Topical Issue Debate

Cabotage Regulations

I welcome the opportunity to contribute on this issue, which, as the Minister is well aware, is of great concern to the road haulage sector. It certainly appears that Irish authorities have barely policed the cabotage legislation, which has resulted in the awarding of haulage contracts worth millions of euro to foreign haulage firms that pay no taxes in Ireland and employ no people here. The Road Safety Authority is responsible for the enforcement of legislation, along with the Garda, and its figures reveal that from 2012 to July 2013 only 78 vehicles were checked in Ireland and only a single breach of the regulations was uncovered. That is too little investigation. In comparison, the UK Department of Transport made over 43,000 checks relating to cabotage legislation, with 310 offences detected.

The legislation allows every haulier to perform up to three deliveries or cabotage operations within a week, starting the day after the unloading of international cargo in the country of destination. This was introduced by the EU to avoid an influx of drivers on lower wages flooding the EU markets. The Department of Transport, Tourism and Sport previously indicated that it was monitoring the level of investigations carried out by the relevant authorities. The head of the Irish Road Haulage Association, Mr. Eoin Galvin, has previously had meetings with the Minister, who promised to clamp down on breaches of the law. I accept that to some extent this falls outside the Minister's remit, as it is a matter for the Garda and the Department of Justice and Equality; nevertheless, he will have to use his influence to protect the road haulage sector because of what has been happening in the summer and is continuing even now.

As the Minister knows, the issue came to light over the summer after a number of foreign hauliers were found to be operating out of Foynes Port, forcing the Irish Road Haulage Association to resort to a blockade when local hauliers had to lay off drivers after contracts were given to foreign firms. In my view, which is shared by many, these firms were acting illegally and flouting the cabotage laws as applied here. At least four haulage companies from Germany, Holland, Scotland and the North appear to be flouting European cabotage legislation, which bans foreign hauliers from doing more than three journeys in a country before they leave. The firms have been involved in the transport of parts for wind turbines being imported by Siemens through Foynes Port. The legislation signed into law by the Minister in January 2012 allows every haulier to perform up to three deliveries or cabotage operations within a week, starting the day after the unloading of international cargo. However, it is illegal for haulage vehicles to enter the State empty and then carry deliveries. I have had the opportunity to visit Foynes port and see what is going on down there, and it appears that trucks and specialised moving equipment are being brought in without any loads and then being used to take heavy, outsized equipment from the port to various destinations, particularly where wind turbines are being placed. It is clear that this is being done in breach of cabotage laws. What is most surprising is that most of these wide loads, because of their nature, get a Garda escort. These people appear to be breaking the law, but they are being escorted in their work by the police, who are acting from a road safety perspective.

Within the past month the Irish Road Haulage Association has alleged that UK-registered trucks have entered the State and carried out deliveries for the ESB to the Carrickmines site from Dublin Port, again with the escort of gardaí. I am not making any allegations against gardaí, who are carrying out a job in travelling with these loads to protect other vehicles on the road, ensure traffic is not delayed, etc. In essence, these companies are breaking a law of the State, which is regrettable, and the issue needs the involvement of this Minister and the Minister for Justice and Equality. The Garda should also review its actions in this regard.

I thank the Deputy for raising this issue. As he is aware, the area of cabotage is not straightforward and there can be confusion as to what is covered by the cabotage regulations. Furthermore, the continued existence of cabotage restriction with the European Union is to a large extent an anomaly in the context of the free movement of goods and services.

Cabotage is the national carriage of goods for hire or reward carried out by non-resident hauliers on a temporary basis in a host member state. Haulage cabotage operations are governed by Regulation (EC) 1072/2009. In accordance with this regulation, non-resident hauliers are permitted to conduct up to three cabotage operations within a seven-day period after the inbound international carriage of goods from another member state or a third country. Advance permission is not required for a non­resident haulier to carry out the cabotage operations in accordance with the regulation. However, there are conditions which must be met. The first is that the non-resident haulier must hold a community licence qualifying him or her to operate internationally; and the second is that the non-resident haulier must produce clear evidence of incoming international carriage and of each subsequent cabotage operation carried out in the host member state, to a maximum of three operations.

The non-resident haulier is also subject to the laws, regulations and administrative provisions in force in the host member state with regard to the conditions governing the transport contract; the weights and dimensions of road vehicles; the requirements relating to the carriage of certain categories of goods, particularly dangerous goods, perishable foodstuffs and live animals; the driving time and rest periods; and the value added tax, VAT, on transport services.

As the Community continues towards a single European market, it is likely that restrictions such as cabotage will be removed. This liberalisation of transport services is supported by the Government. The current cabotage regime in operation across the European Union is largely a protectionist regime that serves to protect domestic operators. The strict operation of cabotage in the United Kingdom, for example, has had negative impacts on Irish hauliers seeking to operate in that market. However, cabotage restrictions are still in place and within that context, I view it as important that the current cabotage rules are enforced here until the market is fully liberalised, to protect our domestic or resident hauliers.

The enforcement of the EU cabotage rules ensures that our national road haulage market operates in a similar manner to the internal markets of other countries. It ensures that our road haulage industry is not placed at a competitive disadvantage, and it also ensures that non-resident hauliers operate in accordance with EU legislation.

The enforcement of cabotage regulations is the responsibility of the Road Safety Authority and An Garda Síochána. I am aware that the enforcement authorities and my Department work closely together and assist one another in ensuring the application and monitoring of cabotage regulations. I assure the Deputy that, at our quarterly road safety meetings with the Garda and the Road Safety Authority, enforcement of haulage laws in general is always on the agenda.

While the Minister has set out his and the Department's position, it is worth noting that while the cabotage laws are in place, it is vital that we protect our haulage sector. As an island nation, we need to have indigenous road haulage operators in place. Operators in other countries, particularly in central Europe, can move trucks freely and, therefore, provide an adequate transportation service for the movement of goods. I am concerned that if our domestic operators end up going out of business because of this unfair competition, we may be left in a very negative position at a later stage. We depend so much on our haulage sector to export the goods that are so vital to our economy. Anything that could undermine the sector in the shorter term could only be damaging to future economic growth and activity.

The Minister will be aware that it is alleged by those who have a very clear view of what is going on that approximately 43% of foreign trucks entering the country engage in illegal haulage activity, as set out under the cabotage rules. We understand that there is really no enforcement of vehicle weights, dimensions and tachograph laws for the foreign operators who are plying their trade here. There is no doubt but that they have an unfair advantage over the domestic hauliers resulting in the displacement of the work in the trade.

I ask the Minister to utilise his position at Cabinet level to urge the Minister for Justice and Equality to make clear to the Garda Commissioner that while there are cabotage laws in place, they should be enforced to the full extent. The Minister is correct that domestic hauliers who travel to the United Kingdom are put under pressure and forced to recognise the laws there. We must level the playing pitch as best we can. I look forward to some action early in the new year by the Government in this regard.

I have a few points. It is important to reiterate that the Government's position is that we should not have cabotage and that there should be a genuine single market. The restrictions should not exist provided each country in the European Union has the same safety and social standards. In the meantime, the law should be enforced.

I was interested to hear Deputy Dooley's statistics. I may have heard them before but I do not recall hearing them. If he passes them on to me, I will certainly distribute them at the next meeting with the Road Safety Authority and the Garda Síochána and ask them for their views on them. Where enforcement is concerned, we often hear only one side of the story, however. People complain when enforcement does not happen but may not tell one when it does. The Deputy raised the issue of the ESB's Carrickmines site. I received an e-mail today in this regard from a foreign haulier whose name I will not give. He states he is from a company that tried last night to deliver a power transformer to the ESB's Carrickmines site and that the delivery was blocked at the port by the Road Safety Authority. The delivery could not go ahead as the inspector said the company was not following cabotage rules. The correspondent states he is informed that the Road Safety Authority will follow instructions given by the Department of Transport, Tourism and Sport and that his company is seeking that the Minister and Department intervene. It is stated that what occurred could result in the omission of a serious piece of the ESB infrastructure for the Dublin area and could result in issues with the electricity network in Dublin. The company states it is looking forward to a derogation in this case in the knowledge that there is no transport company in Ireland with the specialist equipment to move the transformer. This is the kind of stuff I get all the time. Foreign hauliers believe I will change the law just for them. I do not do so. In this case, the Garda refused to escort the haulier.

I am very pleased that placing this on the Order Paper yesterday might have resulted in action. Perhaps we have had a result all round.

I am not sure that is true but if it is, credit must be given where it is due. There is absolutely no way that we will again permit a set of circumstances in which gardaí end up escorting goods against the cabotage laws, whether they realise it or not.

I thank the Minister. That was very helpful. The action of the Road Safety Authority last night was certainly helpful.

Health Services Provision

I am raising this issue on behalf of some parents who have boys with Duchenne muscular dystrophy, a rare disease that affects approximately 100 boys in Ireland. Before I discuss the specific circumstances of the parents on whose behalf I am speaking, I wish to put on record the good work and good service delivery at the Central Remedial Clinic, CRC, in respect of various sectors. Some parents send their boys with Duchenne muscular dystrophy to the clinic. It is important to record that I am not speaking on their behalf but on behalf of parents of boys who do not attend there. Approximately a dozen parents bring their boys to Newcastle, the reason being that bisphosphonates are available there on prescription. In conjunction with steroids, this treatment is producing very positive results for the boys. According to one of the parents, the survival rate is staggering. Another parent has said to me that all parents are trying to do is keep their children on their feet for as long as possible.

With Duchenne muscular dystrophy, best practice changes nearly every six months. It is a new area. There is a clinical trial site in Newcastle but none here. This presents a difficulty for the dozen or so families who are sending their boys to the United Kingdom.

There is a new administration temporarily in charge of the CRC. We are all aware that the board has stepped down and that the chairman is no longer in situ. There is a new administrator. All I am asking on behalf of the dozen or so affected parents is that the new administrator meet the parents and listen to them. They have experience of very good service delivery in Newcastle. They want to bring something to the table that might be of value and help in the delivery of services here. This is not about saying one service is better than the other; it is required of the Government to be big enough to say that if there are new ideas being applied in Newcastle, it is willing to learn from them. All I ask is that the dozen or so parents be listened to because they could bring value to the debate and be of benefit to the other parents in Ireland whose affected boys are just on steroids and who do not have the opportunity to take bisphosphonate.

For many years, I have been advocating the location of a clinical trial site in this country.

I am aware of the current economic constraints, but we should still focus on the possibility of developing a clinical trial site in this country.

I thank the Deputy for raising this issue and his positive comments on the incredible service provided by the CRC. The clinic has been embroiled recently in the controversy over pay and top-up payments, which is unfortunate because 99% of those attending the CRC are extremely happy with the service being provided.

The Department of Health has been unable to obtain the material to answer the specific questions raised by the Deputy in the time given. However, it undertakes to follow up with the Health Service Executive and the CRC and write to the Deputy with the information as a matter of urgency.

The issue of standards of care is at the top of the Minister's and the HSE's agenda. The HSE has established a quality and clinical care directorate to help to improve patient care throughout the health system. Clinical governance will ensure patients can get the right treatment at the right time. Clinical audit programmes will measure and audit standards to ensure they are delivered across the health system, including through agencies such as the CRC.

I will deal with the Topical Issue raised by referring to work under way on rare diseases and the services provided at the CRC. Duchenne muscular dystrophy is a rare, chronic, debilitating and life threatening condition. Most rare diseases have a genetic origin and the life expectancy of persons with rare diseases such as Duchenne muscular dystrophy is significantly reduced. Scientific knowledge of rare diseases, including Duchenne muscular dystrophy, is limited.

Ireland is well advanced in developing a strategy for rare diseases. A national steering group is developing a policy framework for the prevention, detection and treatment of rare diseases. The principles are high quality care and equity and centred on the patient. An integral part of an effective policy framework will be the development of a dedicated HSE clinical programme for rare diseases. This programme will aim to improve and standardise patient care by bringing together clinical disciplines and enabling them to share innovative solutions to deliver greater benefits to HSE service users. It is envisaged that a national rare diseases clinical programme would, over time, assist in developing national treatment guidelines, standard operating procedures and care pathways for many rare disorders, including Duchenne muscular dystrophy, in collaboration with designated reference centres. It would also develop care pathways with European reference centres for those ultra rare disorders on which there may not be sufficient expertise in Ireland.

The CRC provides a comprehensive range of services for almost 4,000 children and 500 adults throughout the country with physical conditions ranging from the very rare to the more familiar such as cerebral palsy, spina bifida and muscular dystrophy, including Duchenne. The CRC services assess, diagnose and treat children and adults with a wide range of physical conditions. In addition, the clinic offers a range of training, development and ongoing support options to adults with a physical disability. The CRC received funding of approximately €16 million from the HSE in 2013. It is also worth noting that it has been designated as a centre of excellence by the national accreditation committee for its high standard of delivery of training in adult services. It also recently received a HSE innovation award for its mobile gait laboratory services.

Dr. Brian Lynch, a consultant at the CRC, has provided additional information for the HSE. He has pointed out that children with Duchenne muscular dystrophy attend the CRC which has run a neuro-muscular clinic for over 25 years. At the CRC, children attend multidisciplinary clinics where they receive input from paediatricians, neurologists, orthopaedic specialists, physiotherapists, occupational therapist and dieticians. They also engage with clinical psychologists and social workers, where necessary. The treatment provided for these children at the CRC is in line with best international standards of care.

I will pass on the Deputy's specific request regarding the new director of the CRC, whoever that may be, meeting the families. Ireland is too small to develop the required research capacity in the area of rare diseases. We will have to continue to co-operate with others across Europe.

I thank the Minister of State for her reply and commitment to try to facilitate a meeting between the new director of the CRC and the dozen or more families concerned. Several aspects of her response are encouraging, particularly the reference to the development of care pathways, in co-operation with European reference centres, for those ultra rare disorders for which there is insufficient expertise in Ireland. The EU patient mobility directive is due to be transposed into Irish law next year and it will benefit the parents of children with Duchenne muscular dystrophy and many others. If the Acting Chairman needs a hip replacement, under the new directive, he will be able to travel to Italy, Germany or France to obtain one.

It will change the way services are delivered in Europe. The parents of the children to whom I refer will continue to travel to Newcastle, regardless of when the directive is transposed. They were a little sore when the E112 forms were withdrawn, but I hope changes will happen early next year in that regard. Sometimes policy makers and politicians sit around the table and make decisions in the absence of the most important people - service users. The parents to whom I referred who travelled to Newcastle had an overwhelmingly positive experience, although that is not to say some of the parents of the children attending the CRC have not had a positive experience, too. The service in Newcastle has given these parents hope.

I do not want to put a figure on life expectancy for those suffering from this debilitating disease because parents have been given hope their children can live longer than expected. The children will be able to stand for longer and will not have to use wheelchairs when they are eight or nine years old. They are living longer and able to play with their peers in the school yard. Their parents want the best for them and we can learn so much from both the parents and children. They have had a great experience and have been given hope. Sometimes we ignore the important things in life like listening to people. The parents of these children have something important to bring to the table. We must sit down and listen to them because we will learn more from them than from the experts with PhDs and other letters after their names.

The Deputy will find no disagreement from me in that regard.

HSE Investigations

The Minister for State will be aware that in recent weeks worrying facts have come to light regarding the sale of used orthodontic braces by a dentist employed by the HSE in Merlin Park, Galway. These braces which should have been incinerated were sold to private practices. The HSE became aware of this fact in 2009 and it was exposed in the Connacht Tribune recently. Four years later, however, there is still no explanation from the HSE as to why this practice was allowed to occur or the action it took on learning of this matter. Furthermore, it has not answered questions on the potential risks for those who had the second-hand braces used in the course of their treatment. More worryingly, further information has since come to light which raises serious concerns about potential exposure to infection. Many parents are rightly concerned and seeking information on whether the braces they worked hard or, in some cases, borrowed to pay for were second-hand.

If so, what are the risk factors for their child?

As both the Minister and the HSE are aware, the information that has come into my possession in recent times raises very serious questions about a range of issues including the action taken by the HSE on being made aware of this practice being carried out by one individual dentist but, most important, it raises extremely serious questions regarding the exposure of patients to the risk of infection.

We must know whether the HSE took steps to address the risk on becoming aware of the practice in 2009 and whether contact has been made with any patient - either private or public - who was potentially exposed to such a risk, as a result of the individual's actions and the sale of second-hand braces. The HSE must also clarify whether the risk to patients continued even after it became aware of the actions of this individual in 2009. People are rightly horrified at the thought of the practice taking place. It beggars belief that the HSE in Merlin Park would not re-use crutches but the re-use of dental braces was going on for a number of years. What action has been taken against the dentist concerned?

The Minister must now establish an immediate, independent investigation into the issues surrounding the sale of second-hand braces by the HSE dentist. Such an investigation is needed to establish when allegations of the practice were first known; what action was taken and when; and also to identify any risks that may exist regarding infection; communicate with patients and-or their parents; investigate the private practice concerned; clarify what cleaning and sterilisation processes were employed before the braces were placed in another child's mouth; if there was an element of fraud involved in the re-use of the braces; and to make the results public as soon as is practicable.

Such an investigation is needed to establish whether the HSE's actions on learning of this practice were in line with its own policies on infection control and patient safety. We must know how long this practice had been going on and when it was first brought to the attention of the authorities. We also need to know where the braces went and the steps taken to trace the children involved.

There are many professional health care staff working within the department in Galway whose reputation must be protected and who would, no doubt, like to see a fully independent investigation take place to expose the truth behind this disgusting practice carried out by one individual and the issues that have arisen as a consequence. The HSE has confirmed that it will fully investigate this matter. However, in light of the information that has come into my possession it is clear that this is not adequate and that a full and independent investigation must now take place.

On behalf of my colleague, the Minister of State, Deputy White, I thank the Deputy for raising the issue. The Minister of State, Deputy White, became aware through recent media reports that a dentist employed by the HSE at the orthodontic unit in Merlin Park hospital has admitted giving braces that had been removed from children at the unit to a private dental practitioner. I am very constrained in what I can say at present on the case. I understand that the HSE became aware of this matter in 2009. It was investigated at the time and the practice of removing braces from the unit ceased. My colleague, the Minister of State, Deputy White, has asked the HSE to advise him if there are any outstanding issues that may need to be addressed concerning the possible re-use of the braces. Deputy Naughten will appreciate that the HSE is not in a position to comment on any individual staff member working within the service.

Where the HSE becomes aware of any patient safety issues, they are dealt with promptly and effectively. In this case, the HSE has provided assurance that staff of the orthodontic unit concerned were trained at the time to ensure correct policies and procedures were followed and to prevent the situation occurring again. The patient safety processes have recently been reassessed to ensure that staff remain compliant. As a further assurance the HSE is arranging an assessment by its dental inspectorate of patient safety control and policies in this area. An intensive infection control audit of the orthodontic unit is carried out once a year as part of the audit of the hospital. A routine audit is also carried out at least twice a year by the local cross-infection team. The Dental Council has been notified of this individual case. The council is liaising with the HSE and treating this as a matter of priority. The General Dental Council in the UK has also been notified to ensure that any patient safety issues will be dealt with in tandem if necessary. I assure the Deputy that there is no ongoing risk to the public in relation to this case. The matter is receiving urgent attention in the HSE. My colleague, the Minister of State, Deputy White, expects a report early in the new year.

I thank the Minister of State for her reply but she did not address the core issue underlying the matter, namely, the potential risk of infection for the children involved in the debacle. Everyone has said checks and balances will be put in place but what is being done about the potential risk of infection for the children who were involved? The HSE is failing to deal with public health and infection issues and is using the excuse that it cannot comment because the matter relates to an individual member of staff. I want reassurances on the issues relating to infection that I have raised publicly and on which I have written privately to the Minister. I raised the issue on a couple of occasions by way of parliamentary question with the Minister of State, Deputy White. The response that I have received is not good enough; that the Minister is waiting for the HSE to come back to him on whether there are any outstanding issues.

The Minister of State, Deputy White, has been aware of the matter for a month. We should know what has happened since then. When did the Dental Council become aware of the matter? Why is it only now that it is inquiring into the matter and making it a priority? Why has it not been a priority in the past four years? When was the dental authority in the UK made aware of the matter, and was it informed that the dentist was not allowed to have direct patient contact in this jurisdiction? What steps have been taken in the past four years to deal with the potential risk of infection? Those critical issues must be clarified because there have been significant breaches of cross-infection control procedures and of data protection.

As soon as the Minister became aware of the issue he made inquiries and treated it as a priority. It is not unreasonable to expect that a comprehensive report would take a month or even two to conclude. The report will concentrate on the outstanding issues such as the re-use of the braces and the contact made in that regard. The issue is being dealt with internally in the orthodontic unit in Merlin Park. The infection teams have been there, as has HIQA, and reassessment has taken place of the training provided. The outstanding issue is the re-use of the braces within the private sector. It begs the question of whether the private sector dentist knew the braces were coming from another dental practice. They are the key questions that require to be answered. It is not unreasonable that we would await the compilation of the report.

I accept the Minister of State’s response but the difficulty is that the matter came to the attention of the HSE four years ago and the answers should be available. That is at the heart of the scandal and that is why I do not have confidence in the individuals carrying out the investigation.

No doubt we should have the answers but the matter just came to our attention recently.

Thalidomide Victims Compensation

The Minister of State is aware that RTE's "Prime Time" programme recently shed light on the Government's handling of the thalidomide scandal in the 1960s. Documents produced show that the Government made a conscious decision not to issue a public warning on the dangers of thalidomide as such a move was regarded as "undesirable". That has serious ramifications for a scandal that has gone on for decades at this stage.

Thalidomide was a drug marketed for morning sickness but problems arose with it which led to the foetus in many instances being malformed and the children being born with serious lifelong physical defects. The German Government and chemical company involved brought forward a compensation package years later. I am aware the programme for Government gave a commitment to reopen discussions regarding this compensation programme. Many of the survivors, of which there are 32, are seeking an enhanced care package with access to adapted housing, cars and other services. They are saying that the spirit of the agreement entered into with their parents in the 1970s should be honoured.

Discussions between them and the Department broke down earlier in the year. The Minister for Health said they had broken down on the basis of legal advice to the Government that the State does not have legal liability for injuries suffered by the survivors of the drug. The recent revelations from documents from the Department cast doubt on the accuracy of the Minister’s statement, however. If the State was well aware of the concerns about the drug in 1959 but failed to take any action until the middle of 1962, then several of these survivors and victims of thalidomide have a legitimate case to argue the State is wholly responsible as it had possession of knowledge with which it refused to deal.

At the time, the drug company involved had withdrawn the drug from the market. Some of the quotes from the Irish State authorities at the time in the recently disclosed documents seem quite callous. Basically, they said because the drug companies had withdrawn it, they need not worry about it. This was inappropriate. Another document reveals, “It was felt that any supplies which had already reached domestic stocks presented a special problem that could only be tackled by public announcements. This step was regarded as undesirable. It was thought that even if it were taken, it would prove largely ineffective”. Sadly, we will never know because the public announcement was not made. Instead, we had a confidential circular issued with an inadequate recall of the drug.

These documents alter the balance of forces in the Government’s position on the negotiations with the thalidomide survivors. The points made by the Minister in July that the State is not responsible have been shown up to be not the case. I hope the Government will take this into account in addressing the outstanding concerns of the victims of thalidomide for adequate compensation to meet their needs.

Before I give the official answer, it often strikes me that it can come across as clinical and simply giving the facts. Everyone in this State knows of a person with a difficulty from thalidomide. I accept sympathy does not pay the bills either. It is also not a case of the Government refusing to open to negotiations.

I am pleased to take this opportunity to outline the current position on the Irish survivors of thalidomide. When one thinks there are only 32 survivors, who would not want to deal with this problem?

Lest there be any misunderstanding, this Government did not suppress any information. The document referred to in recent media reports is a document dating from 1974 prepared by officials in the Department of Health for the then Minister. This document, among other matters, outlines a position adopted in 1962. The distributors of thalidomide in Ireland suspended distribution of the drug in December 1961 and then withdrew stocks of the drug in January 1962. It was decided at that time not to issue a public statement. The document, however, outlines that it was decided in June 1962 that the most effective step to take to deal with the issue was to circulate all chief medical officers to ensure all doctors, chemists and hospitals in their area would secure the return of any unused stocks. As Deputy Clare Daly said, how were we supposed to get to women who had it in the medicine cabinet already?

It is important to bear in mind that action taken in 1962 should not be judged or reviewed applying the rules or regimes applicable today. I am sure we would not do today what was done then. It would seem the position in Ireland did not materially differ from the position in other European countries at the time. Few countries then had systematic controls for licensing drugs and it was in the light of the thalidomide experience that most countries developed such arrangements. This was reiterated by one of the thalidomide survivors on the recent "Prime Time" programme on the matter. The document states: "It is of interest to note that the attitude of the British authorities was no different.” This is not an excuse.

This document was released by the Department of Health in 2010 to solicitors representing Irish survivors of thalidomide, along with all other records available to the Department relating to the period in question. The Government’s focus is to address issues which remain and the programme for Government includes a commitment to reopen discussions with Irish survivors of thalidomide. Given the challenges that persist for each individual, the Government's aim is to address the health and personal social care needs of thalidomide survivors living in Ireland.

There are 31 Irish survivors of thalidomide receiving tax free payments from the Department of Health. A German foundation also pays Irish survivors of thalidomide, payments which are also tax free. Since 1 August 2013, the German foundation has substantially increased its monthly payments to Irish thalidomide survivors. In addition, 15 survivors who accepted it at the time received a once-off payment from the Department of Health in July 2013 of €62,500.

Up to 22 of the Irish survivors of thalidomide have initiated personal injury claims against the State. A mediation conference is proposed for these claims. It is hoped this can proceed early in the new year. Both I and the Minister for Health are determined to ensure equality of treatment for all Irish survivors of thalidomide. The Government will continue to work to find a way forward to progress matters for Irish survivors through discussions. All Members are anxious this matter is resolved as quickly as possible.

While dealing with 32 survivors might seem a small figure, this process has trundled on for decades, over the lifetimes of these victims. The State did not consciously suppress the 1974 documentation but what is revealed is the extent of knowledge which was not shared. Had it been shared, lives could have been changed. In that sense, the State responded inappropriately and is culpable to a degree. The programme for Government accepts State culpability and agrees on the provision of an adequate compensation and care package. The necessity for a proper package is the most persistent demand from the survivors. When we raised it previously, the Minister for Health has said as they get a medical card, they can apply for housing adaptation grants and so forth. They have applied for many of these services but not received them. They want these services to be ring-fenced and guaranteed as a right to people to whom an injustice has been done. We now have the proof that there was knowledge about the dangers of the drug, a better response could have saved many. Hopefully, we have learned from this. The State’s response in 1962, through a confidential memorandum to the medical profession, was wholly inadequate. At least this would not happen now. Transparency and knowledge is a good development that should be encouraged rather than authorities trying to keep a lid on matters.

We are all singing from the same hymn sheet in that knowledge and transparency is what will protect us all. We already have care packages in place for hepatitis C sufferers so we know what is needed in this case. It is a matter of agreement but there is some disagreement between some of the group themselves. There is a solution and we just have to keep trying to find it.

Sitting suspended at 3.21 p.m. and resumed at 4.21 p.m.