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Ceisteanna ar Pholasaí nó ar Reachtaíocht - Questions on Policy or Legislation (1 Oct 2025)

Pádraig Rice: My question relates to tuberculosis, otherwise known as TB. Last year, TB rates increased by 30%, which is really concerning. In 2024, TB cases in children under 12 months equalled the number recorded in the previous decade combined. This year, TB cases are expected to hit 300, yet this growing health crisis has been largely ignored by the Government. The sharp end of this crisis is...

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: I advise members of the constitutional requirement that they must be physically present within the confines of the Leinster House complex in order to participate in public meetings. I will not permit a member to participate when they are not adhering to this constitutional requirement. Therefore, a member who attempts to participate from outside the precincts will be asked to leave the...

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: I thank the Minister and call Mr. Gloster.

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: I thank Mr. Gloster. I will now move to members for comments and questions. We had issues with the clock earlier but it is working again. I call Deputy Daly.

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: I thank the Minister. I remind members that we have less than two hours and 13 members. In order to fit everybody in, we are allocating eight minutes per person. In future, we could take shorter opening statements, or take them as read, but we only received the Minister's statement late last night so it was not possible today. Time is tight so I ask members to stick to the time limit....

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: Before the Minister answers, I remind members that the witnesses are here to answer questions on insourcing and outsourcing.

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: I welcome the commitment that insourcing will be ended by June, as the Minister indicated. I have a number of questions in that regard. The HSE report stated that 23 serving HSE employees were acting as directors of these insourcing companies. Is that still the case?

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: Does Mr. Gloster know if any new contracts for third-party insourcing were provided between the publication of the review in July and the controls being put in place in August?

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: Has the HSE given notice to third-party insourcing providers that the HSE will not renew or enter into new contracts?

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: I note that in the appendix to Mr. Gloster's statement, it says that insourcing can only be used for short-term initiatives approved nationally, including specific initiatives such as the assessment of need, and the others listed include ophthalmology. However, third-party insourcing cannot be used for the provision or maintenance of core services. How does the HSE define short-term initiatives?

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: Would things like assessment of need not be core services?

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: On primary care, the Minister asked the HSE to reduce the waiting times for physiotherapy, occupational therapy and speech and language therapy to less than ten months. How do the Minister and the HSE propose to reduce the waiting times for these therapies?

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: There is a real need to increase the HSE's own capacity here. In speech and language therapy, there is a steady output of 120 to 140 new graduates across Trinity, UCC, UL and Galway, yet in 2014 only 35 speech and language therapists were hired at staff grade. This year, 44 were hired, so there has been an increase but in 2021, the HSE hired 149 and in 2022, it hired 150. There is a...

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: There seems to be a real issue whereby we are training graduates but we are not hiring them, we have these long waiting lists and we are outsourcing instead of directly hiring this cohort. It is not just in this area. It happens in radiation therapy and across the board. We are training highly skilled people but not guaranteeing them employment. Our services are then lacking.

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: In medicine also, we train people who are not offered intern placements out of some of our universities. There are issues whereby we are training people across a whole range of professional areas and then not guaranteeing them places in employment or increasing the staffing numbers to sustain these reduced waiting times in the long term, rather than just using short-term measures to do that....

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: I now suggest we take a five-minute comfort break. We will resume in five minutes. Is that agreed? Agreed.

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: We will now continue the committee's considerations. Our next slot is the Fianna Fáil slot.

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: I ask the Deputy to conclude.

Joint Oireachtas Committee on Health: Management of Hospital Waiting Lists and Insourcing and Outsourcing of Treatment: Discussion (Resumed) (1 Oct 2025)

Pádraig Rice: We are up on time on this slot. Perhaps the Minister can come in later. I call Deputy Sorca Clarke.

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