Mairéad Farrell (Galway West, Sinn Fein)
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1954.To ask the Minister for Health the estimated cost of expanding the free HIV rapid testing and PrEP to within higher education institutes, ensuring students access to such services on campus; and if he will make a statement on the matter. [33119/24]

Colm Burke (Cork North Central, Fine Gael)
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Ireland established a national HIV PrEP programme in November 2019, following a HIQA HTA, which concluded that the introduction of HIV PrEP would be safe, effective and cost saving. The HTA also found that significant investment in public STI services was required to implement PrEP and €5.4 million was set aside in Budget 2020 to roll out a national HIV PrEP programme, managed by the HSE Sexual Health and Crisis Pregnancy Programme (SHCPP).

Free PrEP medication is available to individuals who meet clinical eligibility criteria, attending HSE approved PrEP services. These include public PrEP services, delivered through the public network of STI clinics, and some general practice (GP) services and private providers. There are currently 13 approved public PrEP services, located in public STI clinics, and 17 private or general practitioner (GP) PrEP providers. Appointments at the 13 public PrEP services are free of charge, however, the private providers are subject to consultation charges. Student health facilities, like GPs and family planning centres, are private providers; the same principles would apply to GPs working in these settings.

The HSE SHCPP is working towards increasing the number of GPs approved as PrEP providers, thus giving individuals more choice around who and where they attend for treatment, a number of additional measures have been deployed and are being developed, including administrative efficiencies, the use of telephone consultations and use of the free home STI testing scheme for routine tests. In order to increase the number of providers, a PrEP competency framework and eLearning platform has been developed; these can be accessed by GPs with an interest in providing PrEP.

However, currently, individuals attending GPs for PrEP would have to pay a consultation fee for attendance and may also have to pay for investigations, treatment and vaccines as recommended by their GP, if not attending a free STI clinic. Needless to say, it should also be noted that PrEP protects against HIV infection and not other STIs; it would also be necessary for PrEP patients to attend a public STI clinic for treatment of incident STIs, should these be diagnosed.

In terms of free home HIV and STI testing, this was launched nationwide in October, 2022, and is already freely available, including to those who may be resident on campus or in student accommodation. The scheme can be accessed through www.sexualwellbeing.ie. The home STI testing scheme has received additional funding of €720,000 in 2024, bringing total funding for this to €4.22m.

The Department of Health and the HSE Sexual Health and Crisis Pregnancy Programme have been supporting sexual health on 3rd level campuses through the National Condom Distribution Scheme, which has been supplying free condoms through participating 3rd level campuses since 2019. Since 2023, free condoms are also being provided with orders for the free home STI testing kits.

The free contraception scheme for women, covering prescription contraception, is currently open to women ordinarily resident in Ireland aged 17-35. Student health providers were consulted in preparation for the launch of the scheme and student health clinics are among the approximately 2,400 providers that have signed up to provide services and products under the scheme to date.

It covers the cost of consultations with GPs and family planning centres and prescriptions for the wide range of contraceptive options available on the HSE Re-Imbursement List, including long-acting reversible contraception (LARCs: injections, intra-uterine devices and systems (coils) and implants) and emergency contraception in addition to the contraceptive Pill, patch and ring. LARC fittings, removals, injections and check-ups are also free of charge under the scheme.

Sexual health is a priority for this Government. The National Sexual Health Strategy, 2015-2020, (NSHS), was launched in October 2015 and is implemented by the HSE Sexual Health and Crisis Pregnancy Programme (SHCPP). The NSHS aims to support sexual health and wellbeing across the lifecourse.

Following stakeholder consultation and an independent review, the Strategy is currently being re-drafted by an expert Group; a refreshed version will be published in Q3-4, 2024. In collaboration with the HEA Healthy Campus Co-Ordinator, a stakeholder exercise has been conducted, involving 3rd level health facility staff and other campus stakeholders. We would like to thank all who contributed to this exercise, which will be very helpful in informing the forthcoming Strategy

Any decisions relating to further expansion of services in 2025 will be a matter for the Estimates process in advance of Budget 2025.

Catherine Connolly (Galway West, Independent)
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1955.To ask the Minister for Health the details of his engagement with regard to increasing optometrists’ fees; the reason for the delay in securing approval for the increasing of fees; and if he will make a statement on the matter. [33132/24]

Catherine Connolly (Galway West, Independent)
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1956.To ask the Minister for Health the details of his engagement with regard to the promised over-8s public eyecare programme; the reason for the delay in securing approval for the roll-out of this programme; and if he will make a statement on the matter. [33133/24]

Catherine Connolly (Galway West, Independent)
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2516.To ask the Minister for Health his plans to increase optometrists’ fees, which have not been increased in over 20 years; the timeline for same; the reason for the delay in increasing the fees; and if he will make a statement on the matter. [33359/24]

Catherine Connolly (Galway West, Independent)
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2517.To ask the Minister for Health if his Department has made proposals for the increase of optometrists’ fees to the Department of Public Expenditure, National Development Plan Delivery and Reform; if so, the details of same; the details of his engagement with the Minister for Public Expenditure, National Development Plan Delivery and Reform on this matter; and if he will make a statement on the matter. [33360/24]

Catherine Connolly (Galway West, Independent)
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2518.To ask the Minister for Health for an update on the Programme for Government commitment to roll out a national over-8s public eyecare programme; the reason for the ongoing delays in rolling out the programme; the timeline for the roll-out of the programme; the expected cost of the programme; the status of the promised implementation plan; when it will be published; the details of his engagement with the Minister for Public Expenditure, National Development Plan Delivery and Reform with regard to the roll-out of the national over-8s public eyecare programme; and if he will make a statement on the matter. [33361/24]

Stephen Donnelly (Wicklow, Fianna Fail)
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I propose to take Questions Nos. 1955 and 1956 and Nos. 2516 to 2518, inclusive, together.

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.

All children, including those not covered by a medical card, receive a vision screen while in national school from a Public Health Nurse. The Health Service Executive (HSE) provides optical services free of charge to pre-school children and national school children referred from child health service and school health service examinations who are discovered to have sight problems. These children are referred to the appropriate consultant for treatment. In such circumstances, these services will continue to be provided until the child has reached the age of 16.

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.

Increasing the fee payable to contractors for a standard eye examination under the COSS (to ensure parity with that payable for the same exam under the Department of Social Protection’s Treatment Benefit Scheme) is a priority for my Department, and work with stakeholders is ongoing in this regard.

The Department has also been meeting with Optometry Ireland to discuss the contribution that optometrists provide to our healthcare service and how this contribution could be further expanded.

The HSE Primary Care Eye Services Review Group Report, published in June 2017, highlighted the limitations of the current model of service delivery and set out the way forward for a significant amount of eye services to be delivered in a primary care setting. The Report estimated that 60% of existing outpatient activity could be moved to primary care thus enabling hospital services to focus on patients who require more specialist diagnostics or treatments.

The National Clinical Programme for Ophthalmology developed a model of care, also published in 2017, detailing how the realignment of eye services from the acute hospitals to the community will be undertaken. Included in current priorities is transferring the care of children aged 8+ years to the care of local private optometrists. The HSE have forwarded a detailed implementation plan with costings which is being considered by the Department.

There will be engagement between my Department and the Department of Public Expenditure, National Development Plan Delivery and Reform during the Estimates 2025 process in regard to the funding needed to progress healthcare priorities, including the provision of eyecare.

I believe that there is a real opportunity to work collaboratively with community optometrists, and with other healthcare providers, to make a significant difference to patient outcomes. Of course, any publicly funded ophthalmic service expansion should address unmet public healthcare needs and improve access to public health services while ensuring value for money.