Mary Lou McDonald (Dublin Central, Sinn Fein)
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3. To ask the Taoiseach when the Cabinet committee on health will next meet. [36563/24]

Peadar Tóibín (Meath West, Aontú)
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4. To ask the Taoiseach when the Cabinet committee on health will next meet. [36612/24]

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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5. To ask the Taoiseach when the Cabinet committee on health will meet next. [36722/24]

Simon Harris (Wicklow, Fine Gael)
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I propose to take Questions Nos. 3 to 5, inclusive, together.

The Cabinet committee on health last met on 1 July 2024 and is due to meet again soon. In addition to the meetings of the full Cabinet and of Cabinet committees, I meet Ministers on an individual basis to focus on different issues. I meet regularly with the Minister for Health to discuss progress and challenges in the area of health, including the Sláintecare reform programme.

Sláintecare is about four main things - making healthcare more affordable, making healthcare more accessible, ensuring better outcomes for patients and reforming 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 to the health service since 2020 when this Government came into office. We have increased the total public health sector workforce by more than 28,000 since the beginning of 2020, which includes 9,000 nurses and midwives, over 4,000 social care professionals and over 3,000 doctors and dentists. There is a strong pipeline of capital projects. I opened a new five-bed ward block in Portiuncula hospital last week and phase 1 of the new National Rehabilitation Hospital. There are several new hospitals and significant new facilities for existing hospitals are under way or in the pipeline.

Our multi-annual approach to waiting lists resulted in an overall reduction in the number of patients exceeding the Sláintecare waiting times by 22% since the pandemic peaks. Waiting lists fell last year for the second year in a row. This is interesting at a time when they are not falling in many other countries, including nearby jurisdictions. The figures that matter most are the number of patients waiting longer than the agreed Sláintecare maximum wait time targets of ten to 12 weeks. Most of us adopted the all-party report relating to this in 2017. The fairest way of measuring waiting lists involves people who are waiting longer than the Sláintecare target.

The enhanced community care programme continues to improve healthcare at a more local level and alleviate pressure on hospitals. The majority of community healthcare networks, community intervention teams and community support teams are now in place and providing care closer to home.

We are also making healthcare more affordable at a time when the cost-of-living crisis is continuing to affect everyone by removing hospital inpatient charges, widening eligibility for the GP card and reducing the drug payment scheme threshold, among other things. Budget 2024 funding provides funding of hundreds of millions of euro for waiting lists and action on urgent and emergency care; investments in our workforce such as advanced practice, more college and training places and more hospital consultants; the first full-year programme of publicly funded assisted human reproduction services, including IVF; further expansion of the free contraception scheme to include women aged 35; and additional staffing for CAMHS teams.

Our health and social care service has its challenges but our systems are responding and we have expanded the health service dramatically in recent years. We are treating more people with better outcomes than ever before. Interestingly, Ireland has the highest self-perceived health status in the EU, with 80% of people rating their health as good or very good. Our life expectancy is continuing to increase and is above international averages. Ireland is among a group of seven EU countries where life expectancy is above 82. We continue to reduce mortality rates for stroke and certain cancers and report positive trends in preventative health. Our age-standardised mortality rates have declined for all causes over the past decade by more than 10%.

Ruairi Ó Murchú (Louth, Sinn Fein)
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I raise the issue of the Drogheda department of psychiatry in Crosslanes. Planning permission has been granted for a ten-bed extension. The significant issue in Louth-Meath is historically poor bed provision. We are operating at around 12.9 beds per 100,000, whereas in the rest of the State it is more like 15 or 16 beds per 100,000. We need a timeline for that. The Mental Health Commission has said that a number of times when it has checked, it has found an insufficient number of staff from a safety point of view, even in the current building. We need to look at that.

I am told that in Louth-Meath, there are about 40 nursing vacancies. There were 40 vacancies just before the moratorium, which then suddenly fell to around 13. This raises questions regarding nurses who are acting up when the position they were acting up from suddenly disappeared. I am told that if we take other disciplines into account, the number is even greater. We also have an issue with assessments, which can happen in Our Lady of Lourdes Hospital, particularly in the evening and night when people have mental health issues. This leads to some of the problems in accident and emergency departments.

Peadar Tóibín (Meath West, Aontú)
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I raise the horrific case of Harvey Sherratt. Harvey is an eight-year-old boy. For some reason, he has been removed from the waiting list for scoliosis surgery without his parents being informed of this. Many people will have seen images of Harvey circulating in the media. It is shockingly clear that this child is suffering significantly. The curvature of his spine seems to be in excess of 90 degrees. The curve of his spine has gone beyond what a right angle is. The child is struggling to breath and is screaming in pain but Children's Health Ireland has removed him from the waiting list for some reason. He has been on the waiting list since February 2022. The Taoiseach made promises in 2017 that no child would wait longer than four months for surgery. How can a society that puts away a budget surplus of €8 billion not provide the necessary resources to ensure that children who need these critical and, in certain cases, life-saving operations receive them? Will the Taoiseach explain exactly how Harvey's name was taken off the waiting list?

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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In July, the HSE announced that there was a lifting of a recruitment embargo for the health services. That announcement was a deception. How do I know? It is because over the past number of weeks, I have had multiple calls from people at different grades and in departments in St. Michael's Hospital saying that a staff quota has been imposed. This means maternity and sick leave is not being covered, people who retire are not being replaced, department after department is understaffed and people are demoralised.

All of this is being done under a measure called the pay and numbers strategy. It turns out that this is not specific to St. Michael's Hospital. When the Taoiseach and I were in the National Rehabilitation Hospital, the clinical director confirmed to me that even her post took a while to get past the pay and numbers strategy. This is affecting the hospital and it is being applied everywhere. An arbitrary ceiling on staff is preventing recruitment, rehiring and safe staffing. The Irish Nurses and Midwives Organisation, INMO, confirmed this today. That ceiling needs to be lifted immediately.

Violet-Anne Wynne (Clare, Independent)
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Before this House rose for the summer recess, Members, including me, raised the urgent need for statements on University Hospital Limerick, UHL, particularly overcrowding and the number of patients on trolleys on a daily basis. As the Taoiseach knows, the mid-west is the only region with a model 4 hospital that does not have a supporting model 3 hospital with an emergency department. The Taoiseach stated at the time that he would prefer to wait for the results from the HIQA review but now we know that this is not likely to come before the House before next summer. We also know that surge capacity was triggered every day of last year in UHL and that one quarter of presentations at the hospital are from County Clare. We also know that there are 13% fewer beds in UHL compared with the average model 4 hospital and that the hospital is expected to care for a population of over 431,000. I again acknowledge the national heroes who are making great strides in the face of these extreme pressures. Can we have statements on the floor of the House?

Matt Carthy (Cavan-Monaghan, Sinn Fein)
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Last October, I raised with the Taoiseach’s Fianna Fáil predecessor the case of a young boy in Castleblayney who was seriously injured in a football match and had to wait three hours before an ambulance arrived. The then Tánaiste informed the House that he could not understand why it would take so long but set out very clearly that things were improving and all the great things the Government was doing. A fortnight ago, another young boy in Monaghan town was seriously injured in a football match. He lay screaming in agony for two hours and 20 minutes before an ambulance arrived. As for the lived realities of people in this situation, the only thing the Government has really done that has had an impact is change the target response times for ambulance services. If Fine Gael is in power next year, how long will children be left waiting for ambulances?

Paul Murphy (Dublin South West, RISE)
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Will the Taoiseach commit to introducing free HRT in the budget? Will he also agree not to limit access according to unjust criteria? All women who need HRT deserve equal access to it regardless of age or income or whether they are in menopause, perimenopause, premature menopause or post-menopause.

At the moment, women in this country are forced to pay the full cost of HRT, which ranges between €30 and €80 per month, themselves. It is a lot of money and it amounts to a discriminatory, so-called pink tax on women. It adds up to between €360 and €960 a year, not including the cost of doctor's appointments. If a woman who is lucky enough to have a well-informed GP who will prescribe HRT does not have a medical card, that is an extra €50 to €65 per appointment but if she is forced to see a specialist to get the care she needs, that means €200 per appointment. Very many working-class women simply cannot afford that. Will the Taoiseach commit to free HRT and to providing midlife health checks for all women free of charge?

Mick Barry (Cork North Central, Solidarity)
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The case of Harvey Sherratt has been raised in the Dáil today. Can the Taoiseach give the House a guarantee that no other children were taken off the CHI scoliosis lists without consultation with or notification of their parents and if he cannot, will he investigate whether that was the case? Will he call for the publication of the Arthur Cox investigation into CHI’s management of issues surrounding the scoliosis crisis? Will the State cover the cost of insurance for bringing children with scoliosis to the United States for surgery? The State is refusing to do that and pressure is being put on the parents. Will the Taoiseach guarantee that the State will do that?

Simon Harris (Wicklow, Fine Gael)
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In response to Deputy Ó Murchú, I will follow up with the Minister for Health with regard to an update and timeline for the Drogheda department of psychiatry and the issue of nursing and other vacancies in the health service in the Louth-Meath area.

I thank Deputies Tóibín and Barry for raising the issue of Harvey, which was also raised in the House earlier today. I have received correspondence from Harvey's mother and I have responded. I have spoken to the chief executive of the HSE and the Minister for Health on the matter. The suffering of any child is something nobody wishes to see and I certainly do not wish to see it. What I can say is that I believe it is essential that a clinical appointment is arranged because it is a clinical matter as to whether surgery is the best way to proceed or whether there is a more appropriate way of providing care. I am not the clinician but I believe a further clinical appointment is the right way to proceed and I hope that happens. I am certainly in a position to facilitate that happening. My team has reached out and I have reached out by letter to Harvey's parents. My team are happy to be in contact with them on this matter, which I know is extraordinarily distressing for the family and, most of all, for Harvey.

On the broader point, I will certainly ask the question of the Minister for Health and the HSE as to whether anybody else was removed from the waiting lists. My understanding is that these are clinical decisions but regardless of whether they are clinical decisions, proper communication with parents is, of course, essential at all times.

On a separate and distinct point, there is now a clinical lead, Mr. David Moore, in this whole area of paediatric spinal surgery. It has been important to have that clinician perspective and I look forward to meeting him again shortly and with scoliosis advocacy groups at the start of next month. At that meeting, I will be happy to discuss the reports and any information that can be useful.

On the issue of insurance, the Deputy makes a fair point. I do not want to make a commitment on the floor of the House until I know that I can honour it but let me inquire on that point directly and come back to him.

Mick Barry (Cork North Central, Solidarity)
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What about Arthur Cox?

Simon Harris (Wicklow, Fine Gael)
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That was the report I referenced. I will talk to the Minister for Health and the task force that he set up. I will familiarise myself and come back to the Deputy on whether that can be published. I certainly want to meet the advocacy groups with the head of the HSE and the Minister for Health at the start of next month to see how more progress can be made on this issue, and to discuss any information, reports or otherwise that are in place and that can be helpful in this regard.

In response to Deputy Boyd Barrett regarding St. Michael's Hospital, the embargo has been lifted but there is a pay and numbers strategy, as there is for every organisation. Whether it is the Garda Commissioner, the Minister for Education or the head of the HSE, people have to hire in accordance with their budgets. There was a blunter instrument in place that was causing a significant challenge and we have replaced that with a very significant level of investment.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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It is worse. The IMO says it is worse.

Simon Harris (Wicklow, Fine Gael)
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I do not believe it is. There has been a very significant level of investment. I will read the IMO’s comments in that regard, the Minister will engage on that and, of course, we will have a new health budget delivered on budget day just two weeks from today.

In response to Deputy Wynne, I am happy for there to be a debate in this House on UHL. I might have said on that occasion that it would be useful to have the Frank Clarke report into the horrific and unimaginable loss of Aoife Johnston's life published in advance of that. My understanding is that the report is due to be published next week so perhaps this is something we can discuss and arrange through the Business Committee. I am also conscious of any debate in this House being conscious of her family, as I know the Deputy will be. I think the HIQA review is the way to proceed with regard to a second emergency department.

In response to Deputy Carthy, I will take up the issue of the National Ambulance Service in Monaghan with the Minister for Health and revert to the Deputy in writing.

On the question raised by Deputy Murphy, I would like to see HRT made free but these are matters for the budget in two weeks' time.