Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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732. To ask the Minister for Health the estimated full-year cost of providing and staffing ten additional acute beds in a public hospital; and if he will make a statement on the matter. [24179/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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As this is an administrative matter for the Health Service Executive, the HSE has been asked to reply directly to the Deputy.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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733. To ask the Minister for Health the estimated full-year cost of providing and staffing ten additional ICU beds in a public hospital; and if he will make a statement on the matter. [24180/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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As this is an administrative matter for the Health Service Executive, the HSE has been asked to reply directly to the Deputy.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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734. To ask the Minister for Health the estimated full-year cost of reducing the maximum payment on the drug payment scheme to €40; and if he will make a statement on the matter. [24181/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Drug Payment Scheme (DPS) provides for the refund of the amount by which expenditure on approved prescribed medicines or medical and surgical appliances exceeds a named threshold in any calendar month. The DPS is not means tested and is available to anyone ordinarily resident in Ireland.

The DPS threshold was reduced twice in 2022:

- From €114 to €100 per month on 1 January 2022.

- From €100 to €80 per month on 1 March 2022.

Therefore, currently, under the DPS, no individual pays more than €80 a month towards the cost of approved prescribed medicines. The DPS significantly reduces the cost burden for people with ongoing expenditure on medicines.

The estimated cost of reducing the DPS threshold to €40 per month is €79.2m per annum.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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735. To ask the Minister for Health the estimated full-year cost of providing free primary care (including GPs) for all; and if he will make a statement on the matter. [24182/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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Under the GMS scheme GPs receive a range of payments including capitation payments, fee per service payments and practice supports. Extending GP care without charges to all citizens who do not currently hold a medical card or GP visit card would encompass a further 3 million people approximately. It is not possible to definitively calculate the cost of universal GP care without charges given the wide range of payments and variables that have to be accounted for.

Such a calculation would require a complex and detailed modelling exercise to account for a range of demographic changes, future projections of service demands and variations in the number of GPs and the allowances that could be paid.

Additionally, the fees payable to GPs could only be determined following agreement with the IMO on the scope and content of the general practitioner service to be provided, as well as on the future of the various other supports provided to general practice. For these reasons, it is not possible to give the actual cost of extending GP care without fees to further cohorts.

However, the following recent papers have estimated the cost of universal GP care without charges: the 2018 ESRI study Universal GP care in Ireland: Potential Cost Implications, the 2019 IGEES paper Costing Framework for the Expansion of GP Care, and the 2023 ESRI report Extending Eligibility for General Practitioner Care in Ireland: Cost Implications.

With regard to primary care dental services, the national approach to future oral health service provision will be informed by Smile agus Sláinte, the National Oral Health Policy (2019). The aim of the policy is to develop a model of care that will enable preventative approaches to be prioritised, improve access, and support interventions appropriate to current and future oral health needs. The cost of providing free dental care to the whole population would depend on a number of factors, including the underlying oral health of the population and the level of take-up of such services.

Over the last number of years, several pieces of detailed policy analysis have been undertaken to assessvarious aspects ofexpanding eligibility for near or full universal access to primary care and other care sectors and the associated additional costs for the Exchequer. These include the Expert Group Report on Resource Allocation and Financing of the Irish Health System(2010), the White Paper on Universal Health Insurance (2014)and associated costings, and the Committee on the Future of Healthcare Sláintecare Report(2018).

Sláintecare makes the commitment to providing free or affordable access to healthcare to all, while recognising that the delivery of universal GP care without charges must be done on a phased basis. The Strategic Review of General Practice, the Terms of Reference for which I published last month, will examine the broad range of issues affecting general practice and set out the measures necessary to deliver a more sustainable GP service. Under this review, consideration is to be given to the scope of services to be provided to patients on a universal basis, and also to developing the support model necessary to underpin the provision of sustainable GP services under the Sláintecare vision.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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736. To ask the Minister for Health the estimated full-year cost of providing free dental care; and if he will make a statement on the matter. [24183/23]

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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742. To ask the Minister for Health the estimated full-year cost in 2023 of reinstating all the benefits that were available under the dental treatment services scheme before the economic crash; and if he will make a statement on the matter. [24190/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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I propose to take Questions Nos. 736 and 742 together.

The Dental Treatment Services Scheme (DTSS) provides dental care, free of charge, to medical card holders aged 16 and over. These services are provided by independent dental practitioners who have a contract with the HSE.

As part of Budget 2010 measures, expenditure on the DTSS was capped at the 2008 level of €63 million. Consequently some treatments were limited, restricted to emergencies only or, in the case of prophylaxis (Scale and Polish), suspended. Last year Scale and Polish was re-introduced for all medical card patients along with an expansion of the oral examination to include provision of preventative advice, using €10 million awarded in Budget 2022. The cost of making changes to the DTSS or providing free dental care to the whole population would depend on a number of factors, including the underlying oral health of the population and the level of take-up of such services.

The national approach to future oral health service provision will be informed by Smile agus Sláinte, the National Oral Health Policy (2019). The aim of the policy is to develop a model of care that will enable preventative approaches to be prioritised, improve access, and support interventions appropriate to current and future oral health needs. An additional €15 million has been allocated in Budget 2023 to protect access to current oral healthcare services and progress reform.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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737. To ask the Minister for Health the estimated full-year cost of abolishing all inpatient and ED charges; and if he will make a statement on the matter. [24184/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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As part of Budget 2023, I announced my commitment to abolish all public inpatient hospital charges this year. The Health (Amendment) Act 2023, signed into law by the President on 4 April 2023, removes the acute public in-patient charge of €80 per day for people accessing care as a public patient in public hospitals. This measure came into effect from 17 April 2023.

The removal of these charges is an important step towards reducing the healthcare costs of patients and families. This measure builds on the abolition of public in-patient charges for children, which I introduced in September last year, and is another significant step in ensuring that people have access to affordable healthcare services when needed.

Emergency Department (ED) charges are recorded by the HSE as Out-Patient Income. In 2021 the HSE reported Hospital Out-Patient Income of €22.4m.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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738. To ask the Minister for Health the estimated full-year cost of abolishing all prescription charges for medical card holders; and if he will make a statement on the matter. [24185/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Government is committed to making healthcare more accessible and affordable and has introduced several reductions in the cost of healthcare.

On 1 November 2020, prescription charges under the General Medical Services (GMS) Scheme were reduced as follows:

- For persons over 70, the charges were reduced to €1 per item with a maximum monthly charge of €10 per month.

- For persons under 70, the charges were reduced to €1.50 per item with a maximum monthly charge of €15 per month.

It is estimated that the minimum cost of abolishing prescription charges for all eligible persons would be approximately €60m per annum.

This estimation is subject to the following caveats:

- That demographic changes may impact the number of eligible persons.

- That the removal of prescription charges may result in a change in claimant behaviour.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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739. To ask the Minister for Health the estimated full-year cost of abolishing all parking charges at public hospitals; and if he will make a statement on the matter. [24186/23]

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.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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740. To ask the Minister for Health the estimated full-year cost of introducing a fully funded universal contraception scheme. [24187/23]

Hildegarde Naughton (Galway West, Fine Gael)
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The free contraception scheme for women aged 17 - 25 was launched on 14th September, 2022, and expanded to include 26 year-olds on January 1st, 2023. The scheme is currently open to women aged 17-26, ordinarily resident in Ireland, and is due to be expanded to women aged 30 and under by September 1st, 2023.

For eligible women, the free contraception scheme provides for:

• The cost of consultations with GPs, family planning clinics and other relevant medical professionals to discuss contraceptive options with eligible patients and to provide prescriptions for these;
• The cost of prescription contraception, dispensed at local pharmacy of choice;
• The cost of fitting and/or removal of various types of long-acting reversible contraception (LARC) plus any necessary checks, by medical professionals certified to fit/remove LARCs (e.g. intrauterine devices (IUD), systems (IUS), coils and implants);
• The cost of providing the wide range of contraceptive options currently available to GMS (medical) card holders, which will also be available through this scheme, including contraceptive injections, implants, IUS and IUDs, the contraceptive patch and ring, and various forms of oral contraceptive pill, including emergency contraception.
• Women who have had coils, IUDs, IUSs or implants inserted under the scheme will remain eligible for the subsequent checks and free removal of any devices that were inserted before their 27th birthday, in order to ensure continuity of care.
• Funding through Budget 2023 was also allocated to expand the scheme to 16 year-olds, but this is subject to consultation across Government, legal advice and legislative amendment.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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741. To ask the Minister for Health the estimated full-year cost of staffing public health teams to the WHO-recommended levels [24188/23]

Stephen Donnelly (Wicklow, Fianna Fail)
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There has been significant progress made in relation to enhancements to our Public Health workforce.

As agreed between the Department of Health, the HSE and the IMO in April 2021, a fully reformed model for public health including 84 Consultant posts is being implemented on a phased basis. The first phase, recruitment of 34 WTE posts at Consultant in Public Health Medicine level, is complete. Recruitment of Phase 2 (30 WTE) Consultant posts is progressing well with 19 posts in various stages of contracting to short-listing. Preparation for Phase 3 (20 WTE) of the programme is underway. It is intended that the 84 Consultant posts will be in place before the end of 2023.

There has also been extensive progress made in the area of broader Public Health workforce recruitment which will make up the multi-disciplinary teams (MDTs) as part of the Consultant-led Public Health programme as envisaged by the Crowe Horwath Report. Since 2020 we have almost doubled the Public Health workforce as promised by the Government with the recruitment of over 237 new WTEs at posts including public health doctors, nurses, scientists, and support staff.

Alongside this recruitment, six new Public Health Areas have been established aligned to future Sláintecare areas, led by Area Directors of Public Health and delivering a Consultant-led Public Health service in line with the Hub-and-Spoke model. The HSE has also made progress towards procurement of an Outbreak Case and Incident Management System, a key enabler of a national health protection service.

Additional resources have also been provided to the HSE to ensure enhancements are put in place to existing infectious disease surveillance systems in the Health Protection Surveillance Centre (HPSC). This will ensure effective monitoring and signaling of what is happening with the virus at population level, so that we can greater understand disease transmission and severity along with population immunity and risk. Following provision of additional resources in Budget 2023, eighty nine new posts in disease surveillance are being created with 42 of these already recruited.

This has enabled expansion of GP Sentinel Surveillance, with 90 GP practices now participating in the scheme. In addition, a Biostatistics and Modelling Unit is being established in the HPSC. Wastewater Surveillance and Whole Genome Sequencing programmes are in place and operational.

My Department and the HSE are fully committed to the full implementation of the new Public Health Model by December 2023.