Jennifer Carroll MacNeill
Dún Laoghaire · Fine Gael · Ireland
“It will be provided by a registered pharmacist in accordance with the relevant pharmacy legislation, including this Bill. Section 2 of the Bill makes various amendments to the Irish Medicines Board Act and the Pharmacy Act. Those amendments ensure that whole legislative framework is cross-referenced correctly.”
“We now have a common conditions service where you can go to a pharmacy instead of a GP to get a diagnosis and prescription for eight basic conditions like conjunctivitis or urinary tract infections - the kind of things that just come up in people's lives all the time. We would like to expand more and more what pharmacies can do.”
“In particular, the board will be focusing on aspects of menstrual health, on aspects of postpartum mental health, particularly in traumatic birth cases, on something we have overlooked for some time, which is endometriosis, on women who are finding it difficult to access services in different ways, as Senator Harmon suggested, and on more…”
“The extension to 41- to 45-year-olds could possibly be €5 million to €8 million because there are statistically fewer women in that bracket trying to conceive, so the numbers are higher. It really is a question of funding. I remind Senators that they have also asked me to fund various other programmes.”
“That followed confirmation from the Pharmaceutical Society of Ireland and the Health Products Regulatory Authority that the patch and ring are classified as medicinal products, not medical devices. That is just a correction there.”
“That is why we have put so much money into supporting them in different ways, including the conclusion of a €50 million increase to their fees and to provide for the opportunity to raise private funds in this way, for example, the common conditions service. I want to see pharmacists doing more.”
The complete record
Every one of 1,593 lines we hold for Jennifer Carroll MacNeill, in date order, each linked to its source. Free to read, in full, without an account. Page 16 of 32.
“Part of what we are trying to do is upskill what we are doing here and the complexity of surgeries. We are recruiting additional colorectal surgeons in Tallaght and Cork to try to enable more complex surgeries. We need to improve our understanding of the diagnostics and imaging. Endometriosis is very difficult to see sometimes. Different types can be very difficult to see. We need to do a lot better on that and upskill more broadly our capacity to do complex surgeries. In the meantime, I want to try to provide women with upfront support to those who need to travel abroad.”
“For the most complex and severe cases of endometriosis, it was not the case that we were meeting that need. We were not recognising it either in our public awareness of the impact on a person's life in terms of sport, attendance at work, opportunity to look for promotion and to participate in life in a normal way and how that impacts women and girls and can do so for a very long period of their lives. It is also not recognised that many women got surgeries that were successful here but at the more complex end were travelling abroad, paying considerable sums. In many respects they got all or much of that back through the cross-border directive or the treatment abroad scheme but after the fact. It is not satisfactory to me that women should have had to do that and that the surgeries were not available to them here.”
“I thank the Deputy for giving me the opportunity to raise this matter again. It is fantastic to see the amplification and awareness of endometriosis in Ireland. That is part of what the framework is trying to do. We launched the framework on 18 October. I will set out the timeline again. This was in gestation for some period but it was becoming very clear that we were not meeting the needs or responding or perhaps hearing the acuity of what women were describing in terms of their pain, suffering and the impact on their lives. I also have to recognise the very many women in Ireland - I have met and discussed it with them - who received treatment that was absolutely satisfactory for them but perhaps they are at a different level of acuity.”
“When I have that complete list, I will sit with the Minister for rural affairs, Deputy Calleary, and in particular the Minister of State, Deputy Buttimer, who sits both in the Department of rural affairs and the Department of Transport. There is something we have not yet imagined in terms of rural support services and transport services. It is not the responsibility of the HSE. It should not really be. We cannot do high-quality cancer care and transport. That is not the role but there is something better, more imaginative and more co-ordinated that can be done. I am grateful for the opportunity to discuss it today.”
“I recognise the work done by volunteer groups like Arklow Cancer Support and the support they give to cancer patients travelling for blood tests, infusion services and so on. The HSE is not a land development or transport company. I recognise there are many different groups providing an enormous service to cancer patients, some with some measure of State support and others not. While the HSE will never be a transport company, I have met Volunteer Ireland to ask it to compile a list of all the different volunteer groups who provide transport services for health patients, cancer patients or in the disability space - many overlap and intercept.”
“The south-east region is served also by 50 active community first responder groups, which play an enormous role. Further aeromedical support is provided to the region by the NAS helicopter emergency service and the Irish Coast Guard. These are the different ways in which we are trying to provide support and divert lower-acuity patients.”
“We continue to invest at pace. There are an additional 500 NAS staff since 2020, with the total going from approximately 2,000 to 2,500, which is a very considerable increase of 26%. That increase is needed to ensure the distribution of staff and the different ways in which they can try to keep people close to home, particularly older people whom we do not want having to present at acute hospitals. The south-east region currently has 14 ambulance bases, with 277 whole-time equivalent staff, including paramedics, advanced paramedics and advanced emergency medical technicians. We have new development funding in 2025 for two additional 24-7 ambulances. There is the new rapid response vehicle operating from Newcastle, County Wicklow.”
“Additionally, it is served by the NAS national clinical hub, which offers alternative pathway options for low-acuity patients. The Deputy will be aware of ongoing NAS capital projects in the region, including new ambulance bases for New Ross and Gorey, which are scheduled to proceed to detailed design phase shortly. In addition, a new ambulance base regional training facility and business support hub project is planned for Carlow town and is proceeding towards detailed design phase.”
“The Government remains committed to investing in and developing the National Ambulance Service, NAS, including in the south east. The allocation in 2025 includes an additional €28 million of new service development funding for up to 180 additional posts. Those posts will focus on strengthening front-line emergency services, expanding alternative care pathways and developing specialist services, including critical care retrieval. Government investment in NAS has increased by 64% since 2020. The HSE Dublin and South-East region is served by 14 NAS ambulance bases. Two NAS pathfinder teams aimed at older persons operate from Waterford and St. Luke's hospital in Kilkenny. Four NAS community paramedics also operate in the region. The south-east region has benefitted from two additional 24-7 emergency ambulances based in Tipperary and Arklow.”
“I thank the Deputy for raising this case. He is right that this drug is reimbursed for post-menopausal women with osteoporosis. I would like an opportunity to check this but, as I understand it, the European Medicines Agency, EMA, originally assessed the drug for use in both women and men. However, the company withdrew the male indication during the process following concern over the benefit-risk profile. It has been added to the HSE reimbursement list for post-menopausal women at high risk of fracture but it is not licensed for use in men for that reason. As prescribing it for men would be off label, the HSE does not extend reimbursement to male patients. There is no licence to use it to treat osteoporosis in men. The company marketing the medicine withdrew the licence application for that use.”
“There will be a major conference in January, which will be driven by the Royal College of Physicians and the college of obstetrics regarding endometriosis and the skills available here. One surgeon, who will remain nameless, offered to travel with her patient to a clinic in the UK to shadow the surgery and better inform herself in order to learn how to provide a better service to her patients. It is that sort of leaning in that I have seen from consultants in recent months who want to provide a service to women, many of whom have advocated for this and want to do more and better for their patients. I was heartened to hear that story from a patient about her surgeon.”
“There are not 35,000 people with endometriosis on outpatient gynaecology lists. Approximately 700 are waiting for endometriosis surgeries. An additional colorectal post has been prioritised and advertised for recruitment in Cork University Hospital. The time it will take will depend on the interest generated but I very much hope it will be done as soon as possible. The Deputy is correct. I do not necessarily want women to be travelling abroad. I would much rather they get surgery here but it is not an either-or situation. I want them to be able to get the right surgery as soon as possible. As we scale up, we must also facilitate women to be able to get the surgery they need.”
“The Chief Medical Officer, the CEO of the HSE and the chief nursing officer listened to the voices of 60 or 70 women with very complex and painful endometriosis. On 5 September, I put in place a new action plan, drawn up based on the needs of the women at that forum. From 1 October, we had a new plan for additional surgeries in Ireland to be carried out over three months. On 18 October, I launched a framework and plan to support women who are not able to get the scale of intervention they need here, so that they can get that help internationally while we collectively scale up our complexity on imaging and surgeries in Ireland.”
“Not all of the surgeries take place in Cork and Tallaght but the most complex ones do. I have expanded a scheme to treat women who require complex surgery abroad. It was the case that they would go abroad and get the funding back via the cross-border directive. We very quickly put in place a scheme whereby people could get funding upfront for such surgery in many clinics in the UK and Europe. I have actively asked clinicians in the HSE to visit two clinics in Athens and Bucharest that women report to me as being very good but which did not meet the criteria in the first instance. We are trying to expand services. On 1 September this year, I held a patient voice forum in the Department of Health.”
“The HSE’s budget will help to enable expansion and improve all of our services, including endometriosis. We have to increase awareness. I have written directly to all GPs to try to drive awareness where it is not already there and try to drive a better opportunity for women to have referral pathways much more quickly and a presumptive diagnosis, recognising that women are, of course, the most reliable narrators of their own experience and pain.”
“In recent weeks, I approved a plan to expedite access to care for women with endometriosis. The HSE will, as a consequence, carry out more than 100 additional surgeries by the end of this year. We expected 1,200 but will instead have 1,300 by the end of this year, an important addition. I have provided an additional €0.5 million directly for this purpose. By way of progress update, in October, 34 additional surgeries had been completed against a target of 33. The majority of these were excision surgeries. Complex and severe cases were prioritised. An additional colorectal surgeon is also being actively recruited to try to facilitate more complex surgical treatments. On 18 October, I launched the national framework for the management of endometriosis. It is a necessary expansion of services.”
“I thank Deputy Timmins. I think it may be closer to one in seven - possibly one in six - women who are affected by endometriosis, rather than one in ten. We are learning more about it together. Our specialist endometriosis services are monitored by the HSE's national women and infants health programme. At the end of September 2025, 719 specialist endometriosis surgeries had been carried out. The most complex endometriosis surgeries are performed by multidisciplinary teams. Some 263 of the reported 719 surgeries took place in our complex centres in Tallaght and Cork. Surgeries for less complex endometriosis may also be performed in our acute gynaecology services. I am committed to expanding the scope and standard of our endometriosis services and improving supports for women.”
“Dental hygienists can play a particularly important preventative role and community support role. I am not saying they can provide all of the treatments - of course that is not the case - but I do not think we have come to the end of workforce planning in this respect. I know the people of Deputy O'Shea's constituency would welcome the opportunity to see a dental hygienist at a much earlier stage than has been possible to date. I have some work to do to try to support that.”
“I commit to trying to expand access to oral health and preventative oral health in every way. We need to look at the role of dental hygienists within the dental profession. In every other aspect of workforce planning in healthcare, we recognise that we do not have enough healthcare workers to meet our need. As I mentioned earlier, we are trying to have pharmacists work at the top of their expertise in their profession in order that they can diagnose basic common conditions. We now have an agreement with them that they will do that, but they should be working at the top of their expertise. We will try to have pharmacist technicians there to support them. In the same way, there is a much bigger opportunity for dental hygienists. We have advanced nurse practitioners and clinical nurse specialists. We have all of these advances in practice.”
“The fees to contractors went up from €49 million to €69 million in the same two-year period. It is a very considerable expansion. Indeed, activity in north Cork has increased this year with an additional 286 treatments provided. I recognise it is not enough, but it is a very considerable expansion within a two-year period.”
“In fact, there are 836 contractors on the scheme as of September 2025, although that is a reduction because there was a major data clear-out. There were 1,490 in 2019, when the number was reducing, and there are now 836. A number of inactive dentists were taken off the list in 2022. I can confirm that the fees paid to private dentists to engage in this scheme have increased by 40% to 60%, depending on the nature of the treatment. It is a matter of some astonishment and some disappointment to me that more of them do not wish to engage in it. Notwithstanding that, an additional 256,000 patients have been treated since 2022. As a result of the expansion of the dental facilities in Cork North-West, for example, an additional 44,208 patients were treated in 2024 compared to 2022. I will give this data to Deputy O'Shea directly.”
“There is a three-year implementation plan for the first phase of acceleration of reforms. When I was in Cork last week, I had the good opportunity to attend the annual conference of the Irish Dental Hygienists Association, the members of which perform enormously good preventative work, cleaning work and identifying work. I commend their work to date. Hygienists can play an important role as part of the Government's priority to improve access to preventative oral healthcare, especially for currently underserved populations including people with disabilities, people in residential homes and children in certain areas. There is a body of work there that is not yet completed but is very possible.”
“Those measures should improve access to care as indicated by patient and treatment numbers which, to be fair, have increased since 2022. The Department and the HSE are committed to the reform of services for medical card holders, particularly in the context of the design and development of packages for expanded preventative care. That will require a multi-annual programme of work which is currently being scoped by the Department. We are also trying to improve patient access to oral healthcare in a number of different ways through the implementation of the national oral health policy, which is a complete transformation of oral healthcare services and an expansion to children and adults. I am very focused on the deficits that are there today, particularly for children.”
“I thank Deputy O'Shea. As he is aware, over €230 million is invested in public oral healthcare services annually. The dental treatment service scheme, DTSS, provides oral healthcare free of charge to medical card holders aged 16 and over. Services are provided by private dentists and clinical dental technicians who hold a contract with the HSE. In the north Cork HSE area, there are currently 33 active DTSS contractors, which is up slightly from the 31 who were active in the same period in 2024, although it is not enough. A package of measures was introduced in 2022 to expand the care available under the DTSS and to significantly increase the fees paid to contractors by approximately 40%, which is a very significant increase.”
“I am so glad to see so many pharmacies sign up to this fantastic opportunity to diagnose common conditions and provide prescriptions to people right around the country from early next year. It also enables pharmacies to identify people within their cohort of patients or customers who should be screening for bowel cancer, register them for the system and give them the kits over the counter that may be used at home and sent back. These are life-changing interventions that can happen in people's homes. I ask anyone who is watching to engage in cervical or bowel screening or any of our screening programmes.”
“I am not in a position to say that because I do not know what the recommendation will be. Thankfully this is a country driven by science and scientific evidence. This is a matter of real concern to me. The Deputy referenced advances in cervical screening. While I have the opportunity, I want to reference that it is expanding and that there are home testing kits, which is a huge advancement for women who do not necessarily feel comfortable presenting for screening or who just want to avail of their sheer convenience. This will help us to make sure those screenings get done. In the same way, we have now extended bowel cancer screening through the community pharmacy agreement.”
“As the Deputy has said, in those cases diagnosis often happens at a considerably more advanced stage, which is obviously exceptionally problematic. How do we best capture that group? How do we screen in that group? Under Europe's Beating Cancer plan, in 2022 the recommendation was for further expansion of cervical, breast and bowel cancer screening, and feasibility studies on gastric, prostate and lung cancers. We have to get that balance right around effectiveness. I am so glad to have the opportunity to discuss it in the Dáil today with the Deputy.”
“I am not in a position to give that date at the moment but I will try to come back to the Deputy as soon as I can. Very few countries have introduced lung cancer screening because of the uncertainty around its effectiveness. That does not mean we should not explore it. As the Deputy has done, I want to commend the pilot programme that has been introduced, instituting a community-based lung health check programme by inviting individuals from north Dublin and the north-east region identified as being at high risk of lung problems to attend for mobile screening, for breath tests and for low-dose CT scans. I have met a number of people who were not high risk who have developed lung cancer. They run marathons and do not smoke, and yet they have lung cancer.”
“There are difficulties with risk stratification and high levels of incidental findings that are not necessarily lung cancer that cause their own problems as well. As I am learning, there is a particular complexity to lung cancer screening that was not apparent to me on the first go. Nevertheless, we are continuing to try to assess what may be done through established evidence-driven protocols, as always. I very clearly hear the Deputy and agree with her that there is a particular need to look at this more closely.”
“I met her again last week to unveil Ireland's first White Ribbon for Lung Cancer campaign. I know the Deputy was involved in that and did the breathlessness piece. Lung cancer is a very serious condition, particularly for those who are not identified as being at high risk. For example, a number of non-smokers are getting lung cancer and they would not necessarily see themselves as being high risk. They deserve to have the opportunity to have themselves tested. I particularly favour the mobile unit but I recognise that we have a screening programme and screening advisory programme that have worked well for us. This is under broader consideration. We need to do a complex set of calculations to get a careful balance to deliver population benefit. I am told lung cancer is particularly challenging due to the very significant budget impact.”
“I am committed to supporting Ireland's population screening programmes which are valuable part of our health service. The programme for Government commits to evaluate the current lung cancer screening pilot in line with the WHO criteria and to develop recommendations for a way forward. The pilot, which was led by researchers in Beaumont and the RCSI with support from the EU, the Irish Cancer Society and my Department, is under way. It has issued a call for proposals to advance research in this area focusing on outstanding uncertainties. I have had several meetings with Gillian Ryan who is a leading lung cancer advocate and a leading advocate for a mobile screening service. I have met her in Cork and have hosted her and her daughter here in Leinster House.”
“The Deputy is right to identify the difficulty that would create. I do not have an answer at the moment as to the timeline of the public consultation, but I commit to getting that to the Deputy as soon as I can. The revised timeline for submission of a final report is quarter 1 in 2026 but that is more about the timeline for the broad work, as I understand it. Today or tomorrow, I will have a better answer for the Deputy on his very reasonable question on the public consultation element of it. I will also have clarity for him on the question of people reporting on themselves and making sure there is sufficient independence to be able to analyse what needs to be done, particularly on the regulation of professions.”
“It is wide-ranging work and it is the intention of the group to ensure the final report is comprehensive in the treatment of those matters.”
“The areas being examined by the group include: the existing level and distribution of hearing care provision across Ireland; capacity constraints and opportunities for service enhancement within the HSE; examining the current education structures in place to ensure an adequate number of graduates in public audiology services; workforce planning, with a particular focus on improving recruitment and retention within the public system; the appropriate level and framework for regulation for the audiology profession; improvements to referral pathways in the integration of services between acute and community settings; and mechanisms to strengthen linkages between public and private hearing care aimed at improving patient outcomes and reducing waiting time.”
“The group saw that as an opportunity to ensure that every aspect of the national audiology service was being addressed thoroughly and, as such, the deadline needed to be pushed back. While it is unfortunate that the final recommendations are delayed, as per the terms of reference, the group, I believe, will now be in a position to deliver a much more comprehensive and encompassing plan that factors in all aspects of the audiology space and ensures that patients will receive a greater benefit as a result. In response, the group has adjusted its focus and timelines to ensure that all relevant areas of hearing care are appropriately considered. A structured work stream has been established to support this goal, comprising a number of subgroups focusing on key priorities within the overall scope of the project.”
“The hearing care plan working group was established to develop recommendations for a holistic and sustainable model of hearing care across Ireland. The group initially had a focus on the appropriate linkage of public and private provision to meet increasing demand for services in the short term and to consider the recommendations of the WHO World Report on Hearing in the development of the national hearing care plan. As the group carried out its work, it realised, through its research efforts and deliberations, that the scope of the work needed to create a holistic model of care, as mandated by the published terms of reference, was greater than initially anticipated.”
“I fully respect what the Deputy says about the expansion of diagnostics, the referral pathways, the ease with which people can get the scans more quickly, how we can utilise our existing efficiencies and then, as we build, including with the surgical hubs, how we can consider using those diagnostics in the broader way. We really need more radiologists and radiographers as well. We also need them to be rostered five over seven.”
“I agree with the Deputy. I am also conscious that we have increased the referral pathways for diagnostics, from physios for example. They are all good things, but they increase the number of referrals and, therefore, the waiting time. It is particularly important that the Deputy highlighted a case like that of his mother, who was referred for a scan and really needed it. There is the contrast with an emergency scan in a hospital that might step across her scan. So many people in Ireland are quietly waiting for a scan and are concerned by that. The focus on urgent and emergency care can take from that in some ways, so we have to try to do both.”
“That is entirely dependent on the staff and the way in which it is organised, and the Deputy correctly identified the shortage there. It is important to make sure, as we go hospital by hospital, that everyone is using the deployment of those staff in the most efficient way. I see examples of great improvement on that, and I hope to be able to report more thoroughly to the House after the series of regional meetings in January.”
“I completely agree with the Deputy. Looking at the number of diagnostic scanners and machines in public systems, we have 550 scanners of different forms, including 62 CT scanners, 28 MRI scanners and so on, but it is about the use of them. One of the things we need to consider is how we might use the scanners available in a complementary local injury unit sitting alongside a hospital and how we can maximise the use of all of those diagnostics in different ways. That is another opportunity to expand capacity. I happened to be in County Mayo, and we were talking to staff about how that might be better integrated. In theory, the machines are capable of being used 24 hours per day. That is obviously unrealistic, but you would like to get to the point where they are being used for between12 and 14 hours per day at a minimum.”
“There is particular pressure in relation to radiologists and radiographers but we need to focus on the management of the assets and resources we have at the moment and make sure the culture is one where you should be able to get those scans as quickly as possible, and that is enabled in part by workforce planning.”
“More important than anything else, as all of us here visit our local hospitals and different hospitals in the health system, is that question about the utilisation of diagnostics. It is that heat map of use. I have seen better clarity and analysis throughout this year. It was a source of considerable distress to me, for example, to be in one hospital and see that map going from red to blue at 4.30 p.m. on a Friday, when of course it should be driving hard on Friday evening into Saturday and so on. That is what we all want to see, although I do see more of that happening. I am seeing extended hours in diagnostics. I am seeing real efforts to make sure we are rostering five over seven.”
“Publication of the validated radiology diagnostic waiting list information will enable full analysis of the diagnostic waiting lists and provide a more complete understanding of how many patients are waiting, how long they are waiting and the specific services they are waiting for. This year, the productivity and savings task force published an action plan for 2025 that commits to a range of services being available seven days per week, including diagnostics activity. It will also ensure that all publicly funded diagnostics are captured within the national integrated medical imaging system, NIMIS, by the end of 2025, thereby improving core co-ordination and reducing duplication of tests and procedures. I am informed that St. Vincent's hospital is going on that this weekend. That will have a bit of an impact, but it is important.”
“Waiting times for radiology and diagnostic services have been an issue for some time and the Government committed to the implementation of the Sláintecare report of 2017, which included a maximum wait time target of ten days for a diagnostic test. A key step to achieving that is fully understanding the current position. Implementation of the NTPF’s national radiology diagnostic waiting list management protocol by all hospitals is the step to ensuring that patients are administratively managed in a safe, timely, fair and equitable manner while waiting, as well as facilitating approved data collection and reporting.”
“I recognise the sufferers of long Covid and the change for 159 people who have been receiving full pay and are going onto a different scheme. While there are supports available on that scheme and its duration is also considerable, it is a change and I recognise that. My Department has championed the extension of that scheme, which enabled them to have full pay for as long as they did, on a number of occasions with the Department of public expenditure. As we thought that would end in June, there has been an additional six-month extension. That is in recognition of the work they did, the significance of long Covid and the impact it has on their lives. As the Deputy has stated, it is not feasible to sustain that in perpetuity and there has to be a transition to a different scheme.”
“I am open to correction, but it is not clear to me that any country sustained full pay for workers suffering from long Covid in the way Ireland did with its public health workers through the special scheme. I am open to correction, but that is the information I have. It is important to set out how Ireland tried to treat its care workers in contrast to Europe and for the duration it has.”
“I appreciate what the Deputy is saying. I will make a couple of points in response. The public health sector recognised the risk that staff faced and because of that introduced a scheme that no other sector had. It was appropriate that it did, but it is important to state that so people have a full understanding of what was done. Eligible healthcare workers have had full pay for five years, which is important. The provisions now provide paid supports for a number of years beyond this current period. Recognition of Covid as an occupational illness falls within the Department of Social Protection. The Deputy has alluded to other EU countries. Many EU countries recognised Covid-19 as an occupational illness, but not necessarily long Covid.”
“Under that scheme, staff receive full pay for three months, followed by half pay for three months, and then have the option to apply for temporary rehabilitative remuneration, which can provide up to a further 547 days of paid leave. In addition, the critical illness protocol may provide supports for up to three years. I am aware that the Minister for Social Protection has reviewed the EU recommendation on recognising Covid-19 as an occupational illness. It has been determined that Covid-19 does not meet the criteria required for recognition under the social welfare Acts.”
“At present, about 159 employees, as I understand it, remain on the scheme, the majority of whom have been supported with full pay for almost five years. My Department has consistently worked to ensure these staff were looked after. At my Department's request, the Department of Public Expenditure, Infrastructure, Public Service Reform and Digitalisation agreed to extend the scheme several times since its introduction. Following a Labour Court hearing in June of this year, a final extension was recommended to run until 31 December 2025, when it will formally conclude. Importantly, that does not mean all supports will end. Staff who remain unfit to work will move seamlessly into the public service sick leave scheme, which I appreciate is different but will ensure some measure of continuity of care and financial protection.”
“I thank the Deputy for raising this with me again. We should always acknowledge the extraordinary role, as the Deputy has done, of our healthcare workers and the role they played during the pandemic. They went far beyond the call of duty. Treating Covid in a front-line way at that time was an exceptional thing to do. In recognition of that, especially from 2020, a temporary special scheme was introduced in July 2022 to support eligible staff who were affected by long Covid, in particular, in the public health sector. This was a scheme that no other sector had, which was important and appropriate. The scheme was designed to support those who had worked in high-risk environments, particularly before PPE and vaccinations were widely available and community transmission became more prevalent.”