Mike Kennelly (Fine Gael)
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I would like to speak on an issue that may sound dramatic but is an issue of life and death at the moment, that is, the urgent need to introduce mandatory cardiac screening for all competitive sports players between the ages of 12 and 18. Too often we only act after tragedy strikes. However, now we have a chance to act before it does. Heart conditions are among the leading causes of sudden death among young athletes. Many of these conditions remain undiagnosed due to their silent nature. There are no symptoms or warnings yet the consequences can be devastating.Studies show that early detection through cardiac screening, particularly electrocardiogram, ECG, testing, can significantly reduce the risk of sudden cardiac events by identifying underlying conditions before they become fatal.

Across the world we see compelling evidence for preventative action. Italy's mandatory screening programme introduced in the 1980s has resulted in an 89% reduction in sudden cardiac deaths among young athletes. This is a clear demonstration that proactive measures save lives. In contrast, Ireland lacks a nationwide cardiac screening policy. While voluntary screenings are available, the reach remains limited and many young athletes remain vulnerable simply because they never had the opportunity to be tested.

In Ireland, about 100 young people die every year from sudden adult death syndrome, SADS. Many of them are involved in sports and these young lives are cut short by inherited or undiagnosed heart conditions, silent invisible threats that often show no symptoms until it is too late. We cannot allow a screening programme to depend on tragedy for action. We need to prevent these incidents, not just respond to them.

Sports organisations and charities have stepped up where policy has lagged behind. The Dillon Quirke Foundation, established after Dillon's sudden death during a hurling match in 2022, has already screened more than 10,000 young people, identifying 243 who required further cardiac evaluation. These screenings have undoubtedly saved lives, but no family should have to rely on charity alone for protection. If we require gumshields and helmets to safeguard our children from physical impact, why do we not check the organ most vulnerable under pressure, their hearts? The cost of inaction is measured in lost lives, grief-stricken families and communities devastated by preventable tragedies.

I am calling on the Minister for Health, the Minister for sport and indeed the Government to introduce immediate legislation which would make cardiac screening, including ECGs, mandatory for all competitive sports participants between the ages of 12 and 18. This must be a nationwide State-supported programme developed in a partnership with schools, sports bodies and medical professionals.

Furthermore, we must ensure this programme is accessible to all, regardless of socioeconomic background. It should not be a privilege but must be a right. Screening should be integrated into routine health checks for young athletes, creating a culture of prevention rather than reaction. We owe it to the families who have lost loved ones and to those who could be spared the heartbreak to act now before another young life is lost.

I could go through personal tragedies which families have endured in recent weeks in my own area and even in the Munster area, where young teenagers have passed suddenly. One coach was on to me recently to say they had done a public test in a training dressing room where they asked 30 players how many were using inhalers. Two put up their hands but when they did a private survey on that team, seven were using inhalers to enhance their performance. We are living in a competitive sporting environment right now and, if anything, this cardiac screening must be introduced.

Noel Grealish (Galway West, Independent)
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I thank Senator Kennelly and I have been asked by the Minister for Health to respond to his Commencement matter. I thank him for facilitating this opportunity to discuss this important matter of cardiac screening for young athletes.

Ireland has very robust procedures in place for the introduction of new screening programmes. Any proposed changes to Ireland’s screening programmes will be facilitated through established evidence-driven protocols. The national screening advisory committee, NSAC, is the independent expert group which considers proposed changes to screening programmes or the introduction of new screening programmes. The NSAC assesses the evidence robustly and transparently and against internationally accepted criteria before making recommendations to the Minister for Health.

All screening programmes have both harms and benefits, so these NSAC processes ensure recommendations are based on solid evidence. This is critical to maintaining rigorous processes for effective, quality-assured, and safe screening programme standards. I must emphasise that any changes to Ireland’s screening programmes will always be based on the evidence. The NSAC holds calls for submissions, which invite proposals from all stakeholders and organisations, including members of the public, the HSE and other medical professionals, for the introduction of new screening programmes or changes to existing programmes. The next call for submissions will open shortly. Regarding sudden arrhythmic death syndrome, the cause may be related to underlying cardiac disease, inherited cardiac conditions or may remain unknown.

Children’s Health Ireland, CHI, at Crumlin provides targeted screening and ongoing care of children identified at high risk of or affected by an inherited cardiovascular condition, ICC. Children are primarily identified based on wider family history in partnership with, first, the family heart screening clinic, FHSC, at Heart House, Mater Misericordiae University Hospital and, second, cardiac risk in the young, CRY, at Tallaght University Hospital. CHI at Crumlin, along with FHSC and CRY, work together and as a combined entity are a recognised centre of European excellence for the care of ICC families with accreditation through the European Reference Networks.

The national review of adult specialist cardiac services was published recently. The review provides a detailed, evidence-driven analysis of adult cardiac services. The review provides 23 recommendations around cardiac health policy. The report gives us the data and roadmap reform of cardiac services, and the Minister is ambitious to progress this important work. Specifically, the review recommends that services for inherited cardiac conditions be provided as a national service, with strong links to regional cardiology centres and supported by genetic services aligned with a national clinical genetics service. The Minister has written to the HSE to begin developing an implementation plan for the review’s recommendations. This will be a key facilitator of our new national cardiovascular strategy as promised in the programme for Government.

Enhanced community response is critical to improving cardiac arrest survival rates, and this is wholly recognised in the National Ambulance Service’s out-of-hospital cardiac arrest strategy. The National Ambulance Service has a network of more than 250 community first responder schemes, supported by the community engagement team. In the event of a cardiac arrest, automated text messages direct community first responders to the scene of any cardiac arrest that occurs in the catchment area. The Government is committed to ensuring that Ireland continues to improve out-of-hospital cardiac arrest survival rates. Work is already in progress to implement the National Ambulance Service's national AED - defibrillator - registry, which will be mapped to the National Ambulance Service dispatch system and a supporting app for dispatching first responders.

Mike Kennelly (Fine Gael)
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I thank the Minister of State for the response. Really, it is where we are and where we want to be, to be honest. Even in the last paragraph of his written reply, it refers to response times. I want to get away from the response times and to early intervention, where people are mapped from ages 12 to 18. They need to be mandatorily screened, with a certificate if they are going into competitive sports or whatever. They need to be mandatorily tested. It is not the response on the last page of the Minister of State's reply that I am looking for; rather, I am looking for a response that will put in place a mandatory screening check for every child who wants to participate in sports – nothing else.

I respect that there is a lot going on but it is all nearly parallel to running afterwards. I want it to be mandatory and I want the Government to take up my proposal to make it mandatory. It is not illegal to save a life through early prevention. If we could monitor kids going to school, there could be an underlying condition identified in their older siblings or whatever and a child’s life could be saved in the meantime. I have seen it in Killarney. There was a case recently of a male athlete whose whole family needed pacemakers within a week because there was an underlying condition.

I respect the Minister of State’s response but I call on the Minister to implement mandatory screening for all of the kids involved.

Noel Grealish (Galway West, Independent)
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I am only here delivering the reply from the Minister but, as an avid GAA man myself, unfortunately I have come across these cases. I came across a case where a young person collapsed on the pitch and the ambulance could not even get in with how the barrier came across at the gate. It was terrible to see what happened that day. I agree with the Senator and I hope the Minister and the officials within the Department will listen to what he has to say. I know he is passionate on this issue. As I said, I am an avid GAA supporter and, unfortunately, a lot of these cases occur at pitches where children are involved in sports activities. I do not know how much it would cost to screen people or how a scheme can be implemented but I am sure we would learn from a pilot scheme and could build on it. I will bring this matter to the attention of the Minister. I hope that the officials are watching and listening. Perhaps they will listen to the Senator and put something in place. Screening would be worthwhile even if it saved one life and I am sure it would save a lot of lives. I again thank the Senator for bringing this matter to our attention.

Eileen Flynn (Independent)
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I welcome the students from St. Cronan's Senior National School. Their visit will be the first time I can tell a group of students they do not have any homework today. It is absolutely brilliant to give them a day off from it. We hope that the students make the most of their visit. I hope that at least one of them will end up in here in the future as a politician, and maybe not in the Seanad but in the Dáil. I wish them every success. They will have no homework this evening. Enjoy the rest of your visit to Leinster House.

Before suspending, I welcome the Minister of State, Deputy Cummins, to the House. Even though he did not get to reply to the Commencement matter, it is a privilege for me to see him here as a Minister of State as I served with him in this House in the last term.

John Cummins (Waterford, Fine Gael)
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I thank the Acting Chairperson.