Is the Minister of State taking the next item?

I am taking the fifth Topical Issue proposed by Deputy Cahill.

The next one is to the Minister for Health. We will wait for the Minister of State.

I am sharing this Topical Issue with Deputy McGrath about the crisis in community ophthalmology in south Tipperary. I have raised this repeatedly in the Chamber in other Topical Issue Matter debates and numerous parliamentary questions. This follows the planned retirement of Dr. Hillary, the community ophthalmologist working out of south Tipperary in August 2024. For reasons unknown to me, three recruitment campaigns have failed to recruit a new community ophthalmologist consultant. In the meantime, there are more than 2,300, I think, on the waiting list in south Tipperary. It may surprise the Minister of State to hear that 1,500 of those are children under the age of four, some waiting as far back as 2021. He can appreciate it is very difficult for me as a Teachta Dála representing south Tipperary when parents contact my constituency office - what do I tell them? I am sure as a parent himself the Minister of State will agree that when it comes to ophthalmology, early intervention is crucial. We were promised blitz clinics and a collaboration with the eye and ear hospital in Dublin. There is no evidence any of those initiatives have commenced. I am looking for an update on recruitment as well. We need that multidisciplinary team at the earliest opportunity so that the 2,300 on the waiting list can be dealt with as soon as possible.

I thank the Ceann Comhairle for choosing this Topical Issue. It is an important issue. Deputy Murphy put the figures on the record. I will do it again. Some 2,300 people are waiting, 1,500 of whom are children. It is an appalling vista two years on from Dr. Hillary's retirement, who was an exceptionally wonderful practitioner. She gave a year's notice she was leaving so this has been going on for three years. Why is the HSE so incapable of filling this position? We are told Waterford is now holding extra clinics to accommodate south Tipperary patients but this is not happening. Delays in identifying and treating eye conditions can and will lead to long-term eye problems. That is scientifically and medically proven. They have to be treated before the age of seven, which is a vital cut-off.

Why can we not have private fully qualified eye specialists do these tests on young children, to be reimbursed by the HSE? Clinics call to schools. A school in my area was called to recently. An initial screening is done and they are referred on but then they cannot get a test so they have to go private, which costs €50 minimum and then €300 to €500 for glasses. Will the Minister of State commit to ensuring children who require glasses, following private assessment, can still access HSE funding? It is a simple solution. I think it suits the HSE not have this position filled. It is appalling. The system works in other parts of the country. Surely it is in the interests of our children - mol an óige agus tiocfaidh sí. It is very basic that our children have a right to have their eyesight checked and treated if necessary. There is a roadmap by which it could be paid for until we get a permanent position or even a temporary one. Something is very wrong if after three recruitment campaigns the Government cannot seem to recruit a person, or does it want to?

I thank Deputies McGrath and Murphy for the opportunity to address the House today on an issue that I know has had an ongoing impact on many patients in south Tipperary. I am taking this Topical Issue on behalf of the Minister for Health, Deputy Carroll MacNeill, who I know is committed to reducing waiting lists for both adults and children across all our services be they provided in acute hospitals or in the community.

It is important to highlight that the HSE provides free optical services to preschool and national school children referred through child health and school health examinations as having sight problems. These services continue until a child reaches 16 years of age. The community ophthalmic services scheme allows medical card holders and their dependent children aged 12 and over to access eye care from contracted ophthalmologists, optometrists or dispensing opticians.

In relation to the Deputies’ specific question, the HSE has confirmed that the community ophthalmic physician post in south Tipperary became vacant in October 2024 following a retirement which they both referenced. In 2025, this post was regraded to a consultant in medical ophthalmology to align with the HSE’s national clinical programme for ophthalmology. This clinical programme for ophthalmology developed a model of care to realign eye care services from hospital settings to the community. The HSE has been developing multidisciplinary integrated eye care teams in accordance with this model of care. These teams facilitate assessment, diagnoses and treatment, enabling most patients to be seen in their own locality. The service provided by the previous community ophthalmic physician for south Tipperary operated across HSE south east community services with clinics in both Clonmel Community Care Centre and Cashel Medical Centre.

Since the vacancy arose in October 2024, the HSE has maintained a sustained focus on securing a permanent consultant ophthalmologist for south Tipperary. The post has been advertised on three occasions to date and recruitment efforts remain active. The position is currently being advertised nationally and internationally including through specialist Irish and UK ophthalmology publications. The HSE continues to pursue all available recruitment opportunities to attract suitably qualified candidates and restore permanent service provision to the south east.

Recognising the importance of maintaining access to care while permanent recruitment efforts continue, the HSE south east community service has worked closely with University Hospital Waterford to put interim service arrangements in place. All parents of children were notified of the temporary pause to the service and were offered appointments in University Hospital Waterford. The HSE has also explored other options to ensure service continuity, such as the use of external providers to increase capacity, overtime of existing HSE staff and the possibility of weekend blitz clinics at University Hospital Waterford. Funding has been secured to support delivery of the clinic and engagement with additional staff from another integrated health area is under way to support delivery of the clinic. The HSE has also sought to progress the multidisciplinary model of care, seeking to recruit optometrists and orthoptists to support the delivery of ophthalmology services. Furthermore, the HSE has undertaken a comprehensive validation exercise of all ophthalmology waiting lists in south Tipperary to support the prioritisation of patients and the planning of additional clinical activity.

The HSE remains fully committed to restoring a sustainable ophthalmology service in south Tipperary and will continue to pursue all available recruitment and service delivery options to achieve this objective as a matter of priority.

I thank the Minister of State for his reply. We now entering the third year of this crisis. These figures were made available to me back in December. There are 1,449 children under the age of four, 334 children between the ages of five and 17 and almost 600 adults on the waiting list, yet into the third year of this crisis we are still exploring other options. I was told in January or February of this year about the idea of a blitz clinic but that is still not in place. My appeal to the Minister of State is to engage with the Minister for Health to explore something I previously asked for, which is private provision, the temporary contract, and using the capacity in the private sector to outsource in particular for the children long on the waiting list until the blitz clinic in Waterford is up and running.

To read out that statement is totally out of touch with the situation. The figures are stark. Many of us are directing elderly people to Belfast to get cataracts done - the Belfast or Blind bus. I have eye issues. I understand how difficult it is. We are not even talking about the 500 adults waiting. It is pathetic that three years on, with Dr. Hillary giving a year's notice and with plenty of time that this position is still not filled. Something else is going on.

I demand that we use the private resources that are out there, as Deputy Michael Murphy said, to deal with our youngest and brightest people and give them a fair chance in life. We have Children First legislation and everything else here. These are basic needs that are being deprived to children in south Tipperary. It is not acceptable. The reply the Minister of State read out here today is totally unacceptable into the third year of this crisis. He talks about exploring options. There must be an emergency blitz. It is not correct to say that they are being dealt with in Waterford. They are not.

Gabhaim buíochas leis an Teachta. I call an tAire Stáit.

They do not even take them out of the hatch. They have too many there themselves.

The Deputy's time has expired.

Once again, I thank Deputies Michael Murphy and Mattie McGrath for raising this important issue, which I am taking on behalf of the Minister for Health, Deputy Carroll MacNeill, on the need for strengthened ophthalmology services in south Tipperary. I will make sure to let her and the officials in the Department know the specific views that were made here today in the House on behalf of their constituents in south Tipperary.

While recruitment of a permanent consultant has been challenging, I wish to assure the Deputies that sustained and proactive efforts are ongoing. A further recruitment campaign is now progressing and, informed by previous experience, it is focused on securing a successful appointment. In parallel, there has been progress on service delivery. The expansion of multidisciplinary teams, including additional optometry and orthoptic resources will help improve access and patient flow.

Collaboration with University Hospital Waterford is also delivering practical benefits through the evaluation of waiting lists and the provision of additional clinics. Taken together, these actions demonstrate a co-ordinated focused response. Urgent cases continue to be managed to ensure that patients with the greatest needs are protected while long-term solutions are advanced. The HSE remains fully committed to restoring a sustainable ophthalmology service in south Tipperary and will continue to pursue all available recruitment and service delivery options to achieve this objective as a matter of priority.

Like Deputies Murphy and McGrath, the Minister for Health's clear objective remains the appointment of a permanent consultant and the full restoration of ophthalmology services for south Tipperary. Work continues, including interim arrangements, to achieve this. I will personally bring the points made by both Deputies here today back to the Minister for Health, Deputy Carroll MacNeill, and departmental officials. The Minister for Health and I respect the mandate of the Deputies to come in here and represent their constituents in this particular matter.

Beidh an chéad ghnó eile ag tosú ag a 10 a chlog. We will suspend until 10 o'clock.