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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“They had more than 354,000 patient contacts in 2024, which is a 128% increase on 2023. Significantly, the overall implementation and roll-out of the chronic disease management programme has resulted in a 16% reduction in chronic disease hospital admissions between 2019 and 2023, significantly lower than the 3% reduction for all medical admissions. Linked to this also is GP access to community diagnostics, with 280,000 scans completed last year. We have a mobile X-ray service, providing services to those residing in nursing homes, community disability units and those in their own homes for whom an attendance for an X-ray in hospital would prove challenging.”
“Since its launch in 2020, the ECC has expanded significantly, with 2,000 additional healthcare staff, the establishment of 96 community health networks and 50 of the planned 60 community specialist teams for older people and chronic disease. Last year, community specialist teams for older people had a total of 133,000 patient contacts. This was a 35.1% increase on 2023. The focus of those teams is on prioritising complex and more frail patients and the vast majority of those patients are discharged home as opposed to having to go to an acute hospital. Linked to the GP chronic disease management programme, the community specialist team for chronic disease management provides services for some of our most chronic diseases: respiratory, cardiology and diabetes.”
“As people live longer lives, they want to stay healthy and independent. Government policy is to support people living with dignity and independence in their own homes and communities for as long as possible. The enhanced community care, ECC, programme is a transformative initiative under Sláintecare, shifting healthcare delivery from hospitals to community settings, ensuring patients receive tailored treatment closer to home. We want to strengthen primary care, general practice and integrated community services, preventing unnecessary hospital referrals and admissions while enhancing patient outcomes. This is again consistent with Sláintecare; getting the right care as close to home at the right time.”
“We, and I in particular, have to arrest the drift that has happened in respect of trolley numbers into this year. I have obviously placed a particular focus on the weekend spikes we are seeing. I will be updating the House as regularly as I can - the next occasion will be after St. Patrick's Day - on rostering, scheduling and all of the services that are there to support people and ensure they do not have to wait on trolleys. This includes analysis of admissions, discharges and rostering but also broader community supports and the whole-of-region involvement that is necessary to ensure people can be safely discharged as needs to be the case. There is a body of work to be done to improve on the good progress that was made last year and, indeed, to get it back to where it had been. There is also the issue of access to community care.”
“The vast majority of patients who need a bed get one in a timely manner and do not spend an extended period of time waiting on a trolley. This is happening while our healthcare service is also experiencing a significant increase in our demand for care. On waiting lists and waiting times, there are two important points. If our population is growing, if people are getting a better service within our healthcare system and if they are getting better diagnostics and are being referred for more procedures, I would like to see, logically, the number of people waiting for treatments increase as a consequence of population growth and as a result of being diagnosed and being correctly referred for treatment. I would like to see, however, the time for all of those things coming down. That is why we must focus on waiting times.”
“However, in the past eight weeks I have seen an drift in the very important and good work that was done between 2023 and 2024. I am determined to arrest that drift and turn it around. Our emergency departments experienced an 8% increase in the volume of attendances, equating to nearly 119,000 presentations and an 11% increase in attendances for 75 years and older patient cohort. In that period, however, we achieved at that time a significant reduction in the cumulative daily 8 a.m. trolley count over 2024, with numbers down 11% and fewer older patients waiting longer times. We intend to try to reduce that further this year. It is important to acknowledge that our emergency departments see over 5,000 patients a day.”
“Through this year’s action plan, we aim to further reduce the average waiting time for outpatients to 5.5 months by the end of this year. Reducing waiting times for care will obviously bring a number of benefits from a patient perspective, including improved outcomes and a genuinely better experience of the health service and of a person's experience of the difficulty they are facing. The second point of waiting relates to access to urgent and emergency care and, in particular, that most visible element of it, the trolley count we see, with people unacceptably waiting on trolleys to get access to our healthcare services. The number of patients waiting on trolleys in hospitals at 8 a.m. each day in 2024 was down in comparison with 2023 despite increased attendances.”
“It sets out four key targets that are all focused on reducing hospital waiting times by the end of the year, including further reducing the proportion of longer waiters and average waiting times, as well as having 50% of patients dealt with within the Sláintecare ten- to 12-week waiting time targets. Since the commencement of the approach set out in this plan in 2021, genuine progress has been made in reducing waiting times in acute hospitals. For example, up to the end of 2024, we had achieved an approximately 25% reduction in the number of people on waiting lists waiting longer than the Sláintecare targets. This equates to almost 150,000 fewer people breaching these targets. Over the same time period, we have also reduced the weighted average waiting time for outpatients from 12.8 months to 6.8 months.”
“Of course what we want to do is to reduce waiting times for access to healthcare services. As Minister for Health, ensuring better access to healthcare in Ireland and reducing the time patients are waiting for care in our acute hospitals is one of my highest priorities. Time is what we must focus on. Which would Members rather, 100 people waiting one year for a treatment or 100,000 people waiting for one month? They would of course prefer the latter, and we must focus our emphasis. Our tests and assessments must be based on waiting times, which are coming down but which need to come down further. Our Sláintecare targets are ten and 12 weeks. The Waiting List Action Plan 2025, which I published earlier this month, is another milestone on that journey.”
“There has also been an unprecedented level of investment in the health service workforce in recent years. As of December 2024, there were 126,740 whole-time-equivalent staff working in health services funded by the Department of Health. That is an increase of 25% on the numbers for 2020. This represents an increase in our workforce, which is a positive development. It is important that workforce growth is managed in an affordable and sustainable manner and that we get the best productivity we can from everybody who is working in our health service, which is a reasonable expectation of taxpayers and of the people of Ireland. One of the pressures that we all feel and that we must address is increasing capacity and access to acute hospital services by building infrastructure elsewhere.”
“The construction of the children's hospital is 95% complete against contract value. Once substantial completion is achieved, the hospital will be handed over to Children’s Health Ireland for a post-substantial-completion operational commissioning period of about six to nine months. What we are hoping is to have early access. This is what we are expecting in order for that work to begin in April. To repeat and to be clear, I will be visiting the hospital tomorrow with the Minister for Health for Northern Ireland, Mike Nesbitt. There is good work going on also to develop a children's hospital in Belfast as well so I am excited to speak to him about his project and what is happening Northern Ireland and, of course, to see about the completion of the hospital, which is a priority for everybody in this House.”
“In the programme for Government, we have committed to deliver a significant programme of work through our capital programme by: increasing capacity by between 4,000 and 4,500 new and refurbished inpatient hospital beds across the country; increasing ICU bed capacity by at least a further 100 beds; providing more community beds; building four new elective hospitals; establishing six surgical hubs in Cork, two in Dublin, the first of which I was delighted to open in Mount Carmel two weeks ago, and others in Galway, Limerick and Waterford, and exploring the provision of an additional surgical hub for the north west in a timely manner; expanding trauma services, including facilities in Dublin, Cork and Galway; continuing to increase capacity and open more beds at University Hospital Limerick, UHL, and across the mid-west, taking account of the HIQA recommendations, which are yet to come in that regard; protecting diagnostic pathways and investing in infrastructure and equipment to meet target treatment times outlined in the National Cancer Strategy 2017-2026; building the new national maternity hospital, which is a major infrastructural investment on the part of the State for women’s health, providing much-needed facilities for women, girls and babies for generations to come; and the new children’s hospital, which I will be visiting tomorrow, which is going to be an incredible, state-of-the-art facility and Ireland’s first digital public hospital in which there will be 473 beds in total, 380 for inpatients and 93 for day cases.”
“Planning for future capacity requirements ensures that we address longer term challenges and prepare our health and social care service to be fit for the future. Infrastructure plays a vital role in delivering health services, and we need to ensure that our assets, physical and digital, are fit for purpose and that they help to improve health outcomes and experiences for patients and those who provide their care.”
“In the past decade, the population has grown by 15%. The population of over-65s has grown at more than twice that rate, with an increase of 37%, or just over 220,000 people. By 2044, the number aged between 65 and 84 is projected to increase by more than 65%, while those aged 85 and over will more than double. More people overall and more older people mean more demand for our services, particularly in chronic disease management and long-term care. This is why we have been investing in building our capacity both in infrastructure and workforce. For many decades, we underinvested in our health and social care infrastructure. We are working hard to address this deficit and increase capacity. Under the new programme for Government, significant public investment in healthcare infrastructure and capacity is continuing.”
“These figures point to a thriving population the members of which in large part are enjoying good health. It is important for us to acknowledge this positive reality and recognise the massive contribution our health and social care workforce makes to the lives of everyone in Ireland. The Government is committed to further transforming how we deliver health and social care through the implementation of Sláintecare and the programme for Government. Our aim is to ensure that the right care is available, in the right place and at the right time. We are prioritising increasing access to make sure those who need care receive it and that the care they receive is safe and of high quality. We are increasing capacity while expanding eligibility. The population of Ireland is increasing at an unprecedented rate.”
“A healthy population is beneficial for society as a whole, and improving the health and well-being of the nation is a major priority for this Government. As a result of the strong continuing investment in our health and social care services and changes in behaviours, our people are living longer, healthier lives. Our life expectancy at birth is now 82.6 years, which is the fifth highest among the EU 27 behind Spain and Italy. Both of those countries have lifestyle and weather advantages we cannot compete with, I am afraid. The aim should not just be to live longer, but also to live healthier for longer, and Ireland’s healthy life years at 65 is the third highest in the EU. Ireland also has the highest self-perceived health status in the EU, with 80% of males and 79% of females rating their health as good or very good.”
“I thank an Cathaoirleach Gníomhach for making the time for these statements, which I believe are the first on health in this new Dáil. The Government and I are fully committed to a vision of a universal health and social care service where people have access to services based on need, and not on their ability to pay. The full implementation of Sláintecare remains one of the most significant reform programmes ever implemented by the State. I am so pleased it is a collective effort in this House that is enabling this. We are doing so against the backdrop of the greatest investment ever in healthcare in Ireland, the largest health and social care workforce, and against the challenge of an increasing and ageing population.”
“I thank the Deputy for raising this matter. Perhaps I could follow up with her directly because I do not have notice of this. I will try to find out the position. It should be available consistently. What we want is that there is consistent access to both treatments and medications right across the regions. I will investigate and come back to the Deputy.”
“I thank the Deputy for flagging this issue to me in advance so I could get additional information for this very short window I have to reply to him. He is right to highlight the gaps and the 277 posts that are funded but have not yet been recruited for. It is not through lack of trying. We have increased our numbers in the healthcare system very considerably but we have the funding and wish to do more. A very significant capital programme is going into this hospital, as the Deputy is aware, including the CT upgrade, the dolmen wing, the 86-bed accommodation block, a better outpatient department, the acute floor extension, and ancillary services such as the car park. He is quite right to raise the investment needed in this very good hospital.”
“I compliment the excellent work done by Connolly Hospital, not only on keeping its trolley count down but also on the range of different work it is doing. I refer to the capital investment the hospital deserves to continue to do that. Our plans for Connolly Hospital, with a catchment area of 300,000 people as identified by the Deputy, are to maintain and extend the children's service, the paediatric service, while there will also be a new dental training and surgical facility there. Of course, it will also be the site of the major elective hospital. The Deputy is, therefore, absolutely right. Connolly Hospital is already an excellent facility and is going to be the beneficiary of major capital investment in the next period of time. I look forward to working with the Deputy on the range of different issues.”
“I thank the Deputy. One of the things we are checking is where the responsibility lies with some of the different changes. It is important to recognise that while we have provisions for older people and many of the guidelines relate to this area, my early understanding is that there is space to do an awful lot more here. I will look into the issue and come back to the Deputy, if that is okay, because it is very much an issue of understanding.”
“I thank the Deputy. I am happy to look into it but my initial understanding is that this was always to be 44 additional beds in the overall construction. Will the Deputy please allow me to look into it and come back to him?”
“If a woman is getting two HRT products, for example, she is paying two dispensing fees, which might be €7, €8, €9 or €10 per product. We intend to cover the cost of the medication. If we were to extend the budgetary allowance for that, I would have to take that from somewhere else and that would mean we would not be able to do something else. I am trying to find a resolution. I ask the Deputy to please allow me a couple of weeks to do that. I hope the pharmaceutical union will come back with something we can work on.”
“I am aware of the issue and am beginning to examine that. It is a pan-European problem so perhaps I can come back to the Deputy on it. I am very aware of it. On the cost of HRT, provision was made in the budget for HRT products but not for the dispensing fee. That is covered in parliamentary questions going back to October and November last year and that position has not changed. The Government set aside money to pay for the products but not the dispensing fee for pharmacists. I have met the pharmaceutical union. I am engaging with it to see if there is something we can do but the reality is we do not have the budget to carry the dispensing fees. Patients are being charged €48 or €62 or whatever the fee is, but you do not see the breakdown of the cost.”
“It is not acceptable that the Deputy's constituents are more likely to wait on a trolley on a Sunday or Monday than on a Wednesday. That is not okay.”
“I thank the Deputy. I am more than happy to sit down with him about the provision for Kerry more generally in the capital plan. He is right to highlight the trolley situation. At 8 a.m. on Saturday, 1 February, for example, there were only four people on trolleys in University Hospital Kerry. By Tuesday morning, that number had risen to 18. There were 24 the following day and 28 thereafter. The number then fell to two the following Saturday. It moved to six before going back up to 20 on Monday and Tuesday, following the weekend. I am happy to speak to the Deputy about the underlying issues in respect of capacity but there is a weekend issue in University Hospital Kerry, as much as there is in other hospitals, and we must get to the bottom of that.”
“The Taoiseach and I might go together. It is an excellent hospital that needs more investment. I am happy to speak to the Deputy about the capital plan for the coming year. I will be opening a new lung care research facility in the hospital shortly and I ask the Deputy to come along. It is an excellent hospital that is deserving of continued investment.”
“As he is aware, I have this week placed a particular focus on the deployment of all of the contracts in all of the hospitals to ensure we are getting the best outcomes for patient safety and to ensure that all hospitals are consistently using all the levers available to them to avoid the consistent problems that Limerick has.”
“I thank the Deputy for raising the matter. A number of different things are happening. As the Deputy is aware, Limerick has already been the beneficiary of additional bed capacity and staffing. Another 96-bed unit will be completed shortly. There is also a surgical hub. The Deputy mentioned scheduled procedures being cancelled. Those procedures will be scheduled in the surgical hub and that will be followed by an elective hospital. Limerick is the beneficiary of considerable investment in beds and staff. There are still problems, however, and I thank the Deputy for highlighting them. He is quite right to do so.”
“I thank Deputy Nolan for highlighting this important issue. It is correct to say we are struggling with having enough dentists, both on the public side and, more broadly, to meet the need, particularly the developmental checks that are so important. While I am not aware of the specific case in Offaly, I would be glad if the Deputy might forward me the information so that I can be better informed. I have met initially in respect of this significant issue. There are a number of different new training programmes, especially the specific training programme the Royal College of Surgeons in Ireland is opening at Connolly Hospital Blanchardstown which will be used to both train and treat at the same time. We have to use every lever we can to maximise dental services, particularly for children with their developmental checks.”
“I thank the Deputy for the question. He is quite right to identify that there is a problem, particularly in Dublin. While there has been an increase in the numbers of nursing staff generally, we are struggling in the recruitment of public health nurses. Several measures have been taken by the HSE to try to remedy this, including an equivalence in terms of salary scales and other incentives to try to bring more public health nurses into the health service. I recognise, however, that the work is not complete and there is a shortage. The work that is being done is prioritising urgent care, including newborn checks and so on, but I recognise this is a stress for parents of young children in particular and we really are working to try to get it remedied through those different incentive mechanisms.”
“This is not unique to Drogheda. Other hospitals suffer in the same way. The corresponding figures for Waterford were zero people on trolleys all week. We have two different issues, namely weekends and the underlying capacity issue. We have to treat them differently.”
“I thank the Deputy for her question. I will be bringing the second iteration of the waiting list action plan to Cabinet this week. The first iteration brought waiting times down from an average of 13 months to seven. We have further to go in order to reach our Sláintecare targets. As I said to Deputy Bacik, there are two issues here. One is about moving people out of the general hospital system to surgical hubs, the first of which will open this week, and dealing with waiting times. The other relates to weekends. In the context of Our Lady of Lourdes Hospital Drogheda, the number of people on trolleys on the Tuesday after the bank holiday weekend was 43. On Wednesday last, there were 39 people on trolleys. On Thursday, the number was 28. It was down to 21 on both Friday and Saturday. The number was back up to 45 after the weekend.”
“The issue of trolleys and congestion in hospitals, particularly at weekends, is an absolute priority for me. I will be bringing a series of data points to Cabinet on this next week. There are two issues - I am happy to discuss them with all Deputies - namely those relating to underlying capacity and work practices. Even in the very short period that I have been the Minister for Health, I have seen considerable problems across hospitals on Saturdays, Sundays and bank holiday Mondays. Different hospitals manage matters differently, but this is a matter of major concern for me. I am happy to speak to all Deputies on this, directly and very soon.”
“I thank Deputy Bacik. Like Deputy Bacik, the first thing I want to do is offer my condolences to the family of the lady. A three-hour wait is simply not acceptable. I would like to get more details of the specific case, if the Deputy does not mind.”
“That list changes by the way; a vulnerable person or an older person may be on a list as for a considerable period, or someone may have had an operation and is vulnerable for a shorter period. One of the things I will be checking is how that list is managed over time and how that correlates with the lists the Garda and the ESB have.”
“I use these specific examples to describe the breadth of work done by hard-working individuals in our healthcare system, from consultants and nurses turning up the night before, to facility managers and on-call managers trying to secure accommodation, not just for hospital staff but also for people presenting to emergency departments not just now, but in anticipation of events or in anticipation of a concern. I recognise the extraordinary work they have done. More than anybody else, there is a significant impact on a group of vulnerable people, as the Deputy correctly identified, who are in their homes and remain without power. There has been good work done by the HSE in going to those homes and identifying vulnerable people.”
“Work was done with GPs in advance of the storm, anticipating power outages, to secure as many of those vaccines as possible. Could we do it better next time? Yes, absolutely I think we can. Those are the sorts of questions that I will be drilling in as the new Minister for Health to make sure that we are building further resilience in the health system in anticipation of major events such as that. I also pay tribute, by way of example, to the staff in the Sacred Heart centre in Castlebar in Deputy Lawless's constituency, who spent considerable time making sure that the fuel for generators was topped up throughout the community.”
“Deputies may imagine that one of the first questions that I will be asking in terms of our resilience planning for the next event - we have to acknowledge that with climate change there will be a next event of some kind - is: what is the up-to-date situation with generators across the hospitals? We did not have a problem on this occasion, but let us check and double-check. The same applies with Uisce Éireann and our residential care facilities. There were a number of pieces of important preparation. We needed to secure construction sites at hospitals and other facilities, for example in Limerick where we are building a very significant new facility, as the Deputy will know, and make sure they were okay. We had preparation for vaccines, for example, where there is a chain of cold storage that must be protected and respected.”
“The overall health response and preparation were about ensuring three things in particular: the provision of services in acute hospitals in terms of staff and generators; making sure that those who live in HSE residential care facilities were protected and looked after; and, as many Deputies have highlighted, ensuring people in their homes continued to receive a range of different HSE supports, such as home help and support with medical devices in the home, which are so important. The focus was on making sure those people were looked after and protected. There were successes and failures. The power went out in Limerick and Letterkenny, but the generators kicked in.”
“On the night before the storm, the evening I was appointed as Minister for Health, I went directly from the Áras to Crumlin children's hospital where again the staff were preparing for the storm. Many staff were coming in and sleeping overnight in anticipation of being there for the shift at 7 a.m. They were getting takeaways, putting down mattresses and making sure everybody was there. I pay tribute to the 400 staff in Cork University Hospital and the 200 on site in the Mercy University Hospital. This was replicated across the country.”
“That gave the staff there in recent days and particularly during that storm period real confidence that not just were its generators up to date, but they were well fuelled. It is of the most basic importance. However, as the Deputy said, the difficulty, of course, was that Uisce Éireann did not have the generators, leading to the threat of a water shortage to a hospital. While it did not happen, I am highlighting it as a risk that has to be fixed for the future. We need to acknowledge that this part went well and while something bad did not happen on the second part, it could have happened and we have to fix that for the future. As the Deputy has just raised the issue of Mayo, I want to pay tribute to the staff there.”
“I thank Deputies for coming and raising the different issues today. I congratulate Deputy Lawless on his election by the good people of Mayo. I was in Mayo yesterday. I pay particular tribute to Peter Healy, the facilities manager of Mayo University Hospital and Patricia Hough, the on-duty manager, who did extraordinary work along with all the staff at Mayo University Hospital to make sure that the staff were in in advance, in anticipation of the storm, ready for the next shift. They did extraordinary work in terms of facilities. I also acknowledge some of the difficulties that we will need to fix for the future. Mayo University Hospital, by way of example, had a significant investment in its generators in 2023.”