in practice almost full time, seeing patients. We are seeing those people come through already. We are allowing GPs to come in from other jurisdictions and South Africa in particular. This is because it is an international labour market and people come and go. We are also investing in more practice nurses because in Ireland there is a very low ratio of nurses to GPs. In an Irish general practice, there might be one nurse to four doctors. In a general practice in Holland, there will usually be four nurses and four doctors. That model works very well, so they are the things we are doing.

Ozempic is a medicine used both for diabetes and obesity. We should not forget that obesity is a disease. It is good that treatments are now available for it. However, there is a shortfall of supply internationally and for that reason, and rightly so, diabetic patients are being prioritised. The company, Novo Nordisk, is scaling up production, but thinks that it will be the latter part of the year before enough is being produced to meet demand.

Finally, to Deputy O'Sullivan's question, I will check up on the heel prick test. I do not know what the current status of the review is. I know we test for many more things than we used to. It used to be just four and now it is approximately 60. I am not exactly sure where we are on that but I will follow up on it. I also want to recognise Deputy's advocacy when it comes to new medicines and rare diseases. As part of the Revised Estimates Volume just before Christmas, we set aside dedicated funding for new medicines for this year. Hopefully, that will see more new medicines and more new uses being approved throughout 2024.

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