Bernard Durkan (Kildare North, Fine Gael)
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1. To ask the Taoiseach when the Cabinet committee on health will next meet. [41575/23]

Cian O'Callaghan (Dublin Bay North, Social Democrats)
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2. To ask the Taoiseach when the Cabinet committee that deals with disability will next meet. [42509/23]

Cathal Crowe (Clare, Fianna Fail)
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3. To ask the Taoiseach when the Cabinet committee on health will next meet. [42581/23]

Michael Moynihan (Cork North West, Fianna Fail)
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4. To ask the Taoiseach when the Cabinet committee that deals with disability will next meet. [42584/23]

Aindrias Moynihan (Cork North West, Fianna Fail)
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5. To ask the Taoiseach when the Cabinet committee on health will next meet. [42590/23]

Ruairí Ó Murchú (Louth, Sinn Fein)
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6. To ask the Taoiseach when the Cabinet committee that deals with disability will next meet. [42604/23]

Mick Barry (Cork North Central, Solidarity)
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7. To ask the Taoiseach when the Cabinet committee on health will next meet. [42619/23]

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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8. To ask the Taoiseach when the Cabinet committee on health will next meet. [43865/23]

Paul Murphy (Dublin South West, RISE)
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9. To ask the Taoiseach when the Cabinet committee on health will next meet. [43868/23]

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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10. To ask the Taoiseach when the Cabinet committee on health will next meet. [43871/23]

Pádraig O'Sullivan (Cork North Central, Fianna Fail)
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11. To ask the Taoiseach when the Cabinet committee on health will next meet. [44058/23]

Alan Dillon (Mayo, Fine Gael)
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12. To ask the Taoiseach when the Cabinet committee on health will next meet. [45023/23]

Ruairí Ó Murchú (Louth, Sinn Fein)
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13. To ask the Taoiseach when the Cabinet committee on health will next meet. [45032/23]

Leo Varadkar (Dublin West, Fine Gael)
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I propose to take Questions Nos. 1 to 13, inclusive, together.

The Cabinet committee on health last met on 25 September and is currently scheduled to next meet on 23 October. The Cabinet committee on health oversees programme for Government commitments relating to health and receives detailed reports on identified policy areas. It considers the progress of health reforms, including Sláintecare, and the reform of disability services. The Cabinet committee also maintains an overview of public health.

In addition to attending meetings of the full Cabinet and Cabinet committees, I meet Ministers individually to focus on various issues. I meet the Minister for Health regularly to discuss progress and challenges in the area of health, including finance and the Sláintecare reform programme. We met as recently as yesterday. Sláintecare, which is happening with the support and oversight of the Department of the Taoiseach through the Cabinet committee on health, is about four main things: making healthcare more affordable; making healthcare more accessible; ensuring better outcomes for patients; and reforming and integrating our health service.

We are committed to expanding the core capacity of our acute hospitals, with more health professionals and more acute hospital beds. We have added more than 1,000 permanent beds since 2020. We have increased the total public health sector workforce by more than 22,500 since the beginning of 2020. This includes nearly 7,000 additional nurses and midwives, over 3,000 additional social care professionals and 2,500 additional doctors and dentists. There is a strong pipeline of capital projects, including several new hospitals and significant new facilities for existing hospitals.

Our multi-annual approach to waiting lists resulted in an overall reduction in the number of patients exceeding the Sláintecare maximum waiting times by 21% since the post-pandemic peak. This is at a time when waiting lists are growing in most other jurisdictions. The enhanced community care programme continues to improve healthcare at a more local level and alleviate pressure on hospitals and in more acute settings. The majority of community healthcare networks, community intervention teams and community support teams are now in place and providing care closer to home. Work is ongoing on the reconfiguration of the HSE organisational structures into six new health regions and the establishment of elective care centres in Dublin, Cork and Galway, as well as surgical hubs in Dublin, Cork, Galway, Limerick and Waterford in the interim.

We are making healthcare more affordable at a time when the cost-of-living crisis is affecting everyone. This is being done through the removal of hospital inpatient charges, wider eligibility for the GP card, which has now been extended to more than half the population, and a reduced drug payment scheme threshold, among other things.

Last week, the Government announced a €22.5 billion health budget that will facilitate the continued delivery and expansion of quality, affordable healthcare services. A separate €2.6 billion is being invested in disability services. This budget is being transferred from the Minister for Health to the Minister for Children, Equality, Disability, Integration and Youth. Budget 2024 will provide €500 million for waiting lists, including the opening and staffing six new surgical hubs. The waiting list plan is fully funded. There will be a further expansion of the free contraception scheme to include women aged 31; increased funding for mental health by completing the staffing of child and adolescent mental health services, CAMHS, teams, if staff can be found; increased funding for digital health; the first full-year programme of publicly funded assisted human reproduction services, including IVF; over €36 million for surge measures to respond to periods of heightened demand in acute and community services; over €20 million in extra funding for disability residential services for adults and children to provide about 100 new residential places; €10 million for new respite services; and over €18 million for placements in adult day services for over 1,000 young people leaving school in 2024. The significant allocation also includes a health resilience fund to assist in responding to high inflation and increased patient demand among an expanding and ageing population.

Our health service has its challenges but it is responding and has expanded dramatically in recent years. We are treating more people with better outcomes than ever before. Our life expectancy is continuing to increase and is now well above the OECD average. We continue to reduce mortality rates for stroke and certain cancers and report positive trends in preventive health.

Bernard Durkan (Kildare North, Fine Gael)
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I thank the Taoiseach for the comprehensive reply. At the next promised Cabinet committee meeting, will the inability of the Department of Health in general to come within budget and deliver services as anticipated be recognised? Is it expected that dead reckoning, or as near as possible to it, can be achieved in respect of this? Has sufficient emphasis been put on the people charged with identifying the potential costs over the course of a year or two years? Will it be possible to meet the challenges of the future based on the evidence and experiences of the past, particularly in regard to correctly identifying the potential costs of services over any period in the future?

Cian O'Callaghan (Dublin Bay North, Social Democrats)
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On disability, developmental disability and delays in opening autism units in schools, a new autism unit was meant to be opened for students in Scoil Íde, Kilmore, this September, but this has been delayed, causing great stress among the pupils and families, who are left without any school places. The lack of planning and lack of delivery on promises made are completely unacceptable and put the students and their families under additional stress that they really do not need. Why are autism units that have been promised not being delivered on time? Why are pupils with autism being left without school places as a result?

Michael Moynihan (Cork North West, Fianna Fail)
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Several issues arise. The Taoiseach mentioned respite and residential places. Service providers, predominately section 39 organisations, used to apply to what is now the Department responsible for the environment, and now apply to the Department responsible for housing, under the capital assistance scheme, CAS, for funding. Many find it cumbersome and difficult to access funding where available. A long time ago, many residential places were rolled out under the scheme. This should be examined and made more streamlined so the service providers can access a direct source of funding.

The other issue is assessments of need, for which there is a huge waiting list, particularly affecting young children. It was suggested that funding be made available for parents to get assessments for their children privately. Is the Cabinet committee considering this?

Ruairí Ó Murchú (Louth, Sinn Fein)
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We all have a fear regarding the moratorium. With regard to some of the unfilled positions, we know how difficult it is to get home help hours and to have staff allocated. This is a huge issue in north Louth and, I assume, elsewhere across the State. I met representatives of Family Carers Ireland and noted the issue they still come up with is that of the means test. Very many people with really good jobs suddenly become carers, whether for siblings or parents. Children, in particular, have to give up jobs to care for parents, and sometimes they are put under severe pressure because of the small amount of earnings their spouse has above and beyond the threshold.

The other issue they bring up is services. We all know that. I have asked the Taoiseach before what is the best we can do to get bang for our buck. We will not have enough speech and language therapists, SLTs, psychologists or occupational therapists, OTs, in the near future. We have looked at school inclusion models and pilot projects. I would like to see the results of these and whether we can have an outworking that can benefit everyone as regards assessments and therapies, as it is not working at this point.

Paul Murphy (Dublin South West, RISE)
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The HSE chief executive officer, Bernard Gloster, said the simple reality is that the funding allocated to the health system in the budget is not adequate, that the service plan for 2024 that the HSE will put forward to the Minister will include a built-in deficit and that this will be the first time in his memory that that would be the case. I do not understand how the Government can propose a budget at a time of significant surplus - almost €10 billion is projected for next year - that will entail a worsening of the health crisis. It will entail an increase in the number of people who are on hospital waiting lists and in the number of people who will be on hospital trolleys this and next winter. How can it be the case that we have a budget for a worse health service? How can the Taoiseach stand over that? I understand that other Ministers may not have confidence in the Minister for Health, Deputy Stephen Donnelly. If that is the case, get rid of Deputy Donnelly and do not punish the patients who are reliant on our public health service.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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There is huge concern about a cohort of patients who rely on new drugs and treatments. Bizarrely, in this year's budget the funding for these treatments has been taken away. This will affect thousands of patients. Like all Deputies, I received an email about a person who relies on a particular drug and has been told by their doctor that they will not get it. The person will have to leave the jurisdiction. This is a case of life and death. There are consequences for many people. This is bizarre. The country is awash with money, yet people have to go without. Will the Taoiseach give clarity on access to new drugs?

Alan Dillon (Mayo, Fine Gael)
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I raise the continued absence of a chief pharmaceutical officer, CPO, in the healthcare system or the Department of Health. The role is essential to manage medicine and pharmacy services. It is missing in Ireland, unlike many other countries. We have a chief medical officer, a chief nursing officer, a chief dental officer and a chief veterinary officer. Certainly a CPO would ensure we have the correct medicines and pharmacy services for our people. Our system for medicines and pharmacy is complicated, which causes delays in getting new medicines to treat people. Right now, community pharmacists are dealing with medicine shortages. We need a plan to fix this. Ireland is unique as we have a big pharmaceutical industry. We need a strong voice in Europe to talk about medicines and a CPO could do that. In simple terms, a CPO would ensure we have the right medicines, fix medicine shortages and make sure we have better pharmacies. Does the Taoiseach support the idea of having a chief pharmaceutical officer and, if so, what steps will he take to put one in place? We need to cut through the red tape and bureaucracy in the Department of Health and make this happen for the good of our people and the sector.

Leo Varadkar (Dublin West, Fine Gael)
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In response to Deputy Durkan's question, it is always a struggle for health to come in on budget, no matter what increase is given in any year and whether it is big or small. That is especially so in the acute hospitals. It is much less the case in community care or the primary care reimbursement service, PCRS, which generally come in close to budget. There are areas that are simply not under the control of the HSE or Department of Health and cannot be predicted, such as pension costs - we never know for sure how many people will retire - and the State Claims Agency, which is subject to court judgments.

Deputy Cian O'Callaghan raised the delay in opening an autism unit in Kilmore. I do not know the reason for the delay but we will do all we can to ensure it opens as soon as possible. I will make sure my office takes it up with the Minister of State, Deputy Madigan. I will ask her to come back to the Deputy directly.

Deputy Michael Moynihan raised the issue of respite. An additional €10 million has been allocated for new respite services in 2024. I think the capital assistance scheme is operated by the Department of Housing, Local Government and Heritage under the Minister, Deputy Darragh O'Brien. I will have to double-check that and revert to the Deputy.

The issue of people waiting far too long for assessments of need is quite fraught. Much of it is linked to court judgments in which it was ruled that an assessment of need should be a long process. I think it is approximately 30 hours. Sadly, as a consequence, many resources are going into assessments of need rather than treatments and therapies. That is a real problem and we will have to deal with it. The idea of allowing people to get a private assessment reimbursed is under consideration. The Minister, Deputy O'Gorman, and the Minister of State, Deputy Rabbitte, are keen to do a pilot of that next year and I support them in their efforts. We need to make sure it will be done correctly, that there is capacity and that there are terms, conditions and standards that can be applied.

Deputy Ó Murchú mentioned the recruitment moratorium. It is important to put on the record of the House that it is a partial recruitment moratorium. It only applies until the end of the year and only where the HSE has already recruited the number of people for which it has funding at a particular grade. Unfortunately, in some cases, it has over-recruited. It has recruited people for whom it does not have funding and that has, in many ways, led to the problem. The HSE will be able to increase its total headcount by 2,000 next year. Far from there being a reduction in staff working in the health service next year, the HSE will be allowed to hire an additional 2,000 staff, on top of the 23,000 hired since this Government came into office. We need to make sure it hires the correct 2,000 and not simply any 2,000. We will be engaging with the CEO of the HSE and his team about that.

The carer's means test has been relaxed in the budget for 2024. The Minister, Deputy Humphreys, will set that out in the social welfare Bill.

In response to Deputy Murphy's question, we will work with the CEO of the HSE and his team to put together a credible service plan between now and the end of the year. It will involve a supplementary budget for this year, as everyone is aware. I recall that the CEO, Bernard Gloster, said that the emergency department plan has been funded and there are 120 fewer patients waiting for a bed today than was the case this time last year. The additional beds, including intensive care unit, ICU, beds have all been funded, as has the waiting list plan.