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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“It is important to acknowledge that there has been 30% growth in the staff of the National Ambulance Service, which is a larger proportional increase than the health service received overall. We have invested an additional €75 million in the service since 2022 and staff members have increased by 761 since 2022. The total workforce is now 2,500. Further investment planned for 2026 will deliver 21 extra crewed ambulances at peak demand. I understand that 134 of 168 posts have been recruited, so recruitment is progressing reasonably well so far this year. My overriding priority, of course, like the Deputy's, is the safety of patients and the continuity of the emergency services. It is important to discuss the reforms that have been suggested and agreed in the industrial relations architecture, and I can do that.”
“Those reforms are essential because they deliver real benefits for patients and service delivery, including faster response times, more ambulances available through modern crewing arrangements, greater flexibility across the service, stronger assurance of ongoing regulatory compliance and the ability to treat more patients safely in the most appropriate setting.”
“These included significant pay improvements for staff, of between 3% and 14% on top of the 9.25% pay increases already provided for under the public service agreement. Crucially, those pay increases were linked to agreed reforms and I can go through some of the detail of those reforms, which would generate a more comprehensive ambulance response service for everybody and an easier working life. The HSE and my Department accepted the proposals and the subsequent Labour Court recommendation in full, and both SIPTU and Unite recommended them to their members at the time. The difficulty now is that the unions are seeking to secure all the pay increases while there has been a reluctance to deliver the accompanying reforms.”
“I do not think anybody wants to be involved in strikes of any kind. That is not how we do things, which is why we have the very comprehensive industrial relations architecture we have painstakingly built over some time. The HSE and my Department have engaged extensively, constructively and in good faith, as have the National Ambulance Service representatives, for more than two years to address the issues raised within the National Ambulance Service. That engagement has taken place through the State’s established industrial relations machinery, including the Workplace Relations Commission, WRC, and the Labour Court, and within the framework of the public service agreement. A comprehensive and independently brokered set of proposals emerged from that process.”
“I expect that HTA in the coming weeks and we will base our decision on that and on the intersection of the HSE's pathfinder as well.”
“I thank Deputy Burke for his question. It is certainly true to say that we have had enormous success with the RSV vaccination programme for infants, which significantly reduced infection, mortality and very severe illness for infants. I can confirm that we have sought a health technology assessment, HTA, for RSV immunisation by HIQA. The outcome of that will inform the policy decision that I make as to the most appropriate RSV immunisation strategy for infants but also for adults aged 65 and older. That HTA is due in the coming weeks. It is always the case with vaccinations that we take the World Health Organization's advice as well as the advice of our expert groups. We do that on an annual basis because, of course, circumstances change every year.”
“As we make decisions on reimbursement and rare diseases in a shorter period, which is a really important part of what the Deputy is talking about, we need to be aware of the very significant additional costs we are already incurring in this period of 2026. I assure the Deputy that the Department is considering every aspect of an early access scheme. We will continue to work with the Deputy on that, but I do need to flag the important budgetary consideration to all Deputies.”
“I thank the Deputy for raising this again. I was very pleased to have the opportunity to meet many of the people with Friedreich's ataxia whom he brought to the Dáil. I want to highlight to Deputies that, importantly, our drugs budget has increased significantly this year, being well up at 9%. This is what the Department expected it to be. We made provision in the overall budget for a 7% uplift, and we are now at a 9% increase. We will make decisions more quickly. We are working on the reimbursement process more quickly, but Deputies need to be aware of the scale of the growth of the drugs budget and where that is going. That is because of people living longer and access to drugs of very good quality.”
“I thank the Deputy and acknowledge the number of times she has raised different issues in different sectors in relation to misogyny and questions of harassment. I want to make it very clear as the Minister for Health that in every healthcare setting, all people are to be protected and respected - men, women, people of any race and people of any gender. People are to be respected in all contexts. While I do not want to speak about any individual cases on the floor of the Dáil as Minister, as the Deputy will understand, I very clearly hear what she is saying in the case of all workers. There are close to 170,000 people working in the healthcare sector in different ways and every one of them is deserving of respect and dignity in their workplace, as every other person is.”
“I will discuss the Deputy's suggestion of a refundable tax credit with the Tánaiste and Minister for Finance for the upcoming budget.”
“I thank Deputy Neville. He highlights an important thing, which is the practicality of setting up and extending GP practices. The State supports GP practices to the tune of approximately €1 billion per year. However, we need more. In the Deputy's area, where there has been particularly concentrated population growth at a quick pace, more GP practices are needed. I will discuss the idea of a refundable tax credit with the Tánaiste and Minister for Finance. We need to look at every creative way to expand GP care. We are trying to recruit GPs to the HSE, but the State and private GP practices have a direct relationship - an important symbiosis - and we need to look at every lever we can use to increase GP capacity, either by extending or setting up new practices.”
“When this is finished, we will all go back as Ministers to our Departments, except for the Minister of State, Deputy Healy-Rae, to whom I pay tribute for his contribution and hard work on behalf of the Government and the Independent group more broadly. I know the Minister, Deputy Heydon, will speak to that. The Ministers of State, Deputies Butler, Murnane O'Connor and O’Donnell, and I will go back to the Department of Health to work on behalf of the people, to expand capacity, improve access and support the people who are delivering our health service on all days no matter what.”
“However, when protest flips and steps across to become something else - to risking deliveries of chemotherapies in our hospitals, as it did, to risking timely deliveries of refrigerated medicines and blocking people getting to time-sensitive medical appointments like cancer treatments and dialysis, that is not protest that we enable and embrace. That is something I do not believe our very decent people and our very decent society want us to make any part of this State. We may now have to face even bigger challenges ahead because of the continuing instability in the Middle East. We have to decide now to protect the strength and the stability we have created together and protect ourselves from the type of crossing over of protest that we saw last week.”
“Those who work in our healthcare face challenges turning up to work and doing their job, but they turned up and kept clinics open longer for patients who themselves had difficulty getting there. They turned up for each other and I thank them. As a public representative, I embrace protest. In our democracy, I welcome protest. I will defend it and freedom of expression for all. These are parts of our constitutional politics. We fund civic society in this House in many ways to enable an even more vibrant civic debate.”
“We know we have to keep our people's lights on without dependence on abroad and without the price shocks we have seen from the actions of totally unpredictable players. The time, if it ever existed, for objecting to the development of our infrastructure, however politely, is now long gone. Energy security is central to the functioning of our society. We have seen that this week. Fortunately, we are a small island in the North Atlantic so we can build it, and we can built it well. We have built this State together on predictability, stability and consensus in our courts, in our social partnership and in our democracy. As Minister for Health, I thank all of those who turned up to provide a stable and predictable health service for our patients in the face of real difficulty last week.”
“Today we stand here for respectful debate on behalf of the people we represent at a time of maximum geopolitical uncertainty. It is impacting globally and it is impacting our people. We know that, we see that and we feel that because we are elected representatives in a small, democratic State and we are connected to our people. We know in Ireland we are more impacted than so many others because of the small and deeply internationally interconnected nature of the very stable and successful State that, together, everyone with every perspective has built. This means two things: we have to continue to protect the stable strength of our people and we have to move to defend the country's weaknesses.”
“I cannot answer that for the Deputy this morning but it is an important question. We might put this series of questions to Andy Phillips in respect of that region. I am sorry I cannot answer that question for the Deputy.”
“Locally, at the moment - literally last month - we are trying to retain graduate trainee posts and permanent positions in the south west and recruit four psychology assistants from the national recruitment panel established in December 2025, who will be allocated to support waitlist reduction in the longest waiting areas. We have 15 trainees exiting the doctoral training programme, which will be back-filled to ensure there is a pipeline of new psychologists to engage in that work. I completely acknowledge the challenge, measure of improvement and focus on recruitment. The Deputy and I are going to want to see that delivered for young people who need psychological support in that area.”
“I agree with the Deputy. We increased the number of psychology doctoral training places to 111 at the end of 2025. This was up from 49 places in 2021. It is not just about the doctoral level. We want to create psychology assistant posts too, where we can make sure that people with a master's degree can work to support doctoral-level psychologists to increase workforce expansion. Not everybody has to have a doctorate. People can have a master's degree and still do important psychology work under the supervision of a different level of clinician. We are trying to find different ways to expand the workforce.”
“That has had some success since 2021, removing more than 15,000 children from the waiting list nationally. Additionally, we have put in funding of €4.75 million in budget 2026, which will remove a further 3,000 from the national wait list this year, a number of whom will be from the south Lee area. I am not comfortable with the levels of waiting in the area, as I know the Deputy is not, and I expect a continued reduction, as was the case from 2025, which was better than 2024. We do have a lot of work to do.”
“Furthermore, the regional director of psychology has established a child psychology service waiting list improvement initiative to drive improvements in accessing key areas such as workforce planning and development for the region, waiting list and capacity solutions and clinical service innovation. Local recruitment, last month and this month, will lead to retaining graduating trainees in permanent posts mapped to primary care and CAMHS and adult mental health services priorities. A number of psychology assistant posts from a new national panel created in December 2025 will be allocated to both the IHA south and west, and north and east to reflect the fact that the longest waiters are in the south Lee and north Lee areas. We also have the primary care psychology waiting list initiative to try to target.”
“As the Deputy will be aware, primary care psychology provides a broad range of supports and treatment for mild to moderate mental health conditions. HIs concern is particularly the south Lee area, so I might get to that. Currently 2,445 children and young people under the age of 18 are waiting to access primary care psychology in the south Lee area, with 198 waiting for between 26 and 39 weeks, and 1,792 waiting longer than 52 weeks. That is an aberration and should not be the case. It simply has to be improved. Several key initiatives have been deployed by HSE South West to try to improve access to the services. This is having an impact, to be fair. In 2025, 30% more patients were seen in the region compared to 2024. The Deputy and I, however, want that rate of improvement to continue.”
“But the Deputy did. Let me just be careful. We have clinicians who have been taking their own time to go and see others through surgeries so that they might learn more. We have developed different education pathways and fellowships over the past number of months, particularly with clinicians who really wanted to do better in Ireland and access the opportunity to do better in Ireland. I want to support those clinicians who are taking those steps. On Friday, the Royal College of Physicians is hosting its first conference on endometriosis with the Institute of Obstetricians and Gynaecologists. This is because of the weight we have placed on its importance. It is about clinicians at the highest level in the institute and the college responding and putting their focus onto this issue.”
“If I were to come back and give the Deputy the specific reasons there might be a concern about one clinic, she might take a different view. Perhaps we might have that conversation privately, because I suspect she does not have the complete information that I have, which is not a fair balance. We might perhaps speak about that separately. She is correct that in the past there was a reluctance to refer patients abroad because clinicians did not know where they were referring them to. That is a cultural issue as much as anything else but we have overcome that now. I would not, though, classify all clinicians in that space.”
“I expect there will be some positivity and some negativity in relation to that. A relationship has also been developed with Bordeaux, which is, of course, much closer. There is a dedicated centre there and we are going to include that on the improved list. It is a live and iterative list that we are trying to develop all the time but it has to meet the clinical guidelines as well for our clinicians to refer people on to that scheme, which was one of the barriers in the past.”
“When a new scheme is established, it must be done in a legally robust way. It is necessary to identify a reason these clinicians and not those clinicians are included. For example, the European Endometriosis League, EEL, and the British Society for Gynaecological Endoscopy, BSGE, criteria were picked. All of those clinics that were on those very defined lists automatically came onto the scheme. The clinics that the Deputy is referring to in Athens and Romania were not among those accredited by the EEL or BSGE. We said this clearly at the time. We asked NWIHP to engage further to see had they and could they meet the clinical standards to enable them to be within the scheme in a legally robust way. NWIHP has engaged with Athens and Bucharest. That process is not complete.”
“There have been a number of different questions on it, which is natural with any new scheme, many of which we are smoothing out. This includes referrals by consultants and different issues. I met officials from the national women and infants health programme, NWIHP, and today I have the good fortune of getting to meet up to 100 endometriosis patients in the Department with clinicians.”
“They do not necessarily relate to that scheme but to the operation of other schemes as well. It has provided a single point of contact, which has been useful because the information was too fragmented before. We have had 20 completed applications since it opened on 18 October and approximately ten women have travelled abroad for surgery under that initiative. That is not the total number of women whom we have supported to travel. We have also supported women to travel under the cross-border directive and the treatment abroad scheme because they have been at different stages of their care and have taken different approaches. This has opened up a scheme for people who want an upfront cost paid. However, the focus on it through centralising it in this way has enabled a better conversation with the other schemes as well.”
“We met women with endometriosis at the beginning of September 2025 and this scheme was put in place six weeks later. It was put in place for a specific reason, which was that we wanted to make access to surgeries as easy as possible. There are already two schemes, which are the cross-border directive and the treatment abroad scheme. In many ways those required women to pay upfront when what we wanted to do was pay the upfront cost for them. I understand we set up a dedicated two-year scheme to keep it in line with EU rules and that was launched on 18 October 2025. I need to be cautious with regard to patient confidentiality in my response but I can say that a dedicated email address was established. I think we have received approximately 80 communications with that email address.”
“Of course, it is an extremely difficult situation to have the fear of falling particularly in the winter when weather is bad, and hospitals are already under pressure from respiratory illness. We have seen this winter in particular that combination of respiratory illness and falls from a prolonged period of bad weather. It does not help anybody and makes living as an older person that bit more difficult.”
“The element of preventative care is crucial from the perspective of diet, lifestyle management and the ways in which people exercise. The gym membership piece is interesting but exercise is available in lots of different ways. I am seeing different forms of community exercise groups. There is a fantastic facility in a GAA centre in south Sligo and in other places. What you are doing is turning up as part of a community and going through the different machines. Whether people are post-hospital or post-diagnosis, using those safe, community facilities to build up their strength and bone mass is an important part of preventing illness, future falls and recovering.”
“I do not wish to name communities but I have seen projects in Sligo, in my own constituency and in Limerick, which are encouraging safe exercise among people of all ages to develop their muscle mass and bone strength in a way that is not likely to lead to any injuries, but only to rejuvenation and greater strength. That is a hugely important part of living well as we age.”
“This year my Department approved funding to the HSE to pilot a scalable, multidisciplinary falls and frailty prevention service for women aged 65 plus in Mayo, Galway, and Roscommon. This service particularly targets older women at increased risk of falling, frailty, mobility issues, fear of falling, chronic conditions or reduced function post-hospitalisation. The overall aim is to reduce falls and fractures and the demand for treatment and long-stay care in acute services. Falls assessments, along with osteoporosis drug treatments, are essential for fracture risk reduction and these are being progressed through the community access to diagnostics scheme and the Health (Pricing and Supply of Medical Goods) Act 2013. We are also investing and supporting a range of different forms of exercise in the community.”
“The Healthy Ireland framework provides a number of strategies to ensure everyone in Ireland can enjoy good health as they age, including the national physical activity framework and the obesity policy and action plan. One in three older women and one in five men are affected by osteoporosis. In 2023, the Department published healthy eating guidelines for adults aged 65 and over, which emphasise the importance of a healthy diet for older adults to maintain muscle mass and bone strength to support independent living. A HSE fracture liaison service pathway developed by the National Clinical Programme for Trauma and Orthopaedic Surgery promotes preventative community-based care as opposed to a reliance on reactive medicine, in line with Sláintecare reform.”
“I thank the Deputy for sharing his own experience and perspective because that helps to tell the story of how common this is and what the impact is. We support the Irish Haemochromatosis Association and World Haemochromatosis Awareness Week, which takes place from 1 to 7 June every year. The association also runs the GP practice nurse training and education programme. To the extent we can do so, we will get behind that world awareness programme every year in the first week of June, a lovely week of the year, to drive awareness of haemochromatosis, and I am sure the Deputies will be at the forefront of that.”
“I do not know what the reasons for that are and why Ireland has the highest rate of it. I would be quite interested to find that out. As the Deputy says, this is a condition that can be managed well, particularly at a primary care level. It is the most common genetic disease here, with one in 83 people genetically predisposed to develop the condition. The symptoms are sort of non-specific and include non-specific fatigue and joint pain. The diagnosis is very variable. However, it can be treated well and effectively and it is important we discuss it here in Parliament as part of raising awareness of this very common condition among the Irish population. I thank the Deputy for his question.”
“The diagnosis, treatment and management of patients living with the condition is guided by the hereditary haemochromatosis model of care, developed by the hereditary haemochromatosis working group, and the guidance document of the Irish College of General Practitioners, Hereditary Haemochromatosis: Diagnosis and Management from a GP Perspective. I understand that the condition can be treated very effectively by a process called venesection or therapeutic phlebotomy, which involves the patient having their blood taken. This can happen in acute hospitals or GP surgeries or at an Irish Blood Transfusion Service, IBTS, facility. It is extraordinary that Ireland has the highest rate of this condition worldwide and we need to do more to drive awareness of it.”
“Haemochromatosis is a hereditary condition, common in Ireland, characterised by an over-absorption of iron from the gastrointestinal tract. Excess iron accumulates in organs including the liver, pancreas and heart, causing damage. I am informed that Ireland has been confirmed as having the highest rate of haemochromatosis worldwide. I am advised by the HSE that the Irish Haemochromatosis Association receives €55,000 in funding from the Health Service Executive each year to support engagement, raise awareness, support patients, their families and the medical community and raise awareness of haemochromatosis. The association’s initiatives include World Haemochromatosis Awareness Week, taking place from 1 to 7 June every year, and the GP practice nurse training and education programme.”
“The Deputy is right; we have a challenge in this regard. On the one hand, we cannot tell private GP practices where they should locate. That is a matter for them to determine. At the same time, we want to ensure they locate in areas of need, such as the Deputy’s constituency. He has suggested looking at some measures to create different incentives for GPs to either join a practice or physically extend a practice and how the State could offer the best support to them to do that. This is something the Deputy has mentioned to me before. Perhaps we might follow that up to see how we could consider that to create additional incentives for GPs to set up or expand practices in specified areas.”
“We are trying to increase capacity everywhere through pharmacies, additional GP practices and additional primary care practices. The Deputy’s area has been particularly tight and I know this is not the first time we have spoken about it. The Deputy has articulated this issue on behalf of his constituents a number of times during these questions, and I genuinely acknowledge what he is saying.”
“I agree with the Deputy. The difficulty, again, is that private GP practices determine their location. That is a challenge. The Deputy is right; we need to try to focus on the primary care centres and enable more GPs to come into the public practice. It is a particularly frustrating area because, of course, plans were advanced for primary care centres, which required planning permission to turn a facility into a primary care centre. They have not progressed, however. We are looking at the bigger one to serve Leixlip and Maynooth but that does not answer the question of the Deputy’s constituents today. I agree with the Deputy; it is a considerable challenge for people to have to go back to their original GP, particularly for students, when they need basic access to care. I acknowledge what the Deputy is saying.”
“The HSE is also considering the development of a further centre to serve north-east Kildare. Available figures show the number of GPs with GMS contracts in the Kildare west and Wicklow local health office area has increased by over 20% since 2020, from 110 to 134. Obviously, that is a broader area than Kildare North, the constituency the Deputy represents, but it is the relevant geographic operational area for the HSE. Nevertheless, I recognise the significant population growth in north Kildare and the needs of the Deputy’s community in respect of access to GPs. We very much hope that number will be enhanced, not just for the region but specifically for the towns and villages of north Kildare the Deputy represents”
“The HSE contracts GPs to provide medical services on its behalf, including GP services under the general medical services, GMS, contract. Over 3,200 GPs hold at least one contract with the HSE, which is a 9% increase compared with January 2020. As GPs are private practitioners, they determine the location from which they provide GP services. Increasing GP capacity is a priority for the Government. As I said in response to Deputy Daly, we have significantly increased the new entrant places. Additionally, we are trying to recruit from abroad for the international medical graduate rural GP programme. There are 180 primary care centres operational across the country, with 51 centres having opened since 2020. A total of eight primary care centres are operational in Kildare, three of which are in north Kildare, in Kilcock, Celbridge and Clane.”
“While we are not considering a surgical hub model as such – we have enough work to do to get Sligo and Letterkenny ahead – that does not mean there are not different ways of achieving additional elective capacity. When I say we are open to suggestion in this regard, we really are. That is why we have insisted on this expression of interest process to determine what more can be done to deliver that elective capacity in an even stronger way, recognising the already excellent work done by the triangle of good hospitals.”
“I was just reflecting on how Birr primary care centre has evolved since we saw it last summer. I am looking forward to visiting it in quarter 3 of 2026 when it will be operational to see how magnificent it is. For anyone who has not seen it, it is absolutely huge. It will be an enormous addition to primary care for the people of Offaly generally. Of course, it will have extensive GP practices and a pharmacy. It will also provide space for a National Ambulance Service base. It is extraordinary and it will add enormously. Indeed, I hope it will take some pressure off the hospital as well. It is true that more elective capacity is necessary.”
“The hospital and the midlands need more elective capacity, however. Of course, because of the region it is in, it is within the south Dublin surgical hub, which is connected to St. James’s Hospital. That is a busy hub already and there is a need to reflect on the balance of that provided throughout the midlands. I acknowledge the Deputy’s advocacy on behalf of Tullamore. Indeed, I have visited it with him and seen the value of the space around Tullamore regional hospital. I know it well because of the Deputy.”
“I take this opportunity to compliment Midland Regional Hospital in Tullamore and its excellent manager, Louisea Burke, on delivering consistently predictable urgent and emergency care. While it is not easy, they do it with an extraordinary focus on patient care. Mr. Bernard Gloster, CEO of the HSE, visited the hospital recently to compliment them in that regard. Often we attend hospitals where there is a problem but not often enough do we attend hospitals to compliment them on their excellent work. Tullamore hospital is deserving of that attention. I met Tullamore hospital management reasonably recently, at the end of January at our regional forum, where I again took the opportunity to congratulate Louisea and all of the staff at Tullamore hospital for providing that extremely good, predictable and safe service to the people of the area.”
“The implementation of health infrastructure investment policy via the strategic healthcare investment framework means that any future proposal for new infrastructure will be centred on evidence-based demand analysis and established on a need identified by services.”
“Specifically on that, the HSE Dublin and midlands health region has confirmed that it is undertaking an analysis to inform the future development of an action plan. This early scoping phase is intended to consider potential options for new or additional capacity, including in the area of elective care. An expressions of interest process forms part of this broader review. Work to define scope, parameters and governance arrangements is ongoing. The process is expected to be completed by the end of this quarter. I am assured that the region will provide updates as this work develops.”
“The HSE capital plan sets out a range of investments for the midlands, including the recently completed two-storey emergency department in Portlaoise, the reconfiguration of the renal department to provide additional dialysis treatment space and 2 additional neutral pressure isolation rooms in Tullamore Regional Hospital and progressing the appraisal for the replacement ward accommodation, theatre department and emergency department for projects for Regional Hospital Mullingar. Alongside this excellent progress and the continued strong work by each of the hospitals, there is need for more capacity in terms of elective work. I do believe that this triangle of hospitals, working together, can offer a situation of exceptionally good elective work.”