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 2 of 32.
“I propose to take Questions Nos. 98 and 108 together. I recognise that lipoedema is a chronic and often very painful condition, which can significantly affect physical health, mobility, quality of life and psychological well-being. It is frequently under-recognised or misdiagnosed. I am very aware of the distress many women experience in seeking recognition, diagnosis and appropriate support. Diagnosis remains challenging as there is no specific diagnostic test. It is based on clinical history and examination by an experienced clinician, with investigations used to exclude other conditions or contributing factors. There is currently no medication or cure as such that we are aware of. Management that appears to be the approach, requiring a holistic, multidisciplinary and person-centred approach.”
“I appreciate the point the Deputy is making but I am not going to make any commitments or policy on the floor of the House. I am also operating without information on the specific patients, the duration or the interest costs. I do not have any of that information but if the Deputy wants to speak to me about the matter privately, I will be happy to look at it. However, I will not make promises I cannot deliver as it would not be right for me to do so. I appreciate the Deputy's point and his reasoning.”
“There is no provision for the reimbursement of interest charges, borrowing costs or other consequential financial costs. Reimbursement under the cross-border directive is governed by European and national legislation. Reimbursement of additional costs is not envisaged by the directive because it was never expected people would be waiting in that period. I appreciate the unfairness point the Deputy made. That is why I am saying these delays are absolutely unacceptable and we need to get back but there is not provision in that scheme. We have no flexibility to change a European scheme of that kind in relation to additional costs beyond the healthcare costs.”
“I cannot speak to the specific staff numbers. I generally find it is about process change as much as staff increases, so I think it is a measure of both. I will look for an interim report, probably in October, as to how the work is going. I made the point that it is possible to change processes. For example, this time last year, I gave the Medical Council a significant challenge to sort out its backlog of people applying to be doctors in this country. It was a patient safety issue not to have had them. By September, it had that done. These things can be done with a measure of focus, and I expect it to be done in this case. In relation to the specific question about interest and bank loans, there is a difficulty with this. The reimbursement is limited to the eligible healthcare costs that would have been met by the public health service.”
“This is not the Deputy's question, however. His question is about the timeline, and I hope I have given him some confidence that this will be changed by the HSE.”
“Accordingly, the HSE has advised my Department that additional resources are being assigned to manage this increase in demand with the aim of restoring processing times back to expected and more acceptable levels. I have, however, set the HSE a very specific target of getting back to the 30-day target by the end of 2026. It will need to sort this issue out between now and then and get back to that 30-day target. It is not reasonable to put administrative stress, financial stress or other burdens on people in addition to their healthcare issues. As the Deputy knows, the reimbursement amount is the cost of the treatment in Ireland or the cost of it abroad, whichever is the lesser. Reimbursement is confined to the costs of the care itself and does not include any additional costs incurred by the patient.”
“The increased activity is evidenced by the number of treatments reimbursed increasing by approximately 75% between 2020 and 2024. Nevertheless, it is important this service operates in a responsive way and that reimbursement applications are processed within a reasonable timeframe. The HSE advises that it usually aims to repay patients within 30 days of receipt of all completed documents. However, the HSE also advises that it is currently processing applications received in mid-January 2026. A six-month delay for reimbursement is absolutely unacceptable. It is not fair to patients to have an additional financial burden placed on them that is occasioned simply because of administrative delay, notwithstanding the increase in applications.”
“I propose to take Questions Nos. 96 and 98 together. The cross-border directive allows public patients to access healthcare, which they would have been entitled to access in the public healthcare service in Ireland, in another EU or EEA country. As the Deputy is aware, patients pay upfront for the treatment and are reimbursed upon their return to Ireland. We want to support patients in this way and I do not want them to have additional administrative or any form of burden because of the operation of this scheme. The HSE is responsible for the operation of the cross-border directive and has a dedicated office for that purpose. There has been continued growth in use of the scheme. The HSE tells me that this has placed additional demands on the HSE cross-border directive, CBD, office and given rise to a build-up of applications.”
“Hospital managers are being creative where they can be at the moment, but none of those things are going to equate to the scale of the number of beds we need. We need this significant capital programme, which I hope I have outlined. I do really recognise the challenge.”
“I agree, particularly concerning rehab beds, step-down beds and neurorehab beds. I was in Blarney with Deputy Colm Burke to look at the neurorehab step-down beds in Mercy University Hospital. It was quite creatively done. It was a former hotel on a golf course that was acquired and redesigned for this purpose. We really are trying to be imaginative and innovative about where we can acquire space to be able to provide beds of every kind. I was in Tallaght University Hospital yesterday, where existing space has been found within the hospital to be repurposed for beds. I have been in hospitals where there are plans to turn records rooms, where patient records have been stored, into beds.”
“Some of my European health colleagues do not have that same wonderful situation. Nevertheless, it creates a significant infrastructure challenge for us for the future.”
“I thank the Deputy. He will not hear any complaint from me about people pressing me to deliver more health infrastructure or to spend more capital moneys. I am doing my very best to spend my entire capital allocation as quickly as possible and I run the risk of spending other people’s capital allocation, if I can be so lucky or so bold. This is because, as the Deputy said, this infrastructure investment is essential for the future. While I do not wish to be flippant about it and, of course, we must achieve value for money and we must take the correct decisions through the right processes, we really have to aggressively spend on health infrastructure in the right way to make sure we are going to meet the very excellent challenge of having not just a growing population but an ageing population.”
“The HSE anticipates opening 108 more new beds over the course of quarter 3 and quarter 4 of 2026 and quarter 1 of 2027. Some 259 inpatient beds are currently under construction, including 97 beds at Wexford General Hospital, 42 beds at Sligo University Hospital and 30 beds in University Hospital Kerry. It is intended to open those beds as soon as possible once constructed. In fact, as the Deputy is aware, we are recruiting ahead of the beds being delivered to make sure the staff are there. A further 185 beds are at tender stage and another 152 beds are now at the detailed design stage. We are now seeing this bed-by-bed, significant pipeline of projects progressing through earlier stages of planning, design and approvals. Rather than giving the Deputy broad figures, I thought I would be very specific as to the progress being achieved.”
“I thank the Deputy. The programme for Government, as the Deputy said, sets out a commitment to increase bed capacity by between 4,000 and 4,500 new and refurbished inpatient hospital beds across the country. This will be achieved through a regionally balanced capacity expansion plan. The substantially enhanced national development plan, NDP, provision for the health sector of €9.25 billion will support the delivery of those beds. To give the Deputy a much more specific update, 292 new acute inpatient beds have now opened across the country since the programme for Government was agreed, between January 2025 and June 2026, including 128 beds in University Hospital Limerick, 18 beds in Cork University Hospital, 15 beds in Our Lady of Lourdes Hospital, Drogheda, 20 beds in Beaumont Hospital and 24 beds in Mallow General Hospital.”
“A measure of flexibility will have to come into that too. There are also cases, and again it is hospital managers describing this to me, where families do not want to have a particular outcome and the hospital needs to move the patient, who is no longer an acute model 4 hospital patient but requires a different type of care. It is important that everybody understands that model 4 beds are for the most acutely unwell and people cannot stay.”
“I agree with Deputy Sherlock. I recall speaking with one of the hospital managers where this is a most acute issue with regard to what is going on, what the experience is and what conversations are happening. Again, there is a question of dementia and advanced decision-making. Some of these issues are very complex and that is its own bundle. As Deputy Sherlock said, there is also the need to access nursing homes and public nursing home support. Within this, it is important to say we will not be able to facilitate every request for every patient to be in the exact location they need to be. There are some questions. I do not wish to overstate it or amplify it but I am saying we will be able to provide supports but we will not be able to provide the perfect support for every person either.”
“There is also extended service availability in the evenings and at weekends, including discharge planning, community supports and decision makers addressing avoidable non-clinical delays to discharge where it is possible. I have mentioned the virtual wards. I do not suggest that everybody would move onto a virtual ward but there are people for whom it is clinically appropriate to do so. Crucially, the SAFER patient flow bundle and the plan for every patient are now in place across most sites, supported by seven-day and 14-day length-of-stay reviews.”
“Going back a couple of days, on 6 July there were 526 delayed transfers of care. Of these, 68 involved legal complexity, 35 involved basic housing needs, 90 involved very complex clinical needs, 61 were about access to rehab facilities of various kinds, home support packages were involved in 42 cases, residential care in 217 cases and non-compliance in 13 cases. It is not just about nursing home support; it is also about support at home. For example, it is important to mention the expansion of the enhanced community care teams, which are the multidisciplinary teams supporting earlier discharge from hospital closer to home.”
“There is an increase in complexity, particularly on the dementia side. There are other cases where there is a clear pathway out of hospital. I have highlighted the south west a number of times because of my frustration with the use and non-use of Mallow. There are patients in hospital today who could be discharged to virtual beds that are not being used. I do not need to conflate these different issues but it speaks to efficiency and the management of every bed and seeing every bed as being so very important.”
“The community nursing unit capital programme is ongoing and will have 90 public community nursing units and community hospital beds refurbished or replaced so they meet all of the regulatory requirements. It was a big problem for us that we had beds that were closed because of HIQA standards. This is correct because we have to bring them up to standard but it is a body of work to do this. The public-private partnership project will deliver 528 residential care beds on seven sites in 2026. The programme for Government commits to building more public nursing home beds, including dementia-specific provision, which is a huge issue in the delayed transfer of care. We are developing a new long-term residential care additional capacity plan, which will be published in the later part of this year. There is a complexity to many of the DTOCs.”
“I thank Deputy Sherlock, who is quite right to highlight delayed transfer of care, DTOC. As she said, it has been well over 500 variously for the last period, which is essentially a hospital. This is why the use of every bed is so very important. Deputy Sherlock is correct to identify nursing home beds, community nursing units and all of the appropriate step-down facilities that are, can and should be in the system to make sure we do not have people staying in acute hospitals longer than is necessary. In this context, the national service plan commits to the delivery of 352 community beds in residential settings for older people in this period.”
“I thank Deputy Cullinane and I acknowledge all of the people involved. The impact of it means people can rest easier knowing they will have the care they need at any time they need it. Of course I will discuss it with the Minister, Deputy Lawless, and of course it is collaborative. The more I think about the co-location of hospitals and medical schools, what we are trying to do in medical devices and pharmaceuticals, and the opportunity for research and innovation, it is driving health not just for the benefit of patients but to make sure it is a driver for the economy as well. We have such an opportunity and we have such a talented workforce. We have such a medical clinical profession that is dedicated to research and innovation. All of these opportunities present and I am so glad Deputy Cullinane has raised SETU in this context as well.”
“I know another two consultants are yet to come into post and everyone else did extra work to make sure we met the deadline we set of 6 July. This is very good news. Of course, we will have our surgical hub by the end of the year. As to the medical school, I do not wish to step across my colleague, Deputy Lawless, on that, if Deputy Cullinane will forgive me.”
“I thank Deputy Cullinane. That does sound like a plan of work but I am afraid it is a plan of work for my excellent colleague, the Minister, Deputy Lawless, and the Department of higher education. I do not wish to step across him but I can say in relation to clinical placements and training that I have met the HSE. The Minister, Deputy Lawless, and I have been working on this together, with some frustration that the placements have been too limited to acute settings and they need to be in community settings . We are trying to work on this, although I am still not satisfied it is happening at the scale that is necessary. I am glad Deputy Cullinane mentioned the hospital. We had a very good week this week with the commencement of 24-7 cardiac care in Waterford and I thank Ben O'Sullivan for all of the work he has done to get ready for it.”
“Recruitment of the 2026 graduate cohort is progressing. Three occupational therapy graduates have accepted employment offers to date. This is expected to increase as graduates complete the CORU registration process which comes after their graduation. Recruitment for other disciplines is ongoing.”
“We are also targeting the recruitment of Irish-trained graduates into permanent roles but, although I raised this with the HSE in September and October, we are not in a place I am comfortable with in relation to that for this year. I expect recruitment to be faster and to be co-ordinated with the terms our HSCPs and other students have. It is very obvious they are about to graduate at this time of year. There is a better way of organising that than is currently happening. In relation to the Deputy’s region, the HSE Dublin and South East region conducted entry-level HSCP recruitment campaigns in 2026 to support the recruitment of newly qualified graduates. In 2025, 33 HSCP graduates were recruited into the region: six occupational therapy, ten physiotherapy, five speech and language, six social work and six dietetics.”
“I thank the Deputy. The Government is investing €28.5 million to expand healthcare education and training nationally, supporting over 1,100 additional training places by 2028. That includes 461 additional health and social care professions, HSCP, places across nine priority disciplines. Further expansion opportunities are being considered through the Higher Education Authority's expressions of interest process, informed by workforce needs, regional demand and clinical placement capacity. Clinical placement opportunities are fundamental to development of the future workforce. We are trying very hard to ensure that happens in community settings as well as acute settings, recognising that is where we want people to be able to work.”
“It is a region that is already demonstrating that. As we move forward with the elective hospital in Connolly, we have done the preliminary work of putting in the high-dependency unit beds. It is really interesting. I have asked them to think about the region in an ambitious way and come back to me with a plan for the future. Perhaps a model 4 is possible. I do not know. Let us see what Eamon and Sara come back with.”
“I have asked the regional executive officer, Sara Long, and the regional clinical director, Eamon Dolan, to do a piece of work that considers the whole region. The region is performing exceptionally well in the overall management of demand, although there is more in the community that needs to happen. In that region there is Beaumont, which is a neurology specialist centre; the Mater, which is a cardiac specialist centre; Connolly, which is a position for the future for elective work; the hub; and Drogheda. There is an interesting matrix of hospitals and division of work and specialities there. I have asked them to come up with what the future of the region looks like. How do we best allocate resources? How do we think about where services should be delivered and the concentration of specialist centres?”
“We have organised it such that, over a two-week period, access to the hub will be shared between Beaumont, the Mater, Our Lady of Lourdes, Cavan-Monaghan, Connolly - all of the hospitals in the region - to ensure equity of access for everybody there. The increase in staff for the hub is an increase in staff for everybody because it can take scheduled activity away from Drogheda.”
“Yes, I know. It really is excellent. I am not saying everything and every experience are perfect but it is doing enormously well. It is not just in terms of elective surgery; it has also increased its outpatient capacity by 23% and is at 100% of its endoscopy priority 1 target. That is significant activity, good management of a hospital and an enormous progression for that hospital on 18 months ago, or maybe slightly more, when it was in a different situation. More staff have gone into the surgical hub for the region and that benefits everybody. About half of the staff in the surgical hub will be dedicated to the hub and different hospitals will move in with their own teams.”
“With two slots per fortnight in the new surgical hub in Swords, I expect those figures to further improve in Our Lady of Lourdes and across the Dublin and north-east region as the hub gets up to speed. I intend to monitor the activity in the surgical hub and the corresponding activity in the theatres in the original hospital to make sure activity is being increased everywhere.”
“The interim target in the national service plan and waiting time action plan is 50%, so we really are getting there in Drogheda. Significant improvements can also be seen in individual specialities. Gynaecology inpatient day cases are down 25% on May last year and 18% since January of this year. Ear, nose and throat lists have decreased by 48% since last year and 14% since January. Against a trend of rising referrals and increased demands, waiting list reductions of that kind are very significant. Overall elective surgery increased by 19% to the end of May 2026, which is positive. I have to sit that against continued good management of its emergency department and patient demand overall. You cannot bring patients into an unsafe hospitals. Drogheda is not doing that and it is still getting the lists down.”
“At a time when many waiting lists have been impacted by the ongoing trend of higher demand and increased referrals, it is wonderful to be able to report some positive progress. In Our Lady of Lourdes, at the end of May, 939 patients were waiting for an inpatient day case procedure, which is a decrease of 17% when compared with May 2025 and a 14% decrease from the start of January. More importantly again, 90% of those patients were waiting twelve months or less and the number waiting over 12 months has decreased by 46% since May last year. That is a sign of real activity in the hospital. I am very pleased with it and congratulate the manager, Priya, for her excellent work on that and in managing urgent and emergency care as well. Some 47% of patients in Our Lady of Lourdes are waiting within the Sláintecare target of 12 weeks.”
“We have a very strong commitment to public service. I do not believe there is space for private work in the same way. I am in agreement with the Deputy, but there are still contract holders who have a contractual entitlement to a certain number of private rooms. I see in the new hospital that will be wound down and down, as we get from 71% to 80% and 85%. That will happen over time.”
“Yes, I am a firm supporter of the public system. There is no question about that. Some 71% of our consultants in CHI are on the public-only consultant contract. However, there is also a contractual requirement to continue to provide private space for those old, type B contract holders. It is anticipated that fewer than half of the eight planned consultancy rooms will have any private clinics. The rest of the rooms are dedicated for public clinics. More important, they will be private clinics winding down over time and that will all move to public because only be public consultants will be hired in. We are still committed to the rule of law and to upholding contracts. If I say contracts have to be upheld, I have to uphold them on the other side and we have to make that space, as the Deputy is aware.”
“The Deputy is right that there is a limitation in data, but there is no question but that this audit was done with the best of intent and in good faith. We see more real experiences in the qualitative piece that Lily Collison did. That was an important piece of work that really speaks to the experience children had. It is improving but is not perfect.”
“I reject the question of trying to present this in any particular way. I commissioned the audit because of my concerns about this. There is no question but that I was uncomfortable with what was being found overall, but specifically when I drill into those a bit more there is not a systemic problem I can see. What I did see and what I was concerned about was that less complex procedures were being too easily moved to private facilities, resulting in the more complex procedures remaining. I think what the Deputy describes with those figures reflects some of that. There is a bigger complexity than what he has presented. This is why I initiated it. This was my concern. My concern in particular was that this was more endemic than the report ultimately gives credit for.”
“Those findings were capable of being anticipated - I would not have initiated the report had we not had shared concerns - but nevertheless they are disappointing. We need to provide a better experience for children and their families. I have met with the HSE and CHI and I am more satisfied than I would have been 12 months ago that there is a different attitude in senior management in CHI in its responsiveness and care around this. I am not saying everything situation is perfect - I certainly would not say that - but I can see a real change in the reaction and response of senior CHI management to this audit and qualitative report, which I think is important.”
“The report found no clear evidence of inequity between public and private patients, but it did outline important findings in governance, including recurring delays against clinical recommended timeframes and inconsistent documentation in relation to waiting list management, neither of which is acceptable. Importantly, the patient and family feedback revealed dissatisfaction with waiting list management with significant emotional and health impacts, although it did not need revealing to anybody here as we were already aware. These impacts was not just for the children but also for the parents. Parents and families want to be informed, involved and treated with empathy and respect.”
“I was very concerned about this and specifically about the management of waiting lists, particularly for spinal surgeries. Because of that, along with the former HSE CEO, I undertook an audit into equity of access and waiting list management in CHI. Recognising the challenges families have faced regarding paediatric services, we also undertook a separate qualitative piece of work to try to capture their experiences away from the strict terms of the counting audit and to ensure their voices inform the development of services. The audit took much longer than I wanted it to and much longer than anticipated - I was correctly questioned about that in the House - but that time was essential to ensure that the findings, conclusions and overall report were accurate and robust.”
“I take the opportunity to ask all Deputies and political parties in the House to do everything they can to take any step in terms of public persuasion and public support. Without the transfer of land for the helipad, we cannot progress this plan in a major way. I ask that everyone take what steps they can to advance critical infrastructure, which is what we all need and what Deputies will rightly come in here and ask me about a different day. We want to deliver this, and this is a critical for moment for everybody in the west and north west.”
“Not only was it done in the Mater but it was done successfully in Limerick. As the Deputy says, we have this standardised design that can be replicated and has been in other places. I will take that up with the Department of public expenditure and reform and HSE estates to try to advance it as quickly as humanly possible. There is no question but that the additional beds are necessary for Galway. They still have to manage their demand and do all the other things, but they need more beds. It is an area of rising population, which is a good thing, but no matter how well demand is managed there, that pressure is coming in the future and there is no question but that it is necessary.”
“It will ensure there is a clear flight path for emergency landings away from the future development areas while supporting timely transfer of patients to the emergency department. I understand that the transfer of land is due for consideration by Galway City Council in the coming days. I know there are always concerns among local residents - we all understand that as public representatives - but this is critical to the development of proper emergency services for the people of the north west and enabling the development of the hospital master plan more broadly. I understand that further public engagement by the HSE is taking place this week.”
“I certainly will. In the first instance, I will discuss that with HSE estates. The Minister, Jack Chambers, and the Department of public expenditure and reform are as keen to develop health infrastructure as I am. The accelerated infrastructure report and the work in that is a very significant advancement in that regard. Already we are seeing different areas where we are making quicker progress than we otherwise would have done, so it is very important, and I will certainly do that. It is also important that I highlight the relocation of the helipad. This is important for everybody in Galway and is a matter that sits with Galway City Council. The relocation of the helipad is vital to enabling delivery of the master plan. There is no other way of doing that. It is in the mater plan. It is essential.”
“The reset of the hospital was difficult for everyone to do, but they did it and they have managed to sustain it. They have had a few blips going backwards, but you can see and feel a different culture around the management of patient flow in University Hospital Galway. That is hugely important for patients and the Deputy's constituents, the people he represents, and I acknowledge the work they have done. Furthermore, enabling works are under way to, among other things, clear the site for ward block A. That will maintain momentum on site while we undertake the necessary designs and statutory approval processes. The planned relocation of the helipad is vital. I might pick that up in my further response.”
“I am happy to say that significant progress has been made in advancing phase 1 of this plan. A major milestone has now been reached with the appointment of design teams for two new ward blocks and associated enabling works. Together, those ward blocks will provide 300 additional beds and represent an important step in moving the master plan from being on paper to being in real life for the benefit of patients. The additional beds will help ease pressure generally on the emergency department, reduce waiting times and improve services generally. I thank the management of University Hospital Galway, who at the beginning of March, alongside the region and the excellent Grace Rothwell, initiated a full reset of the hospital because its trolley situation had been so bad for so long, with 50 or 60 people on trolleys every day.”
“It is wonderful to have this conversation with Deputy Kyne in the Dáil because I recall visiting this hospital with Senator Kyne, as he was then, now Deputy Kyne, representing Galway and a continual advocate for University Hospital Galway. He and I were there in May 2025, when we launched the completed master plan, setting out a clear vision for a modern model 4 hospital serving Galway and the west and north-west region. I commend University Hospital Galway and the REO, Tony Canavan, on the way in which they got to that master plan because it took them some time and there were different iterations of it. The way they developed a master plan and a sequential plan for delivery is an exemplar for many other hospitals around the country that might take a leaf out of their book as to how to plan for this.”
“If any child were to see the impact of an acquired brain injury on what their life would look like for the future, I wonder if they might reflect on their use of these vehicles.”
“I have spoken to the Minister of State, Seán Canney, specifically on this in recent days and gave him a copy of the letter as to what is happening in relation to the public health assessment. I know that he, like the Minister, Deputy O'Brien, is very exercised by this, as is the Minister for justice. Not one of us in this House wants to enable or perpetuate a situation where children are acquiring injuries of this kind. They are devastating. At the same time, not one of us can go around and police every incident either. We therefore have to try to take the policy steps that will be appropriate, including supporting the Garda in making sure that it can pursue these cases and take the steps it needs to take to stop them. I thank the Deputy for raising this very serious issue.”