Carol Nolan (Laois-Offaly, Independent)
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699. To ask the Minister for Health if he will support the ability of the Tallaght University Hospital neurofibromatosis clinic to continue to accept referrals for new patients; if he will ensure that the clinic has adequate staffing resources; if he will take steps to address the lack of diagnostic equipment at the neurofibromatosis clinic in Tallaght University Hospital; if he will address concerns in relation to the absence of a paediatric dermatologist, a paediatric neurologist and the unavailability of an optical coherence tomography machine in the ophthalmology department; and if he will make a statement on the matter. [59327/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Steven Matthews (Wicklow, Green Party)
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700. To ask the Minister for Health if his attention has been drawn to concerns within the ophthalmology sector regarding the viability of providing services to medical card holders; if any negotiations are ongoing with respect to the reimbursement rate under the community ophthalmic services medical treatment scheme; and if he will make a statement on the matter. [59332/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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I value the important role community ophthalmologists play in our Health Service in the delivery of holistic patient care. I am fully committed to the development of community services which can facilitate expanded and more integrated provision of eye care in local communities.

The Community Ophthalmic Services Medical Treatment Scheme (COSMTS) was established in 2004 as a pilot project in response to an identified need. The COSMTS engages four practices across seven locations to provide medical and minor surgical care to patients outside of the acute care setting. The COSMTS reduces the demand for these services at hospitals, eye clinics etc. The treatments and the current fees payable under the COSMTS are set out in Schedule 3 of Statutory Instrument 274 of 2013.

It was intended that the COSMTS would be extended nationally on a phased basis following an evaluation in 2006. The HSE explored options in this regard, but resource constraints prevented any further rollout beyond the original pilot practices. The HSE continue to keep this matter under active consideration but advise that a detailed evaluation of the operation of the COSMTS will need to be carried out before it is extended further or before the rates are revised.

The HSE’s 2017 Primary Care Eye Services Review Group Report outlines a blueprint for the future development of Primary Eye Care Services for children and adults in accordance with the needs of the population. A priority for the HSE in 2022 has been the development of Primary Care Eye Teams in CHO 6, 7, and 9.

I believe that a contractual relationship between community ophthalmologists and the HSE which is modernised to emphasise a strengthened primary care system is of paramount importance. My officials are working with their counterparts in the HSE with a view to contracting more services from secondary care settings out to community contractors.

Of course, it is important that any publicly funded service expansion should address unmet public healthcare needs, improve access to existing public health services or provide better value for money or patient outcomes.