Alan Farrell (Dublin Fingal, Fine Gael)
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854. To ask the Minister for Health the way persons can access post-exposure prophylaxis on weekends; and if he will make a statement on the matter. [7345/23]

Hildegarde Naughton (Galway West, Fine Gael)
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Sexual health and wellbeing is a priority for this Government. Sexual health services are being further developed and implemented in accordance with the recommendations set out in the National Sexual Health Strategy 2015 - 2020. The Strategy's lifetime has been extended to 2022. An independent Review of the Strategy is currently being finalised and will be published on the Healthy Ireland website once complete.

In recent years we have seen the launch of a number of major initiatives in the fight against HIV and other STIs in Ireland.

Key achievements in relation to HIV prevention to date include:

- Ireland (Dublin, Cork, Limerick and Galway) joining the HIV Fast-Track Citiesprogramme in 2019.

- Establishing a national HIV Pre-Exposure Prophylaxis (PrEP) programmein November 2019, following a HIQA HTA, which concluded that the introduction of HIV PrEP would be safe, effective and cost saving, potentially reducing the number of people who contract HIV following exposure. A measure of its success has been high demand; existing capacity for PrEP will be looked at as part of the forthcoming development of the new National Sexual Health Strategy.

- In 2021, given ongoing pandemic impacts on attending clinical services in person, coupled with a national outbreak of early infectious syphilis, the Sláintecare Integration Fund initially supported a pilot programme to provide access to online STI testing, in Dublin, Cork and Kerry.

- This pilot was very successful and was expanded, receiving €3m in support in Budget 2022 and an additional €600,000 in Budget 2023. The national online STI testing servicewas launched on a nationwide basis in October, 2022, and, as a result of privacy and convenience, has been very successful in reaching cohorts that may have been reluctant to access STI clinics in person.

- The HPV (human papillomavirus) vaccinewas extended to men and women living with HIV up to and including 26 years; and to gay, bisexual and other men who have sex with men (MSM), including MSM living with HIV. Over 7,400 MSM and people living with HIV have commenced the vaccine to date.

- Establishment of the National Condom Distribution Service (NCDS)in 2015 and subsequent expansion -the NCDS functions as a central point for distributing free condoms and lubricant sachets to HSE services and other organisations working with individuals and groups at increased risk of negative sexual health outcomes - young people; migrants; gay, bisexual and other men who have sex with men; sex workers; people living with addiction issues and people living with HIV. Products are available through public sector bodies, including STI clinics, hospitals, and HSE health promotion & improvement, third-level institutions, public STI clinics, and NGOs.

HIV post-exposure prophylaxis (PEP)is a course of HIV medication that aims to prevent HIV infection following possible recent exposure to HIV. PEP is only available following an assessment by a doctor or a nurse. Not everyone who presents for PEP will need it.

PEP can be accessed through STI clinics (typically during clinic hours and often by appointment). Publicly funded STI Clinics are free of charge for people using the service, including cost-free treatment for STIs and HIV. In terms of out of hours access, including weekends, PEP is available from some minor injury units and from Emergency Departments. Attendance at EDs should be reserved for situations where there is an injury requiring urgent medical attention or where it is not possible to get PEP from a local STI or ID clinic within 72 hours.

Attendance at ED is free of charge with a referral letter from a GP. Individuals who attend an Emergency Department, without a referral letter, will be charged for that attendance (€100 for EU residents). Medical card holders and some other groups are exempt from this charge.

A list of clinics and Emergency Departments, with details of how to access PEP in Ireland can be downloaded from the HSE sexualwellbeing website as follows: www.sexualwellbeing.ie/need-urgent-information-and-care-/post-exposure-prophylaxis/pep-availability-in-ireland-.pdf.

As there may be more information available from the HSE, and as this is a service matter, I have also asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Róisín Shortall (Dublin North West, Social Democrats)
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855. To ask the Minister for Health when he intends to increase the standard eye exam fee paid to opticians for medical card holders in relation to the community ophthalmic services scheme; the amount the increase will be; and if he will make a statement on the matter. [7351/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Community Ophthalmic Services Scheme (COSS) is a national fee-per-item scheme which was introduced in 1979. Under the COSS, medical card holders aged over 16 years can be seen by ophthalmologists, community ophthalmic physicians, optometrists or dispensing opticians.

Eligible patients can receive an eye examination and be provided with prescribed optical appliances in accordance with a national schedule of approved optical appliances.

The Health Professionals (Reduction of Payments to Ophthalmologists, Optometrists and Dispensing Opticians) Regulations 2013 (SI 274 of 2013) sets the fees for optometrists and dispensing opticians under the Community Optometric Services, Community Spectacle Dispensing Services and Health Amendment Act Card Schemes.

I am committed to increasing the fees payable to contractors for a standard eye examination under the COSS. This is a priority for my Department, and work with stakeholders is ongoing to implement this change in 2023.