2026-06-09

I raise the ongoing closure of the south Tipperary memory clinic in Cashel and the growing impact it is having on patients and families across the county. I thank the Minister of State for taking the question, as I know it is an area she is very familiar with, given her previous responsibility in this area. Through a number of parliamentary questions I submitted recently, I received confirmation from the HSE that the memory clinic has been closed since January 2026. There is no reopening date, and while there is a review under way, families have no certainty as to when a fully functioning service will be restored. The figures provided to me by the HSE are deeply concerning. There are currently 450 patients awaiting an initial assessment and a further 168 waiting for follow-up appointments. That is a total of 618 people caught up in a system that is simply not functioning. This matters, as the Minister of State well knows, because dementia diagnosis is not a luxury; it is a gateway to treatment, care planning, family support and future decision-making. While the HSE points to dementia advisers and other support services, those services are not a substitute for diagnosis itself. What families want and what patients deserve is timely assessment and diagnosis. I know the Minister of State is very familiar with the dementia model of care. I think that sets out a pathway for timely access to assessment and intervention of six weeks, yet in south Tipperary, we have a situation where public memory clinics have ceased operating entirely. Patients are being left indefinitely, while GPs are being provided with information on private providers. I think that raises serious questions about equity of access. Will the Minister of State address the stark contrast with services available in other parts of the south east? I know the tremendous work the Minister of State has done in Waterford and Wexford, both of which provide a structured multidisciplinary approach to dementia assessment and support. Why is a comparable service not available to the people of south Tipperary? My understanding is that there is currently no dedicated memory service in north Tipperary either, and if that is the case, large parts of the county are effectively without direct access to specialist memory assessment services. We all know our population is ageing. We know that dementia referrals are increasing year on year. This cannot be dismissed simply as a temporary inconvenience or an administrative issue. This is a systemic failure, in my view. We talked about ophthalmology a minute ago. We have a similar systems failure with ophthalmology provision in south Tipperary, and we have a similar systematic failure when it comes to orthodontic care in south Tipperary. However, this particular memory clinic service failure is leaving hundreds of patients waiting for a diagnosis and is leaving families in distress. I plead with the Minister of State to engage directly with the Minister to address the specific issues. When will the review be completed and when will the memory clinic reopen?

I thank Deputy Murphy for raising this very important issue. I am taking this Topical Issue on behalf of the Minister of State with responsibility for older people and housing, Deputy Kieran O'Donnell, who sends his apologies for not being able to be here tonight. The Deputy is quite right. I was a Minister of State in the previous Dáil for four and a half years, and one of the areas where we made a lot of progress was dementia. Every day in Ireland, there are 30 new cases of dementia. There were 30 yesterday, there are 30 today and there will be another 30 tomorrow. I was delighted to welcome the Minister of State, Deputy O'Donnell, to Cappoquin in Waterford last Friday, where we opened a new dementia day service. It is something I worked on while I was in the role and it was great to get it over the line, because bringing services to people in the community, especially those with dementia, is really important. You can live well with dementia in your community with the correct wraparound supports of home care, day care, meals on wheels and the like of the memory clinics. When I was asked to take this Topical Issue debate tonight, I was disappointed to hear that one of the 25 memory clinics that I worked so hard to open across the country after Covid had been "paused". I do not like seeing that word at all. Memory clinics are so important. They are a specialist service to support people with memory loss, changes in cognitive formation or dementia. As the Deputy knows, it is located in St. Patrick's Hospital in Cashel in south Tipperary. I appreciate the impact that this is having on people who are awaiting dementia services. The HSE has advised me that the memory clinic in Cashel has been paused since January this year due to staffing and resourcing issues. I have spoken to the integrated healthcare area manager for south Tipperary this evening. I rang her and she assured me that the HSE was working both locally and nationally to resume the clinic as soon as possible. I am very conscious of the waiting list that the Deputy called out of 450 patients, 168 of whom have had the initial appointment. That is a significant waiting list. Currently, people are referred to the memory clinic either by their general practitioner or through acute hospitals or community specialist teams. Increasing service demand, combined with staffing challenges, has led to longer waiting lists in the memory clinic, as the Deputy alluded to. The HSE has approved the appointment of a full-time administrative post to support the current clinical administrative systems and allow for their further development. In addition, the current clinic staff are exploring new ways of working to address the waiting lists and resume the provision of a memory clinic service in south Tipperary. As the Deputy quite rightly said, the programme for Government includes a commitment to roll out more memory assessment and support services. I had the honour of being able to write that into the programme for Government. I feel strongly about dementia supports, regardless of where people live. I am disappointed to see that this is the current situation. I have been told that referrals can be made to the south Tipperary integrated care programme for older persons, ICPOP, team in Thurles, which provides specialist secondary care for people with cognitive decline, falls and frailty. I am conscious that the current situation in south Tipperary is difficult. I will give the Deputy a commitment tonight. I have already spoken to the Minister of State, Deputy O'Donnell's office this evening. We will follow this up rigorously because it is really important. We came from a situation where we did not have many dementia supports. We have 25 memory clinics open. They are vital, the length and breadth of the country. I will work with the Deputy and the Minister of State with responsibility for older people to make sure that we get this up and running again.

I thank the Minister of State for her reply and acknowledge the extent to which she has been a positive force. I acknowledge the Minister of State, Deputy O'Donnell, too, and the establishment of 25 memory clinics around the country. The central issue remains that we have no clear timeline for the restoration of service in south Tipperary. At the heart of my question lie the 450 people awaiting an initial assessment and the 168 awaiting a follow-up appointment. That waiting list will only grow as long as the clinic remains closed. As the Minister of State rightly pointed out, behind every one of those numbers is a person or a family living with uncertainty. Delayed diagnosis can mean delayed treatment, delayed supports and delayed planning for the future. I reference the national dementia model of care, which the Minister of State is familiar with, and the six-week optimal waiting list. I appreciate the commitment that the Minister of State has given. We really need to push for a timeline for completion of the review and, more importantly, for the restoration of services in Cashel and the re-establishment of the memory clinic in south Tipperary so that we can set a clear plan to address what is a serious and growing waiting list. This is a systematic failure by the HSE. It needs to be corrected and I sincerely welcome the Minister of State's commitment tonight.

I thank the Deputy. Many of the memory clinics evolved organically over many years. I am aware that there is a memory technology resource room in Clonmel, which supports people with technology when, for example, they are living well at home with dementia, but it is important that we get the memory clinic back up and running. These clinics are a vital cog in the wheel. There is an excellent dementia adviser in south Tipperary. I have met her many times. She is fantastic. There is a great partnership with the Alzheimer Society of Ireland. I commend it on the work it does. The opening of the new service in Cappoquin last Friday brought to 62 the number of dementia day services across the country. I commend the Minister of State, Deputy O'Donnell, for following on and making sure that dementia in general remains a key part of the work that he does every day of the week. We always talk about the prevalence of early onset dementia. We are seeing more and more younger people with it. As the Deputy knows, we had the two fantastic Adams brothers in Ireland only recently. They ran 33 marathons in 33 days. I had the honour of meeting them with the Minister of State, Deputy O'Donnell, and others. We had a very good conversation. I am delighted to say that they will be coming back to Ireland early in July. We will have statements on dementia in the House and the brothers will be present. I thank the Deputy for putting the spotlight on dementia today, specifically with regard to Cashel and the memory clinic. I will speak with the Minister of State in the next week or so and try to make sure that we get traction and get this service back open as quickly as possible.