Mattie McGrath (Tipperary, Independent)
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1. To ask the Taoiseach when the Cabinet committee on health will next meet. [1151/24]

Bernard Durkan (Kildare North, Fine Gael)
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2. To ask the Taoiseach when the Cabinet committee on health will meet next. [1813/24]

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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3. To ask the Taoiseach when the Cabinet committee on health will next meet. [2801/24]

Mick Barry (Cork North Central, Solidarity)
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4. To ask the Taoiseach when the Cabinet committee on health will next meet. [3710/24]

Pádraig O'Sullivan (Cork North Central, Fianna Fail)
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5. To ask the Taoiseach when the Cabinet committee on health will next meet. [3803/24]

Aindrias Moynihan (Cork North West, Fianna Fail)
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6. To ask the Taoiseach when the Cabinet committee on health will next meet. [3806/24]

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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7. To ask the Taoiseach when the Cabinet committee on health will next meet. [4029/24]

Paul Murphy (Dublin South West, RISE)
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8. To ask the Taoiseach when the Cabinet committee on health will next meet. [4032/24]

Peadar Tóibín (Meath West, Aontú)
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9. To ask the Taoiseach when the Cabinet committee on health will next meet. [3975/24]

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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10. To ask the Taoiseach when the Cabinet committee that deals with disability will next meet. [4021/24]

Paul Murphy (Dublin South West, RISE)
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11. To ask the Taoiseach when the Cabinet committee that deals with disability will next meet. [4024/24]

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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12. To ask the Taoiseach when the Cabinet committee that deals with disability will next meet. [4300/24]

Cormac Devlin (Dún Laoghaire, Fianna Fail)
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Is Deputy Ó Murchú substituting for Deputy McDonald?

Cormac Devlin (Dún Laoghaire, Fianna Fail)
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When the Taoiseach is ready, I understand he is taking Questions Nos. 1 to 12, inclusive.

Leo Varadkar (Dublin West, Fine Gael)
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I propose to take Questions Nos. 1 to 12, inclusive, together.

The Cabinet committee on health last met on 7 December 2023 and is currently scheduled to next meet on 12 February of this year. The committee oversees the programme for Government commitments relating to health and receives detailed reports on identified policy areas. It considers the progress of health reforms, including Sláintecare and the reform of disability services. The committee also maintains an overview of public health. In addition to the meetings of the full Cabinet and Cabinet committees, I meet Ministers from time to time on an individual basis to focus on different issues. I meet regularly with the Minister for Health to discuss progress and challenges in health, including the Sláintecare reform programme.

Sláintecare, which is happening with the support and oversight of the Department of the Taoiseach through the Cabinet committee on health, is about four main issues: making healthcare more affordable; making it more accessible; ensuring better outcomes for patients; and reforming our health service. We are committed to expanding the core capacity of our acute hospitals, with more health professionals and more acute hospital beds.

We have added more than 1,000 permanent beds in our acute hospitals since 2020 and 1,000 more consultants. We have increased the total public health sector workforce by more than 26,000 since the start of 2020. That includes an extra 8,000 nurses and midwives, an extra 4,000 social care professionals and almost 3,000 extra doctors and dentists.

There is a strong pipeline of capital projects, including several new hospital projects and significant new facilities for existing hospitals. Our multi-annual approach to waiting lists resulted in an overall reduction in the number of patients waiting more than ten to 12 weeks by 27% since the numbers peaked after the pandemic. Waiting lists fell last year for the second year in a row. We are determined to make sure they fall for the third year in a row this year. The figures that matter most are the number of patients waiting the longest, that is, those waiting longer than the ten to 12 weeks recommended by the Sláintecare report. The target of achieving a 10% reduction in patients waiting longer than ten to 12 weeks was met, with an 11% reduction achieved. This covers inpatients, day cases, outpatients and patients undergoing gastrointestinal, GI, scopes, and equates to 57,000 fewer people waiting more than ten to 12 weeks.

The enhanced community care programme continues to improve healthcare at a more local level and to alleviate pressure on major hospitals. The majority of community healthcare networks, community intervention teams and community support teams are now in place and providing care closer to home. Work is ongoing on the reconfiguration of the HSE organisational structures into six new health regions and the establishment of elective care centres in Dublin, Cork and Galway, as well as surgical hubs in Dublin, Cork, Galway, Limerick and Waterford in the interim.

At a time when the cost-of-living crisis is affecting everyone, we are making healthcare more affordable through the removal of hospital charges, widened eligibility for the GP card and a reduced drug payment scheme threshold, among other measures. We have allocated more than €22.8 billion for health services in 2024. That will facilitate the continued provision and expansion of quality, affordable healthcare services. Separately, significant funding is also being invested in disability services. Budget 2024 will provide for the further expansion of free contraception provision to include women aged 31; just under €3 million for the development of child and adolescent mental health services, CAMHS, with the creation of 68 new posts; the first full-year programme of publicly funded assisted human reproduction services, including IVF; more than €20 million for residential placements for children and adults; €15 million for respite services, €18.2 million for day services; and €8.5 million for developments in children's services, including new therapy assistant positions.

Our health service has its challenges but it is responding and it has expanded dramatically in recent years. We are treating more people with better outcomes than ever before. Our life expectancy is continuing to increase and is now well above international averages, being in the top five in the European Union. We continue to reduce mortality rates for stroke and certain cancers and to report ever-increasing positive trends in preventative health.

Bernard Durkan (Kildare North, Fine Gael)
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I thank the Taoiseach for his comprehensive reply. I accept there have been huge improvements in the delivery of vital health services in very difficult and challenging times. Sufficient recognition is not given to that. However, there are a couple of small measures that could have a considerable impact in improving the delivery of services. One such measure concerns the operation and layout of emergency departments. The staff there are under the cosh all the time. They work in appalling conditions, sometimes under physical threat and always under some type of threat. In some cases, patients move from beds in wards into the emergency department area to confront each other and confront staff in a way that is totally unacceptable. There could and should be a rapid inspection of emergency departments all over the country to stamp out this ongoing behaviour that is causing considerable stress.

The other issue in regard to the delivery of health services is one we need to think about more. We spend a lot of time talking about treatment purchase schemes both within the island of Ireland and overseas. All the services provided under those schemes are readily available here, albeit through the private system. I do not see any reason people should have to travel outside the jurisdiction for services such as eye procedures, which is a regular occurrence, when the services are readily available through the private sector.

Mick Barry (Cork North Central, Solidarity)
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A total of 71 people were on trolleys in Cork University Hospital, CUH, this morning. It was the second most overcrowded hospital in the State last year, with 12,582 patients admitted without a bed. Already this year, the numbers presenting to the hospital's adult emergency department are up by one third on last year. This morning, the hospital's clinical director of emergency and acute care, Professor Conor Deasy, appealed to the Government to lift the staff embargo. What does the Taoiseach have to say about this situation? Will he stick with the recruitment freeze despite all the evidence that last year was a disaster in emergency departments and that demand has increased again this year? If he will not pay heed to the people on trolleys, will he at least pay heed to the words of Professor Deasy? Will he answer the professor's plea for an end to the freeze or will he stick to his worn-out mantras?

Aindrias Moynihan (Cork North West, Fianna Fail)
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Gabhaim buíochas leis an Taoiseach as ucht an cheist seo a fhreagairt. Last week saw the publication of the report of the Citizens' Assembly on Drugs Use, which included wide-ranging recommendations. The general thrust was around having a health-led response to the possession of drugs for personal use. As I understand it, the next stage is for the report to come to the Oireachtas. Will the Cabinet committee on health discuss the report and prepare the various next steps in terms of legislation arising out of it, or, as the report recommends, will that be done by a new committee headed by the Taoiseach? Will he give an overview of plans for dealing with the report and a timeline for same?

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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I met a young mother this week who has a very serious precancerous condition. For six years, she obtained a cream called Imiquimod with her medical card. For no reason for which she can get an explanation, she is no longer able to get it. It has been taken off the primary care reimbursement scheme with no explanation. They only way she can get it now, apparently, is by paying €400 a month to import it from the United State via Holles Street hospital. I understand the product is licensed here. I do not understand how this can be happening. This woman believes a significant number of people will be impacted by the situation. It is very likely she is not the only one. This is outrageous. Her doctors tell her that if she does not get this treatment, it could seriously worsen her situation and she may be forced into a serious operation as a result. Will the Taoiseach talk to the HSE, the Minister for Health or whomever else to address this issue? The treatment is for a precancerous condition that must not be allowed to get worse. The woman has to get the cream. She used to get it with her medical card but now she cannot get it unless she pays €400 a month, which she does not have. I ask the Taoiseach to address her situation as a matter of urgency.

Paul Murphy (Dublin South West, RISE)
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For a number of years, the Government has talked the talk when it comes to a health-led approach to drugs but it definitely has not walked the walk. The failed and failing war on drugs has continued. In 2022, 17,321 controlled drug offences were reported. There has not been the investment needed in the front-line drug addiction services and task forces. Investment has basically stagnated. It is now time to walk the walk. The citizens' assembly was very clear on the necessity of an end to criminalisation and a proper health-led approach.

Tomorrow our Bill to decriminalise the possession of small amounts of cannabis will be debated and voted on. Will the Government implement a health-led approach by supporting that legislation?

Peadar Tóibín (Meath West, Aontú)
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The general practitioner sector was one of the last elements of the health service that functioned properly. Now are seeing incredible two- or three-week delays for a simple first appointment with doctors throughout the country. That is if doctors will take people onto their lists. Many thousands of people now cannot even get on a doctor's list, which means that they are locked out of GP healthcare. Many of these people are then forced to go to hospital accident and emergency departments, which has the effect of increasing the blockage in that element of the health service as well. In the past few months, the Minister, Deputy Donnelly, said that he is seeking to increase the number of medical training places in the universities by approximately 35%. That will take at least seven years to come to fruition in terms of bigger numbers. The key element is that even if we have more graduated GPs, a massive number of GPs still see their career in Australia or other countries rather than Ireland. What is the Government's plan to ensure that Irish citizens can actually get a doctor when they are sick?

Pádraig O'Sullivan (Cork North Central, Fianna Fail)
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I want to raise again the issue of rare diseases. The Taoiseach might have seen the news that last week, thankfully, the drug Libmeldy was approved for patients who suffer from metachromatic leukodystropohy, MLD. I pay tribute to the parent of a child who passed away a number of years ago. Les Martin sadly lost his son, Cathal, a few years ago to this disease. We saw and heard from Les last week. He has been campaigning for a number of years because he has a second child who is also affected by this disease. Thankfully, his second son can avail of this drug because it was approved last week.

This disease can be caught with the heel prick test when a child is born. I ask the Taoiseach to provide us with an update. I understand that there is a review currently to expand the heel prick test. Will the Taoiseach elaborate on whether this particular ailment could be picked up through the heel-prick test into the future?

Leo Varadkar (Dublin West, Fine Gael)
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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.

Mick Barry (Cork North Central, Solidarity)
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Is there any comment on the recruitment freeze in Cork University Hospital?

Leo Varadkar (Dublin West, Fine Gael)
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The HSE can recruit an additional 2,000 staff this year.