Seán Ó Fearghaíl (Kildare South, Fianna Fail)
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238. To ask the Minister for Health if she will carry out a full assessment of the financial impact of heart failure on patients with recommendations on appropriate actions; and if she will make a statement on the matter. [39813/25]

Cathal Crowe (Clare, Fianna Fail)
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252. To ask the Minister for Health if her Department will undertake a full assessment of the financial impact of heart failure on patients with recommendations on appropriate actions; and if she will make a statement on the matter. [39903/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I propose to take Questions Nos. 238 and 252 together.

Heart Failure is a complex condition that affects approximately 2% of the population , and this percentage is expected to grow. This reflects the ageing of the population, growing problems with diabetes and obesity and continued poor control of standard risk factors, in particular blood pressure.

Many people are unaware they have Heart Failure, due to the gradual onset of symptoms, which are often mistaken for typical signs of ageing or attributed to other conditions. Therefore, Heart Failure has frequently progressed significantly by the time a diagnosis is made. Treatment requires coordinated multidisciplinary care. The Government recognises the significant burden that Heart Failure can place on individuals, families, and the healthcare system. A multifaceted approach to care is therefore required, encompassing community-based care, early diagnosis, patient support and targeted interventions.

Ireland has made substantial progress in managing Heart Failure and the implications of the diagnosis). The 2021 Heart Failure Model of Care aims to standardise care and improve outcomes for patients. It has established structured care pathways that support patients from hospital discharge to community self-management. It includes practical tools, patient resources, and signposting. The National Review of Adult Specialist Cardiac Services provides 23 key recommendations to inform future cardiac health policy, including Heart Failure. The HSE are now developing an implementation plan for the Review.

Under Sláintecare reforms, there is a clear emphasis on integrated primary and community care to prevent repeat hospitalisations. Since 2020, the chronic disease management programme has supported those at the most significant risk, including those with Heart Failure. The programme includes prevention, targeted case finding and ongoing management, helping us identify heart disease early, manage the condition effectively and slow or halt disease progression. The HSE is rolling out GP direct access to diagnostics such as a specific blood test and early echocardiogram to aid in early detection of Heart Failure in primary care.

Cardiovascular health has been prioritised in Budget 2025, which allocates over €9 million in full-year funding to support vital cardiovascular initiatives. Budget 2025 allocated €4 million full year costs, and 45 WTEs to progress cardiac services, which includes Heart Failure. This investment facilitates the initial steps in cardiac services reform and will support the development of a new cardiovascular strategy in the longer term. In the short term, we will deliver enhanced cardiac services and develop the necessary structures to ensure success in the longer term.

The HSE provide a wide range of supports for those with chronic disease and disability. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE and is primarily based on an assessment of means. In certain circumstances, the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.

Further information regarding medical cards can be found at: .

Under the Drugs Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.

Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.

Seán Ó Fearghaíl (Kildare South, Fianna Fail)
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239. To ask the Minister for Health her plans to alleviate high levels of depression, anxiety and post-traumatic stress disorder suffered by heart failure patients by increasing access to psychological support which only a fraction of heart failure patients can currently access; and if she will make a statement on the matter. [39814/25]

Mary Butler (Waterford, Fianna Fail)
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As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible

Seán Ó Fearghaíl (Kildare South, Fianna Fail)
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240. To ask the Minister for Health if she will seek a reduction in waiting lists of up to two years for cardiac rehabilitation programmes, which reduce death from heart disease by at least 20%; and if she will make a statement on the matter. [39815/25]

Cathal Crowe (Clare, Fianna Fail)
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253. To ask the Minister for Health if she will provide an overview of actions that are being taken to ensure a reduction in current waiting lists of up to two years for cardiac rehabilitation programmes, which reduce death from heart disease by at least 20%; and if she will make a statement on the matter. [39904/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I propose to take Questions Nos. 240 and 253 together.

The Government is actively working to enhance cardiac rehabilitation by addressing existing challenges through several key initiatives. These include increasing staffing levels, integrating community-based care, standardising services, and expanding digital pathways to improve accessibility. Together, these efforts are thoughtfully designed to minimise delays and ensure timely access to cardiac rehabilitation services nationwide.

The Model of Care for Integrated Cardiac Rehabilitation, launched in October 2023 , provides evidence-based, patient-centred guidelines to ensure that those living with cardiovascular disease across the country have equitable and timely access to high quality cardiac rehabilitation care, no matter where they live.

The recent Report ‘Overview of Cardiac Rehabilitation Services in Ireland’ published in May, outlines current services and identifies areas where additional resources are required to enhance access to cardiac rehabilitation. The HSE’s Enhanced Community Care Programme has provided significant additional resources to support existing hospital and community-based cardiac rehabilitation services. The aim is to roll out a national accredited cardiac rehabilitation programme, available in person, online or hybrid to improve accessibility and reduce delays.

Recommendation 19 of the recently published National Review of Cardiac Services (NRCS) sets out that all patients, following a cardiac event, or those diagnosed with Heart Failure, should be offered and have access to an appropriate cardiac rehabilitation programme. An implementation plan for the NRCS is currently being progressed by the HSE, with cardiac rehabilitation identified as an initial priority.

Funding has been provided through the HSE National Service Plan 2025 to support implementation and evaluation of the Model of Care for Integrated Cardiac Rehabilitation in two Integrated Health Area (IHA) regions in HSE West and Northwest. It will address critical gaps in cardiac rehabilitation teams in two Integrated Health Areas (IHAs), IHA Galway-Roscommon and IHA Mayo, by recruiting additional posts to convene complete integrated cardiac rehabilitation teams, and subsequently enabling these teams to deliver and evaluate an end-to-end implementation of the Model of Care. Thirteen new posts have been funded across four hospitals and three hubs in the region. These posts are currently in recruitment, with four posts having been appointed and accepted, as of mid-June 2024. Learnings from this initial implementation will be shared across all six health regions to inform future services.

The NRCS report provides the data and roadmap for a once-in-a-generation reform of cardiac services, and we are ambitious to progress this important work. The Minister has written to the HSE to develop an implementation plan. Publication of the Review and the development of the implementation plan will be key facilitators of our new national cardiovascular strategy as promised in the Programme for Government. Any future development in cardiac rehabilitation services will be informed by the implementation plan of NRCS and subject to the usual estimates process. The recommendations of the review will inform the future provision of cardiac services nationally.

Seán Ó Fearghaíl (Kildare South, Fianna Fail)
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241. To ask the Minister for Health the steps he is taking towards the removal of barriers preventing cardiac and stroke patients from returning to work on a phased basis without losing their social welfare entitlements; if he will encourage equal treatment in terms of benefits for people living with other lifelong conditions and disabilities; and if she will make a statement on the matter. [39816/25]