Alan Dillon (Mayo, Fine Gael)
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16. To ask the Taoiseach when the Cabinet committee on health will next meet. [7873/24]

Peadar Tóibín (Meath West, Aontú)
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17. To ask the Taoiseach when the Cabinet committee on health will next meet. [8795/24]

Pádraig O'Sullivan (Cork North Central, Fianna Fail)
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18. To ask the Taoiseach when the Cabinet committee on health will next meet. [9014/24]

Paul McAuliffe (Dublin North West, Fianna Fail)
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19. To ask the Taoiseach when the Cabinet committee on health will next meet. [9023/24]

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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20. To ask the Taoiseach when the Cabinet committee on health will next meet. [9319/24]

Leo Varadkar (Dublin West, Fine Gael)
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I propose to take Questions Nos. 16 to 21, inclusive, together.

The Cabinet committee on health last met on 12 February 2024 and is due to meet again shortly. Déanann an coiste comh-aireachta ar shláinte maoirseacht ar ghealltanais i gclár an Rialtais a bhaineann le sláinte agus faigheann sé tuarascálacha mionsonraithe ar réimsí beartais aitheanta. Déanann sé breathnú ar dhul chun cinn athchóirithe sláinte lena n-áirítear Sláintecare agus an t-athchóiriú ar sheirbhísí míchumais. Coinníonn an coiste comh-aireachta forléargas ar shláinte an phobail chomh maith. In addition to the meetings of the full Cabinet and Cabinet committees, I meet Ministers on an individual basis to focus on different issues. I meet regularly with the Minister for Health to discuss progress and challenges in the area of health, including the Sláintecare reform programme. Sláintecare is happening with the support and the oversight of the Department of the Taoiseach through the Cabinet committee on health. It is about four main things: making healthcare more affordable; making healthcare more accessible; ensuring better outcomes for patients; and reforming our health service, with a particular focus on integration and IT.

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 beds since 2020. We have increased the total public health sector workforce by more than 26,000 since the beginning of 2020, which includes 8,000 nurses and midwives, 4,000 extra social care professionals and more than 2,900 extra doctors and dentists, including more than 1,000 extra consultants.

There is a strong pipeline of capital projects, including several new hospitals and significant new facilities for existing hospitals. Our multi-annual approach to waiting lists resulted in an overall reduction of 27% in the number of patients waiting more than ten to 12 weeks to see a specialist or to have an operation, since waiting lists peaked after the pandemic. Waiting lists fell last year for the second year in a row and we are determined to make sure this is the third year in a row in which waiting lists fall.

The figures that matter most are regarding those who are waiting longer than ten to 12 weeks, as recommended in the 2017 Sláintecare report. The core target of achieving a 10% reduction in the number of patients breaching the Sláintecare waiting times was exceeded, with an 11% reduction achieved. The enhanced community care programme continues to improve healthcare at a more local level and alleviate pressure on hospitals. The majority of community healthcare networks, community intervention teams and community support teams are now in place and are providing care closer to home.

We are also making healthcare more affordable, at a time when the cost-of-living crisis is affecting everyone, through the removal of hospital inpatient charges, widened eligibility for the GP card and a reduced drug payment scheme threshold, among other things. Tá níos mó ná €22.8 billiún leithdháilte againn do sheirbhísí sláinte in 2024, rud a éascóidh soláthar agus leathnú leanúnach seirbhísí cúram sláinte inacmhainne agus den scoth. Ina theannta sin, tá maoiniú suntasach á infheistiú chomh maith sna seirbhísí míchumais.

Budget 2024 provides funding of hundreds of millions of euro for waiting lists; action on urgent and emergency care; investments in our workforce such as advanced practice, more college and training places and more hospital consultants; the first full-year programme of publicly funded assisted human reproduction services including IVF; further expansion of the free contraception scheme; additional staffing for CAMHS; €20 million for residential placements for children and adults; €15 million for provision of respite services; nearly €20 million for day services; €8.5 million for children's services, including new therapists; and €11.9 million for other developments, including increased PA hours for people with disabilities.

Our health and social care service has enormous challenges, but our systems are responding and have expanded dramatically in recent years. We are treating more people with better outcomes than ever before. Ireland has the highest self-perceived health status in the EU, with 80% of people rating their health as “good” or “very good”. Our life expectancy is continuing to increase and is above international averages. We are among a small group of countries where life expectancy is above 82. We continue to reduce mortality rates for stroke and certain cancers and are reporting positive trends in preventative health. Our standardised mortality rates have declined for all causes over the past decade by 10.3%.

Catherine Connolly (Galway West, Independent)
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There are seven contributors who will have one minute each.

Alan Dillon (Mayo, Fine Gael)
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I want to raise my concerns in relation to children’s disability network team, CDNT, services in County Mayo. Parents of children with disabilities are in a constant fight to access services, often resorting to private care, which is sometimes oversubscribed to avoid long waiting lists in the public system. The waiting lists continue to grow in Mayo at a pace with which the HSE clearly cannot cope. Children are being left behind when early intervention is of critical importance.

The Minister of State, Deputy Rabbitte, who has responsibility in the area of disability, acknowledges that the Progressing Disability Services for Children and Young People programme is not working. She is trying very hard to fix it and I commend her on that. However, the problem lies not with the disability services, but with accessibility to those services. Our CDNTs are primarily run with a shortage of staff; there is a job vacancy rate of over 25% across the country and of 27% in Mayo. The HSE has continuously stated it is exploring all options available to it to tackle the waiting times. However, it believes that significant population growth has led to an increase in waiting times. Can the Taoiseach confirm what options the HSE is exploring? Has the capacity been evaluated within our private sector? I urge the Government to consider reimbursing patients who have had to pay private practitioners to access services for children with special needs.

Pádraig O'Sullivan (Cork North Central, Fianna Fail)
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It will be of no surprise to the Taoiseach that I will raise the issue of rare diseases again this week. Let us bear in mind that Rare Disease Day was last week. I would like to raise the issue of the Mazars report, which is due to be published shortly. We have spoken about it before and I welcome its publication, but the reality is that the report will not meaningfully reduce the times for which people are waiting for the approval of an orphan drug. When this Government took office, there was an average of more than 900 days for a drug to be approved through the HTA process. When this Government finishes office, which will be any time between now and next year, that approval process will still take more than 900 days. I met a young girl last week who was on her way to the health committee with her mother.

She suffers with epidermolysis bullosa, EB. She was before the committee with Debra Ireland. There is a pharma company promoting the fact that it is ready to go through the HTA process right now with a drug it has developed. I found it very difficult to explain to her mother that the child is going to be waiting 900 days. That is four hours every morning changing her bandages in agony for the next 900 days while they wait for the drug in question to be approved. I urge the Taoiseach to do his best in terms of the Mazars report.

Paul McAuliffe (Dublin North West, Fianna Fail)
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I am also very familiar with the work of Debra Ireland. The HTA process is not just protracted, as Deputy O'Sullivan points out. In 2011, I authored the Irish Platform for Patients Organisations report, which referred to a black hole in decision-making at the end of the process. We have to find a way of striking a balance between value for the taxpayer, which we should pursue without continuously saying "Yes" to pharma companies, and not resorting to patients having to advocate in the way that we do. We have to have a more humane version of the HTA process. The drugs that are put through that process have to be more available to patients while, at the same time, we seek to secure the best value for money for the taxpayer.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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An often undervalued and ignored group of workers in our health service are the housekeepers and cleaners without whom our hospitals would not be able to function. As we learned during the pandemic, the need for infection control means that this is a job whereby people have to have many skills, a great deal of training, etc., in order to get things right. I raised this matter with the Taoiseach previously. In the past couple of days, the housekeepers have engaged in a campaign with their union, the Independent Workers Union, over the fact that they have been refused a change in the aftermath of the job evaluation scheme. They have been left on the same band they were on previously and have been denied the right to appeal a decision by the HSE over properly evaluating their work and giving them the value they deserve. They should at least have the right to appeal this decision over their job evaluation, which the HSE is currently denying them. I ask the Taoiseach to intervene with the Minister for Health on their behalf.

Catherine Connolly (Galway West, Independent)
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I still have three contributors. An Teachta Ó Murchú is next.

Ruairi Ó Murchú (Louth, Sinn Fein)
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I brought up an issue that was brought to me by Alison McCabe and was also raised on "Liveline", that of post-mastectomy products for women who have been through breast cancer and mastectomy. There was a plan involving reducing the funding for the scheme. I brought the decision in that regard to the attention of the Taoiseach and the Minister, Deputy Stephen Donnelly, and it was reversed, which is very welcome. However, Alison McCabe has since been back on to me. There are a number of issues which still need to be addressed. There is a proposal about the paper applications that were made previously by the fitters such as Alison. They say that hey are happy to do this and that the women do not need the added stress. They are also talking about the first fitting being in acute hospital settings, sometimes where the women would have had surgery. I do not think that is a particularly good idea. There is also a disparity between certain areas in how much somebody gets for the funding scheme. We need to look at it. The Minister, Deputy Donnelly, stated that this should happen regardless of medical card status and----

Catherine Connolly (Galway West, Independent)
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I am sorry for interrupting, but we are way over time.

Mick Barry (Cork North Central, Solidarity)
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I want to ask about Government and State neglect of the health needs of people with eating disorders. This issue was highlighted on Saturday, with protests taking place in Cork, Limerick and Dublin. Despite the fact that the HSE identifies eating disorders as resulting in the highest morbidity and mortality within the mental health sector, there are only three beds for adults with eating disorders provided within the State's public health system. I asked the young people in Cork who organised the protest last Saturday what their demands were. They explained that they have four demands, namely: counselling to be available in every region; more inpatient beds; more education for carers; and more accurate statistics. It is not known how many people in the State suffer from eating disorders. I would like the Taoiseach to comment on those four demands.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I would like to speak about the children's disability network teams, CDNTs, in Carlow. The biggest issue I have had for the past few months is the lack of occupational therapists and speech and language therapists. For children who are on the waiting list, there is no one to assess them. Children who should be going into classrooms in September do not have school places because they have not been assessed. They and their parents do not know where they are going to go to school. There are major issues in this regard. It is the same with ASD classes. I have been approached by many schools that are trying to get these classes. There are serious issues within the Department. There are waiting lists. I beg the Taoiseach - this is going to become a crisis if we do not get more speech and language therapists and occupational therapists. We need to build more ASD classrooms as a matter of urgency.

Leo Varadkar (Dublin West, Fine Gael)
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I am conscious that quite a number of Deputies raised CAMHS and also CDNTs. I do not information broken down to local or county level. CAMHS receives dedicated funding of approximately €146 million annually, and €110 million of that has been provided to community-based mental health organisations and NGOs this year. A further €10 million was announced in January for mental health, including the clinical programmes and youth mental health. In collaboration with local CAMHS services, a waiting list initiative specifically focused on children and young people who have waited longer than nine months is under way in six areas. The HSE is also receiving funding under the Sláintecare integration and innovation fund to progress a multiphase quality improvement project to manage CAMHS waiting lists. For the first time in the history of the State, we now have a dedicated national office for youth mental health which will provide leadership, operational oversight and management of all service provision and improvements. Both a new HSE national clinical lead for youth mental health and a new assistant national director for child and youth mental health recently took up their posts. Immediate priorities are to improve access to CAMHS and reduce waiting lists.

On CAMHS and therapists, a matter that Deputy Dillon raised specifically, our understanding is that private sector capacity does exist but it is quite limited. Community healthcare organisations can use private sector therapists for those waiting the longest, ensuring they are prioritised.

I acknowledge the difficulty in meeting the demand for children's disability services. We are very much aware of how this impacts on children and their families. The progressing disability services, PDS, roadmap for service improvement was launched last year. This is a targeted service improvement programme to achieve quality, accessible, equitable and timely services for children with complex needs.

On recruitment and retention, in January, the HSE, working with lead agencies, launched a high-profile recruitment campaign for dieticians, occupational therapists, physiotherapists, psychologists, social workers and speech and language therapists. The campaign recently closed and approximately 495 applications were received. Interviews are due to begin in the coming months. Other initiatives include student sponsorship programmes, therapy assistants to help professionals in providing services, and also marketing CDNTs as a workplace of choice and a good place to work.

I again acknowledge Deputies O'Sullivan and McAuliffe for raising issues around rare diseases and orphan medicines. I am not familiar with the particular medicine relating to EB, but I will look into the matter and come back to the Deputies directly.

As Deputy Boyd Barrett said, housekeepers and cleaners do essential work in our hospitals, especially in the context of infection control. I am not familiar with the issue of the appeal on the job specification. If the Deputy passes on some more information to me, I will make sure he gets a proper reply. I am advised that the average business or average community service pays less than €5,000 per year for insurance, but that varies from business to business, from service to service and from risk to risk. It can depend on the different circumstances that may arise.

On the important issue Deputy Ó Murchú raised, I am glad that the decision to restrict some of the services and payments was reversed quickly, certainly once the political system became aware of it. However, I will pass on what he said to the Minister, Deputy Donnelly. The idea is to standardise what is provided. Standardisation is good, but it has to be done correctly. All of us in the House would take the view that if we are standardising such a provision, it should be standardised upwards and not to the average of whatever is provided.

Deputy Barry raised the really important issue of eating disorders, which are far too common and for which the services are far too sparse. From what he said, the four demands seem reasonable. It is easier said than done though, as is often the case, especially given the labour shortages we face. However, I will certainly take them up with the Minister, Deputy Donnelly, to see whether we can respond to them as soon as possible.