Health Services

I thank the Minister of State, Deputy O'Donnell, for taking this Topical Issue, which is to highlight the healthcare situation in my constituency of Longford-Westmeath. For years, particularly in Longford, we have had to campaign for healthcare services. However, instead of existing services being improved or even maintained, some of them have been removed. Constituents come to my office constantly to ask about ophthalmology, occupational therapy, disability, urology, dental, renal and mental health services and, most recently, the closure of the diabetes clinic in Mullingar. It came to my attention recently that there is no urologist currently serving the area and that the relevant post has not been filled at Midland Regional Hospital Tullamore. I refer to hospitals that are within a journey time of one hour for people in my constituency. They now have to go further for services. In ophthalmology, there is a recurring issue, which I have raised here regularly, whereby patients must go to the Royal Victoria Eye and Ear Hospital in Dublin. Currently, more than 1,000 people in Longford-Westmeath are waiting for an ophthalmology appointment, with an average wait time of 12 to 15 months. My constituents have long commutes to get to the services. There is a similarly significant waiting list to access children's disability network teams, CDNTs. When we submit parliamentary questions about this, the reply is that a detailed response is being prepared by the HSE in consultation with the relevant services and stakeholders. Unfortunately, in many instances, no detailed response is received. In recent times, a contract was given to a doctor to provide a service, including in Lanesborough, County Longford, which is a rural town with a clinic with a high level of need. It was quite obvious from the beginning that the intention was to close down that service in Lanesborough despite the contract stating that it must be provided. Currently, there is no GP service being provided there under that contract. Elderly and vulnerable people deserve proper access to healthcare, not to be treated in this way by someone who signed a contract with the HSE in good faith. The doctor in question is not fulfilling the contractual obligation to provide that service and, therefore, should lose the contract. In my view, the intention from day one was to close the service in Lanesborough. The doctor signed the contract but the service is not being provided. More than 475 children in my constituency are on children's occupational therapy waiting lists. Of 701 sixth class children, 506 still have to be seen for dental screening. Unfortunately, it is a case generally of long lists and people waiting. It is necessary to travel outside the county for nearly all the services that need to be accessed. I recently highlighted that patients are travelling from Longford to Tullamore, and sometimes even to Portlaoise, for renal dialysis. That service could be provided in Longford, which is something for which we plan to campaign. Most recently, as I said, the diabetes unit closed in Midland Regional Hospital Mullingar. That service was covering the entire midlands region and its closure leaves a severe gap in care for people with diabetes who rely on the service for support with medical devices such as insulin pumps. I ask the Minister of State to take those points on board. In addition, an issue that falls under his remit and which I know he is looking at closely is the provision of home support hours and finding the staff to provide those hours.

I thank the Deputy for the opportunity to update the House on these important health-related matters for his constituents in Longford-Westmeath. I am taking this Topical Issue on behalf of the Minister for Health, Deputy Carroll MacNeill. I acknowledge the concerns Deputy Carrigy has raised about health services in Longford-Westmeath, particularly where people experience long waits or need to travel for care. These are important issues and I welcome the chance to outline the measures being taken to improve services and strengthen access to care across the region. Urology services for people in Longford and Westmeath are primarily provided through Midland Regional Hospital Mullingar, with patients referred to specialist tertiary centres when more complex care is required. A number of pathways are in place to improve access and reduce waiting times. They include referrals to other centres, where appropriate, and access to treatment through the National Treatment Purchase Fund, which is helping to ensure patients can receive care as quickly as possible based on their clinical needs. For people living in Longford and Westmeath, renal services are delivered through the wider midlands and Dublin hospital networks, with dialysis care provided through regional renal units and satellite dialysis centres, supported by specialist nephrology teams. These regional networks aim to support patients as close to home as possible while ensuring they have access to the specialist care they need. The midlands integrated healthcare area is currently examining capacity and clinical governance with the aim of improving networks of care. This will include long-term options for further renal satellite opportunities, taking account of patient population needs. That work is in its early stages. The Government is aware that there is limited access to GP services in some areas, including rural areas with ageing populations. I assure the Deputy that we are working to increase the number of practising GPs and improve access to services. Further to measures already taken to increase GP capacity and support GPs in rural areas, a strategic review of general practice is to be completed soon, which will consider additional methods to attract more GPs to rural and underserved areas. I understand that Midland Regional Hospital Mullingar has had to temporarily suspend its diabetes day service due to significant staffing shortages within its multidisciplinary diabetes team. The HSE has assured us that every effort is being made to restore the service to full capacity as soon as possible. The Deputy referred to dental services. A total of €18 million has been allocated via the budget to commence implementation of a two-year national oral health action plan. The top priority is to address current access challenges to dental services nationally, including in Longford-Westmeath. In child and adolescent mental health services, CAMHS, the priority is ensuring timely assessment and access based on clinical need. I have asked the HSE to provide the most recent Longford-Westmeath staffing and waiting list position, including the number of children waiting and the length of those waits. The provision of ophthalmology services is organised on a regional basis to ensure patients have access to appropriate specialist expertise, diagnostic facilities and treatment pathways. Since March 2026, a locum community ophthalmic physician is providing clinics in Mullingar and Longford and delivering care for both adult and paediatric patients. In addition, Midland Regional Hospital Mullingar is going through the process of approval to permanently fill the relevant post. Patients may still be required to travel to the Royal Victoria Eye and Ear Hospital in Dublin depending on the patient's presenting condition and the type of clinical assessment required. The HSE reports that in the Dublin and Midlands region, most patients are seen within 15 weeks and 90% of all patients are seen within 39 weeks. While the occupational therapy issue raised by the Deputy relates to the adult disability service, which falls under the remit of the Department of Children, Disability and Equality, the Minister for Health recognises that the current primary care therapy waiting lists and long waiting times for access to those services are unacceptable, particularly for children. The people of Longford and Westmeath deserve healthcare that is available as close to home as clinically possible. The Government will continue to work with the HSE to strengthen services, address vacancies and ensure that investment delivers meaningful improvements on care. Specifically on home care support, I am working with the HSE to look at the issue in terms of recruitment of staff.

I thank the Minister of State. I will highlight a couple of points, particularly in relation to renal services. He said the aim of those services is "to support patients as close to home as possible while ensuring they have access to the specialist care they need". I looked for figures on the costs to the HSE of the taxis being provided to take patients from Longford to Tullamore for renal services. Currently, two of the staff working in the renal dialysis unit actually live in Longford and have to travel to Tullamore to provide those services. In 2025, there was a cost of €475,000 for taxis and from January to July of this year, the cost was €391,000. There is a ballpark cost heading for €500,000 each year to provide taxi services to bring people down to Longford, while there are staff based in Longford who are working in Tullamore. That service can be provided on St. Joseph's campus. I would like that to be considered seriously with regard to the diabetes clinic. It is only when a clinic like this closes that people who suffer from diabetes, particularly type 1 diabetes, come and explain the difference it makes in their lives. I cannot understand how we got to a situation where we do not have it staffed. This is not just for Longford; it is for the midlands. It has had a severe impact on the lives of patients within my local community and further afield. I ask that it be highlighted and identified. I have looked for meetings with the management of the hospital about it. This needs to be done immediately. On ophthalmology, it is stated that the regional hospital is going through a process of approval to permanently fill a post. We are short of staff to provide ophthalmology services, yet we are waiting for a post to be approved and advertised. There are a lot of issues but I have highlighted three significant ones that can be dealt with. Particularly with renal, there is going to be a saving of €500,000 in taxi services by basing it in another location and bringing it closer to the homes of people who are using it.

I again thank Deputy Carrigy for his contributions, which I will bring back to the Minister, Deputy Carroll MacNeill. Ensuring people receive the right care in the right place at the right time remains a central commitment of Government under the Sláintecare reform programme. The Government has made substantial investment in both Midland Regional Hospital in Tullamore and Regional Hospital Mullingar, the two acute hospitals serving communities across the midlands. More particularly, on the specific points the Deputy has raised, I will bring back his point on renal services to the Minister and the Department. I have no doubt he will raise the issues himself directly with the Minister and the HSE. On the adult diabetes multidisciplinary service in Regional Hospital Mullingar, this service has been temporarily suspended due to significant staffing shortages within its multidisciplinary diabetes team. As I said, the HSE has assured the Minister that every effort is being made to restore the service to full capacity as soon as possible. The Deputy made reference to ophthalmology. A locum community ophthalmic physician is providing clinics in Mullingar and delivering care for both adult and paediatric patients. In addition, Regional Hospital Mullingar is going through the process of approval to permanently fill this post. All the relevant and important points the Deputy makes in respect of the delivery of health services in Longford-Westmeath are valid. The Minister for Health recognises the concerns raised by the Deputy and remains committed to working with the HSE to address vacancies, build sustainable capacity and improve co-ordination across hospital and community services. The Government will continue to build on the progress made in Tullamore and Mullingar with a clear focus on ensuring that investment delivers meaningful, lasting improvements for patients throughout Longford and Westmeath. I will bring the points raised by the Deputy back to the Minister. I have already spoken to the Deputy about delivery of home support hours for the people of Longford-Westmeath. It is something I have committed to working on with the HSE, the Deputy and his colleagues at local level.