I thank the Minister of State, Deputy O'Sullivan, for coming to the House to discuss this all-important matter. In recent weeks I have heard from a lot of older people who had heard of others of their own age applying for, and availing of, a boiler grant through the housing adaptation grants for older people and disabled people. Boilers have been removed from these grants and it is causing a lot of stress for older people, especially because boilers are quite costly. They can cost anything from €3,000 to €8,000. The main issue is that while the Government is trying to encourage everyone towards installing heat pumps and renovating their homes, many people of a certain age will never carry out some of these works or would find it prohibitive to carry them out. It is quite costly to change a heating system and install a heat pump. While people buying new houses understand it, people who have been living in the same house for the past 40 or 50 years or more do not understand it. This needs to be reversed and boilers need to be included in the scheme because there is so much stress and strain. I have heard of ten cases in the past four weeks with regard to the same issue. It is quite a high percentage in such a short time. I look forward to hearing the response of the Minister of State.
Nithe i dtosach suíonna - Commencement Matters
Grant Payments
I thank Senator Byrne. I welcome the fact she has raised this issue because she is quite right to point out it has raised its head throughout the country. People are in homes that are probably not suitable for heat pumps as they have to be at a certain building energy rating, BER, for the heat pump to work and many older homes just do not have this option. I appreciate the point. I do not think we will reverse it completely, as Senator Byrne has asked for, but there are technologies that we could look at exploring, such as hydrotreated vegetable oil, HVO, which requires a simple adaptation of existing boilers. I will give Senator Byrne an update to explain exactly where we stand and why this change has come about.
The Department provides funding to local authorities under the suite of housing adaptation grants for older people and disabled people to assist people in private houses to make their accommodation more suitable for their needs. The suite of grants, which includes the housing adaptation grant for disabled people, the mobility aids grant and the housing aid for older people grant, is funded by the Department with a contribution from the local authority. The housing need for older people grant scheme provides grants of up to €10,700, depending on household income, to assist older people living in poor housing conditions to have essential necessary repairs or improvements carried out.
A European Union regulation of 2024, signed by the Minister for the Environment, Climate Action and Communications in December 2024, transposes into Irish law Article 17(15) of the recast EU directive on the energy performance of buildings. The regulations provide that from 1 January 2025, public bodies shall not provide any financial incentive for the installation of stand-alone boilers powered by fossil fuels other than those already approved under the EU funds. As a result of the recast directive and the transposition regulations, no financial incentive can be provided for the installation of stand-alone boilers powered by fossil fuels. Therefore, under the housing aid for older people grant scheme, grants can no longer be provided for the installation of new stand-alone boilers powered by fossil fuels. Any application for grant funding in respect of the purchase of a new fossil fuel boiler received and approved by a local authority prior to 1 January 2025 can still be paid to the applicant after January 2025.
Importantly, the grant scheme continues to be available for a broad range of measures, including costs relating to the repair of an existing fossil fuel boiler or the purchase and installation of a second-hand fossil fuel boiler by a qualified contractor. Grants under the scheme may also continue to be paid in respect of the repair or replacement of all other parts of a central heating system, such as new radiators, oil tanks or pipework, regardless of connection to an existing fossil fuel boiler.
Grants continue to be paid out in respect of non-fossil fuel heating, such as electric or biomass heating solutions - for example, wall-mounted electric heaters and wood pellet stoves - where these are deemed to be a suitable option in line with the applicant's circumstances.
The detailed administration of the schemes is the responsibility of the local authorities. Therefore, the qualifying works are a matter for consideration and decision on a case-by-case basis by the local authority within the scope of the grant scheme. Grant funding for insulation works and associated heating systems appropriate to the schemes are available from the Sustainable Energy Authority of Ireland.
That outlines the transposition of the legislation and where we stand at the moment. Obviously, there is that option for second-hand boilers as well, which may show the real flexibility, but I will take the points about hydrotreated vegetable oil, HVO, back to the Minister as well as to the Minister of State, Deputy Cummins.
I thank the Minister of State. While I understand we are trying to phase out fossil fuels and there are grants for repairs and so on, it is difficult to explain to an older person that he or she has to make changes. In many cases, it is also an extra cost because people have to make adjustments to their existing systems or bring in a new system. For existing householders, including older people, perhaps fossil fuels could be phased out rather than removed completely. I would like the Minister of State to take this suggestion back to the Minister and have a discussion about it. It is causing a lot of hardship for older people. Some of them do not have the funds to make those extra adjustments.
I appreciate the Senator's points. We are all encountering this problem in our constituency offices across Ireland, in that people could once apply for these grants but cannot now. Obviously, there is a point to it, in that we have to reduce our reliance on fossil fuels, but I will take the Senator's suggestion back to the Minister. The Minister for climate action and the environment will also have a role to play. However, if there is potentially a window for hydrotreated vegetable oil and there is a 90% reduction in emissions from such a small adaptation, it needs to be looked at. I cannot say now whether it is possible, but it could help in providing a solution for older people in older houses.
Gaeltacht Policy
I welcome the opportunity to raise this issue, especially during Seachtain na Gaeilge. It is not just about planning or housing, but about Gaeltacht communities and the Irish language itself. Census data shows the number of daily Irish speakers in Gaeltachtaí has fallen from 69% in 2011 to 66% in 2022. This decline is not a coincidence. It has been directly linked to young people being forced to leave because they cannot build or buy a home in their own community. Groups like BÁNÚ and Misneach have warned that the Gaeltacht housing shortages, rigid planning rules and out-of-control rents are eroding the fabric of these communities. The Irish-speaking population is shrinking and yet, despite these warnings, the Government has failed to act on the issue.
Just one in five families is raising children through Irish. How can we expect the Gaeltacht to survive if people cannot live there? Our planning policies are driving people out. As someone who has lived in Carna in Connemara and is currently living in Baile Bhuirne in Cork, I have seen first hand the deep pride and commitment of Gaeltacht communities. They are places where Irish is not just spoken, but actually lived. Despite all the cultural richness they have, young people and families are being pushed out by planning systems that simply do not work. Local people struggle to build on their own land because of the outdated bureaucratic planning laws. Houses sit empty while families are forced to move outside of the Gaeltacht and the Gaeltacht guidelines, which were first promised in 2021, have yet to be published.
The Gaeltacht is being hollowed out from the inside out, not because people do not want to stay there, but because the system is not allowing them to stay there. Even those who want to move into Gaeltacht areas, integrate and contribute to the community also face planning roadblocks. If you are from the area, you cannot build. If you are not from the area, you cannot move in. The system is broken and it is killing the future of the Gaeltacht. Right now, we see no progress in the Gaeltacht housing guidelines despite years of promises. There has been a failure to invest in infrastructure. There is no public transport, no job opportunities and unreliable broadband. There have been no targeted housing supports to prioritise those committed to living through the Irish language.
We cannot keep talking about Irish language as if it is an abstract problem. It is happening right now and in real time. It is one of the biggest contributors to the failure of planning policy to support Gaeltacht communities. We need immediate and long-term solutions. What is the Government's immediate plan to overhaul the Gaeltacht planning regulations in order that families can stay and live in the community? What is the long-term strategy for Gaeltachtaí?
I thank Senator Ryan. It is a really important issue. I am lucky enough to have a bit of Gaeltacht in my constituency in, for example, places like Cape Clear. I appreciate that this is an issue. The Senator backed up what she had to say with statistics on the number of Irish speakers. What I will outline here are the immediate plans in respect of tying in with the recent planning legislation passed by the Houses, and also the guidelines that are forthcoming.
The Irish language is the first official language of the State, as recognised under Article 8 of the Constitution. The language has a rich cultural heritage and continues to be an important expression of our shared national identity. The language planning process, provided for in the Gaeltacht Act 2012, is the primary legislative mechanism by means of which the objectives of the Government’s 20-year strategy for the Irish language from 2010 to 2030 will be achieved. It is a specific objective of the national planning framework to support the implementation of language plans in Gaeltacht language planning areas, Gaeltacht service towns and Irish language networks. In addition, section 10 of the Planning and Development Act 2000 requires that local authority development plans include objectives for the protection of the linguistic and cultural heritage of the Gaeltacht, including the promotion of Irish as the community language.
The development plan guidelines for planning authorities were published in 2022. Their purpose is to provide planning authorities with further practical guidance on the implementation of this requirement through the objectives of their development plans. Part 3 of the recently enacted Planning and Development Act 2024 provides for the preparation of bespoke priority area plans for Gaeltacht areas, while consultation with Irish language bodies has also been reviewed and improved. The new Act is to be commenced on a phased basis this year. My Department is carrying out necessary preparatory work in advance of bringing the legislation into effect, including the drafting of detailed secondary legislation.
To supplement the level of guidance available to local authorities, since 2022 my Department has been engaged in the preparation of new planning guidelines for Gaeltacht areas. As part of the preparation, the introduction of an agreed standardised language test for all or some of the occupants of new residential development, to be addressed as part of the planning process in Gaeltacht areas, is being considered in conjunction with the Department of Tourism, Culture, Arts, Gaeltacht, Sport and Media. The purpose of this is to create certainty and a level playing field through a consistent and fair approach to language testing, the aim of which is to protect and promote Irish as the community language in Gaeltacht areas. This may involve use of a system known as Teastas Eorpach na Gaeilge, which provides a series of general Irish language proficiency examinations and qualifications for adult learners of Irish. An interdepartmental group comprising officials from my Department, as well as the Department of Tourism, Culture, Arts, Gaeltacht, Sport and Media, and Údarás na Gaeltachta, has been working to progress the development of specific proposals in this regard.
Cognisant of the need to carefully consider the complex matters involved, I must state that any finalised draft guidelines or a national planning statement prepared under the 2024 Act when the relevant provisions are commenced will be subject to mandatory screening under EU law for strategic environmental assessment, as well as for the purposes of appropriate assessment. It is intended that subject to the outcome of these screening exercises, the draft will then be published for public consultation.
I thank the Minister of State for his reply. I am really delighted he is including the likes of Údarás na Gaeltachta in the plan. Will the language testing mentioned make it more difficult for people who want to live in or move to a Gaeltacht area or who have lived there and who may not have the best of Irish to access it? As we all know, there is a housing crisis. If people have another layer of red tape to deal with in order to be able to live in a Gaeltacht area, will that make things even harder for them?
I thank the Senator. I appreciate that her matter relates to trying to reduce red tape. That does seem like another layer of red tape, but it really is important that we protect these Gaeltacht areas and ensure that there is some level of Irish spoken in them.
On the red tape in general, the Senator raised a very good point. There needs to be a bespoke approach to Gaeltacht areas - and I would say island areas as well - involving some type of innovative housing solution.
We are seeing that it is proving more and more difficult for young people, in particular, to establish a connection to an area. They have to jump through hoops. Suitable sites are difficult to obtain. Often, these Gaeltacht areas are visually stunning, so there are issues with site suitability. I appreciate all of that. There needs to be an innovative approach specifically for the Gaeltacht areas and the islands, perhaps something like gateway housing, where people are given an opportunity to experience life in a Gaeltacht with an option to stay there longer. The Senator made a good point. I get the sense of urgency about the guidelines and I will bring that back to my Department.
The bells are ringing in the Lower House, so the Minister of State has to go to vote. The next Minister of State due here has to vote as well, so I ask the Acting Leader that we suspend the House until 3 p.m.
I propose that we suspend until 3 p.m.
Is that agreed? Agreed.
We will switch and take matters Nos. 5 and 6 with the Minister, Deputy Calleary, first. Is that agreed? Agreed.
Pension Provisions
I welcome the Minister. The issue I am raising affects countless women across Ireland who dedicate their lives to raising families, caring for their loved ones or working tirelessly on family farms and who find themselves at a financial disadvantage when they reach pension age. These women who give so much to their families, communities and the economy are being penalised by a pension system that fails to recognise their contribution. This is a long-standing injustice that must be addressed without delay.
Women who stay at home face a double disadvantage. For generations, women have made the difficult choice to leave paid employment in order to care for their children. This work, though unpaid, is essential. The women who do it are the backbone of our society. Yet when they reach retirement, they are punished for this decision because they often receive a reduced pension or, in some cases, no pension at all because they lack the necessary PRSI contributions. Similarly, women who work on family farms, whether helping with livestock, maintaining records or managing the household that sustains the farm, often do so without formal pay, pension contributions or financial independence. These are workers in every sense of the word, yet the pension system does not acknowledge their labour. The result is that these women, who have worked every bit as hard as those in traditional employment, face financial insecurity in their later years. This is not just an economic issue. It is a matter of fairness, gender equality and valuing all work, paid or unpaid.
We already know that women in Ireland receive significantly lower pensions than men, with a gender pension gap of approximately 35%. However, for women in rural areas, particularly those who work on family farms, the gap is even wider. Many farm spouses and daughters work full time on the land but do not qualify for full contributory pensions because they are never formally employed. Family farms are the backbone of rural Ireland, yet the women who keep them running are often left out of the pension system entirely and this must change.
The first solution we are looking for is for the home caring periods scheme to be expanded. The current system does not go far enough. All years spent caring for children or other family members must be fully counted towards a pension. Second, women's work on family farms should be recognised. They should be automatically entitled to PRSI contributions, regardless of whether they receive a direct wage. Family farms should be supported to ensure that every family member, especially those who are women, has pension security. We support a universal State pension that is not means tested and the provision of financial and pension advice for women. Too many women are unaware of their entitlements until it is too late. The Government must do more around education, especially for those in rural areas.
I thank the House for facilitating my presence here and I thank Senator Collins for raising this issue. As she will be aware, the contributory State pension is funded from the Social Insurance Fund through contributions paid by workers and employers. To qualify for this payment, a person must have 520 contributions, which is the equivalent of ten years of paid contributions.
The rate of payment reflects the number of social insurance contributions paid over a working life.
The State pension contributory system gives significant recognition and support to those whose work history includes extended periods outside of paid employment, often to care or to raise families, frequently in full-time caring roles, many of whom are the women the Senator has just spoken about. This is done through PRSI credits and pension caring schemes, which depend on the method upon which a pension is calculated.
The homemaker scheme applies under the yearly average calculation method and home caring periods are used under the total contributions approach. Both the homemaker scheme and home caring periods allow up to a maximum of 20 years spent caring for children under 12 or other dependent relatives to be included in the relative calculation. Since January 2024, long-term carer's contributions can be awarded to a person who has cared for an incapacitated person for a period of 20 years or 1,040 weeks or more. These contributions can be used in the calculation of the individual's State pension contributory entitlement. This is done by attributing the equivalent of a paid contribution to long-term carers of incapacitated dependants to cover gaps in contribution records.
For those who do not qualify for a contributory State pension or only qualify for a reduced contributory pension based on their social insurance records, the non-contributory pension is available. The non-contributory pension is a means-tested social assistance payment for people aged 66 years or over who habitually reside in the State. As with all other social assistance schemes, payments are based on an income need. The combination of both the contributory and non-contributory pensions means that no person without a viable income need is disadvantaged within the State pension system.
Regarding women working on family farms, there are legislative provisions in place that allow for social insurance contributions to be paid, recognising that family members regularly support one another in businesses or other enterprises, including family farming. These include farm partnerships and family businesses incorporated as limited companies. In the case of farm partnership, where two or more family members, which includes spouses or civil partners, operate a business, including farming, as a partnership and share the profits, each business partner is insurable as a self-employed contributor provided that each partner earns €5,000 or more in a contribution year. Provision also exists for people to have their partnership recognised retrospectively on provision of appropriate evidence that a commercial partnership existed for the period in question. When a partnership is recognised retrospectively, both partners incur liability to pay self-employed PRSI for the years in question.
The legislative provisions concerning family employment and social insurance coverage achieve the necessary balance between operating a formal, uniform system and the need to take account of informal and varied practicalities that are inherent in family farms and other family-operated enterprises. However, I take the Senator's point on spreading this information. I will work with the Department to get it this information out there.
I thank the Minister. That is exactly what I was going to raise with him. The education piece is the most part. For so many women whom I have met over the past couple of months, their issue was more that, if they had had another couple of weeks or months adding to their pensions, they would have come away with full pensions. They just lacked those couple of contributions. Maybe a bit of education coming from the Government will help these women to see how much more they need.
I have taken the Senator's position on information on board. We have an extensive presence at farming events, including the national ploughing championship, to provide that information on a one-to-one basis. As with all our office members, my office is more than happy to assist with any specific queries that the Senator may have.
Rural Schemes
I welcome the Minister. The senior alert scheme aims to support older individuals living securely and independently within their communities by providing free, personal monitored alarms. These alarms offer reassurance and immediate assistance in emergencies, enhancing the confidence and peace of mind of the elderly population. While the senior alert scheme has been instrumental in promoting safety among older adults, the effectiveness of the personal alarms is contingent on reliable network connectivity.
Following the recent storms, I want to paint a picture of somebody who had the independence of living alone but who relied on the security of their personal alarm. They were perhaps waking up at night to find the lights and the heat out and could hear the damage being done outside. On getting up and, unfortunately, having a fall or a mishap, they went to the alarm to find there was no response to it. That situation was replicated across most of the west, where phone and mobile networks went down during that situation.
This limitation may result in alarms failing or not functioning correctly during critical moments and undermining the purpose of the scheme. With that in mind, I call on the Minister to consider the possibility of introducing multinetwork SIM cards as a standard within these personal alarms. This would enhance connectivity and the capability to ensure that personal alarms maintain functionality even in areas where single-network coverage is inadequate or should there be network issues like those that happened recently. It would increase reliability, giving peace of mind to those using the alarms, and also increase the coverage capabilities, potentially opening this up to more people.
The Department has supplied over 120,000 of these alarms to individuals in the last ten years, so it has been a resounding success, but that does not mean we should rest on our laurels. We need to adapt and learn from recent mistakes. We need to introduce something that prevents situations where these alarms do not work. To ensure the continued effectiveness and reliability of the seniors alert scheme, it is imperative to adopt multinetwork SIM cards as a standard component of the personal alarms provided. This integration will address current connectivity challenges, offering older people greater security and confidence in their ability to access emergency assistance when needed. By embracing this enhancement, the seniors alert scheme can better fulfil its mission to support older individuals to live securely in their homes, thereby promoting independence and well-being within our ageing population.
I compliment all of the community groups that are registered with Pobal for the distribution of these alarms.
I thank Senator Scahill for raising this issue. There is no doubt that Storm Éowyn brought huge disconnect and upset to many families across our region. It is important that we learn the lessons, particularly regarding connectivity. I and the Minister, Deputy Patrick O'Donovan, have met the telecommunications companies and asked them to present us with resilience plans. This will also address the concerns the Senator has raised around the seniors alert scheme.
As the Senator said, the seniors alert scheme provides a monitored alarm service to those who meet the qualifying criteria, that is, those over the age of 65 who live alone or spend a significant time each day alone. As the Senator said, over 140,000 participants have used the scheme, which is administered by Pobal under the aegis of my Department, and that included 18,000 new applications in 2024. I assure the Senator that the scheme has been using multinetwork SIM since September 2021, when the current iteration of the scheme was launched.
There are currently two companies contracted to the scheme, both of which meet the minimum standards required for GSM - the global system for mobile communications - or a digital connection. While SIM charges are not covered by the scheme, all other elements are covered, such as the personal alarm device, the installation of the device and the monitoring for the first year. The SIM charges ensure that the participant will always have credit to enable them to contact the monitoring centre.
Beyond the need for connectivity, as I have said, it is vital that the devices will still operate during a localised or widespread power event. It is my understanding that the two current suppliers provide between 24 and 48 hours of battery life on devices that have been installed since September 2021, which would allow for a full 30 minutes of call duration even when the device is without electricity. However, in the context of the events during Storm Éowyn and our resilience plans, this is something I will examine to see what alternatives may be available.
I assure the Senator that officials in my Department are working with Pobal to ensure that the seniors alert scheme continues to provide participants with that most valuable commodity of all, peace of mind. I reiterate and endorse the Senator’s thanks to the community groups that oversee the scheme.
I thank the Minister. Even though multinetwork SIM cards are being provided, there are still legacy models in the marketplace. Maybe something needs to be done regarding communication with the people using the systems at the moment in order to help identify the ones most affected by this problem. It is great to see the engagement. I welcome all of the Minister's remarks.
With regard to the networks, we need to emphasise the social responsibility that is required. Be it the Government, the Department, Pobal. or, as the Minister stated, community groups, no one has been found wanting when it comes to supporting this scheme. It is about economies of scale. Potentially, we could update the ones that might not have been updated since 2021. I thank the Minister very much for that.
Before the Minister responds, I take this opportunity to welcome the guests of Deputy Richard O'Donoghue from CBS in Charleville who are here in the Public Gallery. I hope you are all having a good day and enjoying your visit. I also hope the Deputy is looking after you well.
I join the Acting Chairperson in welcoming the guests from CBS Charleville.
I again thank Senator Scahill. I will bring the pre-2021 models to the attention of my officials. The most important thing is that we are looking at all the lessons we have had to learn from Storm Éowyn, particularly in light of the long period the people were without power and the impact that had on, for example, personal alarms. We continue to engage with telecoms companies regarding ongoing problems with broadband connectivity. That is still a major issue for many areas.
Medicinal Products
As we wait for the Minister of State, Deputy Murnane O'Connor, to take the next Commencement matter, I thank Senators Fitzpatrick and Ruane for facilitating the change to suit the Minister, Deputy Calleary.
I thank the Minister of State, Deputy Murnane O'Connor, for coming to the House. Déanaim comhghairdeas leis an Aire Stáit on her appointment. I am sure she will be very successful in her new position. I am disappointed that the senior Minister is not here to take this matter. but I genuinely appreciate the Minister of State's time and the support from the Department.
I am seeking two things. First, I am seeking clarity on what actions the Department and the Minister are taking to resolve the supply side shortages relating to hormone replacement therapy, HRT. Second, I am looking for an update on the provision of free HRT, which has been promised by the Government. It is not an overstatement to say that the supply side shortages relating to HRT are giving rise to significant issues for patients, doctors and pharmacists. This is causing significant distress, worry and expense for those who depend on HRT, for the physicians who prescribe it and for the pharmacists who dispense it. HRT is a lifeline for women. It is not an overstatement to say that it saves women's lives, protects their mental and physical health and saves their social and professional lives. In addition, HRT salvages and saves long-term relationships for many women and men. The importance of HRT cannot really be overstated.
Women comprise half the population. As a result, half of the population will go through menopause at some point in their lives. It is only right that this Government has committed to provide HRT free to those women. It is also right that the Government, the State and the Department take action to ensure there are sufficient supplies of HRT.
When women are prescribed HRT, it is not the case that one size fits all. Every woman's physiology is different. It can be an iterative process. Women who do not have medical cards have to pay for GP visits and prescription fees when it comes to HRT. The dosage can change. When a woman goes to her local pharmacy and the pharmacist does not have the prescribed dosage, there is then a need to try to make up the difference. The cut patches and prescribe gels instead of patches or tablets instead of gels.
It is creating great uncertainty, distress and expense, all the while undermining women's health and their ability to enjoy full and happy relationships, participate fully in the workforce and participate fully socially and culturally.
I hope the Minister of State has been sent to this House with an answer on the actions that are being taken to address the supply-side shortages, but also to ensure that free HRT is made available to everyone. The previous Minister, Stephen Donnelly, and the previous Government must be commended. The Minister of State and I worked on this and Fianna Fáil was the first political party to bring forward a women's health policy. We are very proud to have the proposals we made in that policy adopted by the previous Government, including free contraception and free IVF and fertility treatments and the establishment of menopause and gynaecological clinics. All of those were groundbreaking and historic innovations which were revolutionary for women's health. This Government must continue that work. I hope the Minister of State has been sent here today with word from the senior Minister in the Department that work is under way to address supply-side shortages and ensure the free roll-out of HRT takes place promptly.
I thank Senator Fitzpatrick for raising this important issue. I totally agree with her. I have spoken to the Minister, Deputy Carroll MacNeill, about this. Substantial progress has been made in recent years to support women through their menopause journeys. A number of medicines are authorised for use in Ireland as hormone replacement therapy for the treatment of menopause. Budget 2025 announced the intention to fund the cost of HRT products prescribed to women to help manage the symptoms associated with all stages of menopause. This is supported by a €20 million per annum investment by Government. This new measure aims to relieve some of the cost burden associated with HRT products. The legislation that has been passed means where a woman has been prescribed a HRT product by her healthcare provider to alleviate the symptoms associated with all stages of menopause, the cost of the HRT medications or products will be met by the State. This measure is for women who have been prescribed HRT by their healthcare provider. The measure applies to HRT products reimbursable by the HSE under the community drug schemes. The Department of Health and HSE have been engaging with the representative body for community pharmacists, the Irish Pharmacy Union, on the practical roll-out of this measure.
There is a medicines shortage framework in place which involves a multi-stakeholder approach to handling shortages of human medicinal products. This is the problem. Persistent product shortages across this therapeutic area of HRT have been managed and continue to be managed via the framework, operated by the Health Products Regulatory Authority, HPRA. Suppliers and manufacturers of HRT have notified shortages of HRT products due to manufacturing delays. The HPRA understands from recent meetings with HRT suppliers that shortages have been compounded by a significant increase in demand for HRT globally. Hence shortages of HRT products continue to be notified not just in Ireland but in other countries as well. The HPRA, with other parties across the health service, continues to monitor overall national supply of a single therapy and the current picture is that HRT medicines remain generally available, and this includes oral products.
The HPRA continues to engage with suppliers of medicines subject to persistent shortages to understand the responses of the company to meet the increase in demand and to introduce necessary measures to prevent shortages from occurring. This is the real issue now. Sandoz Pharmaceuticals, the company responsible for supplying Estradot, has notified the HPRA of a shortage of Estradot 37.5 mg, 50 mg, 75 mg and 100 mg patches.
The HPRA has been notified of an expected return date, as the Minister told me, of 7 March 2025 for the three presentations but is currently unable to advise on a date for the 37.5 microgram patch. The HPRA has also engaged with suppliers to explore opportunities for regulatory flexibility. I understand this is probably not the answer the Senator wanted. I understand the seriousness of this issue. Half our population is women but unfortunately this is where we are at the moment. I will continue to work with the Senator.
I acknowledge the work being done by the Department, the Minister of State, the Minister and all of the stakeholders. It is good news. Women will be pleased to hear that there is a date of 7 March for Estradot transdermal patches. That in and of itself is really positive news. I ask the Minister of State to go back to the Department and ask for a date by which HRT will be made available for free. I appreciate a negotiation has to take place between the Department, community pharmacists and the Irish Pharmacy Union but I urge the Department to conclude those negotiations as soon as possible. It is almost discriminatory that women of menopausal age are not availing of free HRT in the same way women of a fertile age can avail of free contraception, as is right, and they get two free GP visits. Free HRT should be dispensed in the same manner as free contraception. It should be treated as just a continuum of women's fertility, health and journey. I urge the Minister of State in her new role to work to achieve that outcome.
As I said, the HPRA has been notified by Xenon Pharmaceuticals of an expected return on 7 March. In relation to new HRT measures, the Minister for Health met the Irish Pharmacy Union on 11 February to discuss her objectives for expanding and reforming community pharmacy and to progress the HRT initiative in budget 2025. That is crucial. This was a constructive engagement and the Minister listened to issues raised by the IPU which committed to come back to her regarding the introduction of HRT measures. The IPU has now responded with further information which is being considered by the Department. The goal remains to introduce the measures as soon as possible; reimbursement supports will be available to participating pharmacies from that date and these measures commence. I agree with and thank the Senator for bringing this to my attention.
I thank the Senator. Before I ask Senator Ruane to speak on her Commencement matter, I welcome guests of the former Captain of the Guard John Flaherty. It is lovely to see him again. He and his guests are very welcome. They are in much better hands than a Senator or a TD bringing them around this building. They are in wonderful hands. It is great to see John.
Health Strategies
I thank the Acting Chairperson. I thank the Minister of State for being here. I am sure we will see a lot of each other over the next four years. I know she is aware this is an issue and an area I have focused on throughout not only my legislative career but also by working in addiction services since the age of 17. When I am not in the Chamber, I am still very much involved with community projects. I still have friends and family who rely on drugs services. A lot of my peers and colleagues also work in the services. The general feeling at the moment is confusion in relation to the national drugs strategy and the steps that have been, and are being, taken in not only the evaluation of the drugs strategy we are just coming out of but also the consultation process for the development of the new drugs strategy. The general feedback from some services is the national oversight committee has been brought in potentially for some departmental consultation regarding the drug strategy.
The feeling, though, is that is very much a top-tier conversation. In the past, we did have to work hard - maybe two or three strategies ago - to ensure that community as a pillar remained in the text of the drugs strategy. We have had to hold on to this element very strongly. In relation, then, to engagement on the consultation process, to have it only with the implementation groups or the national oversight committee would mean the general population of the community and voluntary sector would not get to engage with Grant Thornton in this regard. We want to know if that conversation was the consultation and if it is complete, or if there is going to be a wider consultation where community development projects and drugs services can invite in their members to be part of the consultation.
Going to the evaluation aspect, is potentially under way with Grant Thornton. I do not know if Grant Thornton is doing the consultation - that is one question - or if the company is just doing the evaluation of the last strategy. They seem to have come in reverse a little bit. We are not sure if what has happened with the Department is being said to be the consultation and there will be no wider consultation, and then the evaluation will come after. In the past, there was the evaluation that allowed for consideration of where we are at in regard to the previous drugs strategy and then a steering group and independent chair were put in place. I think, last time, his name was John Carr. That worked really well because we had that independent aspect of the evaluation of the drugs strategy.
Another question, then is: who is overseeing the evaluation? Is there a steering group? Is there an independent chair? Will there be a wider consultation process with the wider community and voluntary sector to ensure we have as representative a sample as we can across the country concerning the drugs strategy. We know drugs strategies will be more successful if the people who are supposed to feed into them feed into them. They will also want to carry the strategy forward because they will be able to see that their voices have been heard within it.
The other question I have concerns with is the citizens' assembly. We have had it and the Oireachtas Joint Committee on Drugs Use. There was word that, potentially, the submissions to the citizens' assembly were going to be used as part of the consultation for the national drugs strategy. This seems like an odd step to take, so I just want to clarify if this is the case. I ask this because it was the role of the citizens' assembly to evaluate those 800 submissions and following that evaluation, it came up with its report. If anything, it is that report of the citizens' assembly that should have formed some sort of part of the consultation, rather than going back a step to the 800 submissions from the wider public to the citizens' assembly. Is it the final report of the citizens' assembly and the work of the Oireachtas joint committee that will be looked at to form part of the consultation with the wider community and voluntary sector?
I thank the Senator. I know how passionate she is about drugs policy. As she said, she has been working on this area for a long time and working with people in her community. Regarding the answers I do not get to today, I guarantee to her that I will meet her in the next few days and come back to her, if that is fair enough.
Yes.
I am delighted to be talking to the Senator about this matter today. The strategic action plan 2023-24 marked a significant milestone in the implementation of the national drugs strategy, Reducing Harm, Supporting Recovery. It contained 34 actions across six strategic priorities. These were to: strengthen the prevention of drug and alcohol use and the associated harms among children and young people; enhance access to and delivery of drug and alcohol services in our communities; develop integrated care pathways for high-risk drug users to achieve better health outcomes; address the social determinants and consequences of drug use in disadvantaged communities; promote alternatives to coercive sanctions for drug-related offences; and strengthen evidence-informed and outcomes-focused practice, services, policies and strategy implementation.
The completion of this strategic action plan marks the end of the current national drugs strategy, as the Senator mentioned. The Department of Health has commissioned an independent evaluation of the strategy and the action plan, which is expected, and we are hoping, will be completed in the second quarter of 2025. The evaluation is being conducted, as the Senator said, by Grant Thornton, which was appointed following a public procurement process.
It will consult with stakeholders involved in the oversight of the strategy, including the network of drug and alcohol task forces and organisations such the National Voluntary Drug and Alcohol Sector, UISCE, CityWide and other community-based drug services. This is part of the programme, and this is what we need to look at. At the same time, the Department of Health has commenced work on preparing a new national drugs strategy. The new strategy will be informed by the evaluation, which is looking at the existing strategy, the Citizens’ Assembly on Drug Use, the programme for Government, developments in the EU drugs strategy and action plan, and consultations with stakeholders, which is an important matter to the Senator.
To support the development of the next strategy, the Department has convened a number of in-person consultations with key stakeholders. The themes of the consultations include priorities for the new strategy; planning and delivery of drug services in the HSE health regions; the lived and living experience of people who use drugs and their families, which I know the Senator is passionate about and is important; the development of the drugs workforce; and drug prevention. More than 250 people have attended the consultations to date. These include representatives of drug and alcohol task forces, drug service providers and civil society organisations. The consultations are being facilitated and reported upon by independent consultants. I expect to receive the reports of the consultations shortly.
A key component of the new strategy will be the report of the Citizens' Assembly on Drug Use. The report argues for a comprehensive health-led response to drugs. It contains 36 recommendations on prevention, harms reduction, treatment and recovery. The Joint Committee on Drugs Use supported the recommendations in its interim report in October 2024.
As Minister of State with responsibility for the national drug strategy, I look forward to finalising the draft of the new strategy in the coming months. We cannot be complacent as to the societal harms and dangers associated with illicit drug use and a volatile drug market. The new strategy will set out an ambitious vision for preventing drug use, improving access to evidence-based treatment services and supporting people’s recovery from drug use. It will also strengthen co-operation with EU member states, the British-Irish Council and the Council of Europe in addressing the challenges of illicit drug use. It is my intention to engage with the Oireachtas in implementing this new strategy because I am conscious that we need to have cross-party support for it. We all need to work together on this.
I appreciate that. It teases out the difference between the evaluation and the consultation. I have some queries that I will follow up on with the Minister of State regarding the consultation, as some people felt that the Department was very top down instead of asking the community and inviting people in, so the community and voluntary sectors did not get to set the parameters of what that consultation looked like, meaning it was a little tight and was not kept open ended.
It is good to hear that the citizens' assembly report will be taken into consideration rather than the submissions being examined again. The Minister of State might request that the Oireachtas Joint Committee on Drugs Use interim report on drugs be taken into consideration because that was the next step after the citizens' assembly. It was a Government decision to have that committee, which means that the interim report and its contents have support from all parties and none. That should also set a basis for the consultation. I will email any other outstanding questions to the Minister of State directly.
Programme for Government 2025: Securing Ireland’s Future sets out the Government's commitment to a health-led approach to drug use. The key actions to support this commitment include assessing the outcomes of the national drug strategy; publication of a new strategy; diverting those found in possession of drugs for personal use to health services, which is a matter the Senator is passionate about; increasing funding for drug treatment services; and launching a major awareness campaign on the impact of drugs on society.
To support the implementation of the new strategy, I will shortly announce details of an additional €4.2 million to be provided under budget 2025. This new funding will enhance access to delivery of drug and alcohol services in the community and strengthen the prevention of drug and alcohol use among children and young people to minimise the harms of drug use for families and communities. There is not a family or someone they know that has not been touched by drugs. It is important that we get this right. I thank the Senator for raising this question with me.