3855. Deputy Pádraig Rice asked the Minister for Health the number of people on a waiting list for pre-exposure prophylaxis (PrEP) by clinic; and the wait time to be offered a new appointment in each clinic, in tabular form. [58039/26]

3856. Deputy Pádraig Rice asked the Minister for Health the public pre-exposure prophylaxis (PrEP) clinics in which waiting lists are closed to new self-referrals, in tabular form. [58040/26]

3857. Deputy Pádraig Rice asked the Minister for Health the reason no funding was allocated to public pre-exposure prophylaxis (PrEP) services for additional staff in 2026; and if she will make a statement on the matter. [58041/26]

I propose to take Questions Nos. 3855, 3856 and 3857 together.

Sexual health is a priority for the Department of Health. A national HIV pre-exposure prophylaxis (PrEP) programme commenced in 2019, following a HIQA HTA, which concluded that its introduction would be safe, effective, and cost saving. Free PrEP medication is available to individuals who meet clinical eligibility criteria, attending HSE approved PrEP services.

Public PrEP services are delivered through the public network of STI clinics and through some approved private providers. Contact details for PrEP providers are available on the HSE website: www2.hse.ie/conditions/hiv/where-to-get-prep/ PrEP medications are free of charge.. Appointments at the 13 public PrEP services are free of charge, however, the private providers charge for consultations.

The population has grown significantly in recent years, and clinical criteria for PrEP eligibility have been widened, increasing the number of people eligible for PrEP. This number has been expanding since inception, with the number of individuals reimbursed for PrEP at least once expanding from 1566 in 2020 to 7,447 users by the end of 2025, a year in which an additional 2,204 new PrEP users were added.

While the PrEP service continues to grow, many PrEP services had reached capacity and service users are reporting challenges accessing appointments. In order to expand PrEP services and provide additional supports to our rapidly growing population, we were allocated additional funding of €550,000, through Budget 2025, and an additional €100,000 in 2026, to further support delivery of the PrEP scheme. The total allocation for PrEP has therefore increased to €6.55m in 2026.

The 2025 allocation included funding for 7WTE to increase capacity for in-person appointments within the PrEP clinics, with all staff in place by October, 2025. In order to further increase the number of providers, a PrEP competency framework and eLearning platform has been developed; these can be accessed by GPs with an interest in providing PrEP. Following the introduction of training, provider numbers have increased substantially in 2025, with more in training (please see the above weblink for contact details).

Budget 26 saw a change in the approach to allocating resources. The Department no longer specifies funding or staffing, line by line, for individual services. Instead, the Department sets the overall budget and required outputs, and the HSE and its Regional Executive Officers (REOs) must manage their resources to meet the agreed targets .

The Minister sets the overall policy and financial framework for the health service through the annual Letter of Determination, which sets out the funding allocation, high-level service priorities and performance requirements for the HSE. These service priorities are then reflected by the HSE in its National Service Plan. Responsibility for the prioritisation of resources and for service delivery rests with the HSE – the Minister does not direct the allocation of funding or workforce resources to individual services or initiatives. Decisions regarding the prioritisation of available resources and the delivery of specific services are operational matters for the HSE and the relevant Regional Health Area.

Under the new HSE regional structure, the Department allocates the overall HSE budget and staffing ceiling – the detailed operational decisions on how those resources are deployed within and across Health Regions are a matter for the HSE and its Regional Executive Officers (REOs), who are responsible for ensuring services are delivered within their allocated funding.

Annual policy priorities and performance expectations are set out clearly in the National Service Plan, including measurable KPIs. The HSE, and specifically the REOs, are accountable for delivering these priorities in their Regions within their budget allocations, supported by the Performance and Accountability Framework.

This means the Department no longer specifies funding or staffing line by line for individual services. Instead, the Department sets the overall budget and required outputs, and the HSE must manage its resources to meet the agreed targets. Where service pressures arise, it is for the HSE to manage and prioritise within its budget, in line with the NSP, performance targets and the accountability arrangements in place.

As funding allocation and waiting lists are service matters, I have asked the HSE to provide this information to the Deputy as soon as possible.