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.”
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“Section 10 amends the functions of the HSE board to include an explicit obligation to ensure systems are in place to provide assurance the HSE is achieving the highest standards of budgetary management and value for money and is operating within authorised resources. It also requires the board to ensure compliance with Government circulars related to expenditure as well as Government policies, codes, guidelines and other relevant documents. Section 11 similarly amends the functions of the chief executive officer to include the same provisions as those in section 10. Section 12 inserts definitions for each of the new strategic direction statements and removes the definition of an approved service plan.”
“Specification of priorities and performance targets to the HSE by the Minister for Health, which is currently facilitated under section 10A, will instead be provided for in section 17 of the Bill. Section 8 updates a reference to the service plan to instead refer to the performance delivery plan being introduced in the Bill. Section 9 amends the principal Act to account for the repeal of section 10D. Specification of priorities and performance targets to the HSE by the Minister for Children, Disability and Equality, which is currently facilitated under section 10D, will now be provided for in section 18 of the Bill.”
“The proposed new process for the setting of priorities is outlined in sections 17 and 18 of the Bill. Section 4 inserts a definition for an approved performance delivery plan, which is to take the place of the definition for an approved service plan contained in the principal Act. Section 5 amends the object and functions of the HSE to include a specific and explicit obligation to have regard to Government circulars related to expenditure as well as other relevant documents in the performance of its functions. Section 6 updates a reference to the service plan to refer instead to the performance delivery plan being introduced in the Bill. Section 7 amends the principal Act to account for the repeal of section 10A.”
“The Bill also makes an unrelated amendment to the National Cancer Registry Ireland, NCRI, establishment order, which seeks to increase the membership of the board and amend the quorum arrangements accordingly. This addresses a recommendation in the Scally report to review the composition of the board of the NCRI. I will now outline the provisions of the Bill section by section to clarify its content. The Bill comprises 28 sections. Section 1 is a standard provision giving the Title of the Bill and when it will come into effect. Section 2 defines the Health Act 2004 as the principal Act referred to in the Bill. Section 3 repeals sections 10A and 10D of the principal Act, which relate to the setting of priorities for the HSE by the Ministers for Health and children.”
“Either Minister may request that the HSE amend the proposals if they are deemed to be inconsistent with the strategic priorities or corporate plan in operation at the time or do not have sufficient regard to Government circulars or priorities. The Bill makes a number of miscellaneous amendments that are required by outlying changes or to address practicalities arising from other provisions. These include, for example, the extension to 28 days of the 21-day deadline for the submission of the HSE performance delivery plan and the HSE capital plan to the Departments of Health and Children, Disability and Equality. A number of provisions correct references to sections of the Health Act 2004 that are being amended, removed or substituted by the Bill.”
“The Bill places an obligation on the chief executive officer of the HSE to notify in writing the executive's board, the Minister for Health and the Minister for Children, Disability and Equality if the CEO forms the opinion that the HSE is likely to exceed its allocated expenditure for any given year. When doing so, the CEO will be required to submit corrective action proposals for the approval of the HSE board. These proposals must outline the reasons for the projected overspend and the actions taken to attempt to avoid it. The proposals must be in line with the strategic direction statement and statement of priorities at the time.”
“The statement will guide the executive in the preparation of the performance delivery plan and will contain priorities that are consistent with the contents of the strategic direction statements in operation at the time. The annual statement of health service priorities will be prepared in consultation with the Minister for Children, Disability and Equality. The latter will prepare a similar statement of priorities for specialist community-based disability services, to issue simultaneously and at a date no later than the issuing of the annual letter of determination from each Minister. The statements can be amended by either Minister in consultation with the other.”
“The statement will be prepared in consultation with the Minister for Children, Disability and Equality. Similarly, the latter will have an obligation to prepare a strategic direction statement in respect of specialist community-based disability service priorities. These statements will issue to the HSE simultaneously no later than three months before the expiry of the corporate plan in operation at the time. The statements can be amended at any time throughout the three-year period if and as necessary. The Bill provides for the replacement of the national service plan with a performance delivery plan. It places an obligation on the Minister for Health to issue an annual statement of health service priorities to the HSE.”
“The purpose of the Bill is to ensure a more formal alignment of HSE and Government planning processes and to introduce more robust financial oversight measures, particularly in regard to any expenditure that exceeds the maximum amount allocated in the annual letters of determination issued by both the Department of Health and the Department of Children, Disability and Equality. This is achieved through the introduction of a number of new measures. The Bill introduces an obligation on the Minister for Health to prepare a strategic direction statement in respect of health service priorities to guide the HSE in the preparation of its three-year corporate plan. The statement will specify the Department's priorities for the three-year period in question and may also specify particular goals or outcomes related to those priorities.”
“The structures and processes are guided by the founding legislation of the HSE, the executive's code of governance, the separate but complementary oversight agreements between the two Departments and the HSE, and the code of practice for the governance of State bodies of the Department of Public Expenditure, Infrastructure, Public Service Reform and Digitalisation. The Bill's provisions will build upon these structures and processes to further enhance the HSE's accountability while retaining the independence and autonomy of the HSE board.”
“Given the implementation of the HSE health regions and the accompanying changes to the governance and structure of the executive, this is an opportune time to introduce these amending provisions and strengthen the oversight relationship between the Department of Health and the HSE. The provisions in the Bill will ultimately enhance the governance of the HSE, the relationship between the executive and the Government and subsequently improve the standard of care offered to those who make use of its services. Since the foundation of the HSE board, the Department of Health has extensively consulted with the HSE and, more recently, with the Department of Children, Disability and Equality to develop robust and effective governance, oversight and accountability structures and processes.”
“I move: "That the Bill be now read a Second Time." I am pleased to introduce the Health (Amendment) Bill 2025, by means of which it is intended to enhance the oversight and accountability of the Health Service Executive to both the Minister for Health and the Minister for Children, Disability and Equality. The Bill addresses a number of goals arising from the Sláintecare implementation plan, which highlighted the need to shift away from the previous directorate structure of the HSE towards an independent board overseeing a chief executive officer. The HSE board was established through the Health Service Executive (Governance) Act 2019 and has been in operation since then.”
“It is very clear that the Medical Council has received very significant additional investment and it is now up to it from a public safety perspective to have as many doctors registered as quickly as can be.”
“We are very keen for them to work here. There are three aspects to that. The Nursing and Midwifery Board of Ireland, NMBI, has done good work on improving its registration times and I am confident about that side of things. CORU, for the health and social care professionals more generally, has made very significant progress, although the Taoiseach and I are discussing how we can bring that further in respect of physiotherapists and a range of professions in that space. That is moving on. The aspect where I have concern is the Medical Council. The Deputy mentioned a GP and a surgeon. I have given a very clear direction to the Medical Council to improve its processes. It is due to report back to me in early September and I will be keeping the Taoiseach and the Cabinet committee updated on this.”
“I greatly appreciate being facilitated, a Cheann Comhairle. It is most unusual for a Member to be allowed to speak a second time in these circumstances. I move the amendment very reluctantly. I do not wish to criticise the motion, which has been put forward in the best of faith by Sinn Féin, but there are a number of references in it that we cannot allow to stand on the Dáil record. I refer specifically to clinical decisions, which are very important and may be relevant in some, but not all, cases, and absolutely are for the discretion of clinicians in the fields. In addition, there are some contradictory elements around not wanting women to have to travel abroad but also providing funding for women to travel abroad. Acknowledging Deputy Danny Healy-Rae's point, I do not wish to be at odds or in disagreement with the House on this issue.”
“I move amendment No. 1: To delete all words after "Dáil Eireann" and substitute the following: "recognises that: — endometriosis is one of the most common gynaecological conditions in Ireland and approximately one in ten women may have endometriosis; — there is a wide range of symptoms associated with this condition and the burden of disease varies from person to person; — some women may have endometriosis that goes undetected, while for others endometriosis can have a significant impact on their quality of life; and — endometriosis is a chronic condition for which there is no definitive cure, many women with endometriosis require long-term care and treatment provided within a multidisciplinary care team; notes that: — the Health Service Executive established the National Women and Infants Health Programme (NWIHP) to lead the management, organisation and delivery of gynaecology services in Ireland; — just over €5 million has been invested in developing endometriosis care and management in Ireland since 2021, and the Programme for Government commits to continue to support specialist endometriosis services; — new development funding of €543,822 provided in Budget 2024, with full year costs of €2.175 million in 2025 is further expanding and improving these services; — investment since 2021 has provided for 24.6 whole-time equivalent (WTE) staff; — services are expanding as recruitment continues for a further 18.6 WTEs with the additional funding provided for this year; — the recruitment process of these specialised posts will take time to complete; — Ireland's first National Framework for the Management of Endometriosis, alongside the implementation of structured care pathways is in final development; — in March 2025, the publication of the National Clinical Practice Guideline: Assessment and Management of Endometriosis, will support the delivery of evidence-based standardised care; — investment in endometriosis services has provided for the establishment of two supra-regional centres in Tallaght and Cork and five regional hubs, providing specialist services in each maternity network across the country; — regional endometriosis hubs operate from the Rotunda Hospital Dublin, the Coombe Hospital, the National Maternity Hospital (NMH), University Maternity Hospital Limerick and University Hospital Galway; — the NWIHP has advised that all regional hub sites are taking referrals and providing treatment pathways for women affected by endometriosis, a specialist endometriosis clinic structure has been formalised in the Coombe Hospital, the Rotunda Hospital, and University Maternity Hospital Limerick; — women are receiving care through the University Hospital Galway and the NMH regional hubs, while the formal structuring of these defined clinics is in ongoing development; — endometriosis care is provided through multidisciplinary teams, these include consultant roles in colorectal, urology and radiology, along with women's health physiotherapists, dieticians, psychologists, specialist nurses and healthcare assistants, recruitment for these funded posts is actively ongoing to further expand specialist capacity; — surgical treatment abroad, under the Treatment abroad scheme, is available when the necessary treatment is not available in Ireland or within the time normally necessary to get this treatment in Ireland; — women may choose to avail of private treatment abroad; and — women who opt for treatment abroad will be provided with ongoing care to manage their condition across the public network after they return; and acknowledges that: — psychologists play a key role in endometriosis care by helping patients manage chronic pain, emotional distress and the psychological impact of the condition, a psychologist has been appointed to support the supra-regional service at Cork University Maternity Hospital with further expansion of the service under consideration; — the diagnostic criteria for endometriosis are determined by clinical experts in the field, the clinical guidelines and the framework emphasise individualised woman centred care rather than rigid staging; — in line with clinical guidelines, general practitioners are encouraged to initiate treatment for suspected endometriosis, where symptoms persist or if symptoms are severe, timely referral to secondary care for laparoscopy is recommended; — the NWIHP has advised that on average 72 per cent of women waiting on specialist services were seen within six months of referral; — women affected by endometriosis may also be waiting on general gynaecology waiting lists, as of 26th June, 2025, 79 per cent of women waiting on gynaecology waiting lists are seen within six months and 97 per cent of women are seen within 12 months; and — improvements in endometriosis care are an integral part of the overall transformation of women's healthcare included in the Programme for Government, 18 ambulatory gynaecology 'see and treat' clinics are currently operational with more in development as part of the Model of Care for Ambulatory Gynaecology, six specialist menopause clinics are currently operational for women who require complex specialist care, six regional fertility hubs will provide support to the estimated 47 per cent of women with endometriosis who will also experience related fertility issues.".”
“-----to reduce the amount of travel and make sure there is an opportunity to get more regional care. In the countermotion we try to set out what has happened, what has yet to happen and to recognise that there are different choices. The point was raised about private treatment and choices. Women are entitled to choose. I want them to be treated within the public system.”
“There is more work to be done. Discussions are ongoing between the HSE and the Irish Medical Organisation, which represents GPs. I would love to be in a position to update the House on that in the next while. There are important diagnostic criteria for endometriosis that are determined by clinical specialists but I do not have time to get into them. I want to address the particular question around motions and how they are dealt with. I appreciate the members of Sinn Féin will disagree with me as is their right. In any event, we take the opportunity to set out the different things that have been done. I do not reject any of the points articulated by the women here. We take a slightly different policy direction in one respect, which is that instead of one centre of excellence, we have decided to do it more regionally-----”
“I have been Minister for a number of months and I have visited Cork and met with women who are really suffering from this condition. A lot more work needs to be done. We have see-and-treat gynaecology clinics that you can walk into and be treated immediately. Those are having a real impact. I hear from women that they are making an impact on waiting lists and on women's lives. They are being seen and treated at the same time. There is work on related issues. Let me address the national framework. For the first time in Ireland, we have this defined clinical pathway for women with endometriosis at the highest level expressed in the national framework for endometriosis. We are not finished with it yet. There is a body of work to be done to agree with GPs how they will fit in and how they will be part of that. That is not yet complete.”
“More than 300 specialist surgeries were provided between August and December last year and another 200 in the first three months of this year. I know more needs to be done on that. However, it is important for me to put those facts on the record of the House. Women with endometriosis may be on other gynaecology waiting lists. That is also important. There was an increase of 108% in general gynaecology referrals over the past number of years. I hope in part that this is some recognition of women presenting with their conditions and being listened to about their conditions and being referred onwards. There has been significant investment since 2021. It has enabled twice as many women to be referred to our gynaecology services with more than 80% of women waiting less than six months. As a woman, I would say that is still not enough.”
“They are all operating and taking referrals. Women are receiving care through Galway and the National Maternity Hospital. There is more work to do on the structuring of those clinics. We now have clinical guidelines in relation to this. GPs are encouraged to initiate treatment for suspected endometriosis. They can and are encouraged to refer suspected cases through those different pathways. That all sounds very clinically-led, and it is, but it is about the visibility of this condition in GP services and GP surgeries, so that they know there are pathways where more complex cases can be progressed. I understand more than 1,100 new patients were seen in 2024 and that, on average, 72% of those women were seen within six months, between August and December.”
“That is why it is so welcome that Deputies are telling this story as broadly as possible, as many women have been doing for many years. The moderate and severe cases of endometriosis, however, may require - they do require it, in my view but it is a clinician's decision - referral to the specialist model of care. At the moment, as Deputies are aware, there are two services, one in Dublin and a more recent one in Cork. I visited the Cork service where I spoke with the nurses and doctors and some of the patients. I understand the care pathways and where that has yet to go. There are also five regional endometriosis hubs that many people will be aware of. For those who are not aware of them, they are in the Rotunda, the Coombe, the National Maternity Hospital, in Limerick, in Galway and in Lee Road clinic.”
“So far, that investment has allowed us to recruit 24.6 whole-time equivalent staff, or 24 people and one part-time person. We have the funding. Specialist services are expanding further with the HSE recruitment process to recruit another 18.6 people, or 18 people and a part-time person, with the funding provided this year. We are more than halfway through that recruitment programme and there is no question about that. That is for some of the specialist services. For most endometriosis cases, particularly at the less severe end - and I appreciate many of the people here are perhaps at the more severe end - most of the care can be provided by GP care. That requires GPs who understand endometriosis and listen to women who are presenting with these symptoms. It also requires having this dialogue in public.”
“We know and recognise it and while our amendment does not go through the physicality of that in the same way the Sinn Féin motion does, I totally understand that. There is a huge range of very difficult symptoms and there is also asymptomatic endometriosis. There is a different spectrum of experience, and with the divergence, it is important that we listen to all of those experiences. It is also important that we respond to that complete spectrum of experience, some aspects of which can be responded to at GP level, while others need specialist intervention services. I have to try to make sure all of that is there. Since 2021, we have invested over €5 million to expand specialist endometriosis services to provide treatment for women with moderate and complex endometriosis. There is an additional €2 million this year to continue to do that.”
“What is important for us is actually making progress on endometriosis and there is some progress taking place. The first major difference we have, and this does not account for the many years of underinvestment in and under-recognition of women's health, is that we have a dedicated women and infants health programme. That has made some difference to how maternity services are conceived. We have more work to do there. It has made some difference with regard to how menopause services are conceived and we have more work to do there. It has made some difference with regard to endometriosis and we have more work to do there. We know, of course, that endometriosis is one of the most common gynaecological conditions. How this was under-recognised for so long is beyond me, when there are so many women presenting with such consistent symptoms.”
“I never deliver the speech that is prepared. It is welcome to have it but Deputies know that, as a matter of courtesy, I do not deliver what is prepared.”
“I will, of course, answer the women, whom I thank for coming tonight, on the technical pieces - the motion, the amendment and how they work. However, I am interested, as the first female Minister for Health in a long time, and who, by the way, has also had friends, family and constituents describe to me the pain in their lives and in their bodies that they have lived with for so long as a consequence of endometriosis and, in particular, undiagnosed endometriosis and what that does for their mental health as well. I share all of the stories the women have told. It is so important that they are told on the floor of the Dáil. They are, with every respect to them and they will know this, stories I have also heard already, albeit perhaps from different women but nevertheless on precisely the same experience.”
“There is an important programme in place now, which is a different way of listening to and respecting women. I cannot make up for previous experience but what I can say is that, as the first female Minister for Health for a long time, I have a very strong commitment to delivering services that are going to make a difference in people's lives. We can deal with the technicalities and politics of an amendment and how that works. Deputies are welcome to make whatever charge they wish against me. I am not here for that. I am here to take steps forward on service delivery, to give some description of what has happened, and to discuss what needs to happen next and how we might deliver that. I have no interest in politics with regard to this. I am only interested in service delivery.”
“I thank the Deputies for the work they are doing with and on behalf of women. It is wonderful to see so many different parties and so many different voices, male and female, articulate the female health experience. Every single person knows that it has been overlooked. Every single person knows that experience of telling a story and not being listened to or believed. I completely respect those experiences and I have no interest whatsoever in engaging in politics around something as important and serious as this. What I am interested in is service delivery and the quickest possible way of ameliorating, fixing and making good the sheer lack of service delivery for women's health that has gone on for so long. There have been important advancements in the last five years.”
“I move: That Dáil Éireann approves the following Regulations in draft: Data Protection Act 2018 (Section 60(6)) (Inquiry into the Licensing and Use of Sodium Valproate in Women of Child-Bearing Potential in the State) Regulations 2025, and Data Protection Act 2018 (Section 51(3)) (Inquiry into the Licensing and Use of Sodium Valproate in Women of Child-Bearing Potential in the State) Regulations 2025, copies of which were laid in draft form before Dáil Éireann on 14th July, 2025.”
“I am seeking significant capital funding to transform Galway hospital, including the maternity unit, and to make sure the resources are available in the longer term as well.”
“I thank the Deputy for her question. This concern is specific to Portiuncula, which demonstrated a much higher than expected rate of requirement for Caesarean sections and cooling of the baby. This was a specific issue. All of the recommendations of the Walker report were implemented. There has been a 100% increase in the number of obstetric consultants and a 25% increase in the number of midwives at Portiuncula. The report has been implemented and increased resources were provided yet there is still a problem. We have to respond to that problem from a patient safety perspective. High-risk pregnancies are being moved to Galway. I have visited the maternity unit in Galway. I know what the Deputy means.”
“I will take this on the basis of it being a health matter. The HSE and the NCCP have recently been working with community organisations to distribute the 2025 funding of €5.5 million. The first call for the full members of the Alliance of Community Cancer Support Centres, of which Purple House is one, is now almost complete and the second call for the associate members is now under way. I think some of the groups the Deputy mentioned are within that group. The Alliance has 21 full members and 22 associate members. The associate members will now go through that process as well but the priority is, of course, for the full members.”
“I suspect it will take between four and six months to do this correctly, so we will come back to this. I do not know what that will throw up but it is an important test of the system and it is appropriate at this point. We need collectively to articulate every time the need to have a public system working in the public interest and that this is the absolute emanation of the State delivering public services for the public in public hospitals. We need to drive that as hard as we all can together in the spirit of Sláintecare.”
“Notwithstanding the legislation, it is also important that the reforms I am trying to push through the public hospital system of maximum productivity, the use of the public-only consultant contract, the working of five days over seven, the maximisation of all capacity, and I mean diagnostic capacity and theatre capacity, and doing that in a greatly enhanced way are all important for delivering services to children in a timely way. I would welcome Senators' help in making sure we are seeing what is happening, improving what is happening and really assessing it in a granular way, which is the only way anything will be managed and improved on a sustained basis. In that sense, I would welcome their support and help in driving that forward. Second, we will have the outcome of this internal audit.”
“We have to respect all those different things that are involved in any of these different calculations. Nevertheless, there is quite a lot of activity in Blackrock, for example. There were 48 procedures done in Blackrock this year, but as I look at this year's projections I see that, to my mind, they seem to be higher in Blackrock and not as active internationally. Those are the sorts of things that are important to monitor and to interrogate, and we need to do that together. We have shared goals as regards meeting Sláintecare targets. There is no question about that. This Bill is an important legislative underpinning of the Sláintecare targets in respect of this medical field and of our shared intent to make sure that children are treated appropriately.”
“I will supplement that audit with my own perspectives on making sure that the resources that have been put in are being used in the most efficient way. There is a measure of appropriate insourcing and outsourcing going on in this field. It has been identified that there are children travelling to hospitals abroad. In 2024, 513 spinal procedures were completed. That was a 10% increase since 2023 and a 35% increase compared with 2019, so for sure activity is increasing. Of those 513 in 2024, however, ten were sent to New York and five were in Great Ormond Street. There are some restrictions in that regard. Children have to be suitable, by which I mean medically suitable, to travel. Not every child is capable of making that journey. Then there is an important element of parental decision-making as well. It is not for every family.”
“Perhaps some people are not qualified, perhaps some people do not have the correct experience and perhaps some people withdraw and take positions elsewhere. I appreciate that consultant recruitment is difficult. Nevertheless, significant additional capacity and resources have been put into this area over several years and I do not see a commensurate jump in activity. I definitely have more questions and more analysis to do in that regard. Bernard Gloster and I, working together, have started an internal audit into some of the practices around waiting lists in CHI broadly, in Crumlin and Temple Street, in three areas in particular. Two of those are to be surgical; one is to be medical. Obviously, one of them has to be this because this is what Senators have identified as an area of real concern.”
“That is something that has been introduced in recent weeks and that I think we as a group and the health committee more broadly should keep under active review to see what difference it makes. It is frustrating to me to observe the scale of additional resources that have gone into this area: the hiring of more healthcare professionals in Crumlin, Temple Street and Cappagh, the details of which I have set out; a fifth theatre in Temple Street; additional MRI scanners; 24 beds; further activity at Cappagh; and an additional 52 full-time equivalent posts to enhance spinal services, approved at a cost of €5 million. Recruitment is ongoing for the latter. I appreciate that it can be difficult to recruit to consultant positions. If a consultant position is advertised, there may be a range of people who go for it.”
“Senator McDowell noted the report on insourcing that I published yesterday. I apologise that it was published so close to the committee meeting, but the reality is that I got the report on Monday and I wanted the health committee to have it. I can either keep it in my desk, in my drawer, or publish it. That is the way the world works. You have to publish these things and make sure that everybody has sight of them as best you can. The insourcing report shines an important light, and this came up in respect of earlier conversations about CHI, although it is by no means confined to CHI, that the centralised mechanism for referral is absolutely essential in managing waiting times and managing the balance between any incentives broadly to hold patients here or there rather than making sure they are being managed in the most efficient way.”
“Obviously, I would like it to be 100%, and we have to work to get it to 100%, but that is a very significant improvement from August 2024, when 108 children were waiting over three months, which means that, at that time, only 28% were within the Sláintecare targets. That is a very considerable difference between August 2024 and May 2025, and I recognise that. However, as a new Minister coming in and looking at the resources that have been put into this area, the sheer level of effort put in by my predecessor, his predecessor, my departmental officials and right across the board, I am not yet satisfied with the efficiency of this system. While I will always mark improvements that have been made, I am still not satisfied at all. It is important to me to note a couple of things.”
“Of course we will look at the organisation of services more generally. It is very important to me that every hour a therapist works delivers therapeutic services. I do not want to see therapists in cars. That is one of the reasons the Minister, Helen McEntee, is doing such strong work to make sure there are therapists based in schools, where they can have the most effective and efficient use of their time. I appreciate that is a transitional period at the moment as she moves to do that and provide services in special schools in the first instance. There will be a measure of travel if we are going to get the best out of every hour from every therapist who wants to do therapy work. I hear the Senator about the geography and I will reflect on it.”
“In the meantime, until we reach that, we have to do this as efficiently as possible to get the best for every therapist and every therapeutic service and to make sure they are seeing as many people as possible, recognising the increased number of presentations and the increased complexity of those presentations. I hear the Senator very clearly about the needs of the people of Cavan.”
“Cavan community healthcare network speech and language therapy services, as I understand, are currently delivered in Cootehill; Breffni Care Centre, Ballyconnell; and Cavan town in line with the current staffing resource that is available. That is our big challenge: making sure we have enough therapists to be able to deliver the service to the people who need it as close to home as possible. We are not there yet, and I appreciate the Senator raising the complexity of this intersection for the people in his area. I hear him very clearly in that regard. All I can do is try to increase the number of therapists insofar as possible, expedite recruitment where we can and make sure that the therapists and the services are delivered as close to home as possible.”
“On do-not-attends, it is very important that people attend their appointments because every appointment that is not fulfilled costs somebody else the opportunity. We have to take a strong approach to do-not-attends generally in order that we can continue to get the best for our all-too-scarce-yet services, particularly in disability. I am committed to building capacity in primary care, recruiting additional staff and promoting advanced practice roles in the community for health and social care professionals. The Government is committed to increasing the number of college training places for health and social care professionals.”
“I am aware that recent increases in the number of referrals as well as an increase in the complexity of presentations require many more intensive interventions that have put more pressure on many primary care services, including speech and language therapies. Furthermore, a number of primary care services face staff shortages and we have ongoing recruitment challenges. Combined, these factors have increased the waiting lists for services across the country. I fully recognise the frustration of people in Cavan who have to address both long waiting lists and the geographical proximity of the services available to them. I want to make sure they have timely access to therapeutic services.”
“In the past number of days I have met with officials from CORU about the speed of registrations and how we might do that better to get more people onto the register to be able to serve our community. I met with the national clinical directorate for disability yesterday on the same point about making sure that as many speech and language therapists, and indeed therapists more broadly, are available in our system to be able to provide services to everybody who needs them but, in particular, as the Senator correctly identified, and as the Sláintecare principle goes, as close to home as possible. We are not there yet, however, and we have to organise services in a way that maximises our ability to get the most out of the good training and the good experience of every therapist.”
“I thank Senator O’Reilly for raising this matter and for the opportunity to discuss this very important issue for Cavan but for people more generally. As we know, at a higher level, primary care therapy services generally, such as speech and language therapy, play an absolutely central role in enhancing the health and well-being of both children and adults in the community. However, the Senator and I are both aware and have discussed separately the very important early intervention measures that speech and language therapy can provide. I am doing everything I can, working with the Minister, Deputy Lawless, to get more speech and language therapists with regard to the number of training places.”
“I know that the Senator has been a very strong advocate for this area. It is my privilege to be able to provide this update to her. I thank her for raising this so that I could provide this update to her very publicly and her constituents. Perhaps we might have a further conversation a number of months into their work from September 2025. I will certainly bring the Senator's suggestion back to the HSE. Again, I thank her for advocacy.”
“They provide reassurance and comfort as well as an early identification system for difficulties at a most vulnerable time of both a mother and baby's life. My Department is working with the HSE to address those challenges and I will continue to do so. I appreciate the Senator raising this issue and the opportunity to be able to provide an update to her today.”