Parliamentary questions

588. Deputy Ken O'Flynn asked the Minister for Health the number of claims submitted under the General Medical Services Scheme, Drugs Payment Scheme and Long-Term Illness Scheme for salbutamol nebules or equivalent short-acting bronchodilator nebule products in (a) 2024 and (b) 2025; the number and value of such claims paid; the number and value rejected or unpaid; and whether she will provide the…

589. Deputy Ken O'Flynn asked the Minister for Health whether the Department or the Health Service Executive maintains centralised data on the number of patients whose access to reimbursable salbutamol nebules or equivalent substitute products was impacted during registered shortage periods in 2024 and 2025; if so, the number recorded; and if not, whether she intends to introduce a monitoring mech…

590. Deputy Ken O'Flynn asked the Minister for Health whether any formal risk assessment, clinical safety review, or value-for-money analysis was conducted in relation to the ongoing shortages of salbutamol nebules during 2024 and 2025; whether contingency procurement arrangements were activated; and what governance structures are in place to ensure uninterrupted reimbursement access for essential…

591. Deputy Ken O'Flynn asked the Minister for Health the total expenditure incurred in 2024 and 2025 on salbutamol nebules and equivalent substitute products under the Community Drug Schemes; the additional expenditure, if any, arising from the use of Exempt Medicinal Products during shortage periods; and the budgetary provisions in place to manage future supply disruptions. [13632/26]

592. Deputy Claire Kerrane asked the Minister for Health when 24/7 cover of the Rapid Response Vehicle (RRV) in Roscommon will be operational given that the advanced paramedic roster for the RRV is now full; and when this cover will be restored. [13636/26]

593. Deputy Ken O'Flynn asked the Minister for Health whether the 2021 consultant post in child and adolescent psychiatry approved under the National Gender Service Model of Care (2018), referenced in PQ 70457/25, included in its job description or person specification any requirement to adhere to WPATH Standards of Care; and if so, the exact wording of that requirement and the date on which it wa…

594. Deputy Ken O'Flynn asked the Minister for Health the governance and approval pathway by which any requirement to adhere to WPATH Standards of Care was authorised for inclusion in the 2021 consultant child and adolescent psychiatry post referenced in PQ 70457/25, including the Departmental or HSE national clinical governance structure under which such approval was granted. [13642/26]

595. Deputy Ken O'Flynn asked the Minister for Health the policy rationale, evidential basis, and clinical guidance relied upon when approving the 2021 consultant child and adolescent psychiatry post referenced in PQ 70457/25; and whether any written clinical safety assessment, risk assessment, or governance memorandum was prepared at the time of approval. [13643/26]

596. Deputy Ken O'Flynn asked the Minister for Health whether the Department or the HSE retains documentary records, minutes, memoranda, or correspondence relating to the approval of the 2021 consultant child and adolescent psychiatry post referenced in PQ 70457/25; and whether the Minister will confirm the existence of such records and their retention under national governance procedures. [13644/…

597. Deputy Ken O'Flynn asked the Minister for Health the number of recruitment campaigns undertaken to fill the 2021 consultant child and adolescent psychiatry post referenced in PQ 70457/25; the dates of each campaign; and the policy-level reasons recorded for the campaigns being unsuccessful. [13645/26]

598. Deputy Ken O'Flynn asked the Minister for Health when the review of the National Gender Service Model of Care (2018), referenced in PQ 70457/25, formally commenced; the governance structure overseeing the review; and the anticipated completion date. [13646/26]

599. Deputy Ken O'Flynn asked the Minister for Health the manner in which the findings of the Cass Review are being incorporated into the review of the National Gender Service Model of Care (2018); and whether the Minister will publish the terms of reference for that review. [13647/26]

600. Deputy Ken O'Flynn asked the Minister for Health what national clinical governance arrangements currently apply to specialist gender healthcare services for children and adolescents while the National Gender Service Model of Care (2018) is under review; and whether any interim clinical guidance has been issued since publication of the Cass Review. [13648/26]

601. Deputy Ken O'Flynn asked the Minister for Health whether any future recruitment specifications for consultant posts in child and adolescent gender-related services will be required to align strictly with the revised National Gender Service Model of Care; and the national clinical governance structure that will approve such specifications. [13649/26]

602. Deputy Ken O'Flynn asked the Minister for Health the oversight role exercised by her Department in approving or reviewing national clinical models of care which inform consultant recruitment specifications; and whether the Minister retains ultimate policy responsibility for ensuring that such models align with international evidence and best practice. [13650/26]

603. Deputy Ken O'Flynn asked the Minister for Health whether her Department has conducted a formal risk assessment of the requirement that dispensing pharmacies must contact the primary care reimbursement service on a case-by-case basis to secure reimbursement approval for clinically equivalent substitute medicines during a formally declared shortage; whether any patient-safety analysis has been …

604. Deputy Ken O'Flynn asked the Minister for Health whether there is a formal departmental policy providing for automatic reimbursement of clinically equivalent substitute medicines once the Health Products Regulatory Authority has listed a reimbursable product as being in shortage; if not, whether she will outline the policy rationale for the absence of such an automatic trigger mechanism; and …

605. Deputy Ken O'Flynn asked the Minister for Health to set out the statutory, regulatory, or administrative basis under which Exempt Medicinal Products are supported under Discretionary Hardship Arrangements during medicine shortages; whether these arrangements are governed by published criteria; and whether her Department intends to place such arrangements on a formalised national footing. [136…

606. Deputy Ken O'Flynn asked the Minister for Health whether her Department has assessed the administrative burden placed on community pharmacies in circumstances where substitute reimbursement must be individually queried with the Primary Care Reimbursement Service; whether any review has been undertaken of processing times, approval rates or rejected applications in such cases over the past thr…

607. Deputy Ken O'Flynn asked the Minister for Health whether national clinical governance guidance has been issued by her Department or by the HSE in respect of reimbursement decision-making during shortages of time-sensitive respiratory medicines, including salbutamol nebules; whether such guidance addresses continuity of care, risk mitigation, and equity of access; and if she will make a statem…

608. Deputy Ken O'Flynn asked the Minister for Health the number of occasions in the past three years on which medicines listed on the Community Drug Schemes Reimbursement List were formally declared in shortage by the Health Products Regulatory Authority; in how many such cases substitute reimbursement required discretionary approval; and whether her Department maintains a central register of suc…

609. Deputy Ken O'Flynn asked the Minister for Health whether her Department has conducted any value-for-money or cost-comparison analysis between maintaining automatic substitute reimbursement mechanisms during shortages and operating the current discretionary case-by-case approval model; and if she will provide details of any such analysis undertaken since 2020. [13658/26]

610. Deputy Ken O'Flynn asked the Minister for Health whether any equity impact assessment has been conducted to determine whether patients without medical cards or without established drugs payment scheme eligibility face additional barriers in accessing substitute medicines during shortages; and whether she will outline any measures in place to prevent differential access arising from reimbursem…

611. Deputy Ken O'Flynn asked the Minister for Health whether her Department has engaged with representative bodies for community pharmacists, respiratory clinicians, or patient advocacy groups in relation to reimbursement continuity during medicine shortages; whether any formal consultation process has been undertaken since 2020; and if she will provide details of the outcome of any such engageme…

612. Deputy Ken O'Flynn asked the Minister for Health whether she will commit to publishing a formal contingency reimbursement protocol setting out clear, automatic procedures for substitute medicine reimbursement where a reimbursable product is listed in shortage by the Health Products Regulatory Authority; and if she will indicate a timeframe for the development and publication of such a protoco…