Robbie Gallagher (Fianna Fail)
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Cuirim fáilte roimh an Aire Stáit. It is estimated that there are 137,000 people in this country living with heart failure. Last week, a cross-party delegation of Senators and Deputies met a group from the Irish Heart Foundation to hear about this condition. The group is calling for greater access to cardiac rehabilitation, psychological support and help to ease the financial hardship caused by this condition.

I thank the two patient champions, as they are known, who spoke at the meeting, namely, Teresa O'Hanlon, who hails from Monaghan and whom I know personally, and Stephen Comerford. I salute them on their efforts, not alone in living with the condition but also in trying to champion the cause of the 137,000 people who live with the condition. I also salute the professionals who attended the meeting.

We know much more about this rapidly growing condition. Heart failure is a chronic disease that occurs when the heart muscle does not pump blood as well as it should. We also know of the disabilities and challenges faced by people living with heart failure in Ireland. The Irish Heart Foundation told us that it is estimated that 30% of heart failure patients are back in hospital within 90 days of discharge and that half of all admissions are due to poor self-care and are, therefore, largely preventable.

It is clear that heart failure patients need more help to address the psychological impact of their condition and the financial hardship that flows from that and to gain greater access to rehabilitation services. This includes incentives like direct access to diagnostics for GPs, integrated care programmes and multidisciplinary support teams in community settings. Allowing GPs to directly refer patients for heart failure diagnostics in community settings, rather than requiring hospital visits for routine checks, can reduce travel time and the associated costs for patients. Community-based services and investment in primary care centres with multidisciplinary teams can improve access and ease pressure on hospitals. Targeted financial aid can help people manage costs associated with medications, transportation and other related expenses. Leverage in digital solutions can improve patient outcomes and quality of life, and self-management and support can empower people to take more control of their health. An integrated approach to heart failure care, which implements these measures, could significantly improve the lives of people living with heart failure and enable them to maintain a better quality of life.As can be clearly seen, this is a condition that is, unfortunately, growing and needs more attention than is currently being given to it by the Department of Health. For the sake of the people suffering from this condition, I hope we can hear some positive news as to what Government will do to address the many physical, psychological and financial challenges these people have to go through daily.

John Cummins (Waterford, Fine Gael)
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I thank Senator Gallagher for raising this important Commencement matter, which I am taking on behalf of the Minister for Health. Heart failure is a complex condition that affects thousands of people in Ireland. Many people are unaware that they have heart failure, due to the gradual onset of symptoms, which are often mistaken for normal signs of ageing or attributed to other health conditions. Therefore, heart failure has often progressed significantly by the time a diagnosis is made. Treatment requires co-ordinated multidisciplinary care, as the Senator rightly pointed out, and the Government recognises the significant burden that heart failure can place on individuals, families and the health system, as a whole.

Cardiovascular health is a priority in the programme for Government, which commits to developing a new and more ambitious cardiovascular plan, enhancing patient care and timely access for all regions of the country. The national review of cardiac services was published recently. Its recommendations provide an evidence base for reform of cardiac services and the report is a key enabler of progress. The HSE is currently developing an implementation plan for this.

Ireland has made significant progress in managing heart failure through the heart failure model of care 2021. This aims to standardise care and improve outcomes for patients. The enhanced community care programmes are supporting the development of 30 ambulatory care hubs for chronic disease management in the community and the roll-out of modernised care pathways. The enhanced community care programme has expanded from the nine pilot community healthcare networks in 2019 to 96 now. To date, 27 of the 30 planned community specialist teams, CSTs, for older persons and 26 of the 30 CSTs are in place, with 81% of the planned 3,500 whole-time equivalents recruited.

As part of the enhanced community care programmes, the integrated care programme for chronic disease provides enhanced access to diagnostics and specialist opinion for general practitioners, which sets the foundation for expedited heart failure diagnosis. Ireland is recognised as a world leader in identifying those at high risk of the development of heart failure. An approach to heart failure, STOP-HF, has been developed where a specific blood test determines the impact of risk factors on heart function. It identifies high-risk cohorts and facilitates appropriate management. The chronic disease management programme now encourages GPs to perform the blood test on those at risk of heart failure. STOP-HF has now been adopted in several international guidelines, a testament to the innovation of Irish clinicians. The model of care for integrated cardiac rehabilitation was published in October 2023 and presents best evidence and practice for high-quality, equitable and person-centred cardiac rehabilitation services for those living with heart disease in Ireland. To address gaps in cardiac rehabilitation, 13 staff were funded in 2025 and these posts are currently being recruited for. Funding was also made available for one day per week to provide psychology services, which, as the Senator rightly pointed out, is important as part of the treatment programme, as part of the rehabilitation teams in the 30 new specialist ambulatory care hubs for chronic disease.

The second women's health action plan also places a spotlight on cardiovascular health in women, because they often experience heart failure differently. To support this, the Minister for Health has funded €1.23 million for six projects on women's heart health and, in particular, to improve our understanding of services for heart failure.

Robbie Gallagher (Fianna Fail)
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I thank the Minister of State for his comprehensive response to my question. I acknowledge the great strides being made on heart care in the State. I note the developments regarding this area as well. Unfortunately, as I said earlier, this condition is rapidly on the increase. It affects almost 150,000 people in the country. We need to be aware of it. Those affected have to endure physical constraints daily, and the psychological effects of having to live with that are immeasurable. There are also financial hardships associated with this condition, never mind the treatment of it, as Teresa O'Hanlon outlined in her contribution. This young lady was a schoolteacher who had to give up work because of this condition because she did not have the energy. As long as those three pillars are being addressed and we can see progress, I welcome it and I look forward to continued progress being made on this issue.

John Cummins (Waterford, Fine Gael)
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I acknowledge that cardiovascular health is a central pillar of health funding as part of budget 2025, which included more than €9 million in full-year costs to support important cardiovascular health initiatives. The budget commits €4 million in additional full-year costs and 45 new posts to reform how we deliver cardiac services. Since 2020, the chronic disease management programme has supported those at the greatest risk, including those with heart failure. The programme includes prevention, targeted case finding and ongoing management, which helps us to identify cardiovascular disease early, manage the condition effectively and slow or halt the disease's progression. As with anything in health, early diagnosis is really important and is key. When we were negotiating the programme for Government, I can recall that this issue got a lot of attention. The line in the programme for Government about timely access to cardiac services across all regions was an important part of those commitments. It will continue to be so as part of the budgetary allocation process going forward.