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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“The cost of the medication has always been available to be free since 1 January. I hope that answers the fair questions people have asked. It was never to cover all the cost; only the cost of medication. I have gone back to check this a few times but I appreciate how these things sometimes may get lost in translation. Senator Flynn highlighted women in prison and some of the more intersectional issues. She is quite right and I will address this in terms of some of the issues of more marginalised communities. Women in the Dóchas Centre prison suffer in particular with addiction and mental health issues. I was on the penal reform committee of these Houses before I became a Minister and this is a serious issue.”
“Pharmacies could have a much greater and expanded role in healthcare in terms of diagnostics, prescriptions and common conditions. I am really excited about the opportunity for pharmacy and I met the IPU about this. There is a huge body of work to do to support pharmacists a little more than we have been - there is no question about that - to go further in our ambition on what pharmacy can do, as well as to resolve this. In fairness, this is the first time the question of a dispensing fee has come up. It is not within my budget. I do not have a budget to cover a dispensing fee but I am genuinely trying to find a space in the middle that enables the implementation of this scheme as early as possible, which certainly will cover the cost for medication and then we will see what else is possible. I want to be transparent.”
“What it does not say is the cost of the medication or the dispensing fee charged by the pharmacist for each medication. For example, in a scenario where the cost is €60, perhaps the medication costs €10 for one product and €30 for another with a €10 dispensing fee for each product. This scheme has been available for implementation since 1 January to cover the cost of medication, not the dispensing fee. It is the first time this has happened but there was a reluctance to implement it. I met the IPU on 11 February and have been engaging with it since then. There is a huge opportunity here and I would love to speak with the Senator further on this. Pharmacies are a bit like credit unions in that they are in every town in Ireland.”
“The second piece, correctly, relates to the cost of HRT. It is important to distinguish something. The former Minister, Stephen Donnelly, secured €20 million funding to cover the cost of the HRT products. That did not include - Senator Tully inquired about this - a GP scheme, nor did it include funding to cover pharmacists' dispensing fees. Those are different. The State has not done that before. I refer to these incremental initial steps. I think the former Minister wanted to pay for the medication as a contribution to reduce the cost. I spoke with a woman yesterday who is getting HRT, as we all do in our different areas, and who paid about €60 for two products. On her receipt, it just says €60 – or whatever the cost – and it names the medications, the number of pills and the dosage, whatever that happens to be.”
“Regarding the authorisation holder, we cannot get an estimated date of return for the 75 mg patch. Senators can see how case by case it is. That is a difficulty. I do not wish to be dishonest in any way. Strictly speaking, the Government cannot override that shortage of supply. We can do everything we can to try, but, ultimately, we are suffering in the same way as the rest of Europe is in respect of the availability of certain medications and how that changes over time. I will always try to get updates and provide information. This is where the expertise of pharmacists is very important. They have - not in every case but in some - been able to find alternatives that have long since been licensed medications to try to support some, not all, women while shortages obtain. I just want to be honest about what is possible.”
“There are two primary issues with HRT. The first is the shortages involved. Specifically, we are talking about HRT patches, in particular, Estradot, which is in short supply. That comes in four different versions or doses. There is a certain amount we can do, and then there is the reality as well. The issue is not access to this drug, as it is with other drugs, for example, where it has not been licensed or anything of that nature. The issue is demand, the growing demand across Europe and the manufacturer’s ability to produce it quickly enough to meet demand, not just here but across the Continent. I am getting updates about the availability of the different patches. The 37.5 mg, the 50 mg and the 100 mg patches should all be resupplied by 7 March.”
“How would we capture that in the best way? What are we doing in respect of lung cancer? What is the position when it comes to bowel screening? How are the different cancers picked up at different stages? I am not a clinician, so there is a process to be engaged with in that context. All those things cost additional money but, in many ways, they have saved us enormous hardship, most importantly, in terms of patient care, and saved us money in terms of treatment. We have to make sure that as we make choices – they are definitely choices – we get the best return for our extended investment in the healthcare system. I will be very honest about all of those things over time. Many different points were raised, and I want to try to respond to them appropriately. I will deal with HRT first because many Senators raised that.”
“While I want to say "Yes" to everything, it is just not realistic or possible for me to do so. I want to be honest about my approach, which is that I want to extend everything as much as possible. However, I also want to try to get the best value for what we are doing. For example, many Senators referred to screening in general and to extending the age limits in respect of, for example, with BreastCheck. We looked at this in the development of the programme for Government in the context of wanting to broaden the age thresholds. We quickly realised we are not clinical experts and it is probably better, as we review these schemes - which is stated in the programme for Government - to take the advice of clinical experts on the best way of doing that. Do we, for example, simply extend BreastCheck in terms of ages? What would be the best ages?”
“I genuinely want to try to respond to everything I can. I will preface my remarks by saying that I do not know the answer to everything, but I will try to get better answers as I get further into the brief and things come more naturally to me. I will honestly try to give the best answers I possibly can. I will also try to give very honest answers because I do not think there is anybody in this room who does not want to see the health service improve over time. There is no disagreement on that. There is really no difference between us in wanting to see it improve. The only difference is that I am responsible for paying for it, so I have to be honest about how we can do that and by how much we can increase the budget. Many of the issues that were raised involve a price tag.”
“It is important that, while we shine a light on women's health action plans generally and the work to support women in their healthcare across the board, we make sure there are appropriate responses for the physiological differences in women, serious research is directed at improving women's health outcomes and we get to a point where women's health is treated as naturally as all health and there is no real differentiation. I welcome Senators' contributions.”
“It might seem like a small step but it is a recognition that it is a natural part of life and that some women may be financially disadvantaged. I would like to see a period where we do not have to have these weeks or specific task forces and women are just part of the national conversation in a completely normal way. I recognise that that is not yet so. On the other hand, women are living longer than men at 84 years compared to about 80 years. Nevertheless, our health outcomes in cardiovascular care and osteoporosis care are worse, and certain cancers are more prevalent among women. One would think lung cancer would operate equally between men and women but women get it much more often. There are certain outcomes, because of women's sex, that are more difficult.”
“Some groups are still left behind. We are trying to produce programmes that will target women who might for different reasons be harder to reach. For example, we have introduced a pilot programme to support Ireland's effort to eliminate cervical cancer by improving the HPV vaccination rate, not just among girls, but also boys, and in every community, including some healthcare underserved communities that may include Traveller, Roma and certain migrant groups living in Ireland. We have also supported a project to raise awareness among women and girls of the signs and symptoms of common types of cancer in different communities across Ireland. We continue to build on initiatives such as the provision of free period products, providing free tampons and pads women in every community and placing them in the bathrooms of public buildings.”
“We are also working to improve breastfeeding rates, recruiting additional lactation consultants to support women on their breastfeeding journey and developing a new national breastfeeding strategy. All of that works while we continue to progress the tender process for the new national maternity hospital. We are working hard to get to a place where everyone has access to quality tailored care that provides treatment and research appropriate to our physiology. Through the women's health action plan, my Department is also investing in such research that will expand the evidence base for women's health and lead to better healthcare. I mentioned this morning the cardiovascular project in Dún Laoghaire, which is an example. Despite this focus on the women's health action plan, some voices are still not being heard quite loudly enough.”
“I do not know if any of the Senators have spoken to new mothers who have had the opportunity to experience these postnatal hubs but the feedback I am getting is they have been quite positive and constructive. I am interested in Senators' feedback. The hubs have proven a good support to women with breastfeeding, physiotherapy and other emotional and physical supports for up to 14 days post birth, which is a very delicate time. There are four additional see and treat gynaecological clinics being put in place to complete the national network of 21 clinics for the fast and efficient management of gynaecological conditions. Those clinics have had a big impact on waiting times for those procedures.”
“We have hubs that have now treated about 1,100 of the more complex cases but there is quite a bit more to do in that area and to recognise the impact it has on people's lives. Similarly, we started to meet women's long-overdue right to treatment for the management of menopause. While much of that can be done at primary care level and we have been working with GPs to improve awareness and training, we have also established six specialist clinics for the treatment of more complex cases. I appreciate that these clinics run at limited capacity but they are an example of a start and where we would like to go further with them. As we continue to implement the national maternity strategy, we will open eight new postnatal hubs to improve the care provided to new mothers and their babies.”
“We recognise that these are many good starts, and there may be more to do and a need to examine how we might get better value, better outcomes or spread that particular fund in a more effective way. This year, we will see further work on the establishment of the Assisted Human Reproduction Authority, with the enactment of the amendment Bill and the establishment of the authority two key elements that will enable expanded eligibility for AHR. We are getting closer to the opening of the first public AHR centre in Cork. We have established hubs for the treatment of endometriosis. Most endometriosis cases can be managed perfectly well with within a GP or primary care setting, but there is a need for complex intervention and complex services.”
“For example, there is the free contraception programme for women aged 17 to 35. There is much better investment in screening services and a commitment in the programme for Government to go further with that, based on clinical advice, not politicians' thoughts. We have expanded termination of pregnancy services. I think we are at 18 out of 19 maternity units now, and soon to be at 19. I will have an update for the House on that in a number of weeks. We have established a growing network of see-and-treat gynaecology clinics, which are working quite well. We have developed public services for fertility and, for the first time, limited funding for IVF for people whose fertility issues cannot be managed at primary or secondary care level.”
“That work has been enabled through the women's health task force. I thank each member of the task force for their work, which, driven by the demands of women, has provided the foundation for the women's health action plans. Good progress has been made. I pay tribute to my predecessor, Stephen Donnelly, who drove much of that work with the women's health task force. It is a starting point, however. There is an awful lot to do. I am excited to work with all of the Senators to find the particular areas where we can do considerably better. Let us recognise some progress. The State has invested an additional €180 million in women's health since 2020. That dedicated initiative has resulted in the beginning of new initiatives across the country, often the first of their kind.”
“I recognise the considerably greater difficulties that many women around the world are facing in terms of health inequalities more broadly. It is always important to recognise our own reasonably privileged, favourable position vis-à-vis many other women, and some of the intersectional issues that women in Ireland face in terms of their health. A week like this, unnecessary as it should be, nevertheless enables all of us to shine a particular light on issues that were previously shrouded in some silence. In the past, we only heard something like menopause being mentioned in whispers. Thankfully, the silence around that, periods and endometriosis has begun to lift. That public conversation becoming louder has, thankfully, driven service delivery at a better level, although there is much to do.”
“Women have to be listened to, understood and respected in the most basic way. It seems ridiculous to have to say this out loud but nevertheless, women's experiences and symptoms can be different from men's. These wrong diagnoses and inadequate treatments lead to poorer results. It is a systemic issue that we have to recognise. I welcome Senator Clonan and the other Senator. I am sorry; I do not know his name. I am delighted to see them and thank them for coming to women's health week. Inequalities in health mirror inequalities that women face in other areas of life. I do not just want to focus on inequalities in women's health in Ireland. Next week I will attend the United Nations Commission on the Status of Women.”
“This morning I opened a women's health initiative in cardiovascular care, where it is not that women are not listened to, but because their symptoms present more subtly and in a more nuanced way, they are often not recognised or understood as a cardiovascular issue. The women's health fund in my Department has provided significant funding to address three specific projects between St. Vincent's, St. Michael's in Dún Laoghaire and UCD, to try to shine a light not just on the operation of bias in some of the diagnostics but also the tracking of particular risk factors in gestational diabetes and other markers in the maternity system that may lead to cardiovascular difficulties. There is so much to do in recognising that women may present differently. That is not a question of bias but simply different symptomatic presentation.”
“The reason I highlight it is that time and time again in maternity services, there seems to be a systemic difficulty in actually listening to the voices of women, including heavily pregnant women in maternity units. That is not unique to this situation but across maternity hospitals and units. No matter what report I read into lack of care or adverse incidences, including the most recent report of the working group on medical negligence costs, I read about women highlighting that they did not feel they were listened to and how often that impacts on their care. That is not just in the case of maternity issues.”
“Perhaps just let us focus on a health service for everybody, recognising the basic dignity, human rights and respect that every person, male or female, deserves in the health system and right across the rest of society. I would like to highlight, though, that some issues impact women more than men. One of those is maternity, naturally. I would like to highlight in particular, recognising that this is women's health week, that the maternity system's impact on women is very considerable. I want to recognise the women who have had difficult experiences in Portiuncula and Ballinasloe hospitals, where I have travelled twice in the past number of weeks to meet and sit with those women and spend time with them, whose babies' births and, in some cases, whose babies' deaths are the subject of review.”
“As a female Minister for Health and Member of the Oireachtas, I am more than ever struck and wonder why these weeks should be necessary. I really do have a sort of cranky difficulty with the continuous focus on women being different or having to be different - women for election, women in finance when I was in the Department of Finance, women's health - as though women are not half the population. I am the only female representative for the Dún Laoghaire constituency, not just in this Dáil but in the previous Dáil. For some reason, women have to go out of their way to highlight the different issues that have led to so many inequalities. Health is one of those.”
“I thank the ladies of the House so much for the invitation to speak on women's health, with International Women's Day this coming Saturday. It is wonderful. I also congratulate and thank Senator McDowell for coming into the Chamber. It was well commented on by the ladies present that there were quite a lot of men in the Chamber for the previous debate. There was not quite a stampede to the door but, my goodness, quite a rush to the door. It is wonderful to speak, yet again, with women, about women's health and women's issues in international women's week and women's health week. Senator McDowell is gloried among women. I thank him for being here. It is sort of pointless to have to make these remarks continually but there we are.”
“It should not be a million miles away with pharmacies. If I get a bill, I would like to see what the cost of the medicine was, what the cost of the dispensing fee was and what the State paid towards that, recognising that the State is paying €500 million of taxpayers money to pharmacists every year to support taxpayers in accessing medicines. There is a lot of merit in what the Deputy is describing. Let us have a think about the best ways we might approach that. This issue has also been highlighted in respect of HRT. I will take ten seconds to pay tribute to my predecessor, Stephen Donnelly, who put enormous work into this position, developed the database and placed a strong emphasis on data, process and productivity that has led to significant improvements.”
“Bernard Gloster on the scheduling that it anticipates over the next number of weeks. The hospital's response was one of the best and most proactive. There is a balance to be achieved. I also compliment Limerick on the fact that it progresses its elective surgeries when certain hospitals cancel them. I will do my best to try to flatten those lines to make the approach across Ireland more consistent and there are not geographical differences. I thank Deputy Timmins for raising the issue of transparency in terms of pricing and pharmacies. It is a long-standing issue. When we had the energy credit scheme, it appeared on our bills - on my bill, at least - as a credit put towards the charge. Taxpayers understood that it was their taxes, not Government money, contributing towards paying their bills.”
“It should not be a geographical accident. While I am highlighting these examples as regards the broad trends I am seeing, I recognise that there are local differences and nuances and that this is a broader, whole-of-region responsibility as well as a whole-of-hospital responsibility. I welcome the debate by Professor Collins and others in this space because it highlights some of the issues we need to focus on. At the end of the day, there is a weekly spike that is exacerbated on bank holidays because of the two-day window where there are not enough people, including consultants, working. I have tried to track resources and the scheduling of resources over the past number of weekends. I thank Deputy O'Donoghue for highlighting Limerick and the substantial body of work to be done there. I compliment Limerick on its response to Mr.”
“One of the things I have highlighted is the bank holiday weekend precisely because that was one of my first weekends there, but this is an every weekend problem. I would expect to see in the scheduling consultants routinely being there from 8 a.m. until 6 p.m. on a Saturday, not 8 a.m. until 2 p.m., thereby reducing the time when there are no senior decision-makers present. Of course, they have to be supported by the rest of the team in the hospitals and by diagnostics. That is very much an inconsistent experience at the moment. In some hospitals, there is access to diagnostics. In some, there is not. That is not okay. I need to be able to come to the Chamber and confidently say that there is a consistent experience across Ireland. Deputy Ward recognised the experience in Letterkenny and Deputy Pa Daly recognised the experience in Kerry.”
“Obviously I would like very much to be put under pressure to get the finance for that electronic health record, which is extremely important for everybody. On Deputy Ó Muirí's point, I believe we have committed to that emergency department and to the additional block. My colleague, the Minister for Finance, Deputy Chambers, launched the Beaumont strategic plan a little while ago, so there is a strong commitment. I highlight to all Deputies that the HSE capital plan is coming and a very significant body of work in this regard is outlined there. I thank Deputy Burke for raising the complex issues with emergency presentations. Of course consultants are not the only part of that, as Deputy Cullinane also recognised, and there are multiple different factors.”
“Similarly, I met some from the Cared Ireland group, which was also highlighted by many different groups. I thank Deputies for raising the issue of HPV vaccination. I must highlight how important it is for boys as well as girls and the emphasis on that. The Minister of State, Deputy Murnane O'Connor, has answered on GP access but we can have a conversation about the Summerhill family practice because we do have some solutions to that. I thank Deputy Rice for raising not just the digital structure but also the subject of digital health. The Deputy is absolutely right about the delay in delivering that and it needs to be done. As the Minister, I am glad my predecessors have done the work on the development of the app, which is at the first stage, but we need to continue to drive on that.”
“Of course, where we have additional pressures, either from RSV or other pressures, appointments and surgeries are getting cancelled. The Deputy is right that this is precisely why the new elective hospitals have not happened yet and they must happen. This was linked to what Deputy John Connolly said about some of the procedures around that. I need planning permission to turn a hospital into hospital, so to speak, and the public infrastructure guidelines that go out to public consultation in these ways are not, strictly speaking, the most efficient way of doing that. I would like to try to do that slightly differently. I would ask for Members' help in that. On Deputy Sherlock's points, I did attend with and met the rare diseases community today.”
“It is very much a team here who are here to work with Members as a team. I thank the House for the acknowledgement that, when we all do well together, it is the people who benefit. That is the way we will work here. I say this on behalf of all of the Ministers of State here. Deputy Rice made a very good point that this is not the most efficient way of using Dáil time. It is most unusual at this time until the legislation comes in and until the committees are structured. At least 37 people have spoken in this debate so allow me to try to respond as much as possible. I recognise that Deputy Rice has been here this whole time. I thank Deputy Cullinane for highlighting some of the additional issues regarding the pressures on hospitals in January.”
“That is the expectation we should have for our healthcare system, trying to use not just the infrastructure for better care outside of the acute hospital system but also making sure we are getting the productivity we expect of the people - public servants, as we are - who are employed by our healthcare system to ensure they are delivering for the people of Ireland. I assure the House that as Minister for Health I will work every day to ensure we are fully realising the benefits of the very considerable investment Irish taxpayers have put in to our healthcare system, that we are building on the outcomes we already have and that we are improving access for everybody in Ireland.”
“However, we also have this body of people who should be getting surgical treatment in elective hospitals and in surgical hubs and it is my intention to try to get the funding and make sure we manage the delivery to ensure we have those. The week before last, I opened the Mount Carmel surgical hub facility, which is the first of six such facilities. This will do about 11,000 small surgical procedures every year, whether it is carpal tunnel surgery or a pain relief medication that has to be done in a clinical setting, but it will also have 18,000 outpatient appointments. It is appropriate that people are not going to acute hospitals for outpatient appointments of that kind. However, I also want to see outpatient clinics delivered by consultants in hospitals on Saturdays. That is what our public-only consultant contract enables us to do.”
“What that means is making sure we get the funding and the process in place to deliver the remaining surgical hubs, the elective hospitals, the national maternity hospital and our digital health programme, to make what I genuinely hope can be a leap in the infrastructure for our healthcare system to try to keep as many people as possible out of our acute hospitals. We have heard some examples this evening of what we are trying to do in the community whether it is enhanced community care or the community interventions schemes. We try to keep people away from acute hospitals in the first instance and try to keep them at home rather than in hospitals for different types of care.”
“If I could summarise our health system more broadly as I come in as Minister for Health for the first time, every time I look at our public policy questions and challenges around health, I am struck by our very long life-expectancy relative to our EU peers and by our extremely good outcomes in care right across the spectrum. Whether it is cardiac care, stroke care or cancer care, our outcomes are extremely good when people are in the health system. That is a good public policy situation to be in. Where we struggle, and we all know this, is access to care such as to diagnostics and treatment. That is why a focus on waiting times and on access to urgent and emergency care is so important. I say to the Members of this House, to whom I am accountable, that my focus is on improving access as much as I possibly can.”
“I will ask the other maternity hospitals to do the same where that sort of cooling process is used. It is the gentle changes that are a bit more compassionate and more understanding of the patient's experience. If any Deputy has any examples of where we can make the patient experience when things go wrong a little gentler, softer, kinder, a little more compassionate and perhaps more thoughtful by all the parts of the State working together, will they please bring those to me and I will do everything I possibly can to make sure they are implemented? Separately, on patient safety, obviously HIQA are doing an important body of work. I am running out of time. We will be dealing with those issues over time in any event.”
“It is the little things that would have made their lives easier, for example, knowing people do not wear sleeves in a neonatal intensive care unit. The family would have felt more comfortable had they known that coming up. Yesterday, I met the Master of the Rotunda, Sean Daly, and I made these points to him and asked him to set up a dedicated liaison for anybody coming from anywhere around the country to make that experience a little easier. This extraordinary family offered to even share pictures of their little baby or of the cooling process itself, just to, as they said, take the edge off that terribly traumatic experience. The Master of the Rotunda has already come back to me to say he will implement those changes and put together a practical care pack for people coming.”
“For example, one family told me about the experience of coming to Dublin with their baby who had been transferred to the Rotunda Hospital for cooling, which was a completely appropriate response in the case. If a mother has just had a baby and her baby has been appropriately taken for cooling and taken away, that is a traumatic experience to go through. The family described the experience of coming to Dublin and while all the care was correct, the experience around the care was different. It would have made their lives easier to know there was discounted parking available in the Spire car park and it would have made their lives easier to know they could get discounted food in the staff canteen downstairs.”
“I met more families this week on Monday in Portiuncula who have been impacted by patient safety. Members will possibly see an over-indexation in the programme for Government on patient safety. It is very important to the Government that we get on top of responding to patients in a timely and a caring way and making the experience of having a difficulty in hospital easier. One of the families I spoke with in Portiuncula this week identified the experience. Some of the situations in Portiuncula appear to be emergencies that have been responded to by the hospital. Others are different types of cases. I will not pre-empt the investigations and the analysis of the reports but the experience is so important - not just the facts, but the experience.”
“We will then have a shared care record and ultimately, the electronic healthcare record. I hope this House will put me under great pressure to secure the funding and make sure the electronic health record because, of course, it is in everybody's interest we do so. I want to get lots of PQs about how we are progressing with that so please do put me under as much pressure as possible. Separately, I want to mention improving patient safety outcomes. My Department leads the direction of patient safety policy and legislation via the work of the national patient safety office. This is something that is important. The office is responsible for notifiable incidents and open disclosure but I am particularly sensitive this is something that is deeply relevant today with Portiuncula Hospital.”
“If you can do your shopping and your banking on it, you should really be able to look after your own health on your own phone and using the technology everybody in this House has. For example, I can see on this my flu and Covid-19 vaccination records and I am horrified by the gap between my vaccinations but I can see it. If I had a series of medications or if it was difficult for me to remember, I can track that. How many of our constituents do we know who are tracking their medications on paper? This should make it dramatically easier for them. The reason I pick my phone up is to show Deputies and I ask them to please download the app. They should go to the App Store or Google Play and download the HSE health app. Please do it as it is a big step forward in our electronic health record programme. That is the first step.”
“It started with a pilot in Cork with maternity patients where they could clearly see their antenatal and other appointments throughout the system, both prior to having a baby and also for some of the follow-up care. It will enable us to schedule appointments over time. There will be a series of roll-outs relating to this but right now, for example, users can look locally and find a GP wherever they happen to be. If they have an emergency in some other part of the country, they can see where the local urgent emergency care centre or primary care centre is and look up what they need. It will also enable them to track their medication. The idea is this will be a single point of information.”
“It will address a deficit of investment in technology to date and significantly impact on productivity for people working in the system and access for everybody trying to access health and social care services. This started just yesterday with the launch of the app, which is what I was trying to show the Deputies on my phone. This is my version of the app and if anybody has not downloaded it yet, as health spokespeople and Members of Dáil Éireann, I ask them to download it. A MyGov ID is needed to do that. Not everybody has that to hand, but if they do not have one, they should please get one. It is a fantastic app and provides an opportunity for people to schedule appointments in the public system.”
“As the House knows, this is an area where I have a particular focus and forgive me for looking at my phone but I want to show the House something that has been important this week and it relates to digital health. Under Sláintecare, funding has significantly increased to expand digital health technologies across the health service, building cyber resilience and progress towards digital health records for patients. The health service has an ambitious forward-looking digital pipeline to deliver on our vision of digital for care 2024-2030 and its accompanying implementation roadmap, coupled with an appetite and momentum for change. This is something for which everybody has been looking for a very long time.”
“We now have 4,5000 consultants, which is a very significant increase, and 60% are on that public-only contract. The primary objective of that is to enable the move towards genuine, universal healthcare with public hospitals exclusively used for the treatment of public patients. A core objective of implementing this contract is to enhance the senior decision-maker presence on-site, out of hours and at weekends, and ensure those senior decision makers are present and delivering patient care when demand is at its highest. It means that more patients are treated by consultants, treated quicker and getting out of hospital quicker, where appropriate.”
“It is a very significant increase in spending but we must make sure we are getting the best from that. The productivity and savings task force, established 12 months ago, is driving a programme of work designed to achieve savings and efficiencies across the HSE to optimise the use of health funding by delivering safe health services. I am committed to making sure that task force continues its work and we all see the benefit on behalf of the tax payers and people of Ireland, and that we meet our savings targets and continue to implement a range of productivity measures that maximise access to health. One of the most important reforms in recent years is the public only consultant contract, which was implemented in March 2023, and more than 2,700 or 60% consultants are now in that contract.”
“At the moment, the State is supporting approximately 58,000 people to receive home support. The overall budget for home support stands at €838 million, which is an increase of 70% on 2020. That allocation meant we could provide more than 24 million home support and complex home support hours in 2024, which is more than we have ever done before. While we are investing more in our health and social care services, it is really important we see that investment used as productively and efficiently as possible. Since 2016, the budget for health has increased by more than 82% from €14 billion to €25 billion in the budget now for 2025. Expenditure on acute care has increased by more than 80% over seven years from €4.4 billion in 2016 to €8.1 billion in 2023.”
“In 2024, 7,200 patients were provided with a mobile X-ray diagnosis through that service and 95% of them were treated at home and did not require transfer to hospital, the majority of whom were in nursing homes. The community intervention team service prevents unnecessary hospital admission or attendance and facilitates early discharge of patients for whom that care is appropriate. It provides access to nursing and home care support, usually from 8 a.m. to 9 p.m., seven days a week. There are 23 of these teams operating nationwide and again, in 2024, their activity continued to go upwards with an approximately 16% increase on 2023. That home support is an absolutely essential service for people to be able to live longer in their own homes and live well in their own homes.”