Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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1. To ask the Taoiseach when the Cabinet committee on health will next meet. [21327/24]

Aindrias Moynihan (Cork North West, Fianna Fail)
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2. To ask the Taoiseach when the Cabinet committee on health will next meet. [22344/24]

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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3. To ask the Taoiseach when the Cabinet committee on health will next meet. [22348/24]

Pádraig O'Sullivan (Cork North Central, Fianna Fail)
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4. To ask the Taoiseach when the Cabinet committee on health will next meet. [22349/24]

Paul Murphy (Dublin South West, RISE)
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5. To ask the Taoiseach when the Cabinet committee on health will next meet. [22695/24]

Bernard Durkan (Kildare North, Fine Gael)
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6. To ask the Taoiseach when the Cabinet committee on health will meet next. [22709/24]

Mick Barry (Cork North Central, Solidarity)
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7. To ask the Taoiseach when the Cabinet committee on health will next meet. [22817/24]

Ruairí Ó Murchú (Louth, Sinn Fein)
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8. To ask the Taoiseach when the Cabinet committee on health will next meet. [23653/24]

Christopher O'Sullivan (Cork South West, Fianna Fail)
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9. To ask the Taoiseach when the Cabinet committee on health will next meet. [23895/24]

Rose Conway-Walsh (Mayo, Sinn Fein)
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10. To ask the Taoiseach when the Cabinet committee on health will next meet. [24104/24]

Simon Harris (Wicklow, Fine Gael)
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I propose to take Questions Nos. 1 to 10, inclusive, together.

The Cabinet committee on health last met on 12 February 2024 and is scheduled to next meet on 1 July. In addition to the meetings of the full Cabinet and of 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 about four main things: making healthcare more affordable; making healthcare 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 hospital beds since the Government came into office in 2020. We have increased the total public health sector workforce by more than 28,000 since the beginning of 2020, which includes 9,000 more nurses and midwives, over 4,200 social care professionals and over 3,000 doctors and dentists. These are very significant additional numbers of people working in the health service who are working hard every day.

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 in the number of patients exceeding the Sláintecare targets by 25% since the pandemic peaks. Waiting lists in the Irish health service fell last year for the second year in a row. The figures that matter most are the number of patients waiting longer than the agreed Sláintecare maximum wait time targets of ten to 12 weeks. We had a cross-party consensus, or what was largely cross-party consensus, around health reform in this House, called Sláintecare, that said that people’s wait times should be around ten to 12 weeks. It is, therefore, appropriate that we measure progress in relation to that. We are seeing significant progress on that. The core target of achieving a 10% reduction in patients breaching the Sláintecare wait times was exceeded, with 11% achieved. This covers inpatients, day case, outpatients and GI scopes.

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 with the aim of 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.

The last budget provided funding for hundreds of millions of euro for waiting lists and 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 in vitro fertilisation, IVF; further expansion of the free contraception scheme to include women aged 31; and additional staffing for CAMHS teams to improve access to services and reduce waiting lists.

We all know our health and social care service has its challenges, that is also a global phenomenon, 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 the international average. Ireland is among a group of seven EU countries where life expectancy is above the age of 82. We continue to reduce mortality rates for stroke and many cancers and report positive trends in preventative health. Our age-standardised mortality rates have declined for all causes over the past decade by 10.3%.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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I have raised this issue with the Taoiseach before but I would like to repeat it so that action follows.

Simon Harris (Wicklow, Fine Gael)
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I am listening.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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It is the issue of medical evidence being provided to local authorities on the question of medical priority housing allocation. Something needs to be done about this. Medical adjudicators are second-guessing specialists, whether they are consultants, OTs, psychologists or psychiatrists. They are often people who do not have these specialties but they are second-guessing them and putting families where there are often very severe, extreme medical conditions through the ringer. It has to stop and a circular needs to be issued. This is a health issue but it intersects with housing.

To give an example I have mentioned a couple of times, there is a young woman who has had a shocking, life-changing situation where her two children were born with muscular dystrophy and cystic fibrosis. These are two life-limiting conditions and this case is unique in the world but there is still this constant back and forward with the local authority over the medical evidence because there are multiple consultants involved. As we can imagine, this creates unique requirements in relation to housing. I also had a case recently of someone with scoliosis who is getting into a bath which is dangerous but the council stated the person would have to find a HAP tenancy that would suit their medical needs, which is impossible. We need to do something where we do not have second-guessing of medical professionals, mental health professionals or allied health professionals when it comes to ascertaining what someone’s housing needs are. It should not be determined by the question of resources. I understand that local authorities are under pressure but we have to start with the needs. We have to trust the medical professionals and the people who have health issues themselves and establish objectively what the medical needs are rather than second-guessing them because of resource questions.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I raise the issue of nursing homes. I was contacted recently by a nursing home because residents who need to see a doctor to have their ears syringed are being charged €35. These residents have medical cards and they are on the fair deal scheme. They must also pay for a taxi which costs between €65 and €75 and, furthermore, the nursing home has to get a member of staff to go with them in the taxi.

I welcomed what the Taoiseach said about people living longer and he is right that it is good news but as people live longer, it brings challenges. As I said, residents of a nursing home who have medical cards and are on the fair deal have to pay this money. It is too much money and they do not have it.

Another matter I have raised several times is that people on medical cards are being charged for having their bloods done. Some of them have visited my clinic. People are struggling, particularly those who are on a pension, and then there are all these extra charges. We need a proper system. Whether we review doctors' contracts or do something else, something needs to be done. These residents are concerned and have contacted me.

Pádraig O'Sullivan (Cork North Central, Fianna Fail)
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I read an article last month which reported that the European Commission is considering giving pharmaceutical companies financial incentives and enhancing their market exclusivity in the way they produce drugs, particularly in the niche area of orphan drugs and rare diseases. I found the article welcome but in another way it was amusing in the context of the access patients here have to drugs for rare diseases. Some 80% of all diseases identified these days are actually genetic mutations. I note the importance of clinical trials and research in gaining better treatment for patients in that sphere, and sometimes even cures. If we compare ourselves to any EU counterpart by any metric, particularly in terms of access to orphan drugs, we fail abysmally. Those league tables are well documented and are published for all to see. Given what the Commission intends to do in terms of offering incentives to pharmaceutical companies to enhance research, clinical trials and so on, what will we do here to do the same because we are failing?

Paul Murphy (Dublin South West, RISE)
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I raise a particular issue related to the health of those who live in the shadow of the Aughinish Alumina plant in Limerick. It dates back to 1989 when animals began dying on farms in the area, after which there were increased incidences of serious human health problems, including increased rates of fatal foetal abnormalities, cancer, upper respiratory tract issues, eye inflammation and so on. Later, there was an investigation into this involving the Environmental Protection Agency, Teagasc, the Department of agriculture and others.

Later on, there was an investigation into this involving the Environmental Protection Agency, EPA, Teagasc, the Department of agriculture and others. The crucial problem in that investigation was that the human blood samples went missing, which meant that the investigation was not really able to be comprehensive and independent.

In 2018, while the Taoiseach was the Minister for Health, he was given a 26-page dossier by the former Deputy, Dr. Harty, who was a representative of the area, as well as by Deputies Connolly and Catherine Murphy. They asked him to appoint an independent health expert, as he did for the cervical cancer scandal, to investigate the dossier outside his Department because new information was contained within. As I understand it - and the Taoiseach may not remember this, which is fine - the Taoiseach refused to have any independent view of it. Instead, he simply went back and said that there was nothing new there, etc. I am asking the Taoiseach to look at this dossier again, which I can send to him, and agree that there will be an independent investigation.

Ruairí Ó Murchú (Louth, Sinn Fein)
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I ask for the Taoiseach for an update on the Covid-19 inquiry, its terms of reference and its individual modules. I am incredibly interested in the families that lost loved ones in Dealgan House Nursing Home at the beginning of Covid-19. I think the Taoiseach met with one of the family members when he was recently in Dundalk. At least 22 lost their lives in a really desperate set of circumstances. When the Minister for Health, Deputy Stephen Donnelly, met with them recently, he spoke of how they need some sort of mechanism to provide them with the necessary answers. They have done a huge body of work through freedom of information, FOI, requests. At times, they have been pushed back by every agency, but they have put a huge amount of information into the public domain. We have to provide them with truth, justice, and the learnings needed in relation to elder care, in case we have to deal with circumstances such as these ever again. I ask for an update on that, which would be really useful.

Christopher O'Sullivan (Cork South West, Fianna Fail)
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I do not say this lightly, but when it comes to our islanders and healthcare, they are treated as second-class citizens. This is especially the case in the west Cork islands and I will explain why. On Bere Island, which is near Castletownbere, at one point they had two full-time nurses. They had nursing cover on the island for 24 hours a day, seven days per week, but they now only have one nurse, whose nursing cover has been reduced to the hours of 9 to 5, five days per week. It is simply not good enough because of the unique geographical nature of an island and access to healthcare. Similarly, on Cape Clear Island, which is not too far away from there and is off Baltimore, they also had full-time nurse cover, but that too has been reduced. The nurse comes in on a Tuesday and leaves on a Thursday, so there are large portions of the week where there is no nurse cover. That is a pretty distant island and it takes approximately 40 minutes to get there by boat. We need 24-hour cover for nurses on our islands. It is the least that our islanders deserve.

I will raise a slightly related issue, which is that Bantry General Hospital had a neurology service for four days per week in the mornings and afternoons. That has now been cut to two sessions per month. That will be a serious issue for people with Parkinson’s disease and multiple sclerosis, MS.

Rose Conway-Walsh (Mayo, Sinn Fein)
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What measures does the Taoiseach propose in order to urgently fix the systemic problem at University Hospital Galway, UHG, to fulfil its mandate to operate as a centre of excellence? That question comes from a man in Mayo who is currently undergoing chemotherapy at University Hospital Galway. He has an aggressive form of lymphoma cancer, he requires urgent and intensive treatment and, devastatingly for him and his family, there has already been a delay of 17 days to his treatment simply because there was no bed for him. He says: "It is ethically and morally wrong that my prospects of survival are currently in the hands of hospital administrators who have to try to decide when I am allocated a bed for my treatment. It is wrong that I am forced to advocate for the repair of a broken system at a time when all my energy should be directed towards recovering."

This is a fact of life for many people living in the west who are really seriously ill, and the Taoiseach’s Government has failed them. It has failed them for the last 13 years. The Taoiseach was in that position himself. This is something as simple as a bed. We have hugely expensive equipment and we have the best expertise in the world, but we do not have a bed. I think the Taoiseach and his Government owe this man an answer, as well as others in the west of Ireland and Mayo who are in a similar position.

Simon Harris (Wicklow, Fine Gael)
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I thank the Deputies for raising a range of issues. Obviously, Questions Nos. 1 to 10, inclusive, were about when the Cabinet Committee on Health will next meet, so Members will have to excuse me if I must come back to them on some of the specifics because quite a few of the questions strayed very significantly, I would imagine, from the Standing Orders, although they are valid and important questions in and of themselves.

Deputy Boyd Barrett's question, which he has raised on a number of occasions, is a serious point about medical prioritisation and the local authorities. He has requested a circular on this. The disadvantage I am always at on this is that I do not have the benefit of having the line Minister here with me. Let me speak directly with the Minister for housing about that issue because we do not want a situation, such as the one the Deputy outlined, whereby somebody who has two children with muscular dystrophy and cystic fibrosis must have a back-and-forth debate about the status of their healthcare with their housing authority. While the Deputy and I might hold different views, we both know the housing constraints that people face. Parents of children who are sick, or indeed people in general who are sick or have a disability do not need to be going back and forth. Let me look into that, as will my own officials who are watching this. We will engage with the Minister for housing on that issue and I will come back to the Deputy directly on it.

I thank Deputy Murnane O'Connor for raising some important issues about nursing homes and nursing home care. She has made a request for clarity and transparency around what is and is not covered through the fair deal scheme, the nursing home support scheme and the medical card. She gave the examples of the ear syringe costs, the staff burden that is being faced by nursing homes and how people are being charged for bloods when they have a medical card. I will raise both issues with the Minister, Deputy Stephen Donnelly, and the Minister of State, Deputy Butler. We will come back to her about that.

Regarding Deputy Padraig O'Sullivan’s point, I just met some people earlier today at the DART station who were on their way to an important conference about rare diseases. This is a very important issue. Again, I want to speak with the Minister for Health about this, but it is a fair point that the Deputy makes. We have some very large pharmaceutical companies here. I think that nine of the ten biggest pharma companies in the world are based here in Ireland. We have incredible universities and research infrastructure and we have a health service that we are now funding with the sum of well over €22 billion per year. Can we do more on access to orphan drugs and learn from the European example? I think we can and I think we have to. I will talk to the Minister, Deputy Stephen Donnelly, about the Deputy’s suggestion and I will come back to him.

Deputy Paul Murphy spoke about Aughinish Alumina. I thank him for offering to send that on again, because I do not want to reference something on the floor of the Dáil when I do not have the documentation before me. I would appreciate it if Deputy Paul Murphy sends that to me again. I am happy to look at that and speak to the Minister for Health and the Department of Health about it.

Deputy Ó Murchú spoke about Dealgan House. I did have the opportunity to meet a woman when I was in Dundalk in recent days in relation to this. The Deputy used a very important word there, which was "mechanism". I do not want to speak for the families, but it is my sense that that the families want to know about what mechanism can be put in place so that they can get truth, justice and answers. I share that view, as I know Deputy Ó Murchú does. It is a matter of deciding what is the best mechanism. Will that be the Covid-19 review or will it be a particular pillar of work? Some suggestions were made to me when I met with her, and I also exchanged contact details with a family member. I am happy to engage with the Minister for Health on this and come back to the Deputy about it, but I do fully accept that answers are needed about what happened in Dealgan House. It is the very least that the families deserve. I will work constructively with the Opposition to work out what the best mechanism is to bring about those answers.

Deputy Christopher O'Sullivan raised islander healthcare in Bere Island and Cape Clear Island, as well as the nursing resources and the importance of supporting island healthcare. I will speak with the HSE and the Minister for Health. I take the point the Deputy makes. We want to see the offshore islands thriving. Access to healthcare is an important part of making sure we have sustainable communities. Similarly, I will follow up about Bantry General Hospital and the neurology service there and the importance of the department to patients. I will ask the Minister for Health to come directly back to the Deputy.

Deputy Conway-Walsh spoke about University Hospital Galway, its importance as a centre of excellence, and the traumatic experience that one of her constituents has encountered there. The Deputy said she believes it is being replicated by many more. I was in Galway recently and I met some of the leading doctors working in this area. I know the Secretary General at the Department of Health was there, as was the Minister for Health in relation to the development plans for the hospital services for centres of excellence.

I will get the Deputy a detailed note that he can share with his constituent.