Jerry Buttimer
Cork South-Central · Fine Gael · Ireland
“Its priority is to provide scheduled public transport services on the TFI network. It works with event organisers, operators, local authorities and An Garda Síochána to provide additional transport supports where it is possible to do so.”
“I commit to relaying the points the Senator has made on the floor of the House, and has conveyed to me in private, to the Department of Transport. To be fair to the Senator, it was not only this morning that he has articulated this. The travelling supporters of Kerry and Mayo deserve additional transport.”
“I understand from the company that the Expressway team is currently examining whether additional services on route 22 will be added on the morning of Sunday, 26 July.”
“In this case, for Kerry and Mayo, as the Senator rightly said, it will see a high demand for scheduled and additional services. The Senator has outlined the volume of tickets sales. This is the busiest time for scheduled intercity services anyway, given that it is peak summer time, and that is a priority.”
“I understand from speaking to Irish Rail that it hopes to be in a position to confirm the number of additional services later this week - I am hoping this will be today or tomorrow - and it will advise customers as soon as these services are available to book.”
“The Senator mentioned Sneem and Ventry. He and I will remember our great friends, the late, great John Egan and Paudie O'Shea, as well as the Senator's brother Tim. I get emotional because they were great GAA people. Cork and Kerry have the best supporters of the GAA.”
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“I again emphasise that I hear Deputy Cahill. Sceilg Mhichíl is a site of extraordinary significance and the OPW is seeking to carefully manage the built and natural heritage of the site for the enjoyment of current and future generations. The OPW recognises the significance of the Skelligs with regard to tourism and the economic activity of Kerry, as articulated by Deputy Cahill, and in particular the Ballinskelligs region. The OPW has worked collaboratively with local stakeholders for many years to ensure this site of outstanding universal value is protected in line with the best practice of UNESCO world heritage standards and works, but that it is also accessible and can be enjoyed by a range of visitors who deliver a significant economic value to the region each summer.”
“Regarding this current competition, under European procurement rules the compliant procurement process for this competition was an open competition via eTenders. It is awarded for a five-year period, to be renewed on a yearly basis but subject to adherence to terms and conditions. The volume of applications exceeded the number of permits available and I can only acknowledge the disappointment felt by some at the outcome of the competition. As publicly reported, the results of the permits competition are now the subject of legal proceedings. As such, I cannot comment further on the current competition to award boat permits but I do understand the Deputy's concerns.”
“The OPW does not receive any income from this and does not charge visitors to visit the island, nor does the OPW get involved in the setting of prices for the boat trip to the island as it is considered the prerogative of permit holders to set their own prices. I would like to think that the OPW enjoys a strong working relationship with the boat permit holders, as well as recognising and sharing the same goal - to showcase the island at its best while at the same time making sure that we are protecting its special qualities for the next generation. The season is due to commence on 10 May and it will run until 29 September. Last year, 15,800 people visited the island, with numbers limited to 180 per day in order to sustainably manage and conserve the delicate archaeological remains as well as the diverse flora and fauna of the island.”
“There are over 90 actions in the plan and it is in this context visitor access and numbers to the island are strictly managed. Access to the island is regulated by limiting the number of boatmen who are permitted to land passengers at the island during the visitor season. The established number allowed is 15 boats. A boat permit system was originally introduced to improve health and safety on the journey to and during visitation to the island after the deaths of two visitors to Sceilg Mhichíl in 2009. The OPW’s approach is to sustainably manage visitor activity to the island in line with the agreed UNESCO policy and visitor management plan. I can advise Deputy Cahill that the OPW does not make any profit from the operation of the boat permit system.”
“The visitor season, as Deputy Cahill has alluded to, generally begins around mid-May and runs to late September each year and the OPW staff are present on the island at all times during this period. Access to the island is highly dependent on weather and sea conditions and there are days in every season when visitors cannot land due to unsuitable weather or maritime conditions. The OPW, together with the Department of Housing, Local Government and Heritage, published a ten-year Sceilg Mhichíl management plan for 2020 to 2030 which sets out the State’s approach to managing and conserving the built and natural heritage of the island and ensures sustainable access for visitors to enjoy the outstanding universal value of this unique world heritage property.”
“In 2024, over 16 million people attended and visited OPW-managed heritage sites to explore and enjoy Ireland’s iconic heritage sites such as Clonmacnoise, the Rock of Cashel, Dublin Castle, Kilmainham Gaol, the National Botanic Gardens of Ireland and Kilkenny Castle. As Members will be aware, Sceilg Mhichíl is situated 16 km off the coast of Kerry. It was founded by St. Fionán around the sixth century and is the home of an early monastic site. The monastery came into State care in 1880. The OPW manages the island and conserves the built heritage of the island, including the monastic site. The OPW has been managing visitor access to the island for decades and has a detailed management plan and operating procedures relating to visitors. Due to severe sea conditions, the island cannot be accessed during the winter.”
“I congratulate Deputy Cahill on his appointment. He is a very fine ambassador for the tourism sector not just in Kerry but across the country. I wish him well on that. I heard him raise it this morning with the Tánaiste during Questions on Policy or Legislation. First, to briefly put context on it, the Office of Public Works conserves and manages Ireland’s national heritage estate, which comprises 780 national monuments and 32 national historic properties, with over 5,000 acres of designed landscapes and parks. This estate includes two UNESCO world heritage sites, namely, Sceilg Mhichíl in County Kerry and the Brú na Bóinne complex comprising Newgrange, Knowth and Dowth in County Meath.”
“Focusing on waiting times is the proper metric and here the system is showing progress and outcomes are improving. By continuing to build capacity in our public health system, employing more staff and continuing to make targeted interventions through the waiting list action plan, we will continue to make progress in our ultimate aim of achieving the Sláintecare waiting time target of ten weeks for an outpatient appointment and 12 weeks for an inpatient day case procedure. I join with the Deputy in thanking the staff for the work they are doing. We are increasing investment and will ensure our health system is of a high quality, scheduled around the care of the patient. That is the most important thing we should be doing.”
“As I outlined to the Deputy, the budget and staffing at Beaumont Hospital have increased significantly during a five-year period. However, despite the increased level of activity, we are seeing a growing and an ageing population, which is leading to an increased demand and unprecedented levels of additions to our waiting times and waiting lists. As the Deputy said and as we all know, this has resulted in the number on our outpatient waiting lists and on a significant number of other lists growing which means they are higher than we would wish. We must focus on waiting times rather than the overall volumes on the lists. A growing population and increased and expanded services will always drive appropriate referrals for consultations and procedures.”
“I thank Deputy Hearne. It is about dignity, which I fully accept. As a former Chair of the health committee and as a TD, I am very much aware of this. People are waiting for too long for procedures and outpatients appointments, not just in Beaumont Hospital but across our hospital network. The Government is committed to addressing these issues. It is a priority of the Government and of the Minister for Health. The importance attached to reducing waiting lists is demonstrated by the level of investment over the last number of years through the multi-annual waiting list action plan, including €420 million this year. As I said, this investment, together with additional significant investment across our health budget, means our acute hospitals are delivering higher levels of activity than ever before.”
“In addition to this planned care, our hospitals also treated approximately 1.8 million patients during this same period in emergency care, which represents a 9% increase on the full year 2023 and reflects the continuing demands on our hospitals. With increased investment across the public hospital system and through the 2025 waiting list action plan, the Department of Health, the HSE and the NTPF are taking the next steps in progressing the multi-annual approach towards achieving this Government’s vision of a public healthcare service where everyone has timely and transparent access to high-quality scheduled care services, where and when they need them. I note the Deputy's remarks about Margaret and the BreastCheck waiting lists. If the Deputy has the details and wishes me to bring them back to the Department, I will do so.”
“Under its hospital bed expansion plan a total of 289 new and replacement beds will be delivered by 2031. Ireland’s acute hospitals are treating more patients than ever before. The latest activity report published by the HSE outlined that there were approximately 3.9 million outpatients and 1.9 million inpatient or day case procedure, IPDC, attendances during the full year of 2024. In comparison with the levels of activity delivered in 2023, these figures represent increases of 9% for outpatient departments, OPDs, and 5% for IPDC activity. In Beaumont, outpatients attendances increased by close to 12% and IPDC by almost 3% between 2023 and 2024.”
“However, as the Minister has consistently said, what is much more important than the numbers waiting, is the length of time these people are waiting for treatment. There is a more positive position here, with 91% of outpatients, 82% of inpatients and 99% of those awaiting a GI scope waiting 12 months or less. The Government is committed to the ongoing development of acute hospital infrastructure, and since 2020 significant resources have been invested in Beaumont to meet the need of patients. The hospital budget for 2024 was €504 million, a 29% increase in just four years. Staffing at the hospital has grown by 13% since January 2020. This includes 257 more nurses and midwives, 75 more medical and dental staff, and 37 more health and social care professionals.”
“The most recent waiting list figures, published by the NTPF for March, show an increase in waiting list volumes in the year to date. The delivery of elective care in the early months of the year is always impacted by the winter surge in demand for unscheduled care and because of elevated levels of respiratory illness circulating. However, we are starting to see signs of stabilisation in April and expect to see the volume growth mitigated over the coming weeks. The national trends are reflected in the figures specific to Beaumont hospital. At 40,556, the number of patients waiting for an outpatient appointment has increased by 5% since December 2024. In the same period, the number of patients waiting for an inpatient or day-case procedure has increased by 10% to 9,455 and the number waiting for a GI scope has increased by 30% to 1,583.”
“The Government is focused on having a public healthcare service in which everyone has timely access to high-quality, scheduled care where and when they need it. The Department of Health continues to work with the HSE and the National Treatment Purchase Fund, NTPF, to identify ways to improve access to care. On 12 February this year, the Minister for Health published the waiting list action plan for 2025, representing the Government’s commitment to reducing waiting times for patients and improving access to hospital care. In keeping with this commitment, significant funding of €420 million was allocated to the waiting list action plan for 2025, with €190 million for the HSE and €230 million for the NTPF. With the 2025 plan, we will continue to build on the progress delivered to date under the multi-annual action plan approach.”
“I join the Cathaoirleach Gníomhach in welcoming the Deputy's kids, Aisling, Erin and Caolán, to the House. I thank the Deputy for raising the important matter of Beaumont hospital and in congratulating and thanking the staff of Beaumont hospital on International Workers' Day for the work they do. I do not have the answers to some of the questions raised. However, if the Deputy supplies the details, I will pass them onto the Department and get an answer for him. I welcome the opportunity, on behalf of the Minister, to recognise that waiting times for many scheduled appointments and procedures are too long, not only in Beaumont hospital but in hospitals throughout the country, and that many patients are waiting an unacceptably long time for care.”
“To this end, a joint Department of Health and HSE programmatic approach to primary care waiting lists is under way to develop both short-term and long-term solutions to the long waiting lists for primary care services in order to ensure consistent, equitable and timely access to primary care services.”
“Aligned to the ECC programme, GP access to community diagnostics provides a direct referral pathway to GPs for patients to access community-based radiology scans, including X-rays, DXA, MRI and CT scans and chronic disease tests. This service has received significant funding of almost €47 million for its continuation this year, and will provide 240,000 community radiology scans and up to 161,000 chronic disease tests within the year. The Government fully recognises the frustration in the local area, as articulated by the Deputy, in regard to waiting times and lack of availability of services. It also recognises that much work needs to be done to fill vacancies at local level and address waiting lists.”
“This suite of strategic reform initiatives seeks to reduce dependency on the hospital system by delivering increased levels of healthcare provision in the community setting, with service delivery reorientated towards healthcare general practice, primary care and community based services, which is what the Deputy has articulated and is what we are committed to. Since its launch in 2020, the ECC programme has significantly expanded, with more than 2,800 additional healthcare staff recruited and the successful establishment of 96 community health team networks and 53 of the planned 60 community specialist teams for older people and chronic disease.”
“I understand the Deputy's frustration. Primary care and the utilisation of the centre are perhaps matters that the HSE is best placed to tackle. Equally, the local regional health forum is a forum where the Deputy and other public representatives can put pressure on the HSE. However, I take the Deputy's point. Again, on behalf of the Minister, I wish to reassure the Deputy and I thank her for raising this important issue. The Government is as committed as the Minister is to the development of primary care and community healthcare services, as committed to in the programme for Government. To expand and develop community care services, recurring annual funding of €195 million has been provided to the enhanced community care, ECC, programme.”
“I am here on behalf of the Minister, as the Deputy will understand but I will take the points she has made back to the Minister regarding idle spaces and the lack of delivery. She is right; there is a need to urgently expedite the whole issue of primary care in many of our emerging towns and the area she has mentioned is one.”
“Each of the health regions has its own budget, leadership team and responsibility for local decision-making and continuing to work towards the Sláintecare objectives. Each of the six health regions and each national service has been provided with a specified number of whole-time equivalents in terms of staffing and can replace, recruit and prioritise staff within that approved number. This has provided the health regions with further control to focus resources where there is the greatest need and greater capacity for decision-making at a local level regarding prioritisation and filling of available posts. As I said, I will take Deputy O’Reilly’s points back. I know some of the points she raised have not been addressed in the reply I have given and I accept that.”
“The Minister is committed to building capacity in primary care, as outlined in the programme for Government, by recruiting additional staff numbers, promoting advanced practice roles in the community for health and social care professionals and increasing the number of college training places for health and social care professions. The Minister for Health acknowledges there are challenges, particularly with local vacancies articulated by the Deputy in her comments here this afternoon, which are impacting the waiting times for access to services. The establishment of the HSE’s six health regions means services can plan and deliver around the specific needs of people in each area.”
“In addition, several social inclusion services operate from Balbriggan PCC, including a social inclusion liaison officer, a Roma clinic and the north Fingal community development project. A central objective of the programme for Government is to deliver increased levels of integrated health and social care with service delivery re-oriented towards general practice, primary care and community-based services to enable a “home first” approach. It is acknowledged – as the Deputy has rightly said - that the Balbriggan area has grown significantly in recent years, with the population increasing by 12% between 2016 and 2022. Among towns with more than 10,000 people, Balbriggan is the youngest town in Ireland with a diverse population.”
“The area of Fingal west is located in the integrated health area of Dublin north county and delivers a wide variety of integrated community and primary care services to meet the health needs of the local population. The health and social care services currently available in Balbriggan Primary Care Centre, PCC, include primary care therapy services and community specialist teams for older people, alongside a chronic disease hub. Disability services located in Balbriggan PCC also include the children’s disability network team. There are two community mental health teams in the primary care centre which accommodates the second highest attended CAMHS clinic in 2024.”
“I first congratulate Deputy O'Reilly on her appointment as Chair of the petitions committee. I served on that committee for eight years and I wish her well because it is an extraordinarily important committee of the Houses. I hear the Deputy's concerns and I thank her for raising the matter. As the former chair of the health committee, I understand fully the Deputy's articulation of the issues surrounding the provision of primary care and healthcare. The Minister for Health has asked me to convey to the Deputy her apologies for not being here, to thank the Deputy for raising these matters and for the opportunity to update the Dáil on the provision of primary care services in Fingal West and, in particular, Balbriggan Primary Care Centre. I have taken note of the comments the Deputy has made and I will bring them back.”
“Moreover, a number of generation projects have been delivered in recent years, including capacity market projects, renewables and, as I said, a new 500 MW interconnector to Britain has begun operation. Emergency exercises regularly take place with key stakeholders to test the resilience of our national grid in extreme scenarios like this. As the Deputy rightly said, it is incumbent on us to take the learnings, to plan and to understand what has happened here, and to bring the learnings and best outcomes for our country to ensure we have security of supply. I will bring the Deputy’s concerns and his points back to the Minister.”
“I again thank Deputy Ó Muirí for raising the matter, which is of critical importance. The Deputy is right that there must be learnings from what happened yesterday, whatever the cause of the Iberian blackout is, and that has not been confirmed yet. The authorities in Portugal and Spain are continuing to assess the cause and it may take time. The point the Deputy makes is that we must take learnings from this. In Ireland, EirGrid recently published a resource adequacy assessment, which has forecast a significant improvement in terms of security of supply over the next ten years. The Commission for Regulation of Utilities-led programme of actions has delivered a number of actions to ensure security of electricity supply since 2021, namely, temporary emergency generation and the conversion of Moneypoint from coal to heavy fuel oil.”
“Furthermore, it will provide an independent internationally peer reviewed assessment of what Ireland needs as we move to a highly renewables system to ensure both security of supply, that is, whether we have enough supply to meet demand and system security, that is, the ability of the electricity system to retain a normal state or to return to a normal state after any type of event as soon as possible. The Department expects to receive a copy of this report before the end of the year and will publish it thereafter. Deputy Ó Muirí's points are well made and I will bring his concerns back to the Minister. I congratulate Deputy Ó Muirí on his appointment as Chair of a committee and I wish him well in his term ahead.”
“For example, EirGrid is procuring low carbon inertia services to replace the need for running conventional generation in a highly renewable grid. Ireland has successfully implemented up to 75% variable renewables sources on the grid at any one time and these inertia services will allow us to go further. The Department has also commissioned the International Energy Agency to conduct a study of our electricity security in the context of our energy transition to 2035. This study will be focused on the role of the power sector in achieving that secure transition. It will help Ireland to plan the integration of power sector planning within the wider energy sector as we electrify heat, transport and industry.”
“Moreover, a number of power generation projects have been delivered over the last few years, including capacity market projects, renewables and a new 500 MW interconnector to Great Britain that began operation this year. It is important to note that conventional generation is still critical for the secure operation of a power system. The spinning motion of conventional fossil fuel generation provides inertia to the system that can protect frequency oscillations from cascading through the system and causing other generators to trip off. EirGrid is already taking a range of actions to ensure our system security during the energy transition. It is also continuing to assess how it can securely integrate further variable renewables at any one time.”
“EirGrid’s recently published generation adequacy assessment shows a significant reduction in risks from recent years. This substantial improvement is in large part due to the mitigations from the Commission for Regulation of Utilities-led programme of actions to ensure security of electricity supply. New temporary emergency generation capacity has now been delivered in four locations, namely, North Wall and Huntstown in Dublin, Shannonbridge, County Offaly, and Tarbert, County Kerry. Additionally, Moneypoint power station is converting from coal to heavy fuel oil and has been contracted to remain open until 2029 as an “out of market” unit to provide power only when required by the system operator for electricity security.”
“I thank Deputy Ó Muirí for raising the matter, which I am taking on behalf of the Minister. The Deputy is right that we are not immune to extreme events and he rightly illustrated and highlighted our vulnerability in terms of 2.5 times our usage having gone in five seconds. He is bang on. It is important to note that we do not yet know the causes of yesterday’s event. This kind of cascading event has happened to power grids before. We remember the north-east of the US in 2003, when 55 million people were affected, in particular in New York, and more recently in Chile in February of this year, when the vast majority of the 19 million customers lost electricity for a number of hours. EirGrid regularly tests the resilience of our grid to extreme events such as these as part of National Emergency Co-ordination Group emergency exercises.”
“Deputy Mattie McGrath made reference to May Day. I repeat that there has been engagement. We have a humanitarian duty. The Government and Department are working in compliance with tax requirements, the Companies Registration Office and EU trade agreements. I ask Members to be careful in the language they use. I recognise their views are sincerely held. However, our language and how we express ourselves is very important. We are talking here about people who are looking for refuge and are living in communities. I urge all Members to be sensitive to the needs of everybody.”
“The Government is working towards a more sustainable international protection accommodation system that will include moving away, over time, from an over-reliance on commercial and emergency accommodation contracts. The Government is working to ensure that a greater proportion of accommodation is provided on State-owned land over time. The degree of control given to the State by the creation of a core supply of State-owned accommodation for both emergency and permanent options will increase as supply is delivered, re-establishing strategic direction over the accommodation type, location and dispersal pattern. This work will be progressed as part of the development of a new migration and integration strategy, and will shortly transfer from this Department to the Department of Justice. That move is to be completed in the coming days.”
“To Deputy O'Hara, I repeat that those people from Ukraine who remain in the property will stay at the Merriman Hotel and will be accommodated under new arrangements. That is fairly black and white. I take on board the comments of both Deputies and will bring them back to the Minister. The Department has been working with communities all over Ireland to source and provide accommodation for people applying for international protection. Emergency centres have been opened in all parts of the country. This is part of Irish and EU law and is also part of our humanitarian duty to provide shelter to people fleeing war and persecution in their home countries. I repeat that it is our humanitarian duty. The State is currently accommodating over 33,000 people in over 320 international protection accommodation centres around the country.”
“Where the Department enters into a contract, the onus is on the accommodation provider to ensure all activities at the property are within legal limits. The Department understands the local authority is in contact with the property with regard to planning matters, and as this is a large site with various distinct areas and uses, these matters are largely unrelated to the areas of the site contracted to the Department. The Department is also aware of ongoing court proceedings with regard to this property, which is not appropriate for me to comment upon. I assure the Deputy that should any action be required as a result of any court proceedings or the local authority’s engagement at the property, these will be addressed by Department officials as appropriate.”
“Offers of accommodation can be made by a property owner, leaseholder or other authority. As part of the Department's appraisal process, it can confirm if an offer has come from someone with the appropriate authority. The Department carries out due diligence on accommodation being contracted to ensure Companies Registration Office and tax compliance. In line with EU trade arrangements, a company or company director from another EU member state may operate contracts within Ireland or work with an Irish business to do so. In terms of the contract in this case, the registered company named on the contract is a newly established entity that fully met the Department’s requirements. The company is part of a wider commercial group that has experience in providing international protection accommodation.”
“This figure includes beneficiaries of temporary protection due to the war in Ukraine who were already being accommodated and is not therefore an increase in the overall capacity at this centre since 2022. The community engagement team has extensively engaged with the local community about this property since May 2024, including discussions on the potential accommodation of international protection applicants. On 15 April 2025, the community engagement team sent a formal briefing note, including the name of the accommodation provider, the type and nature of accommodation to be provided and details about the services to be put in place. In terms of the provider themselves, the Department can consider offers of accommodation from a tax-compliant company, subject to compliance with statutory requirements and minimum standards.”
“As such, it was not considered necessary to exclude it from consideration for this much-needed accommodation for families in need of shelter. Deputy McGrath raised the issue of Dundrum House Hotel, which ceased operation as a hotel in 2015. There is a golf course, grounds and a hospitality business on site, which have remained open to the community while part of the site operates as an accommodation centre. The former hotel has been providing refuge to a peak capacity of 270 people from Ukraine since 2022, and to more than 50 international protection applicants since the summer of last year. A new contract has commenced at this property, and the centre will provide accommodation to up to 277 people in families seeking international protection.”
“My information is that the engagement with the community has been extensive over recent months, and we will now progress to providing refuge to families at this location. In terms of the people from Ukraine who remain at the property, they will stay at the Merriman and will be accommodated under the new arrangements. One of the queries raised during community engagement in Kinvara was the agreement to not contract IPAS accommodation in a given town’s only operating hotel. This was accepted by Government and was agreed to on the basis of not removing an important current amenity from public use. The hotel has not been in public use since the Covid-19 pandemic, and since 2022, it has been providing accommodation under contract to the Department.”
“I thank Deputies O'Hara and McGrath for raising these important matters tonight and for allowing me, as Deputy McGrath said, to respond on behalf of the Minister. I say to Deputy O’Hara that the Department recently announced that 98 beds for families seeking international protection will be provided at the Merriman Hotel in Kinvara. The property was previously used to house people who were beneficiaries of the temporary protection directive due to the war in Ukraine and was also used as an international protection accommodation services accommodation centre prior to 2022. The community engagement team has been sharing information with local representatives and community groups since 18 March, including, as the Deputy said, a detailed briefing note, meetings and personal contacts.”
“More generally, the Minister asked that I take this opportunity to urge all those eligible for any vaccine under the national immunisation programme, at all stages of life, to avail of the opportunity to be vaccinated. In particular, the Minister encourages all parents to bring their young infants, in line with the vaccination schedule, to the GP for their important childhood immunisations. This will help us to reach the shared objective of protecting public health by preventing the spread of disease in our community. I will take the Deputy's remarks back to the Department and the Minister. He made valid points that should be listened to.”
“It is hoped that the introduction of the shingles vaccine to the immunisation schedule in Ireland can be reconsidered if and when the cost-effectiveness of the vaccine is confirmed as more favourable. Members will be aware that the immunisation programme in Ireland is based on the advice of the national immunisation advisory committee. The committee's recommendations are based on the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation. To protect the public from serious outcomes of diseases, vaccines included in the national immunisation programme are administered free of charge to those in eligible at-risk groups.”
“Deputy Burke made some very valid points. He is right about the long-term effects of shingles and the ageing population. I thank him again for raising this important matter. He is right that we should be forward thinking. Vaccination is regarded as one of the most effective, cost-effective and successful public health interventions that exist, saving many lives every year. As has been highlighted, shingles can impact anyone who has been infected with chickenpox during their life, leaving a significant proportion of the general population vulnerable. Up to one in three people who have had chickenpox will go on to have shingles. That is why the Department requested that HIQA carry out a HTA to review the evidence for adding the shingles vaccination to the adult immunisation schedule in Ireland.”
“The Minister for Health has no role in decisions relating to approving which medical products are covered under these schemes.”
“Given that the healthcare budget is finite and decisions regarding increased spending relating to a change in one area could impact the provision of other health technologies and treatments within the healthcare system, the cost-effectiveness must be considered in any decision-making process. The Department considered the findings of this HTA and determined that the introduction of the vaccine could be reconsidered when the cost-effectiveness of the vaccine is confirmed as more favourable. On the question of the shingles vaccine being included in the drugs payment scheme and the medical card scheme, it is the Health Service Executive which has statutory responsibility for decisions on pricing and reimbursement of medicines in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013.”
“The cost-effectiveness and budget impact were also reviewed, along with the ethical, social and organisational implications of including the vaccine in the adult immunisation schedule. HIQA published this HTA on 19 July last year. The HTA found that adding the shingles vaccine to the routine immunisation schedule at the vaccine price at the time for all adults aged 65 and over would not be cost-effective and would be associated with a substantial budget impact. While the HTA found that the introduction of the shingles vaccine was not cost-effective based on the cost of the vaccine, it found that it could be cost-effective for vaccination of those aged 75 years and 80 years if the cost of the vaccine was reduced by 80%.”
“Shingrix has also replaced Zostavax as the preferred vaccine against shingles internationally. The national immunisation advisory committee guidelines state that the Shingrix vaccine may be considered in those aged 65 and older due to the greater burden and severity of disease and post-herpetic neuralgia in this age group and in those aged 18 years and older at increased risk of shingles. The shingles vaccine is not currently provided as part of the national immunisation programme. The Minister for Health advises that following a request from her Department, HIQA carried out a health technology assessment, HTA, on the herpes zoster vaccine which protects against shingles. This assessment examined the evidence on the clinical effectiveness and safety of shingles vaccines.”
“Approximately one third of people who have had a varicella infection will develop a shingles infection at some point during their lifetime due to reactivation of the virus. Morbidity associated with herpes zoster increases with age. The most common complication is post-herpetic neuralgia, a persistent pain in the area of the rash. This has the potential to cause significant reductions in quality of life, activity, mood and sleep. Two thirds of cases occur in those aged 50 and older. The risk of developing the disease in those aged 85 and over is 50%. A non-live, recombinant shingles vaccine called Shingrix is available in Ireland and is given as a two-dose vaccine. Shingrix is more effective than the previously available live vaccine Zostavax and can be safely administered to immunocompromised patients.”