I first congratulate Deputy O'Reilly on her appointment as Chair of the petitions committee. I served on that committee for eight years and I wish her well because it is an extraordinarily important committee of the Houses. I hear the Deputy's concerns and I thank her for raising the matter. As the former chair of the health committee, I understand fully the Deputy's articulation of the issues surrounding the provision of primary care and healthcare. The Minister for Health has asked me to convey to the Deputy her apologies for not being here, to thank the Deputy for raising these matters and for the opportunity to update the Dáil on the provision of primary care services in Fingal West and, in particular, Balbriggan Primary Care Centre. I have taken note of the comments the Deputy has made and I will bring them back. The area of Fingal west is located in the integrated health area of Dublin north county and delivers a wide variety of integrated community and primary care services to meet the health needs of the local population. The health and social care services currently available in Balbriggan Primary Care Centre, PCC, include primary care therapy services and community specialist teams for older people, alongside a chronic disease hub. Disability services located in Balbriggan PCC also include the children’s disability network team. There are two community mental health teams in the primary care centre which accommodates the second highest attended CAMHS clinic in 2024. In addition, several social inclusion services operate from Balbriggan PCC, including a social inclusion liaison officer, a Roma clinic and the north Fingal community development project. A central objective of the programme for Government is to deliver increased levels of integrated health and social care with service delivery re-oriented towards general practice, primary care and community-based services to enable a “home first” approach. It is acknowledged – as the Deputy has rightly said - that the Balbriggan area has grown significantly in recent years, with the population increasing by 12% between 2016 and 2022. Among towns with more than 10,000 people, Balbriggan is the youngest town in Ireland with a diverse population. The Minister is committed to building capacity in primary care, as outlined in the programme for Government, by recruiting additional staff numbers, promoting advanced practice roles in the community for health and social care professionals and increasing the number of college training places for health and social care professions. The Minister for Health acknowledges there are challenges, particularly with local vacancies articulated by the Deputy in her comments here this afternoon, which are impacting the waiting times for access to services. The establishment of the HSE’s six health regions means services can plan and deliver around the specific needs of people in each area. Each of the health regions has its own budget, leadership team and responsibility for local decision-making and continuing to work towards the Sláintecare objectives. Each of the six health regions and each national service has been provided with a specified number of whole-time equivalents in terms of staffing and can replace, recruit and prioritise staff within that approved number. This has provided the health regions with further control to focus resources where there is the greatest need and greater capacity for decision-making at a local level regarding prioritisation and filling of available posts. As I said, I will take Deputy O’Reilly’s points back. I know some of the points she raised have not been addressed in the reply I have given and I accept that. I am here on behalf of the Minister, as the Deputy will understand but I will take the points she has made back to the Minister regarding idle spaces and the lack of delivery. She is right; there is a need to urgently expedite the whole issue of primary care in many of our emerging towns and the area she has mentioned is one.
Sentiment score: 0.35
I understand the Deputy's frustration. Primary care and the utilisation of the centre are perhaps matters that the HSE is best placed to tackle. Equally, the local regional health forum is a forum where the Deputy and other public representatives can put pressure on the HSE. However, I take the Deputy's point. Again, on behalf of the Minister, I wish to reassure the Deputy and I thank her for raising this important issue. The Government is as committed as the Minister is to the development of primary care and community healthcare services, as committed to in the programme for Government. To expand and develop community care services, recurring annual funding of €195 million has been provided to the enhanced community care, ECC, programme. This suite of strategic reform initiatives seeks to reduce dependency on the hospital system by delivering increased levels of healthcare provision in the community setting, with service delivery reorientated towards healthcare general practice, primary care and community based services, which is what the Deputy has articulated and is what we are committed to. Since its launch in 2020, the ECC programme has significantly expanded, with more than 2,800 additional healthcare staff recruited and the successful establishment of 96 community health team networks and 53 of the planned 60 community specialist teams for older people and chronic disease. Aligned to the ECC programme, GP access to community diagnostics provides a direct referral pathway to GPs for patients to access community-based radiology scans, including X-rays, DXA, MRI and CT scans and chronic disease tests. This service has received significant funding of almost €47 million for its continuation this year, and will provide 240,000 community radiology scans and up to 161,000 chronic disease tests within the year. The Government fully recognises the frustration in the local area, as articulated by the Deputy, in regard to waiting times and lack of availability of services. It also recognises that much work needs to be done to fill vacancies at local level and address waiting lists. To this end, a joint Department of Health and HSE programmatic approach to primary care waiting lists is under way to develop both short-term and long-term solutions to the long waiting lists for primary care services in order to ensure consistent, equitable and timely access to primary care services.
Sentiment score: 0.30
I join the Cathaoirleach Gníomhach in welcoming the Deputy's kids, Aisling, Erin and Caolán, to the House. I thank the Deputy for raising the important matter of Beaumont hospital and in congratulating and thanking the staff of Beaumont hospital on International Workers' Day for the work they do. I do not have the answers to some of the questions raised. However, if the Deputy supplies the details, I will pass them onto the Department and get an answer for him. I welcome the opportunity, on behalf of the Minister, to recognise that waiting times for many scheduled appointments and procedures are too long, not only in Beaumont hospital but in hospitals throughout the country, and that many patients are waiting an unacceptably long time for care. The Government is focused on having a public healthcare service in which everyone has timely access to high-quality, scheduled care where and when they need it. The Department of Health continues to work with the HSE and the National Treatment Purchase Fund, NTPF, to identify ways to improve access to care. On 12 February this year, the Minister for Health published the waiting list action plan for 2025, representing the Government’s commitment to reducing waiting times for patients and improving access to hospital care. In keeping with this commitment, significant funding of €420 million was allocated to the waiting list action plan for 2025, with €190 million for the HSE and €230 million for the NTPF. With the 2025 plan, we will continue to build on the progress delivered to date under the multi-annual action plan approach. The most recent waiting list figures, published by the NTPF for March, show an increase in waiting list volumes in the year to date. The delivery of elective care in the early months of the year is always impacted by the winter surge in demand for unscheduled care and because of elevated levels of respiratory illness circulating. However, we are starting to see signs of stabilisation in April and expect to see the volume growth mitigated over the coming weeks. The national trends are reflected in the figures specific to Beaumont hospital. At 40,556, the number of patients waiting for an outpatient appointment has increased by 5% since December 2024. In the same period, the number of patients waiting for an inpatient or day-case procedure has increased by 10% to 9,455 and the number waiting for a GI scope has increased by 30% to 1,583. However, as the Minister has consistently said, what is much more important than the numbers waiting, is the length of time these people are waiting for treatment. There is a more positive position here, with 91% of outpatients, 82% of inpatients and 99% of those awaiting a GI scope waiting 12 months or less. The Government is committed to the ongoing development of acute hospital infrastructure, and since 2020 significant resources have been invested in Beaumont to meet the need of patients. The hospital budget for 2024 was €504 million, a 29% increase in just four years. Staffing at the hospital has grown by 13% since January 2020. This includes 257 more nurses and midwives, 75 more medical and dental staff, and 37 more health and social care professionals. Under its hospital bed expansion plan a total of 289 new and replacement beds will be delivered by 2031. Ireland’s acute hospitals are treating more patients than ever before. The latest activity report published by the HSE outlined that there were approximately 3.9 million outpatients and 1.9 million inpatient or day case procedure, IPDC, attendances during the full year of 2024. In comparison with the levels of activity delivered in 2023, these figures represent increases of 9% for outpatient departments, OPDs, and 5% for IPDC activity. In Beaumont, outpatients attendances increased by close to 12% and IPDC by almost 3% between 2023 and 2024. In addition to this planned care, our hospitals also treated approximately 1.8 million patients during this same period in emergency care, which represents a 9% increase on the full year 2023 and reflects the continuing demands on our hospitals. With increased investment across the public hospital system and through the 2025 waiting list action plan, the Department of Health, the HSE and the NTPF are taking the next steps in progressing the multi-annual approach towards achieving this Government’s vision of a public healthcare service where everyone has timely and transparent access to high-quality scheduled care services, where and when they need them. I note the Deputy's remarks about Margaret and the BreastCheck waiting lists. If the Deputy has the details and wishes me to bring them back to the Department, I will do so.
Sentiment score: 0.37
I thank Deputy Hearne. It is about dignity, which I fully accept. As a former Chair of the health committee and as a TD, I am very much aware of this. People are waiting for too long for procedures and outpatients appointments, not just in Beaumont Hospital but across our hospital network. The Government is committed to addressing these issues. It is a priority of the Government and of the Minister for Health. The importance attached to reducing waiting lists is demonstrated by the level of investment over the last number of years through the multi-annual waiting list action plan, including €420 million this year. As I said, this investment, together with additional significant investment across our health budget, means our acute hospitals are delivering higher levels of activity than ever before. As I outlined to the Deputy, the budget and staffing at Beaumont Hospital have increased significantly during a five-year period. However, despite the increased level of activity, we are seeing a growing and an ageing population, which is leading to an increased demand and unprecedented levels of additions to our waiting times and waiting lists. As the Deputy said and as we all know, this has resulted in the number on our outpatient waiting lists and on a significant number of other lists growing which means they are higher than we would wish. We must focus on waiting times rather than the overall volumes on the lists. A growing population and increased and expanded services will always drive appropriate referrals for consultations and procedures. Focusing on waiting times is the proper metric and here the system is showing progress and outcomes are improving. By continuing to build capacity in our public health system, employing more staff and continuing to make targeted interventions through the waiting list action plan, we will continue to make progress in our ultimate aim of achieving the Sláintecare waiting time target of ten weeks for an outpatient appointment and 12 weeks for an inpatient day case procedure. I join with the Deputy in thanking the staff for the work they are doing. We are increasing investment and will ensure our health system is of a high quality, scheduled around the care of the patient. That is the most important thing we should be doing.
Sentiment score: 0.30
I congratulate Deputy Cahill on his appointment. He is a very fine ambassador for the tourism sector not just in Kerry but across the country. I wish him well on that. I heard him raise it this morning with the Tánaiste during Questions on Policy or Legislation. First, to briefly put context on it, the Office of Public Works conserves and manages Ireland’s national heritage estate, which comprises 780 national monuments and 32 national historic properties, with over 5,000 acres of designed landscapes and parks. This estate includes two UNESCO world heritage sites, namely, Sceilg Mhichíl in County Kerry and the Brú na Bóinne complex comprising Newgrange, Knowth and Dowth in County Meath. In 2024, over 16 million people attended and visited OPW-managed heritage sites to explore and enjoy Ireland’s iconic heritage sites such as Clonmacnoise, the Rock of Cashel, Dublin Castle, Kilmainham Gaol, the National Botanic Gardens of Ireland and Kilkenny Castle. As Members will be aware, Sceilg Mhichíl is situated 16 km off the coast of Kerry. It was founded by St. Fionán around the sixth century and is the home of an early monastic site. The monastery came into State care in 1880. The OPW manages the island and conserves the built heritage of the island, including the monastic site. The OPW has been managing visitor access to the island for decades and has a detailed management plan and operating procedures relating to visitors. Due to severe sea conditions, the island cannot be accessed during the winter. The visitor season, as Deputy Cahill has alluded to, generally begins around mid-May and runs to late September each year and the OPW staff are present on the island at all times during this period. Access to the island is highly dependent on weather and sea conditions and there are days in every season when visitors cannot land due to unsuitable weather or maritime conditions. The OPW, together with the Department of Housing, Local Government and Heritage, published a ten-year Sceilg Mhichíl management plan for 2020 to 2030 which sets out the State’s approach to managing and conserving the built and natural heritage of the island and ensures sustainable access for visitors to enjoy the outstanding universal value of this unique world heritage property. There are over 90 actions in the plan and it is in this context visitor access and numbers to the island are strictly managed. Access to the island is regulated by limiting the number of boatmen who are permitted to land passengers at the island during the visitor season. The established number allowed is 15 boats. A boat permit system was originally introduced to improve health and safety on the journey to and during visitation to the island after the deaths of two visitors to Sceilg Mhichíl in 2009. The OPW’s approach is to sustainably manage visitor activity to the island in line with the agreed UNESCO policy and visitor management plan. I can advise Deputy Cahill that the OPW does not make any profit from the operation of the boat permit system. The OPW does not receive any income from this and does not charge visitors to visit the island, nor does the OPW get involved in the setting of prices for the boat trip to the island as it is considered the prerogative of permit holders to set their own prices. I would like to think that the OPW enjoys a strong working relationship with the boat permit holders, as well as recognising and sharing the same goal - to showcase the island at its best while at the same time making sure that we are protecting its special qualities for the next generation. The season is due to commence on 10 May and it will run until 29 September. Last year, 15,800 people visited the island, with numbers limited to 180 per day in order to sustainably manage and conserve the delicate archaeological remains as well as the diverse flora and fauna of the island. Regarding this current competition, under European procurement rules the compliant procurement process for this competition was an open competition via eTenders. It is awarded for a five-year period, to be renewed on a yearly basis but subject to adherence to terms and conditions. The volume of applications exceeded the number of permits available and I can only acknowledge the disappointment felt by some at the outcome of the competition. As publicly reported, the results of the permits competition are now the subject of legal proceedings. As such, I cannot comment further on the current competition to award boat permits but I do understand the Deputy's concerns.
Sentiment score: 0.15
I again emphasise that I hear Deputy Cahill. Sceilg Mhichíl is a site of extraordinary significance and the OPW is seeking to carefully manage the built and natural heritage of the site for the enjoyment of current and future generations. The OPW recognises the significance of the Skelligs with regard to tourism and the economic activity of Kerry, as articulated by Deputy Cahill, and in particular the Ballinskelligs region. The OPW has worked collaboratively with local stakeholders for many years to ensure this site of outstanding universal value is protected in line with the best practice of UNESCO world heritage standards and works, but that it is also accessible and can be enjoyed by a range of visitors who deliver a significant economic value to the region each summer. The OPW is committed to working with all locally to ensure this will continue to be the case. It must be acknowledged that, for now, the OPW cannot comment further on the award of permits for the season given that the competition process to award such permits is subject to judicial proceedings.
Sentiment score: 0.57
I am taking this matter on behalf of the Minister for Health. I congratulate Deputy Ward on his appointment as Chair of the European affairs committee and wish him well in the role. He has raised a very important matter regarding women's health and the healthcare provided to them. The urogynaecological transvaginal mesh is used in the surgical treatment of stress urinary incontinence and pelvic organ prolapse in women. Such mesh devices have been widely used to treat those conditions over the past two decades. For many women suffering the distressing symptoms of stress urinary incontinence and pelvic organ prolapse, surgical procedures using synthetic mesh devices have provided a more effective and less invasive form of treatment than traditional surgical procedures. However, as the Deputy noted, concerns about the safety of mesh devices have arisen in many countries because of the frequency and severity of complications associated with their use. In November 2017, in response to public and patient concern about the ongoing safety of mesh devices, the then Minister for Health, Deputy Harris, requested the Chief Medical Officer to prepare a report for him on the clinical and technical issues involved in ensuring both the safe and effective provision of mesh procedures in urogynaecology and an appropriate response to women who suffer mesh complications. In July 2018, the CMO asked the HSE to pause all mesh procedures where clinically safe to do so, pending confirmation of the implementation of specific recommendations in the CMO's report. In November 2018, the CMO's report on the use of urogynaecological mesh in surgical procedures was published. It contains a number of recommendations regarding the safe and effective provision of mesh procedures in urogynaecology and an appropriate response to women who suffer complications as a result of undergoing such procedures. The CMO's report included 19 recommendations across four key areas, namely, patient information and consent, aftercare for women suffering complications, clinical and professional recommendations, and information systems. In 2018, the HSE commissioned a review of the CMO's recommendations. In 2019, it began work on the recommendations, providing regular progress updates. The Covid-19 pandemic subsequently delayed that work. Implementation of the report's recommendations will provide significant assurance that all patients presenting for treatment for stress urinary incontinence and pelvic organ prolapse, and all women who develop mesh-related complications, receive high-quality, patient-centred care in accordance with accepted evidence and supported by robust clinical governance mechanisms. In 2023, the HSE established a national vaginal mesh implant oversight group to oversee vaginal mesh implants in HSE acute hospitals in terms of both primary implant surgery and tertiary complications services. The focus of the group was to review and assess implementation of the recommendations as set out in the CMO's report and assess the appropriateness of resuming urogynaecological mesh procedures, cognisant of international developments and approaches in this complex area. I have noted the Deputy's comments regarding services in other jurisdictions. The Department recently received a report from the HSE's national vaginal mesh implant oversight group. Officials are actively liaising with the HSE on all aspects of this work to ensure comprehensive implementation of the CMO's recommendations. I again thank the Deputy for raising this very important matter. I will convey the points he raised to the Minister for Health.
Sentiment score: 0.20