Topical Issue Debate

Brexit Issues

Deputy Brendan Smith

I thank the Leas-Ceann Comhairle. I appreciate the Ceann Comhairle selecting this Topical Issue. It is an issue of huge concern in the Cavan-Monaghan area and in the general Border region, namely, the need to upgrade our infrastructure, particularly road infrastructure. I welcome the fact the Minister, Deputy Ross, is here. From my observations in this Chamber, in previous debates he is a very good attender and replies to the Topical Issues put to his Department. That is a welcome development but unfortunately, it is not one that is followed by all Ministers.

As the Minister will be aware, Cavan, Monaghan and Donegal are more heavily dependent on road infrastructure than other counties in the State because we do not have a rail service.

Allied to that dependence on the road network is the fact that the local economy is very heavily dependent on the agrifood, construction products and engineering sectors. By and large, these are bulky products that are transported by heavy goods vehicles, HGVs, either to the domestic market outside Cavan and Monaghan or to ports and airports for export to foreign destinations. Those HGVs, in transporting the finished products from our region, need proper roads and proper infrastructure to get the products to markets within Ireland and to the ports and airports in good time. In previous debates in this House, through both parliamentary questions and topical issues, I have highlighted the need for additional resources for the Department's road works programme in the mid-term review of the capital programme. In those debates I made a special appeal to the Minister to address the infrastructural deficits of the Border region. This is particularly urgent in the context of the difficulties and challenges we face as a Border region. If enterprises in Cavan, Monaghan and the general Border area are to have any hope of remaining competitive, the Government must invest urgently in infrastructure.

Again, I refer to the fact that our local economy is very heavily dependent on the agrifood, construction and engineering sectors. These are also the three sectors in our economy that are most heavily dependent on the British market for exports. The economies of Cavan and Monaghan and North of the Border in Fermanagh and Tyrone are heavily dependent on these three sectors and in turn, these three sectors are most heavily dependent on the British market. These sectors are already facing difficulties because of the serious decline in the value of sterling since the middle of 2016, following the Brexit referendum. There is an obvious need to try to assist enterprises to remain competitive. The Government, we as public representatives and non-governmental organisations, NGOs, will put the very best case forward to Europe and to the British in regard to the best possible deal and the fact that we cannot countenance the return of a border on our island. Those issues are all up for negotiations but there is one decision that is totally within the competence of our own Government, namely the decision to invest in infrastructure and to provide additional financial resources to upgrade a road infrastructure that is deficient. There are many historical reasons, as the Leas-Cheann Comhairle will attest, for the deficits in the Border region, including the impact of decades of the Troubles on our doorstep and the lack of investment that followed on from that. Thankfully, since 1998 we have had huge positive developments in all of the province of Ulster and throughout our State following the signing of the Good Friday Agreement. We have had an increase in North-South trade and the development of enterprises on an all-Ireland basis. Those enterprises that are based in the Border region face very serious challenges in trying to remain competitive. We must ensure that at Government level extra investment is targeted at the Border region to try to assist those companies to remain competitive. If we are to have any hope of those enterprises retaining their current complement of employees, not to mention creating much needed additional jobs, there is a huge onus on Government to prioritise investment in the deficient infrastructure in that region.

Minister for Transport, Tourism and Sport (Deputy Shane Ross)

I thank Deputy Smith for his tireless representation on this and other issues affecting his region, particularly through the raising of topical issues in this Chamber. The impact of Brexit is a major concern for the country as a whole. As regards road infrastructure, as the Deputy is aware, while I have responsibility for overall policy and funding in relation to the national roads programme, the planning, design and implementation of individual road projects is a matter for Transport Infrastructure Ireland, TII, under the Roads Acts 1993-2015, in conjunction with the local authorities concerned. Within its capital budget, the assessment and prioritisation of individual projects is a matter in the first instance for TII in accordance with section 19 of the Roads Act. The improvement and maintenance of regional and local roads is the statutory responsibility of each local authority, in accordance with the provisions of section 13 of the Roads Act 1993. Works on those roads are funded from local authorities' own resources supplemented by State road grants. The initial selection and prioritisation of works to be funded is also a matter for the local authority.

The capital plan published in September 2015 outlined proposed transport investment priorities to 2022. Maintenance and renewal of the road network will continue to be the main priority over the next period and the bulk of the roads capital budget, approximately €4.4 billion, is earmarked for such essential work with a further €600 million allocated for implementation of the public private partnership, PPP road programme which is already underway.

The capital plan provides for significant investment in transport links impacting on the wider Border region including the N4 Collooney to Castlebaldwin upgrade scheme, the rolling schemes on the N56 from Dungloe to Glenties and Inver to Mountcharles, strengthening links in Donegal, and subject to necessary consents, the N2 Slane bypass on the Dublin, Monaghan route. The capital plan also restates the Government's commitment to contribute £75 million to the development of the A5 in Northern Ireland. In addition TII announced in July that it is reactivating planning work on the N2 Clontibret to the Border scheme to narrow down the number of options to a single preferred route. Further action being taken on the N2 relates to a safety review of the section between Drumgeeny and the Castleblayney bypass. The draft engineering advisor’s report concluded that the rate of fatal collisions on this single carriageway road exceeds the rate from a reference class of similar national primary roads. The report also identifies a number of measures to improve safety on this section of the route. Arising from this report, TII has committed to provide additional funding to develop the recommendation for an online upgrade of the N2 extending from north of Ardee to the south of the Castleblayney bypass. The intention is to progress the preliminary design and the achievement of planning consent as soon as possible. As I have said many times, as Minister I have to operate within the budget available to me and the capital plan allocations set the parameters for what I can do. The review of the capital plan was initiated earlier this year and I put forward a strong case for additional funding. The Minister for Public Expenditure and Reform, Deputy Donohoe has now published a report setting out the conclusions reached in relation to the additional global amount available to boost capital investment. While I was heartened to see transport identified as one of the priority areas for consideration for additional funding, decisions on specific allocations to Ministers remain to be made by the Minister for Public Expenditure and Reform.

Deputy Smith makes a good case for his region. In the present circumstances, obviously anything that is particularly affected by Brexit must get special consideration when funds are being allocated.

Deputy Brendan Smith

I thank the Minister for his response, in particular his references to the necessary upgrading of the N2, the Border to Clontibret road design reactivation, the Castleblayney bypass and the need to implement safety measures there because unfortunately there has been a considerable loss of life on that stretch of road in recent years. I have highlighted one particular route in this House previously. In the early 2000s, the development of an east-west route from Sligo to Dundalk was identified. At that time, it was concluded that the best route would be from Sligo, through Enniskillen, Belturbet, Cootehill, Shercock and Carrickmacross to Dundalk. Substantial funding was provided to upgrade the route through the development of the Cavan bypass and the Belturbet bypass, both of which were integral parts of the proposed route. Then, in 2009, Cavan County Council was identified as the lead local authority - to work along with Monaghan and Louth county councils - to plan and design the upgrade of the route. Substantial funding was provided in the road works allocations in 2010 and 2011.

Substantial planning and design was carried out at that time, the details of which I will communicate to the Minister in writing. I would like to see that project re-activated because there are many substantial employers on that route, including Abbott and a number of engineering companies in Cootehill, Manor Farm, the Carton Brothers poultry enterprise, in Shercock and a number of other major enterprises in Dundalk. The time delay in terms of transporting the finished products from those factories and manufacturing facilities in Cootehill to Larne, Warrenpoint or the ports in this State, because roads are not up to the standard required for heavy goods vehicles, is a substantial additional burden on those enterprises. It is a route that I would like to see upgraded.

I recall that when planning was under way in respect of the development of the N3, I made a presentation at the then Oireachtas transport committee, which was based on research carried out by Glanbia. One of the Glanbia manufacturing facilities is located in Virginia, Cavan, in my own constituency. The Glanbia analysis dealt with the delays and costs to it arising from its trucks sitting in traffic on the N3 and the impact of this right back to the primary producer and reduced prices. If enterprises in the Border region are to have any hope of maintaining existing employment or growing employment the local infrastructure must be upgraded.

In regard to the final sentence of the Minister's initial response, I sincerely hope that he will ask the Minister for Public Expenditure and Reform, Deputy Donohoe, to ensure that the prioritisation of the road infrastructure needs of Cavan-Monaghan is given urgent consideration.

Deputy Shane Ross

I do not like off-the-cuff commenting on specific issues or roads, such as has just been bounced on me, because I am not qualified to speak about them ad lib but in light of what the Deputy said I will ask my officials to contact the appropriate people and have the matter examined. It is only reasonable that I would do so. I appreciate that infrastructure in the Border areas is well below par, as it is all over the country, particularly the roads. I was in Cavan-Monaghan recently. I do not think the situation there is all doom and gloom. I acknowledge it is the job of Deputy Smith to bring these matters to my attention but in my view some of the roads are in fairly good condition and there are signs there of prosperity. I appreciate what the Deputy said about the need for competitiveness and the effect of the fall in sterling on the Border areas and the enterprises to which he referred but when I was in the area I noted a light of bright spots, including a new greenway, which is a cross-Border greenway and an important piece of infrastructure, the opening of which I was honoured to be associated with.

I will raise the specific points made by the Deputy about the roads and I will report back to him.

Schools Building Projects

Deputy Jim O'Callaghan

I welcome that the Minister for Education and Skills, Deputy Bruton, is here this evening to respond to this issue concerning the land in Harold's Cross which was purchased by his Department during the summer and the purpose for which that land will be used by it, which is an important issue for the people in my constituency and beyond.

The Minister will be aware that a number of years ago his Department approved the opening of a new post-primary school to service the Dublin 2, 4, 6 and 8 postal districts. It has been communicated to the persons involved in the new school that the school will open in September 2018. As the Minister will no doubt be aware, following a patronage process announced by his Department in early 2016, Educate Together was approved the patronage of the new secondary school. Since then, in May of this year it was announced that the Department of Education and Skills had purchased the former greyhound track in Harold's Cross and it is to be used to accommodate new schools. In terms of this Topical Issue, I am asking the Minister to consider the use of the land in Harold's Cross to accommodate the new Educate Together secondary school. It is a priority in the area that this school is constructed as soon as possible.

For the purpose of determining whether a new school was required, the Department carried out a report on the patronage of the school and what catchment area was suitable for a new school. As I said, it was concluded that a school was needed to serve the Dublin 2, 4, 6 and 8 areas. Taking that area of land, the meeting point in terms of the areas to be covered by the new school is an area near my constituency called La Touche Bridge. It is the centre point of the catchment area. In terms of the land available at the former greyhound track in Harold's Cross, it is the ideal location for the new school as it is only 1.4 km from La Touche Bridge. I suggest that it would be an ideal location. It is important that steps are taken to establish a new multidenominational, co-educational, non-fee paying secondary school in the area. Many of the secondary schools in the area are single-sex fee paying schools. They are all excellent schools but there is limited choice for parents who wish to send their children to a non-fee paying school or a secondary school that is multidenominational and co-educational.

I understand that Educate Together has done a considerable amount of work in respect of assessing the demand for this school. The demand exists. There is ample land at the former greyhound track to facilitate construction of a school and playing fields. There is an urgency around this issue in light of the announcement that the school will open in September 2018. There are many stands beneath the former greyhound stadium that could be converted to classrooms on a temporary basis. I urge the Minister to give consideration to constructing the new school on this land, which is in the centre of the catchment area, has been purchased by his Department, and would be hugely popular in the area.

Minister for Education and Skills (Deputy Richard Bruton)

I thank Deputy O'Callaghan for raising this issue. This is a very significant purchase by the Department. From our point of view, it is an area where it is difficult to get land and we were very pleased to get the opportunity to acquire this site. As the Deputy will be aware, courtesy of Dublin City Council the land has been rezoned from recreational and part residential zoning to Z15 zoning, which is to protect and provide for institutional and community uses. This rezoning, agreed by the city council only this week, will facilitate the provision of a school on the site. Conveyancing and so on must be completed before plans for the development of the site can commence.

The Deputy is aware of how the system works. There are 314 school planning areas across the country. While this site is directly in the Dublin 6-Clonskeagh area, there are four other adjoining planning areas whose trends we would examine. The expectation of the Department is that in the future there will be very significant requirement for additional school places at post primary level in these areas. It is projected that as many as 5,000 places will be needed over the medium term.

Against that background, this is a very significant acquisition by the Department. It will help us to plan for pressures both at primary and post-primary level.

The precise usage of the school will have to be determined by the Department. A demographic review is taking place. If it reveals pressure for an additional school, that would go through the system the Deputy described under which Educate Together was selected for a post-primary school. There would once again be an opportunity for parents' preferences to be expressed in regard to whose patronage should arise.

I have carefully noted the Deputy's comments regarding the suitability of this site for a particular school. As he can understand, any such issues will have to be carefully evaluated by the Department. It will not be a political decision, rather it will be a decision based on the best interests of planning the future of the area. Given the capacity of the site, although it is constrained, I believe the Department would hope it could have both a primary and a post-primary school on it, if it can be developed. Good design of such a site would be the first matter the Department would examine, namely, the potential of the site and what are the best ways to deploy that resource to meet the needs. I will pass on the Deputy's points about the particular patron and about the school that is developing. As he will be aware, there is an early stage after a school starts up and builds up its numbers where there is usually time to anticipate what is the best way to meet the needs of the school as it develops.

Deputy Jim O'Callaghan

I thank the Minister for his response. I appreciate that he cannot give a definitive answer in respect of whether the land will be used for this Educate Together secondary school, but I would urge him and his Department to bear in mind that a decision should be made on this as soon as possible. The Educate Together secondary school is due to open in September 2018. That is what the Department had indicated. As a result of that, the patronage and the parents have indicated that it is already heavily subscribed. It is already fully subscribed for its first year with a significant waiting list. That reflects the level of demand and the necessity for such a school in the area. I urge the Minister to take that on board in order that decisions can be made on a prompt basis.

The new secondary school will ultimately provide up to 1,000 secondary school places. I note what the Minister said about the intention being to perhaps house a primary school and a post-primary school there. That would be an excellent idea. There is a significant amount of land available there in an area of Dublin where it is hard to get land. There would be a benefit in having a primary and post-primary school together but there is no reason that cannot occur with the Educate Together secondary school using that site on a temporary basis. It would only start off with one year there and the works could be done at the same time.

I know that individuals associated with this school are concerned about the fact that a decision has not as of yet been forthcoming from the Department as to where the school will be based. I have spoken to Vanessa Barcroft, a representative of the school, who is anxious to ensure that it is up and running as soon as possible. Educate Together is also anxious and is awaiting confirmation from the Department on the location of the new school. As it is the case that the school is to open in fewer than 12 months but no confirmation has been received to date as to its location, it is incumbent upon the Department to communicate with the patron and the individuals involved.

This is a hugely positive project. It is enormously supported by people in the locality, the Harold's Cross council, which looks after the issues affecting Harold's Cross. It would be a great development for the future. I urge the Minister not to let the potential for an Educate Together school to be on that site to be lost. There is an opportunity for that but we need to align the timings so that it can happen.

Deputy Richard Bruton

I have noted what the Deputy said. I have attended Harold's Cross on many occasions, not for schooling, only for the schooling dogs. Whether it would be appropriate to use that site as a temporary one for education while its longer-term potential is being designed and assessed by the Department is an issue that I would have to refer to those who are expert in designing and planning. I note what the Deputy said and I will bring it to the attention of those who are more intimately involved in evaluation of how this site can be best deployed to meet the local school needs. I am delighted our acquisition of this site has been received so positively in the community and that people see the potential of this. It is important in areas of the city like that where, as the Deputy said, there is a need for non-fee charging post-primary schools to develop that we have a site now where we can plan for the future.

School Management

Deputy Gerry Adams

Gabhaim buíochas leis an gCeann Comhairle as an deis an t-ábhar tábhachtach seo a phlé anseo um thráthnóna. Táim buíoch as an Aire as a bheith i láthair.

Tá muintir mo dháilcheantar buartha. Tá an chás millteanach agus tá eagla mór agus imní ar dhaoine i dtaobh an ábhair seo.

Tá daoine ag lorg freagraí faoi Scoil Náisiúnta Bhríde i gContae Lú.

I thank the Ceann Comhairle for the opportunity to raise the serious ongoing situation at Scoil Náisiúnta Bhríde in Faughart, County Louth. I previously raised my concerns directly with the Minister, and I thank him for his attendance here this evening. I have also raised my concerns with the school management and the school patron regarding the welfare of pupils, the morale of the school and the danger that the school might close if the problems were not resolved urgently. They have not been resolved and the situation has been made even worse. We now have a situation where a once thriving school, which had more than 100 pupils, in Faughart now has no pupils left, and has effectively closed its doors. The school has been a hub of activity for the local community for generations. Grandparents and parents of today's children all attended that school. No one wants to see the school closed. There have been ongoing difficulties for a long period of time and for that to be allowed to happen is very sad and disappointing.

The Department of Education and Skills undertook an inspection earlier this year. The whole school evaluation report, published in May, made a number of critical findings. The inspectors reported that "leadership for learning within the school was not prioritised sufficiently". The report stated that "the oversight role of the Board of Management was not being discharged satisfactorily". It found "a significant variation in the quality of teaching of certain subjects, ranging from outstanding to poor". We might ask ourselves what we would do if our children were attending that school. The report stated that action should be taken as a matter of priority to "rebuild trust within the school community and to improve enrolment".

The whole-school evaluation report confirmed the parents' concerns and as a group they took the decision to escalate their efforts to peaceful protest. They have privately and publicly justifiably raised their concerns about their children's education. They have engaged with the board of management, the school patron - the Archbishop of Armagh - and the Minister.

As a result of a lack of a resolution, this has culminated in a decision for them to withdraw their children from the school and to seek alternative school places for them. There are now no pupils left. We are seeing the decimation of a rural thriving school community. It is no exaggeration to say that those in the community are devastated. I have met and spoken to families directly affected and they have all told me that their hope against hope is that the Department and school management would resolve the issues at hand. It is unacceptable that a rural school can close the way that Naomh Bríd school has. We can ill afford the closure of any rural school. The people of Faughart deserve better.

This is a close knit school community within a wider community who feel let down. They fear that the survival of the school, with no pupils attending it, is in danger.

They believe that, with the intervention of the Minister directly, the school patron and the new management, the school can flourish again. I am sure the Minister will agree that simply standing back and allowing a rural school to close its doors is totally unacceptable. He should meet and speak to the families. I ask him to do so as soon as possible.

Deputy Richard Bruton

I thank the Deputy for raising this issue. It is disturbing and he has accurately outlined the backdrop to it.

A whole-school evaluation of the school in Faughart was conducted in March this year and the report was published in May on the Department's website. As the Deputy indicated, the report found a number of significant problems with the capacity of the school to deliver on its mission and made a number of strong recommendations, including that the board of management, in consultation with the staff, the wider community and the patron, formulate, implement and monitor a strategic plan for the operation and development of the school in order that its mission statement could be implemented satisfactorily. The report stated the oversight role of the board of management needed to be strengthened significantly and that within the school leadership for learning should be greatly developed and, to that end, leadership and coaching supports should be accessed by the principal.

Following the completion of the inspection, senior officials of my Department held a meeting with the school management and the patron of the school on the issues identified during the inspection and the need to implement the recommendations made in the report. Responsibility for implementing recommendations rests, in the first instance, with the management and patron of a school. As section 15 of the Education Act makes clear, it is the duty of the board of a school to manage the school on behalf of its patron and for the benefit of the students and their parents. The patron then began the process of dissolving the board of the school and appointing a single manager to manage the school on the patron’s behalf. However, the board resigned and a single manager was appointed by the patron in June 2017 to manage the school. The manager is taking on the responsibility, acting on behalf of the school’s patron, to take the steps necessary to address the issues identified. I have outlined in the written reply the normal support provided to assist in that work, including follow-up by the Department and access to support services.

As the Deputy outlined, despite having an enrolment of 55 pupils this time last year which would warrant a staffing complement of a principal and two mainstream classroom teachers, no students are now attending the school as their parents have opted not to send them to the school. My Department is concerned about this. It is not its policy to see schools such as this close, but, ultimately, these decisions do not rest with it. The decisions and the authority to make them rest with the patron and the school community, but the Department is working to try to find a solution. As recently as today, officials had a meeting with the school authorities and the patron. We will continue to engage with the school management and the patron to address the matter. It is our desire to achieve a solution, whereby parents will have the confidence to send their children back to the school. I am informed that the school manager is taking this task seriously and I hope that, with the support of the wider community, we can find a solution that will protect the continuing role of the school which has a proud tradition dating back many years. It is a difficult issue, but we are working vigorously with local interests to find a solution and open to continuing that work.

Deputy Gerry Adams

I thank the Minister for his response. I do not envy him his job. This is a small school in a small community and he has a huge Department to manage, but a solution to what is now a crisis should have been found months ago. The Department had been aware of the problems in Faughart for some time and I had brought them directly to the Minister's attention, but the Department decided not to intervene and to leave it to the patron to manage the school. The Minister has said the Department does not have authority in that regard, that it rests with the patron and the school community. However, it is now a school without pupils and the mind boggles. The school manager has a role to play in place of the board of management and although I have serious reservations about whether schools should have patrons - I certainly believe this issue should be reviewed to meet modern needs and ethos of our society and attitudes in a changing Ireland - the patron has a role to play, as does the community. The Department, however, should be the driver in the relationship and I welcome the Minister's remark that it is engaging locally. I sincerely hope we can save a school that has been in place and served the community well for generations. There is a fabulous school community which comprises parents who want the very best for their children. I appeal, as I did previously, to the Minister to meet the parents. I note that he did not respond to me, but he should listen to them first hand and then use his common sense and goodwill. If he was a parent placed in his dilemma, the last thing he would want to do is to remove his child from education. That so many parents have done so to the point where the school has no pupils shows how seriously they feel about the issues involved. As it would not take up much of the Minister's time, I ask him to take a hands-on approach. The issues can be resolved, but only if the process is driven by him and the Department.

Deputy Richard Bruton

I am taking a keen interest in this matter, but we deploy professional staff, including inspectors and others who have decades of experience, to support patrons, school managements and communities. One should not seek to politicise the solution because, from a departmental point of view, we are committed to providing the funding required. We stand ready to provide the teaching resources required, the capitation grant and all of the standard supports. Following the inspection report which set out a path to a solution, locally the patron-cum-management-cum-board has been unable to convince the parents to enrol their children. We stand ready to provide support packages to improve the quality of delivery in the school and the Department will not be found wanting in the provision of professional support and so on. We have long experience of doing so. Ultimately, however, there has to be a desire locally to make this work. We have to rebuild the parents' confidence at local level through the work of the school management supported by the professional staff we are making available to it. It is not a political scenario where someone goes in and bangs heads together. The parents will have to be content with it for a long period. They have to work with those taking responsibility and be convinced that it can work for them.

We absolutely stand by small schools. There is a commitment in the programme for Government not to close schools unless that is the desire locally. Parents have voted with their feet as to their view on this issue. We need to retrieve the position. I am putting in the professionals in my Department to work with the community to come up with an answer. We will continue to offer that support in order to find a solution which the Deputy is clearly keen to see.

Medicinal Products Availability

Deputy Tony McLoughlin

I thank the Ceann Comhairle and his staff for giving me the opportunity to raise this important issue which is a matter of life and death for a constituent of mine and many others throughout the country. It relates to the provision of the life-extending drug, nivolumab or nivo for short, by the HSE and the Department of Health.

Nivo is an immunology drug that can be used by oncologists to treat a range of cancers, such as melanoma, non-small cell lung cancers, renal cell carcinoma, Hodgkin's lymphoma and a host of other illnesses. It is a drug that is readily available to patients in the United Kingdom via the National Health Service. However, it is only available in this country to private patients who can afford the extreme bill of between €100,000 and €140,000 per year. I ask for an urgent update on the status of the drug today.

I thank the Minister for taking my recent calls. From them he knows that a number of people throughout the country are currently sitting in hospitals and will die if they cannot access this drug soon. In particular I will mention one patient from County Sligo who is suffering an advanced form of kidney cancer. Mr. Peter Milne, a retired teacher, is a good person and has given his time and energy freely to so many good and worthy causes in Sligo. He ran a youth theatre for young people in Sligo for many years. Before his admission to hospital, he continued to teach English to asylum seekers, and he also helped to guide young people through their university applications process in his free time. When Peter was told two and a half years ago his cancer was back and inoperable, he set about climbing the four highest peaks in the British Isles to raise thousands of euro for the cancer support centre in Sligo. It is the type of person he is. He is a good neighbour and friend to many and, most importantly, a loving husband and father. As I speak tonight, Peter and his family desperately await access from the HSE to the only drug that can prolong his life. I am not here tonight asking for the impossible or for the impossible to be done for Peter. I am simply asking that he and other patients like him are given accurate and up-to-date information by the HSE after recent announcements as to when they can hope to access this drug. I am assured by the HSE that this is very close to being made available.

The Minister might recall that during May 2017, there was a positive update from the HSE on the provision of the drug for a number of different illnesses, bringing delight and happiness to many families nationwide. The head of customer services at the HSE indicated in a letter dated 18 July 2017 that the nivo drug had been approved by the HSE as being effective for advanced renal cell carcinoma. He stated that the HSE notified the Department of Health in July that it had completed its assessment of nivo for use in Hodgkin's lymphoma and advanced renal cell carcinoma. I have since learned the Department of Health has sanctioned the funding for this drug and a decision on its reimbursement will occur shortly. The Minister is aware the patient and family I mentioned need to know when the drug, announced as being effective by the HSE in May 2017 and which I am advised will be funded by the State, will be made available to Peter.

Minister for Health (Deputy Simon Harris)

I begin by thanking Deputy McLoughlin for raising this issue and constantly advocating on behalf of the people of Sligo and bringing forward concerns of importance to them regarding health services to my attention. I greatly appreciate that. As the Deputy very eloquently outlined, medicines play a vital role in improving the overall health of patients and securing access to new and innovative medicines in a timely manner is a key objective of both the Government and Irish health service. However, the challenge, as always in delivering on this objective, is to do so in an affordable and sustainable way. Under the community pharmacy schemes alone, over 70 million prescription items will be dispensed in 2017 at an estimated cost of approximately €1.7 billion, taking account of both fees and ingredient costs. In addition, the HSE will spend in excess of €500 million in 2017 on medicines through a range of other schemes in hospitals and in other care setting, including nursing homes.

Expenditure on medicines represents one of the largest areas of expenditure across the health service and will continue to grow in the years ahead as our health service continues to meet the needs of our citizens. In addition, the pipeline for new medicines is very strong and it is estimated that in the region of 45 new molecules are due to receive market authorisation in Europe each year over the next five years. Innovation by pharmaceutical companies is delivering treatments and in some cases cures for diseases that were previously untreatable. This is most welcome and can absolutely have a transformative impact on the health of patients. However, as I have stated previously, the cost some companies are seeking to charge for their medicines may result in a position not just in Ireland but globally where certain treatments may never become available to patients. This is not just an Irish phenomenon but one evident globally and we must find that spot where we can manage to purchase drugs and do so in a way that is affordable and means we can purchase many drugs that we wish to for our patients. That is why it is essential that Ireland has a scientific, robust and evidence-based assessment process in place, rather than one where the Minister makes the decision. The evidence should be followed closely and this ensures decisions on the reimbursement of medicine are made in an objective and scientific basis, recognising the health needs of our population.

The Health (Pricing and Supply of Medical Goods) Act 2013 provides the legal framework in Ireland for such a process. This Act gives full statutory powers to the HSE to assess and make decisions on the reimbursement of medicines, taking account of expert opinion as appropriate. The HSE follows the process set out in the Act passed by this House for the assessment of all drugs.

With regard to the specific treatments mentioned by Deputy McLoughlin, it is important to state, as I have outlined, that it is a matter for the HSE and not me or my Department, to make decisions on drugs. However, in certain circumstances, as the Deputy correctly outlines, where the HSE wishes to fund a treatment but does not have the resources to do so, it may inform my Department of its decisions. The HSE has received separate applications for the reimbursement of nivolumab for eight separate indications, including for use as a combination therapy. I am pleased to inform the Deputy that following an assessment by the HSE and consultation with the Department of Health regarding the funding implications, nivolumab has been approved by the HSE for the treatment of melanoma, renal cell carcinoma and Hodgkin's lymphoma. I understand the HSE expects the reimbursement of nivolumab for these indications to commence in the coming weeks. I know that is the information sought by the Deputy this evening. In addition, it is important to put on the record of the House that the HSE has decided not to support its use in the treatment of locally advanced or metastatic non-small cell lung cancer. The remaining applications are currently being considered in line with the decision making criteria and are at different stages of the assessment process.

I will be clear. Each of the conditions that my Department was informed of by the HSE and for which it sought reimbursement has now seen reimbursement agreed. The reimbursement for those conditions will take place in the coming weeks and patients should absolutely know that. On the floor of the Dáil I cannot determine any patient's clinical needs and that is a matter for doctors. I am clear in saying it is my responsibility to provide funding and ensure it is in place. In this case, the funding has been agreed with the HSE for nivo for those conditions and reimbursement will take place in the coming weeks.

Deputy Tony McLoughlin

I thank the Minister. In my comments and those of the Minister there was reference to timing, which is of the utmost importance. Time is of the essence. I spoke to Peter's wife earlier today. That man is in a private hospital currently and I cannot understand why the drug cannot be administered there. It has been approved by the HSE and time is most important. A special effort must be made for a number of patients in a similar position to that of Peter. It was stated the process would take some weeks and it might happen by the end of September. I appeal to the Minister to use his good office to ensure the timeframe will not be extended further in facilitating Peter's treatment with nivo. He and his concerned family desperately need it.

Many others have contacted me over the past number of weeks on behalf of the family. I am speaking about Peter this evening and I am sure many other families or people around the country are in a similar position, pleading for treatment like this Milne family in Sligo. It should happen as quickly as possible. I appeal to the Minister to use his good office and ensure we can reduce the timeframe as much as possible so the drug can be administered to this man and many others.

Deputy Simon Harris

I want to reassure Deputy McLoughlin and all patients that in so far as my Department has any role to play in terms of clarifying funding arrangements for drugs, it has discharged that in relation to nivolumab and eight other drugs in July. There is agreement between the HSE and my Department on the funding requirement for this and in that regard, the HSE has, in discharging its own legal responsibilities, now proceeded with the provision of nivolumab and eight other drugs and I expect that will be reimbursed in the coming weeks.

I cannot comment on individual cases for very obvious reasons, nor am I qualified to make decisions about individual patients' clinical needs. Obviously I send my best wishes to the constituent of Deputy McLoughlin and, indeed, any patient experiencing illness who wants to know about the availability of drugs.

There is an important point to be made in the context of the reference by the Deputy to private hospitals. The HSE provides drugs for the public health service. If a patient is in a private hospital or, indeed, with a private insurance company, it is a matter for the individual private hospital or insurance company to engage directly with drug manufacturers in the best interests of its customers and there is no need whatsoever for it to wait for the HSE reimbursement to have those conversations. There is absolutely no reason such engagement must await the HSE's finalisation of the reimbursement. That issue should be raised with private hospitals and insurance companies by public representatives. There is nothing to preclude a private entity making available a drug that is available in Ireland. It does not need to wait for the HSE to resolve the reimbursement situation. In such cases, it is important that hospital consultants and insurance companies should be clear and upfront with their patients that the availability of a treatment in the private facility is not decided by the HSE but is an individual decision that they could make in relation to their own facility.

In regard to public hospitals, the public health service and public patients, I want to assure people that nivolumab will now be funded by the HSE for the conditions I have outlined on the record of the House and will be reimbursed by the HSE. I expect that to take place in the coming weeks.

Dáil Éireann debate - Wednesday, 20 Sep 2017