I thank Deputy McGreehan for raising this important issue. Ireland's healthcare system is changing with the introduction and implementation of Sláintecare, the first cross-party plan for major health reform in Ireland which was introduced in 2017. The Sláintecare vision is to provide universal, accessible, affordable, person-centred, safe and high-quality health and social care for all the people of Ireland. As the Deputy said, it should be based on need, not on the ability to pay. The Path to Universal Healthcare: Sláintecare and Programme for Government 2025+ was published in May 2025. It includes three high-level priority areas, which are: improving access, improving service quality and delivering capacity. Good progress has been made to date in terms of access. However, the latest hospital waiting list figures, for August 2025, show that important progress has also been made under the waiting list action plan approach which was implemented in late 2021. The number of patients on waiting lists has been reduced, as has the length of time they are waiting. Since September 2021, there has been a 56% reduction in the number of patients waiting over 12 months. In the same period, the total weighted average waiting time for patients on waiting lists has reduced by approximately 44%. We are seeing continued progress in terms of long waiters and the most recent figures indicate there has been a reduction of 7% in the number of patients waiting over 18 months since this time last year. A total of 66% of consultants have now signed the public-only consultant contract, made up of 943 new entrants and 2,147 change of contracts. This is a key reform aimed at creating a universal, single-tier healthcare by removing private practice from our public hospitals. We have also seen an 8% reduction in the cumulative daily 8 a.m. trolley count for January to August 2025. There were almost 5,700 fewer patients waiting when compared with 2024. This is despite an increase in emergency department attendance of over 10,000, or 7%. Some 2.53 million people in Ireland, or 46% of the population, currently have private health insurance. Most consumers have private health insurance plans which provide substantial cover in private hospitals, but this cover is mainly provided for semi-private accommodation. Some 8% of consumers have plans which provide cover in mainly public hospitals and these are typically less expensive. Private health insurance is voluntary and there are many reasons that people take out private health insurance. The Government continues to support those who choose to take out private health insurance through tax relief and community rating. This spreads the risk across the system and allows more affordable access for older and sicker people. The Deputy made reference to specific areas around early access, pilot medication programmes and ensuring the removal of barriers to new innovative medicines becomes part of Government's primary policy. The Minister, Deputy Jennifer Carroll MacNeill, whom I am deputising for today, is very much focused on how we can ensure that medicines are increasingly accessible.
Sentiment score: 0.20
I thank the Deputy for raising this important matter. I certainly agree on the necessity around an early access programme. We are making significant progress in regards to the treatment of cancer. However, I would agree that access to medicines should not become a barrier; it should become part of the normal process. I will report what the Deputy has said here to the Minister. In regards to the Government's continued work to support the model of care through its Sláintecare programme, we are very much committed to ensuring that patients get first-class access. Indeed, we will continue to invest. We will continue to look at how we can reform the system, very much being focused on productivity but also patient care. It is very much the Government's priority that we continue to improve service delivery, increase capacity across all the hospitals - acute, step down and community healthcare - and, indeed, reduce waiting lists and times, and also, to the Deputy's point, ensure that all patients and all citizens have access to the best medicines available.
Sentiment score: 0.43
I thank Deputy Quinlivan for the timely opportunity to address the House on capacity at University Hospital Limerick. I am taking this matter on behalf of the Minister for Health, Deputy Carroll MacNeill, who sends her apologies that she cannot be here to provide an update on the measures that are being taken to alleviate overcrowding. Since the Deputy last raised a Topical Issue on this matter in July, the work to increase capacity and alleviate overcrowding at UHL has continued at pace. In May 2024, HIQA was requested to undertake an independent and expert review of urgent and emergency healthcare services in the mid-west by the then Minister for Health. The priority for this work is ensuring safe, quality acute care. HIQA has today published this review and the Minister for Health briefed the Government on the report this morning. She also placed on the record of the House during Questions on Promised Legislation her points regarding this publication. The Minister and the Government are concerned at the significant challenges being experienced in Limerick and the wider mid-west, and the impact this is having on patients and their families in the region. I thank the hard-working front-line staff at the hospital, who continue to deliver excellent care for patients every day. The Minister and her officials will now consider the reports and advice provided, including the three options that were identified. The Minister will report back to the Government on these considerations. As the Deputy will appreciate, the reports and analyses involved are extensive and involve a stakeholder consultation, regulatory inspections, data analysis and international evidence reviews. I acknowledge the substantial work that has been undertaken by all of those who conducted and took part in this review. HIQA’s analysis finds that inpatient capacity in the region needs to be increased to meet current and projected demand. The report identifies three options, including expanding capacity at the Dooradoyle site, extending the UHL hospital campus, and developing a model 3 hospital and, consequently, a second ED for the region. The HIQA review notes that real improvements are continuing to be made at UHL and across the mid-west. This work of improvement and reform will go on while the HIQA findings are being considered. As the Deputy is aware, through Government investment, 140 new beds have opened in UHL since 2020. This includes the successful delivery of two fast-tracked 16-bed inpatient blocks, which opened in December 2024 and in June this year. More new bed blocks are being developed, which will provide up to 292 additional beds by 2028. This includes two 96-bed blocks, the first of which is starting to receive patients this week. This increase in capacity will go towards reducing the number of people waiting on trolleys. The opening of this new 96-bed block will be a major boost to increasing capacity at UHL. I know it will be welcomed by all the people of the mid-west. Bed capacity is being further expanded throughout the region through the acute hospital inpatient bed capacity expansion plan. This will deliver 572 new inpatient beds in the region by 2031, including 24 new beds at Nenagh Hospital, 48 new beds at Ennis Hospital and 42 new beds at St. John’s Hospital. I would like to reassure the Deputy and all patients in the mid-west that substantial work is ongoing to improve healthcare services in the region.
Sentiment score: 0.22
We are all in agreement that the people of the mid-west rightly deserve access to responsive urgent and emergency care. The HIQA review was published today. It has an extensive range of findings across the healthcare service in the mid-west. I would be interested to hear what the Deputy disagrees with in the HIQA report.
Sentiment score: 0.22
I would be interested to hear if there is anything in the report that he disagrees with. It will be given full consideration and all the findings-----
Sentiment score: 0.05
-----are under way to determine the future direction of the services in the region. It is important to also highlight UHL's annual budget spend has increased from €265 million in 2019 to over €507 million in 2024. A package of wide-ranging reform support measures also is being implemented. It is important these measures are aimed at both capacity and reform of the healthcare system in the region. Increased staffing levels are also being prioritised. Staffing at UHL has grown by 32%, an increase of 1,465 whole time equivalents, since 2019 to August 2025. Other measures and reforms to alleviate congestion include the extension of opening hours for the medical assessment unit in the model 2 hospital in the region and the new surgical hub, which is expected to be operational by quarter 4 in 2026. These are real steps being taken to ensure patient flow through ensuring sufficient staff and decisions are available for UHL seven days a week. I am sure many of these improvements and those identified within the HIQA report will make a real impact on the delivery of healthcare services in the mid-west.
Sentiment score: 0.33
I thank both Deputies for raising this important matter around concerns relating to the delivery of maternity services at Portiuncula University Hospital. I am taking this on behalf of the Minister, Deputy Carroll MacNeill, who is unavoidably absent today. The safety and quality of our maternity services are of critical importance to the women and families who use them, as well as to the Government. I understand recent developments at Portiuncula may undoubtedly cause concern and worry for many women and families who attend or plan to attend services at the Portiuncula maternity unit. However, steps are being taken to support the unit and to ensure the safety of women attending maternity services across the region. There are 12 external reviews related to maternity care at Portiuncula, which are at various stages of progress. Seven of these reviews have now been completed. The individual review reports were shared with the relevant families in July 2025. The HSE has engaged individually with each family to discuss the findings of these reviews, address their questions and outline the next steps. The Minister for Health has previously met some of the families concerned and has asked Portiuncula to provide the families affected with whatever support they need. The HSE has set up an information line for women booked with the maternity unit to contact if they have any further queries. The HSE has advised that work to implement the recommendations arising from the reviews is in progress through the work of the Portiuncula external management team and the regional women’s and children’s managed clinical and academic network. An implementation team has been established to ensure the implementation of the recommendations arising from all reviews and to progress any further changes required over the coming months. There are currently 52 recommendations being implemented, arising from the seven reviews completed to date. This implementation team will also oversee the transfer of care for an expanded group of women with higher risk pregnancies from Portiuncula to University Hospital Galway or the hospital of their choice. This is in line with well-established pathways already in place for the transfer of care of complex or higher risk pregnancies within the regional maternity network. This approach has now been broadened to include women with a wide range of clinical factors known to contribute to higher-risk pregnancies. The HSE has communicated this to the women and families booked at Portiuncula, as well as their GPs. The HSE has advised the Department that ongoing engagement is happening with GPs with a briefing session being held this week. The reconfiguration of maternity services in Portiuncula University Hospital to move higher risk pregnancies off the site will mean some women in rural communities who previously attended Portiuncula will now need to travel to University Hospital Galway or other units for certain aspects of their maternity care. It is acknowledged these changes may create additional travel demands for expectant mothers and their families. HSE west and north-west, through the work of the implementation team, will consider what contingencies and supports can reasonably be put in place to assist women affected. A highly experienced external management team was put in place in January 2025 to oversee and manage maternity services at Portiuncula. This work will continue to progress over the coming months, with close monitoring and engagement within both the HSE and the Department of Health. This will include ensuring that sufficient capacity and resources are in place across the HSE west and north-west region.
Sentiment score: 0.30
Again, I thank the Deputies for raising this important matter. I am sure they will understand that the Government and the Minister for Health are very much committed to ensuring that all women and families receive the highest standard of care, both at Portiuncula and across all maternity services nationally. The Minister and her Department officials will continue to work closely with the HSE, the clinical leads and families to ensure that the necessary improvements are delivered and sustained. Pregnancy in Ireland is predominantly a safe experience with good outcomes. Ireland compares well with other similar countries on international standards. However, considering that the future direction of maternity services and their development will require extensive evidence-based assessment, of which the review of the implementation here is an important provision, I will relay the concerns the Deputies have raised back to the Minister. Through ongoing communication and a management plan, which is currently in place for Portiuncula University Hospital by the HSE, the Department of Health will continue to engage regarding all patient safety incidents to ensure they are being managed in line with the HSE incident management framework but also that the work being delivered through the programme for Government commitment in developing an extensive national maternity strategy is developed and that the new strategy will include wider policy issues arising from the Portiuncula review and its recommendations.
Sentiment score: 0.56
I thank Deputy Farrelly for raising this important matter. I take his point. I was a backbencher too so I understand the frustration when you put in a Topical Issue and the relevant Minister or Minister of State is not present. I will relay that back to the Chief Whip. The Government is very much committed to supporting children with additional needs to reach their full potential, and the programme for Government makes a number of commitments to deliver on this objective. On the ground, an important way to support children with additional needs in our schools is the provision of SNAs. They play a central role in the successful inclusion of students with additional and significant care needs in our schools. SNAs help to ensure that students can access an education and enable them to achieve their best outcomes and reach their full potential. As the Deputy is aware, the NCSE has full responsibility for co-ordinating and advising on the education provision for children with additional needs. The number of SNAs available for allocation has continued to increase annually, resulting in a significant increase in the number of SNAs employed by schools. Budget 2025 provided for 1,600 SNAs, the largest number ever allocated. This means that, by the end of the year, there will be over 23,000 SNAs working in our education system committed to supporting and nurturing children with additional needs. The NCSE manages the allocation of the SNAs to schools and it is the responsibility of the NCSE to ensure that these resources are allocated to the children with the greatest level of need. The NCSE advised each school in June of its allocation for the 2025-26 school year. Each year, schools are advised of their SNA supports, which indicates that the NCSE will undertake reviews to ensure that SNAs are allocated to the children with the greatest level of need. Such reviews can see an increased or reduced level of support or no change in allocation. This has always been part of the work of the NCSE and is necessary to ensure that resources are allocated in line with the level of need. The NCSE has advised that Scoil Mochua applied for an SNA allocation review during the last school year. A review of the care needs was completed and the school was advised that there was no change to its current allocation. The school has reapplied to the NCSE for an SNA allocation review and this is progressing. The Minister cannot prejudge the outcome of this review. The NCSE has confirmed to the Department of Education and Youth that it will advise the school of the outcome of the review as a priority. Where additional SNA resources are necessary to support the needs of students in the school, they will be provided, as has been done in previous years.
Sentiment score: 0.33
I thank the Deputy for articulating the case for Scoil Mochua and the challenges it faces. It is no different than any other constituency. Indeed, I have faced many challenges regarding families and children deserving and demanding access to resources. There is a challenging environment. I acknowledge the particular circumstances the Deputy mentioned. When one engages with the NCSE, it is responsive. It is being considered as part of the review process. On Tailte Éireann, I will work with the Deputy on how we can engage with the Minister of State for local government and planning - Tailte Éireann falls under that remit in the Department of Housing, Local Government and Heritage - to see what solution can be provided regarding that opportunity for the school and for many families with children with additional needs. On the Department of education's commitment, the Minister and Minister of State are focused on trying to build capacity in the special education sector. That involves working with the NCSE and SENOs on the ground to allocate resources as best we can. On the ratio of three SNAs to 700 pupils, as part of the overall allocation and review, school management has its part to play in engaging with the SENO and the NCSE.
Sentiment score: 0.31