Jim O'Callaghan (Dublin Bay South, Fianna Fail)
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531. To ask the Minister for Health the main policy achievements of his Department since 27 June 2020; and if he will make a statement on the matter. [61652/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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My Department is engaged in policy development and implementation across the full spectrum of issues that impact health and wellbeing in Ireland. To support the Deputy, I have listed below the main policy achievements and initiatives undertaken by my Department since I took post as Minister for Health in June 2020 which mark significant milestones in the development of health policy for Ireland. Relevant policy documents are available in detail on gov.ie/health.

Further details of the main achievements made are and will continue to be documented in the Department of Health Annual Reports. These documents will detail the achievements of my Department over the period of a year, in particular our achievements as they relate our commitments in the Programme for Government: Our Shared Future.

Since March 2020, officials from my Department continue to provide ongoing advice in relation to the overall response to COVID -19 . Further to this, in 2020, my Department was successful in:

- Establishing the CervicalCheck Tribunal in line with Justice Meenan recommendations for an alternative system for dealing with claims arising from CervicalCheck.

- Publishing the Final Report of the Expert Groupto review the law of torts and the current systems for the management of clinical negligence claims.

- Continuing implementation of the National Maternity Strategy with the expansion of the supported care pathway across maternity services.

- Ensuring all 19 maternity services in the country have at least one Advanced Midwife Practitioners by funding 12 additional Advanced Midwife Practitioners were funded to support the further roll-out of the Model of Care.

- Publishing Ireland’s first ever Maternity Experience Survey with the results being very positive overall and all hospitals having developed Quality Improvement Plans.

- Healthy Ireland Communicationsmanaged the cross-sectoral Keep Well campaign, which provided supports for population resilience in the context of Covid-19, from October 2020 to June 2021. Healthy Ireland has since partnered with Sport Ireland for a citizen engagement campaign called Let’s Get Back to encourage people to return to sport and physical activity, in late 2021 and early 2022.

- Under the Public Health (Alcohol) Act 2018 the following measures on alcohol pricing, advertising and public health input into licensing came into operation. From 12 November 2020, in mixed retail outlets alcohol products and advertising are confinedto one of the following:

- an area separated by a 1.2m high barrier, or

- units in which alcohol products are not visible up to 1.5m height, or

- up to three units that can be a maximum of 1m wide by 2.2m high.

- In addition, alcohol products can be contained but not be visible in a unit behind the counter. (Section 22)

- Publishing two National Clinical Effectiveness Committee (NCEC) National Clinical Guidelines; No. 24. Diagnosis, Staging and Treatment of Patients with Colon Cancer and No. 25. Diagnosis, Staging and Treatment of Patients with Rectal Cancer.

- Publishing Version 2 of NCEC National Clinical Guideline No. 1. Irish National Early Warning System (INEWS).

- Publishing the Report of the Expert Review Body on Nursing and Midwifery .

- Completing and publishing the Framework for Safe Nurse Staffing and Skill Mix in Adult Emergency Care Settingsin Ireland.

- Completion of the testing and publication of the results of an integrated nurse-led community virtual wardproof-of-concept.

- Developments in mental health services continue in line with the national mental health policy, Sharing the Vision, as does work on Connecting for Life, the national suicide reduction strategy, which both align to the Programme for Government commitment. Connecting for Life was extended for a further 4 years from 2020 to 2024 .

- Sharing the Vision was published, and the National Implementation and Monitoring Committee(NIMC) was established to drive the policy recommendations forward and ensure robust policy implementation oversight and governance.

- 5 Early Intervention in Psychosis Teamsare in place out of 20 Early Intervention in Psychosis teams required. 48 Whole Time Equivalents have been funded via National Clinical Programme for Early Intervention in Psychosis since 2019. Of which 17.1 Whole Time Equivalents were funded since 2020. 556 service users have accessed the 5 teams since 2020.

- Introduction of the paid induction weekfor Interns – previously this was an unpaid week.

- The Strategic Plan for Critical Care was brought to Government in December 2020.297 permanent adult critical care beds are now open, an increase of 42 over the 2020 baseline of 255. Funding is in place to increase this to 340 beds by late 2022/early 2023.

- Significant progress was made toward operationalising the Medical Cannabis Access Programme and consultants can now register patients with the HSE.

In 2021, some of my Department’s main policy achievements were, as follows:

- Developed key legislative work, including the preparation of over 50 Statutory Instruments under the Health Act 1947, in order to provide for the public health measures required by Government in response to COVID-19. Officials in my Department also oversaw the development of national legislation and infrastructure to implement the EU Digital COVID Certificate Regulationduring the COVID-19 pandemic, to facilitate ease of movement within the European Union.

- An overall improvement in compliance among approved mental health centres in recent years. In 2021, 59 approved centres (89%) achieved at least an 80% rate of compliance (in 2020, 82% of approved centres achieved this). Of these, two-thirds achieved at least 90%.

- The Sláintecare Implementation Strategy & Action Plan 2021-2023 was approved by Government in May 2021. The new Strategy builds on the progress of Sláintecare reform to date and on the lessons learned from COVID-19. A mid-year progress report on implementation of the Strategy & Action Plan was published on 10 September 2021.

- The HSE Winter Preparedness Plan for 2021/2022 was published on 15 November 2021. The Plan aims to ensure that the health service is prepared for the challenges of winter 21/22 in the context of the ongoing Covid-19 pandemic.

- The opening of the CHI Tallaght Outpatient and Emergency Care Unit on 15 November 2021 was a major milestone in the new children’s hospital project. The new facility delivers services in a modern, fit for purpose environment and significantly expands acute paediatric capacity in the Greater Dublin Area with 2022 full-year activity projected to reach 7,000 outpatient appointments and 30,000 emergency care attendances.

- The establishment of two Major Trauma Centresis one of the major commitments of the Trauma System for Ireland. In April Government approved the designation of the Mater Misericordiae Hospital in Dublin as the Major Trauma Centre (MTC) for the Central Trauma Network. Recruitment in 2021 enabled the commencement of phase one of the development of the MTC at the Mater and facilitated the development of Planned Trauma Care in the MTC for the South Trauma Network, Cork University Hospital.

- In 2021 the National Ambulance Service (NAS) invested €10m development funding into strategic goals outlined in its five-year strategic plan, Vision 2020. The NAS is currently finalising a new strategic plan to build on the progress made under Vision 2020.

- Significantly increased funding of €7.3m in 2021 ensured implementation of the National Maternity Strategy was further progressed. 96.5 additional WTEs were approved for maternity services in 2021, resulting in further development of community-based midwifery services, increased choice for women and improved access to specialist services, including obstetric, endocrinology, perinatal pathology, neonatology and perineal services.

- Funding in 2021 ensured that all 19 maternity hospitals/units now offer the Strategy’s midwifery led Supported Care Pathway.

- On 11th May 2021, funding of €1.58m was announced to provide an additional 24 Lactation Consultants across hospital and community settings, which are required to implement the National Breastfeeding Action Plan and ensure timely skilled assistance for mothers who wish to breastfeed.

- Healthy Ireland published the Healthy Ireland Strategic Action Planin May 2021, setting out the actions and priorities for the next 5 years of Healthy Ireland implementation.

- RTE’s Operation Transformation was sponsored by Healthy Ireland in 2021 and 2022. Healthy Ireland also ran it’s Let’s Get Set public engagement campaign and is running a Healthy Weight Campaign currently. Healthy Ireland and the Women’s Health Taskforce are working with Sport Ireland on the current It’s My Time campaign to promote participation in sport and physical activity amongst women over 40, which was funded by the Women’s Health Fund.

- Healthy Ireland, through Sport Ireland, supports and funds national strategies on promoting walking, cycling, running and swimming.

- Sláintecare and Healthy Ireland, working with the HSE and local authorities and community agencies, launched the Sláintecare Healthy Communities Programme to provide increased health and wellbeing services in 19 community areas across Ireland where health and wellbeing risk factors may be particularly concentrated.

- Healthy Ireland’s National Healthy Campus Framework was launched in July 2021. The Framework will help higher education institutions across Ireland to embed health and wellbeing into campus life for staff and students.

-A Roadmap for Food Product Reformulation in Ireland was launched in December 2021 This fulfils a key objective of the Obesity Policy and Action Plan by setting targets for the reduction of the levels of saturated fats, sugar and salt in processed foods. Healthy Ireland funding has been provided for a dedicated Food Reformulation Task Force, situated in the FSAI, to implement the Roadmap. The Task Force is to operate until the end of 2025. Engagement with industry is a key element of the work of the Task Force.

- The National Cancer Strategy Implementation Report and Key Performance Indicators for 2020 was published on 5 May 2021. Progress on implementation of the National Cancer Strategy has continued throughout 2021, with investment of €20m having a significant impact on access to cancer diagnostics, treatment and supports.

- The National Screening Advisory Committee (NSAC) launched the first ‘Annual Call’ for proposals from the public on new population-based screening programmes that may be adopted in Ireland, as well as submissions on proposed changes to existing screening programmes.

- Publication of the mid-term review of the national drugs strategy Reducing Harm, Supporting Recovery and the six strategic priorities for the remaining four years of the strategy, 2021-2025. The strategic priorities will strengthen the health-led approach to drug use and align with the EU Drugs Strategy and Action Plan. The mid-term review of the strategy shows significant progress in implementing the action plan for the period 2017 to 2020, with only a small number of the 50 actions outstanding.

- Tobacco Free Ireland 2020 Annual Report was published on 9 September 2021. Tobacco Free Ireland is Ireland’s national tobacco control policy. It sets a target for Ireland to be tobacco free by 2025.

- The 3rd Progress Report on implementation of the COVID-19 Nursing Homes Expert Panel’s (NHEP) recommendations was published in September 2021. Many of the short- and medium-term recommendations have already been implemented. The third progress report highlights the achievements in implementing nationally focused recommendations as well as detailing the ongoing supports under NHEP to the Nursing Home Sector.

- From 11 January 2021 the Public Health (Alcohol) Act 2018 (Sale and Supply of Alcohol Products) Regulations 2020 came into operation. The Regulations prohibit:

- the use of bonus or loyalty card points in relation to alcohol products

the sale of alcohol products at a reduced price when sold with another product or service, and

- the sale of alcohol products at a reduced price for a period of 3 days or less.

- From 12 November 2021 the Act provided for:

- A prohibition on alcohol advertising on a sports area during a sporting event, at events aimed at children or at events in which the majority of participants or competitors are children. (Section 15)

- Alcohol sponsorship of events aimed at children, events which the majority of participants or competitors are children and events involving driving or racing motor vehicles is prohibited. (Section 16)

- Significant progress was undertaken to update the Mental Health Act 2001. Draft Heads of Bill were approved and published by Government in July 2021.

- Proof of concept of the Community Virtual Ward (CVW) model is complete and published.

- The Disability Capacity Review to 2032 was published in July 2021. In order to drive the process of implementing the recommendations of the report, a Disability Action Plan Framework was also published which sets out key priorities over the period to 2025.

- The development, publication and commencement of implementation of Ireland's second One Health National Action Plan on Antimicrobial Resistance 2021-2025, known as iNAP2 (published Nov 2021).

- In November, 15 applications submitted from Ireland’s Rare Disease / Highly Specialised Care Centres of Expertise, were approved to join the European Reference Networks (ERNs). This achievement will be pivotal to drive innovation, training and clinical research for highly specialised care in collaboration with the established momentum of the ERN model which incorporates the most talented clinicians and investigators in the European Community and also for individuals and families affected with rare diseases.

- Introduction of two agreements for 2021-2025 pertaining to drug pricing and supplies, the Framework Agreement on the Supply and Pricing of Generic, Biosimilar, and Hybrid Medicines with Medicines for Ireland and the Framework Agreement on the Supply and Pricing of Medicines with The Irish Pharmaceutical Healthcare Association.

- The Review of the Health (Regulation of Termination of Pregnancy) Act 2018 commenced in line with statutory and Government commitments in December 2021. The Review will assess the effectiveness of the operation of the legislation and is being conducted in a fair and transparent manner. Ms Marie O’Shea, B.L. was appointed as the independent Chair of the Review and a final report will be made available no later than 7 February 2023 for consideration.

- Publication of the NCEC National Clinical Guideline No. 26.Sepsis Management for Adults (including maternity

- Publication of the NCEC National Clinical Guideline No. 27.Management of Chronic Obstructive Pulmonary Disease (COPD)

- By the end of December, 93.7% of urgent referrals to CAMHS were responded to within three working days, above the 90% target.

- An additional CAMHS Community Mental Health team was set up in 2021 bringing the total to 73 CAMHS teams today with 72 acute in-patient beds.

- An extra 120 intern posts were permanently established in 2021. This represents an increase of 16% to standard Intern intake and an investment of approximately €5.5 million annually (excluding overtime costs).

- We introduced the permanent establishment of 40 Post CSCT (Certificate of Satisfactory Completion of Specialist Training) Fellowships. Not only do these Fellowships offer opportunities for graduates of our training programmes to stay in Ireland to continue to build on their expertise, but our health service is also seeing the benefit of these highly trained graduates working in Ireland.

This year, 2022, officials in my Department have successfully achieved:

- The 2022 Waiting List Action Plan, published on 25 February 2022, allocated €350 million to stabilise and reduce waiting lists and times, while also bringing forward longer-term reforms such as care pathways and enhancing capacity in hospitals and specialties. The Plan is part of a multi-annual approach to reduce and reform waiting lists and times, which were exacerbated during the Pandemic.

- Development and opening of COVID-19 Healthcare Worker Death in Service Schemein September 2022.

- The Chronic Disease Management Programme in general practice commenced operation in 2020. It engages with patients to encourage a pro-active management of four chronic conditions: COPD; diabetes; asthma; and cardiac failure. The Programme has been progressively extended to include all GMS patients suffering from the four conditions, and in 2023 final roll-out, to include opportunistic case-finding for all aged above 45, will commence. To the end of October this year, GPs conducted 333,000 consultations under the Chronic Disease Management Programme, with over 284,000 patients now registered. This figure includes over 30,000 consultations with high-risk patients and patients identified through the Opportunistic Case Finding element of the Programme. 2022

- The Women’s Health Action Plan 2022-23 was published on 8 March 2022, to mark International Women’s Day and commits to improving health outcomes and experiences for women.

- To date, significant investment has been made in areas expressed as a priority for women including endometriosis, menopause, gynaecology, maternity, contraception, mental health, HPV vaccines, period poverty, health and wellbeing, post-natal care.

- Budget 2023 commits €69.2 million for women’s health initiatives.

- Funding of €8.66m has been allocated to the National Maternity Strategy in 2022 for its continued implementation. This is facilitating the recruitment of an additional 94.7 WTEs to support the Strategy’s vision of a new model of integrated, team-based care that provides increased choice to women. The posts cover a variety of disciplines including, obstetrics, neonatology, endocrinology, anaesthetics, dietetics, midwifery, physiotherapy and occupational therapy.

- The funding is also providing additional home-from-home birthing suites, upgrades to theatres and wards, as well as additional training/supports for our maternity staff to increase choice and improve outcomes and experiences for women and babies accessing maternity services.

- Significant progress has been made in implementing a range of gynaecology service reforms, which is continuing.

- My Department is responsible for establishing a network of 20 “see-and treat” ambulatory gynaecology clinics; 12 clinics are open with 8 more in development.

- To date, I have put in place 5 specialist menopause clinics in the NMH, Nenagh General Hospital, Rotunda, Galway and the Coombe and a 6^thclinic in Cork expected to open in 2023.

- Furthermore, my Department is establishing 2 supra-regional specialist centres for complex endometriosis care and developing 6 additional interdisciplinary teams to support holistic treatment of endometriosis within each of the maternity networks.

- We have opened 5 Regional Fertility Hubs, which are facilitating the management of certain patients presenting with infertility issues at secondary care level. A 6^thRegional Fertility Hub is expected to open early in 2023.

- The HSE’s National Women & Infants Health Programme has developed a draft Framework for the establishment of a National Perinatal Genomics Service, which it is intended will be located in Dublin, across two sites.

- With effect from 21 September 2022, acute public in-patient charges for children under 16 years have been abolished in all public hospitals.

- The Health (Miscellaneous Provisions) (No.2) Act 2022 removes the acute public in-patient charge of €80 per day (including day-case charges) for children under 16 years of age in all public hospitals. Following enactment of the legislation in July 2022, the measure came into effect from 21 September 2022.

- On 17 May 2022, the Government approved the legal framework that will underpin the ownership and governance arrangements for the new National Maternity Hospital (NMH) at the Elm Park campus.

- Healthy Ireland, in partnership with the Dept. of Sport and Dept. of Transport, funded and supported the hosting of a major international conference on walking, Walk21, held in Dublin in September 2022.

- Waves 7 and 8 of the Healthy Ireland Survey were published on 7 December 2021 and 5 December 2022 respectively, providing valuable data with regard to the health behaviours of people living in Ireland, in the context of COVID-19.

- The Healthy Ireland Outcomes Framework First Report and the Review of the National Physical Activity Plan were published in Q3, 2022 and are available on the Healthy Ireland website.

- The Healthy Ireland Healthy Workplaces Framework was launched in December 2021. The Framework provides strategic direction and flexible guidance for workplaces to promote health and wellbeing among Ireland's workforce. An Implementation Group for the Framework was established in May 2022 and the development of a website to support workplaces will be launched in early 2023.

- The development of the National Mental Health Promotion Plan commenced in early 2022 and to date an Evidence Review and consultation with key stakeholders has been completed. The National Mental Health Promotion Oversight Group was established in September and the drafting of the plan is underway.

- A Review of the Obesity Policy Action Plan is due to be published the week beginning 12 December 2022.

- The free contraception scheme for women aged 17-25 was launched on 14 September 2022.

- A nationwide home STI testing servicewas launched on 4 October 2022.

- The Department of Health and HSE have provided supports for period poverty, through CHOs, local authorities and NGOs, to those most at risk of same; those living with homelessness, addiction, consistent poverty, minorities including Travellers and Roma and lone parents, in line with recommendations in the Period Poverty in Ireland Discussion Paper, which were supported by Government.

- Under the Public Health (Alcohol) Act 2018the following measures on alcohol pricing, advertising and public health input into licensing came into operation:

- From 4 January 2022. a prohibition on selling alcohol below a minimum unit price of 10c per gram of alcohol came into operation (Section 11)

- From 24 November 2022, an applicant for an intoxicating liquor licence must notify the Environmental Health Service in advance of an application and the Environmental Health Service may appear and give evidence at the court hearing on an application (Section 4).

- The health system has deployed the use of electronic health records at 4 of our maternity hospitals (~50% of births) and at the largest acute hospital in the country (St. James). My Department is in the process of delivering EHR /CMS systems at the National Rehab and National Forensics hospitals. Earlier this year, Government gave approval for CHI to enter into contracts for an enterprise level EHR for the new children’s hospital, and work is now progressing on that programme of work.

- On the 28 March 2022, the first ever Consultants in Public Health Medicine in Ireland started their tenure.

- Approval of the 2022-2027 Risk Equalisation Scheme from the European Commissionunder State Aid Rules in March 2022. This decision followed a significant process involving pre-notification and notification of and discussions on the new Risk Equalisation Scheme. The 2022 Risk Equalisation Scheme enhances the previous Scheme with the addition of a high-cost claims pool which improves the efficiency of the scheme by allocating credits based on health status rather than age.

- The Health Insurance (Amendment) Bill 2022makes further provision for the appointment and powers of authorised officers of the Health Insurance Authority, the statutory regulator of the health insurance market.

- Secured Cabinet approval to legislate for the designation of Safe Access Zones around healthcare premises to safeguard access to termination of pregnancy services in July 2022 and published the General Scheme of the Health (Termination of Pregnancy Services (Safe Access Zones) in August 2022. I am committed to progressing this legislation as expeditiously as possible and the drafting process is ongoing.

- The Traveller Health Action Plan was published on the 28 November 2022. The Action Plan was developed by the HSE and endorsed by the Department of Health. It fulfils a commitment in the Programme for Government and the National Traveller and Roma Inclusion Strategy.

- In 2022, I asked the HSE to facilitate and the Laura Brennan HPV Vaccine Catch-Up Programme. This programme, which is expected to launch in mid-December 2022, will offer free HPV vaccines to all boys and girls in second level education who were previously eligible to receive the HPV vaccine and who have not yet, for whatever reason, received it. Young women, up to the age of 25, who have now left secondary school, and who did not receive the vaccine, will also be eligible to receive the vaccine as part of the catch-up programme.

- The Report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Healthcare Assistants was published on 15 October 2022 and details 16 recommendations to address the challenges associated with the recruitment and retention of care-workers in home-support and long-term residential care.

- At a joint press conference on 30 November 2022, the Minister of State for Business, Employment and Retail, Damien English, T.D. and Minister Butler announced that, as recommended by the Advisory Group, 1,000 General Employment Permits will be made available for home-support workers from January 2023, enabling the employment within Ireland of non-EU/EEA citizens as home-support workers.

- The Department is at an advanced stage of developing a new palliative care policy for adults to update the 2001 report of the National Advisory Committee on Palliative Care. In April 2022, I established a steering group to develop the new palliative care policy for adults. The new policy is expected to be published in 2023.

- Work on a Model of Care for Dementia is at an advanced stage and the HSE plans to publish it in the first quarter of 2023.

- The first National Nursing Home Experience Surveywas conducted with results published in November 2022.

- The first National Maternity Bereavement Experience Surveywas launched in September 2022.

- Development work on the first National End of Life Surveywas completed.

- Two NCEC National Clinical Guidelines were published in 2022; No. 28. Stop Smoking, No. 29. Unexpected Intraoperative Life-Threatening Haemorrhage.

- The NCEC National Clinical Audit No. 2. Perinatal Mortality was published.

- The publication of Sharing the Vision Implementation Plan 2022 – 2024. The was the first of three implementation plans which will cover the ten-year term of the strategy. An implementation status report is published each quarter.

- Awarding of a contract for the continuation of the Patient Advocacy Service from 2022-2027. This contract commenced on 1 November 2022 and will see the service expand into private nursing homes, as well as continuing existing work in the acutes sector and public nursing homes.

- Since coming into office, both Minister Butler and the Government have illustrated their commitment to enhancing mental health services by announcing record Budgets each year. Budget 2022 allocated a record €1.149 billion to mental health, which was followed by another record €1.2 billion in Budget 2023. This funding has facilitated the ongoing implementation of these strategies.

- In addition, Specialist Groups in Specialist Youth Mental Health Transitions, Women's Mental Health, Acute Inpatient Bed Capacity, Digital Mental Health and Primary Care Mental Health have been established to progress the implementation of complex recommendations and work is ongoing. In Quarter 1 2022, the Reference Group was established to provide the service user and family member perspective. The Reference Group inputs into official reporting processes.

- The Report of the High-level Taskforce between the Department of Health and the Department of Justice to access to Mental Health, Addiction or Primary Care services for those who come in to contact with the criminal justice system has been finalised and was approved by Government on the 20 of September 2022, and subsequently was published.

- The new National Forensic Mental Health Service (NFMHS) in Portrane to replace CMH Dundrum was officially opened on 4 November 2022, and patients were moved in mid-November. It will provide 170 beds when at total capacity (130-bed CMH, a 10-bed forensic CAMHS unit and a 30-bed Intensive Care Rehabilitation Unit (ICRU) and these will be opened on a phased basis).

- Psychologist Assistant grade now established as a permanent grade, delivering on a Programme for Government commitment.

- Significant investment in the five HSE Mental Health National Clinical Programmes, resulting in huge service improvements in accessing specialist mental health care and better patient outcomes.

- Full implementation of the specialist perinatal mental health network. A total of 74 staff members working specifically in Specialist Perinatal Mental Health Services.

- The National Clinical Programme for Self-Harm and Suicide-Related Ideation is now implemented in 25 adult Emergency Departments (operating 24/7 days) out of 26, with planning underway to ensure full national coverage by end of 2022. Over 40 Clinical Nurse Specialists now in post.

- There are 3 Adult ADHD Teams in place and seeing patients, with 4 new teams in an advanced stage of development. Consultants have been identified for 3 out of the 4 new teams.

- There are 4 regional eating disorder teams in place out of 16 teams required with an additional 5 teams in the final stages of recruitment and expected to be operating early 2023 bringing the total to 9.

- Telehealth services are fully established, showing the government’s ongoing work to meet their Programme for Government commitment to improve digital mental health The Yourmentalhealth.iesite is on track for 1 million visitors by year end 2022.

- The National Dialectical Therapy office established a Dialectical Behaviour Therapy training team, which will allow expansion of Dialectical Behaviour Therapy within community mental health teams across Ireland.

- A new mental health ten-year Capital Programmeis now in development, with the focus on upgrading existing facilities, replacing inappropriate community residential and non-residential facilities and the continued expansion of services.

- I ensured funding for the development of a critical mass of Advanced Nurse and Midwife Practitioners posts with 149 new additional ANMP posts allocated in 2022.

- An agreement with the Irish Medical Schools to increase the number of Irish /EU medicine undergraduate students places by 200 over the next five years. This agreement with the medical schools will see the number of Irish/EU student places available in medicine increasing from 730 in 2021 to 930 in 2026.

- We have achieved a steady annual increase in postgraduate training posts in line with workforce planning projections. Overall, the Basic Training intake increased by 19% and the Higher specialist Training intake increased by 14% over the last 5-year period up to 2022.

- For 2023/2024, continued increases in the number of training posts in national training programmes will be achieved, by conversion of suitable non-training posts, to reflect national policy, workforce planning recommendations and capacity for training. These increases are targeted predominately within Surgery, General Practice, and Psychiatry HST programmes.

- Major changes to working arrangements and immigration permissions for most non-EEA doctors were announced on 8 March 2022 by the Tánaiste Leo Varadkar TD, Minister for Justice Helen McEntee TD and myself as the Minister for Health.

- Ongoing engagement with the Department of Enterprise Trade and Employment regarding employment permits for certain health professionals who are in short supply. On the 20 June, the Minister of State for Business, Employment and Retail, Damien English TD, announced changes made by S.I. to the employment permits system which includes adding the occupations of Pharmacist, Cardiac Physiologist; Medical Scientist; Occupational Therapist; Physiotherapist; Podiatrist/Chiropodist; Psychologist and Speech & Language Therapist to the Critical Skills Occupations List. This means these jobs are now eligible for a Critical Skills Employment Permit.

- Establishment of a National Taskforce on the (NCHD) Workforce chaired by Professor Anthony O’Regan (Consultant Physician, University Hospital Galway). The purpose of the Taskforce is to put in place sustainable workforce planning strategies and policies to address and improve NCHD experience to support present and future retention of NCHDs in Ireland. Three individual workstreams have been established to focus on specific topics and the workstream members are working together to progress tasks.

- The 4th Progress Report on the implementation of the COVID-19 Nursing Home Expert Panel's (NHEP) recommendations was published in June 2022. The Report highlights that many of the short and medium-term recommendations have already been implemented or operationalised. This report outlines the pathways and identified processes for the continued implementation of the recommendations as they are integrated into the wider reform agenda.

- The Department of Health (DOH) is actively progressing the implementation of Regional Health Areas (RHAs) in partnership with the HSE, Department of Children, Equality, Disability, Integration and Youth.

- Six RHA Workstreams Groups were established in June and continue to meet. The work of the Workstream Groups is feeding into the detailed implementation plan which will be finalised by the end of 2022.

- Six Regional Engagement Events for health service workers took place in September and early October.

- Work has started on the development of a population-based approach to service planning and resource allocation. A population-based resource allocation (PBRA) funding model will be used as part of Estimates 2024 to allocate funding by RHA. A first spending review on international examples and approaches to PBRA models was published in August.

- The Framework Action Plan Working Group have completed their work on the Action Plan for Disability Services, in line with the commitment in the Programme for Government to work towards implementing the Disability Capacity Review. The final plan, which will be an implementation plan for the first phase 2023-2026, is now being prepared.

- The National Cancer Strategy Implementation Report and Key Performance Indicators for 2021 was published on 2 December 2022. Progress on implementation of the National Cancer Strategy has continued throughout 2022, with investment of €35m having a significant impact on access to cancer diagnostics, treatment and supports.

- The Sharing the Vision: A Mental Health Policy for Everyone policy implementation status report was published for Q4 2021, Q1 2022, Q2 2022, and Q3 2022, alongside NIMC’s Quarterly Report Analysis.

Additionally, for each of the last three years, a comprehensive Winter Plan has been prepared and published, implementing initiatives and measures to support emergency departments throughout the country meet the challenges and heightened pressures of the winter season. Furthermore, the provision of 1,146 additional acute inpatient beds above the number available on 1^stJanuary 2020, has been fully funded.

From 27 June 2020 to now, my Department has been responsible for progressing countless, important initiatives aimed at improving the health system for the people of Ireland. The achievements listed above are an encompassing view of the main policy achievements made by officials in my Department over the past two years.