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DÁIL ÉIREANN · FORMER

Jennifer Carroll MacNeill

Dún Laoghaire · Fine Gael · Ireland

IN THEIR OWN WORDS

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.

SITTING OF 2026-07-16 · READ THE OFFICIAL REPORT

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.

SITTING OF 2026-07-16 · READ THE OFFICIAL REPORT

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…

SITTING OF 2026-07-16 · READ THE OFFICIAL REPORT

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.

SITTING OF 2026-07-16 · READ THE OFFICIAL REPORT

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.

SITTING OF 2026-07-16 · READ THE OFFICIAL REPORT

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.

SITTING OF 2026-07-16 · READ THE OFFICIAL REPORT

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 3 of 32.

  1. That public health assessment that is being done between the deputy chief medical officer, who was a clinician in Temple Street and who is very well linked into the paediatric system, and the HSE is the sort of basis on which we need to take other steps in other Departments to try to regulate and restrict usage.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  2. As the Deputy and I are in broad agreement on this issue, I will simply use this opportunity to reiterate the potential impact of an acquired brain injury on a child or a teenager. Acquiring a brain injury is a lifelong and potentially life-limiting condition. It can impact their ability to walk, to think, to speak, to eat. It is important that we say these things in the Dáil. The impact of an acquired brain injury can be devastating, not just for the individual but for everybody around them. To acquire a brain injury, whether as a rider, a pedestrian or any person, as a consequence of the misuse of these micro-mobility scooters, or whatever we want to call them, is such a tragedy and such a catastrophe. The Deputy is right that we need data.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  3. Therefore, I have referred the Deputy's question to the RSA for direct response as best it can. However, as to the Deputy’s question on the numbers presenting with injuries arising from incidents with e-scooters, whether as riders or pedestrians, emergency departments are in the business of treating people and not recording the nature or source of the injury or the location. Nevertheless, the public health assessment is an extremely important part of this and while I do not want to pre-empt it, I imagine it will give weight to any further actions to be taken by the Department of Transport.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  4. I can also confirm my Department is in ongoing engagement with the Minister, Deputy Darragh O’Brien, and his officials in the Department of Transport to ensure that health, transport and road safety policy remain aligned as micro mobility usage continues to grow. The Deputy’s question asked about the number of people who present to emergency departments with injuries arising from e-scooters. Emergency departments do not track that data. They certainly do not track the location of an incident outside the hospital. Their job is to treat the child that has come in with a severe trauma. Nevertheless, the Road Safety Authority, RSA, has statutory responsibility for the promotion of public awareness, including the advancement of education and the safe use of roads.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  5. I agree this is a very serious issue for paediatric trauma cases and potentially acquired brain injuries. In light of the recent series of cases and the position paper published by the faculty of paediatrics, the deputy chief medical officer has formally written to the HSE’s national director of public health seeking an initial public health report on e-scooter related injuries in children and young people. That report is intended to clarify the scale of the issue, the impact on health services and whether any recent public health assessment has been undertaken. The deputy chief medical officer has requested that initial report be provided by the end of July or in a proposed timeline if additional data is required in relation to it.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  6. We need to invest more in the community. We need these services to be available in the community. That also means applying the outpatient toolkit, once we are finished with the acute hospitals, to the community lists and the management and scheduling of those. It also means extended hours for all of those therapeutic services in primary care centres, as much as it will mean in the acute. The Deputy can understand why we focus on the acute services first. Nevertheless, that is where we need to get to.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  7. We are trying to end the practice of the money moving from community to acute care and make sure that this does not happen. I will name some additional waiting list initiatives that are important. In budget 2025, we had base funding of €8 million for community-based waiting lists, particularly for psychology and audiology which had previously only received once-off funding. That is more embedded now. I totally agree with the Deputy in relation to the number of people waiting. We will have a dedicated programme over two years to address orthodontic waiting lists. We are just not quite there yet in terms of the negotiations with the Irish Dental Association. Nevertheless, €20 million has been invested in that initiative, resulting in more than 5,500 removals from waiting lists. The Deputy and I are not in any sort of disagreement here.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  8. It is not just the postcode that matters but the specialism as well. That speaks, in some way, to the number of professionals who are available and trying to get them into place. As the Deputy knows, we are trying to make it easier for physiotherapists across Europe to work here. The profession has been too restricted. Similarly, with psychology, it should be the case that people with master's degrees are able to do much more than they have been able to do thus far. We are trying to expand the workforce, but we are also trying to expand the range of qualifications where people can deliver services.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  9. I agree with the Deputy. As I look at the actual numbers on the lists, not only is there regional variation but there is variation by specialty as well. To be very transparent, if I look at the waiting lists from May 2025 to 2026, for example, there has been a reduction of nearly 7,000 people on the audiology list. There has been, however, an increase of nearly 3,000 people on the occupational therapy list. There is an inconsistency there. There has been some progress is some areas, which is great, but none in others. If I look at the number of people waiting more than 39 weeks for audiology compared with May 2025, there has been a considerable reduction. In occupational therapy and psychology, there have been significant increases, while in physiotherapy, there has been a decrease.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  10. We can see the beginnings of real system reform, including much better scheduling and much better use of digital supports, as appropriate. Obviously, those improvements benefit patients, but they also benefit therapists and primary care teams delivering these services by easing some of the burden in managing the different lists and enabling them to focus on timely, patient-centred care. We want to see that progress replicated nationally. Furthermore, alongside that, we are building capacity through the recruitment of 200 additional primary care posts this year. We are increasing the student training places for health to ensure the pipeline going forward.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  11. As the Deputy is aware, last year I approved a national waiting list initiative across physiotherapy, occupational therapy and speech and language therapy, targeting the removal or treatment of over 80,000 people by year end. To date, over 21,000 removals have been recorded, of which 13,000 were by validation and 8,000 by treatment. While this work is advancing across several integrated healthcare areas, IHAs, we are not where we want it to be at this point. A number of discrete industrial action issues are holding up implementation, but they are, I hope, nearly resolved. The HSE is engaging with unions to address these issues, and we are determined that progress must now accelerate. Where the initiative is being fully implemented, it is showing results, including reductions of 80% to 90% in long waiters.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  12. I agree that too many people are waiting too long to access primary care and community services. A total of 1.3 million patients were seen by primary care therapists in 2025, which is significant. There is no question, however, that there is rising demand and increasing complexity, particularly for children's services. This is placing sustained pressure on services nationally. As the Deputy has referenced, that is why my Department and the HSE are driving forward a joint programme to reduce these waiting lists. This includes detailed analysis of therapy activity, productivity and workforce capacity to identify opportunities to improve service delivery and develop a much better therapy waiting list management protocol.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  13. The first step in that is that it is the responsibility of clinical directors, both hospitals and in regions, to make sure that if work is being done outside the public-only consultant contract in a private hospital, it does not impact the public and it does not create and disincentives and that, crucially from a patient safety perspective, not too much of it is being done. It is crucial that a type B contract holder has a maximum of 20%. I do not want to see any instance where a type B contract holder has been doing more than that in a public hospital.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  14. I could not agree more. I thank the health committee for its robust engagement. This is a shared project, making sure that this contract and structure that we have all agreed are implemented. I have concerns about the operation on a hospital by hospital basis, for example, how intensive care facilities might be used between private and public and what the reimbursement structure is. I do not have robust answers to questions about the use of diagnostics, for example, if I am in a private hospital in a region and suddenly need intensive care facilities, and how that transfers. I do not believe those things have ever really been delineated or tested in different ways. It will be quite the challenge to do that.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  15. It is my intention, once I know there is compliance or issues to work on, to initiate a broader audit of how that is done. I have also cross-referenced the admitting rights of public-only consultant contract holders with private hospitals. None of this is enough for me to be able to publish and stand over, but I want the Deputy to be aware that I am doing this work and am trying to do it in a way that is verifiable and robust. It will lead to a much more significant analysis of what is happening in different hospitals.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  16. As I said to the Deputy privately and am happy to say to him on the floor of the House, we did a productivity analysis in the Department of the actual activity being carried out in each of the four big maternity hospitals to try to determine what the level of private and public activity was. It certainly showed instances of type B contract holders going way beyond the 20% that would be implied in their contract, but it is not information that I felt was of a sufficient standard to be able to publish, share and stand over with the committee. On that basis, I have been a little reticent. However, it is certainly more than enough for me to have done the following. I have written to all the hospitals, asking that the clinical directors confirm compliance with the type B contracts.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  17. The HSE CEO wrote again to all regional executive officers on 15 June 2026, making clear that regions must ensure compliance and address any additional issues. This was then followed by letters from the HSE chief clinical officer, Dr. Colm Henry, on 24 and 30 June, to all regional executive officers and regional clinical directors, stating that POCC consultants could not carry out private work in public facilities, and we have asked for formal assurance on its implementation. Crucially, we have also asked for formal assurances on the implementation of the type B contracts to ensure that does not exceed 20% of workload, as per their contract, and that extended-hours rostering is being fully implemented. Responses are due by 10 July, with a further rostering return due by 31 July. I have more to say but I have run out of time.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  18. There has been clear instruction from my Department and the HSE since early 2025, setting out the requirement for compliance. This includes HSE CEO circulars of 14 February, 21 July and 25 September 2025, which required implementation of the POCC rostering provisions, extended consultant-led services and the completion of consultant work schedules. I also established regular workshops with regional and hospital senior management teams to monitor implementation of the contract and rollout of extended working. I met with each region in September 2025 and again in early 2026, as well as online in April 2026. While progress has been made, it has not moved quick enough. However, that is on the implementation of the contract.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  19. I thank the Deputy for raising this matter. It is my view and his view that care in our public hospitals must be based on clinical need, not ability to pay. He will also be aware of - and shares - our commitment to ensuring full compliance with the terms of the public only consultant contract, POCC. The position regarding consultants on the POCC is unequivocal: they are not permitted to engage in private practice within public hospitals. There can be no local discretion, exemptions or deviation from the terms of the contract without express written permission from both me and the HSE, which is imagined in certain circumstances of great emergency to give us that flexibility. Where issues have arisen, such as in the Rotunda Hospital, I have been very clear that immediate action must be taken to ensure full compliance.

    SITTING OF 2026-07-09 · READ THE OFFICIAL REPORT

  20. The Minister, Ms Warken, and I were determined to try to use our platforms as women ministers for health in Europe and the platform of St. Patrick's Day to amplify the experience of endometriosis not just in Ireland and Germany but on a pan-European basis. I have of course invited the Minister, Ms Warken, to the endometriosis ministerial conference in December. I do not have time to speak further but this is a body of work the Oireachtas has leaned into in a huge way, as advocates have done many times. I really want to acknowledge and apologise again that before now, the services were not the way they should have been and the reaction was not always what it should have been. Many women were cared for and cared for enough but there are so many who were not. I really acknowledge that in everything we do.

    SITTING OF 2026-07-07 · READ THE OFFICIAL REPORT

  21. Patrick’s Day programme. Instead of our meeting happening in a government office, she and I went to an endometriosis clinic in the Charité hospital in Berlin, which is a specialist service. We had our bilateral meeting there, with our two flags on the table. We had our meeting in a women’s health clinic, in an endometriosis clinic, at the Virchow clinic, which is a part of Berlin's Charité hospital. Then we had a meeting with the wonderful Professor Sylvia Mechsner, together with advocates and patients. Professor Mechsner, who I hope is coming in December, has developed an endometriosis treatment pathway that is a real multimodal approach. Despite this technical capacity the Germans are, like us, struggling with costs and capacity. We are not on our own in terms of the needs to improve services.

    SITTING OF 2026-07-07 · READ THE OFFICIAL REPORT

  22. I am so grateful to the Senator and to everybody who has raised awareness of endometriosis. I thank Senator McCormack as well for highlighting Kathleen King and Cate O’Connor. We are now better and more profoundly aware of the impact of endometriosis on women’s lives and we really are trying to expand the specialist services. I might come back to the Senator with information on Greece, because it is the subject of particular work at the moment. I hope, though, that the Senator can see the authenticity and sincerity with which we are trying to approach this work. As part of my St. Patrick’s Day visit to Germany, I made a special effort concerning endometriosis, along with my counterpart, the German health minister, who is the minister for health for 80 million people, an enormous position. I was there to meet her as part of the St.

    SITTING OF 2026-07-07 · READ THE OFFICIAL REPORT

  23. This is why we now have two education officers recruited to deliver the menstrual information specialising in endometriosis, MISE, programme that promotes mental health, education and awareness of endometriosis in schools, workplaces and sports clubs. I ask everybody to ask their local community to bring MISE in to try to tell the story better. Finally, as the House will be aware, Ireland took up the Presidency of the Council of the European Union. I get four ministerial conferences on everything to do with health, and I have prioritised one of them specifically for endometriosis. It will be on 3 December. We are inviting specialists from all over Europe and patient advocates to discuss this issue in Ireland. I am sorry, I realise I have gone way over time.

    SITTING OF 2026-07-07 · READ THE OFFICIAL REPORT

  24. We are also supporting trying to get British Society for Gynaecological Endoscopy accreditation, which is an important step. This is a big and significant body of work undertaken by our clinical community. We are also trying to promote awareness of endometriosis. It is wonderful to have the opportunity to discuss it here today. A national menstrual awareness campaign is being developed, to which, of course, endometriosis is not limited, but it must be understood in that context. It will have a particular focus on endometriosis and improving public understanding of symptoms and available supports. Just last week, I spoke with a girl whose position in a bar in Cork was not advanced because she had taken so many sick days when she was in the accident and emergency department in desperate pain, and it was not well understood.

    SITTING OF 2026-07-07 · READ THE OFFICIAL REPORT

  25. The Institute of Obstetricians and Gynaecologists held its annual conference on 6 March, focused on endometriosis, with participation from experts across Europe and advocates from Ireland. Endometriosis is now included in GP training, with additional education resources being developed. I can get the Senator more details. Our clinicians are working with specialist services across Europe. They have attended endometriosis intensive courses across Europe. Several HSE clinicians are now undertaking fellowship training in complex gynaecology in Europe. Two fellowship posts are also funded across our two supra-regional services to train professionals for future service delivery. The first two candidates will complete their fellowships this month and recruitment for the next cycle is ongoing.

    SITTING OF 2026-07-07 · READ THE OFFICIAL REPORT

  26. As the Senator is aware, we try to fund that for them proactively through the endometriosis surgery abroad interim scheme. This is a specific two-year scheme established by us to support patients waiting for surgery for endometriosis who do not have a date in Ireland or whose cases are too complex. Since the launch of that scheme in October, it has engaged with over 150 patients and received 50 applications. We are working to approve additional centres, including in Greece, which has been a request for some time. That is in development. I fear, however, that Romania is not possible for very specific clinical reasons that I think we discussed. The clinical community has leaned into this in a big way.

    SITTING OF 2026-07-07 · READ THE OFFICIAL REPORT

  27. As the Senator is aware, I prioritised the recruitment of an additional 65 whole-time equivalent positions in the 2026 service plan. These are being recruited and include consultants, nurse specialists, psychologists, physiotherapists, radiographers, occupational therapists, medical scientists; a whole team. Recruitment is ongoing across the regions. For example, in our supra-regional centre in Tallaght, five additional consultants will be in place by September. It takes a while to recruit a consultant because not only do we have to find and recruit them but they have to give notice elsewhere. It takes time but they are in place. These specialist posts will enhance services for the most complex patients. The Senator mentioned, however, that services have not been what they have needed to be and that women have had to look abroad.

    SITTING OF 2026-07-07 · READ THE OFFICIAL REPORT

  28. The HSE at my request has allocated additional funding to increase services and I have mandated an action plan to raise awareness and improve services for women in the longer term. In quarter 4 of 2025, I allocated funding for the provision of 100 extra surgeries to be done in that quarter and I am pleased that 142 were done in that period. This required considerable effort but it had to be done. These surgeries were carried out over those three months. Our work on recruitment has resulted in the successful recruitment of an additional colorectal surgeon in Cork University Maternity Hospital and in Tallaght. This is so important because they need to work alongside other surgeons to be able to do work on the bowel. These are complex cases requiring more than one surgeon.

    SITTING OF 2026-07-07 · READ THE OFFICIAL REPORT

  29. It sets out for the first time a defined clinical care pathway for women and girls with endometriosis. It reflects better many of the voices of patient advocates and aims to transform how endometriosis is recognised and treated across the country. We made as many changes as we could and as were appropriate after our first patient voice forum in September, on which we followed up in March 2026. We have had quite good engagement with many more patients than we ever would have before. Although it is not perfect, it is so much more than has ever been the case before. We have an endometriosis priority action advisory group that meets regularly to support the ongoing development and implementation of priority actions.

    SITTING OF 2026-07-07 · READ THE OFFICIAL REPORT

  30. I thank the Senator and I am glad to have the opportunity to discuss our ongoing work in improving endometriosis services for patients. So much has happened, as she is aware, since October but so much more is needed. As I look around the Seanad today I see so many women here of so many different ages and experiences. I am well aware that women here may have endometriosis or may have family members who have endometriosis but it has not been a conversation that has been had as loudly as we are all trying to amplify, to drive awareness about endometriosis. It is a significant health issue affecting as many as one in seven women, as the Senator has said. As the Senator is aware, in October I launched the national framework for the management of endometriosis.

    SITTING OF 2026-07-07 · READ THE OFFICIAL REPORT

  31. I thank the Deputy for raising this issue. I will come back to him on the specifics of the maternity services in Limerick, which I do not have to hand - forgive me - but there has been a very considerable increase in staff. The recent questions around staffing, posts unfunded or changes are something of a surprise to me in that context. I will clarify the issue both for the Deputy and for his constituents but there should be no basis for that given the very considerable increase in staff both in the mid-west in UHL, and in the maternity services. I will clarify that for the Deputy, of course.

    SITTING OF 2026-07-07 · READ THE OFFICIAL REPORT

  32. We have improved our cancer treatment enormously. We have more people living with and beyond cancer. The vaccination, like all vaccinations, is a life-saving medical intervention that protects people all over the world. We will not be doing that. I will discuss the Deputy's suggestion and comments with the Irish Cancer Society.

    SITTING OF 2026-07-07 · READ THE OFFICIAL REPORT

  33. The HSE is assessing this medicine in line with the criteria detailed in legislation. It is important to say that the company which markets this medication submitted the document ten months after the health technology assessment, HTA, was commissioned by the HSE. There has been substantial delay in relation to this. We received a commercial proposal on 27 May and the drugs group is meeting in July, as it does, bringing together the scientists involved to assess the effectiveness of the medication and the cost together. It is a scientific process led by our scientists and we need to let that process continue.

    SITTING OF 2026-07-07 · READ THE OFFICIAL REPORT

  34. Eight children have successfully completed the MRI through that approach without the need for general anaesthetic. I thank the Deputy for raising this really important issue for children's care, including as it relates to resource deployment. I assure him that I will figure out what is going on and get back to him on it.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT

  35. I am aware that the south west has recruited ahead of everyone else. If there is a challenge in terms of where the resources are, it is one we have to figure out. Certainly, that area has recruited more than anybody else, so there should not be this issue. It may be that deployment is more the issue than availability. It is for me to figure that out and to get back to the Deputy. He is correct to raise the issue here today because we do not want children discriminated against in this way. CUH has invested in a Smileyscope distraction system, which works to develop children's tolerance - where possible; it is not always possible - of MRI without anaesthetic. Instead of sedating children, two play therapists distract and keep them occupied during the MRI. We do not want to have to sedate children where it is possible to avoid it.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT

  36. I certainly will, and I could not agree with the Deputy more regarding the importance of resolving and identifying the issue and of making sure that children are getting the diagnostic scans they need. I could also not agree more with him regarding the importance of investing in paediatric care outside of Dublin. That is very important, and it is important to articulate it here this morning. I am in agreement with the Deputy in every possible way in relation to this matter. I just want to figure out exactly what is going on and how this has come to be. I should have said earlier that there are 269 children currently waiting for an MRI under general anaesthesia at CUH. Having an MRI under general anaesthesia requires a nurse and an anaesthetist as well as a radiologist. It is a more complicated team.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT

  37. The Government has invested significantly in paediatric care in CUH. Phase 1 of the paediatric department has been operational since 2017. Phase 2 will focus on the paediatric inpatient unit and will deliver 82 much-needed new and replacement inpatient paediatric beds. We continue to invest in and support that. It is very important that we get to the bottom of the situation relating to MRI scans.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT

  38. The letter to which the Deputy referred relates to a diagnostic concern. That must be sorted out because the people who must not be prejudiced by what is happening in this regard are children who are awaiting diagnostic scans. The issue around the letter and the timing of everything certainly raises more questions for me to interrogate and investigate. As I said, the south west has recruited many more people than other regions. Dublin Mid-Leinster has recruited about 300 people, so the south west is well advanced in terms of its recruitment and the availability of people to do this work. We must figure out exactly what has happened and how that may be managed, but this does raise quite a number of new questions for me to investigate. The Deputy asked about developments relating to paediatric care at the hospital.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT

  39. Sure. What I would point out is that the south west has a more than ample number of ample staff at the moment. It has recruited 617 people this year alone, which is a nearly quarter of all the people who have been hired by the HSE this year. The HSE has recruited 2,700 people overall. As stated, 617 of them have been appointed in the south west, which is one of six regions. Those in the south west have dramatically increased their recruitment. They are still very high when it comes to agency staff and overtime, which means that there has been no lack of people available to work in the south west. As already stated, third-party insourcing ceased yesterday. I am not suggesting that this is directly related, because I do not have that information. However, some of that third-party insourcing in CUH related directly to diagnostics.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT

  40. I can fairly infer that what the Deputy is describing may be a consequence of the ending of third-party insourcing of the kind that those on the health committee found so problematic. I do not know if it is the case that this was a third-party insourcing arrangement that has ceased. The Deputy is not sure. We can follow up and check the names.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT

  41. I appreciate the Deputy raising this matter. I feel as though I may be operating in something of a vacuum here. I might follow up with the Deputy in order to discover who exactly are the people who signed that letter. It is not a letter I have seen. It may have been sent to my Department, but I have not seen it yet. I certainly want to discover who they are and see the issue they are raising. Due to the fact that I am operating in a bit of a vacuum, I have to rely on information on what is happening at the same time. As the Deputy knows, we ceased third-party insourcing as of yesterday, 30 June. He stated three times an external group of people were coming in to CUH to do some diagnostic work, which is exactly what we were seeing with third-party insourcing.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT

  42. What the Deputy is talking about is the excellent "see and treat" model of care, delivered away from acute hospitals in an excellent model 2 hospital for the people of Roscommon and beyond. It is an exemplar of Sláintecare. I compliment Marie Doorly, Dr. Deirdre Jones and all of the people working there who have delivered this. I will do anything I can to support that kind of committed Sláintecare focus they have had.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT

  43. I had the opportunity to see that for myself when Marie Doorly came to our regional meeting for the north west and presented on behalf of Roscommon hospital. It was clear to me. I have huge respect for Roscommon hospital and the role it is playing in the health architecture in the north west. As the Deputy knows, the local injury unit is highly regarded, with people coming from all over the north west - from Mayo and elsewhere - to that unit as an alternative to going to Castlebar. I am pleased to say there will be another injury unit in Ballina, which hopefully will take the pressure off Roscommon somewhat, because it has been filling that role. I know what it is doing in terms of endoscopy and helping with stepdown beds for the other hospitals to ensure the appropriate flow.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT

  44. It is a really streamlined pathway to the correct model of care. In many cases, the patient may not need an appointment and the GP is advised as such. Therefore, it is a very efficient, productive and caring model, where patients are prioritised on the basis of clinical need. Roscommon hospital has excised twice as many skin cancers - 1,200 in 2024 - as benign lesions, and has also treated 10% of Ireland's melanoma patients. That is quite an output for the work in a model 2 hospital. We will continue to invest in the plastic services, and the opportunities for expansion of the services can be reviewed. I happen to be in Roscommon in July, and I might drop in and have a look.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT

  45. What I really admire about this treatment process and the way the hospital is running it is that it is a direct access model. It is a "see and treat" service, which is fantastic for patients because they do not have to come back again and again. It also runs a skin cancer surveillance service under the national cancer control programme, which has been in operation for 15 years. It ensures that all patients who have had any sort of cancer diagnosis are kept actively under surveillance and monitored. In the past three years, it has introduced a photo triage element of the service, which is fantastic. It means that GPs can send in a GP referral as requested but also include a photo, so they are getting ahead of the question all the time. The clinical nurse manager reviews that in conjunction with the consultant.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT

  46. I think that unit could run harder in the evenings and that we could do more there. Where we see really efficient practice is what we want to support. As the Deputy stated, the clinic in question is run by Dr. Deirdre Jones. There is a lot of advanced nursing practitioner support within the clinic, which is a real example of what is good about and what is possible with Sláintecare. There is no reason for people from Roscommon to have to travel to Galway for this service when it can be and is being delivered so capably in Roscommon. The service is led by a consultant and provides day-case and outpatient care. Of course, it has the ancillary benefit of reducing pressure on the acute hospital in Galway, which does not need to see these day case procedures that can be supported so well elsewhere.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT

  47. I am so glad to have the opportunity to discuss this matter with the Deputy. I want to compliment the work of Dr. Deirdre Jones and that of the hospital manager, Marie Doorly, who has transformed Roscommon University Hospital into an enormously important part of the infrastructure of the north west. The hospital is doing great work, and we want to see it doing more great work. Roscommon is a level 2 hospital. The Government is pleased to have been able to increase its budget by 63%, from €28 million in 2020 to €46 million in 2025. Staffing has grown by 31%. In-patient bed capacity has grown by 5%. As Deputy Daly is aware, what we are trying to do at the hospital is so much about day-case procedures. He referenced the endoscopy suite, which I am going to go to see.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT

  48. It is absolutely fantastic. The Deputy is aware what has happened is a turnaround for both the hospital for the people she represents. We are so pleased to be able to do more to support that really excellent level of care. I thank the Deputy for raising this matter.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT

  49. I checked that at 8 a.m. this morning, and it is only just after 9 a.m now. There were also no people on trolleys on Saturday. As indicated, all week long, the hospital has been within the green threshold, which is the accepted safe level. We have given Drogheda hospital additional resources for a virtual ward that has 12 beds. I am pleased to say that Drogheda hospital is using that ward. There were eight people on the virtual ward yesterday. The figure for the ward has been in and around that each day. They could put a few more on because there are 12 beds on the ward. The point is that the hospital is using the resources it has been given intelligently, well and in a way that serves the people Deputy McGreehan represents in County Louth. I am so pleased to champion, highlight and promote what Priya Madhu and her team have done.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT

  50. I am delighted. I again thank Deputy McGreehan for raising this matter. Deputy Paula Butterly also raised it with me but in a different way. I just want to compliment the region in general and the hospital management in Louth, particularly Priya Madhu, who is the hospital manager there and who has done so much. Our Lady of Lourdes Hospital in Drogheda, which the minor injury unit supports, has done phenomenal work. There are zero people on trolleys there today. For the past ten days, the hospital as been completely within the green threshold in that regard. As a representative for County Louth for so long, the Deputy knows how that was very much not the case a year and a half ago or two years ago and that the emergency department in the hospital was really challenged. There were no people on trolleys in the hospital yesterday.

    SITTING OF 2026-07-01 · READ THE OFFICIAL REPORT