The issue was raised with the Taoiseach by Deputies Lisa Chambers and John Curran on Tuesday. Deputy Lisa Chambers just hosted a meeting to which every Member of the House was invited, and there are several hundred people outside the front gate of Leinster House, so the matter should be on the Tánaiste's radar. I do not have to give him notice of questions I ask. He says he wants the best drugs available on the market. We want that too, and that is why we supported the initiative. Why, however, are we the only country in the initiative where this drug is not being made available? Why do children living in Belgium, the Netherlands, Luxembourg, Austria or at least 20 other countries have the future that is being denied to these 25 Irish children? It just does not make any sense. Biogen has submitted a new proposal to the HSE, which, as I said, is delaying a proper analysis. There is no time for delay. Families see the life-changing possibilities of this drug. They are being denied these possibilities by a bureaucracy that does not understand what it is like, a bureaucracy that should go out to the front gate, talk to these children, talk to Grace, Cillian and Sam, see how strong they are and how determined they are to live their lives and put the bureaucracy aside and put these children first.
Ceisteanna ó Cheannairí (Atógáil) - Leaders' Questions (Resumed)
I was not suggesting we change precedent and that the Deputy give me notice of questions. I am just saying I would have liked to have given him a more accurate answer. I am conscious of this issue. It is being considered by the HSE for approval right now but it needs to go through the process to ensure that the same procedures apply to this drug as to others. I am very familiar with the pressures that families are under while waiting for decisions such as this. That is why they come to Leinster House on days like today to try to push that process along. I hear that and I will speak to the Minister, Deputy Harris, who is not the decision-maker here. There is a process that needs to be gone through for a drugs approval. As I said, many other drugs have been approved through a similar system this year, and a decision will be made on this drug as soon as we can make it.
Yesterday, RTÉ aired a piece that can only be described as shocking about the provision of assessments of need for children with a disability.
Figures released by the HSE show that there are 3,850 children across the State with a disability or suspected disability who are overdue an assessment of needs. Children with signs of autism make up a large part of this number. The Tánaiste knows that under the Disability Act 2005, any child suspected of having a disability is eligible to apply for an assessment of needs to identify his or her health requirements. He will also know that such an assessment is legally required to be completed within six months of the making of the application. However, nearly 4,000 children are being denied this right. They are being failed by the health service and the Government. The parents of children who find themselves in this situation are at their wits' end. They are desperate to find out why their children are displaying such symptoms and for a diagnosis in order that their children can access the services they need.
They are not the only children who are being failed by the health service. Others are also being treated disgracefully. I want to talk to the Tánaiste about Sophia McGuinness. Sophia is 12 years old. She has scoliosis and cerebral palsy and has been waiting for surgery for almost a year and a half. On Tuesday her father, Aaron Daly, delivered a letter to the Tánaiste in which he outlined Sophia's case, in addition to the plight of another 188 children in need of spinal surgery. Sophia is one of more than 50 children who do not feature on the scoliosis waiting list because they have had their surgery suspended. Her father says the waiting lists are an exercise in manipulation. My colleague, Teachta Louise O'Reilly, recently met Sophia. It was heartbreaking. Sophia cannot speak, but she can communicate with her eyes using assistive technology. The first thing she said to Teachta Louise O'Reilly when she went to visit her in her home was "I am in pain." Children like Sophia are living in agony and their parents are exhausted from battling the system. They are worn out from fighting for their children's needs day in and day out. It is a battle they should not have to fight. No father should have to come to Leinster House to look for a meeting with the Minister. We all watched in horror last year when RTÉ aired its programme "Living on the List". It gave us an insight into the struggles faced by these children and their families on a daily basis. In the aftermath of that programme the Minister for Health, Deputy Simon Harris, offered an apology and made promises. Those promises have been broken again and again.
When is the Tánaiste going to do right by Sophia and the other 188 children who are waiting for spinal surgery? When will he do right by the 3,850 children who have a disability or suspected disability and are legally entitled to an assessment of needs but who are being failed by the State? Will he ensure Sophia's father who travelled to Leinster House on Tuesday to meet the Minister will have that meeting? Will he ensure the Minister will meet her father and listen to the agony, pain, trauma and upset the family have had to go through? The same is experienced by many other families in the State.
When I met Sophia's father on the way into Government Buildings on Tuesday, I spoke to him about the matter. I experienced some of the frustration which I am sure the Deputy has also experienced when speaking to him at the pressures he, his family and daughter are facing as a result of having to wait for surgery.
The long-term strategy to develop sustainable scoliosis services from 2018 has been prioritised by the Department of Health and the HSE in the 2018 HSE national service plan. An additional €9 million has been provided for the HSE in 2018 specifically to develop paediatric orthopaedic services, including further increasing access to scoliosis services. The Children's Hospital Group continues to progress the move towards implementation of a long-term, sustainable and safe paediatric orthopaedic service, including scoliosis services for children and young people. In July the group published the redesigned scoliosis ten-point action plan and an orthopaedic implementation group has been established to oversee its implementation. The action plan was developed with the participation of professionals, families and advocates. Importantly, it has ensured the voices of the children involved have been incorporated into it. The action plan contains commitments that the HSE and the Children's Hospital Group will, in 2018 and beyond, maintain the four-month target, which is international best practice for all patients who are clinically deemed to require surgery. In 2018 the Children's Hospital Group aims to deliver 447 procedures, compared to 321 in 2017 and 224 in 2016. The 2017 figure rises to 371 when 50 outsourced procedures are included. Activity levels to the end of August show that the Children's Hospital Group has delivered 279 surgeries, of which 135 were spinal fusions. Activity levels in the year to date are running slightly ahead of target.
Progress is being and will continue to be made. We will continue to put funding into these services, as necessary, in order to get back to where we need to be - a point at which we can meet international best practice standards in waiting times in order that we will not again hear the hugely emotive and difficult stories of Sophia and many other families who are traumatised and being damaged by the inability of the State to date to provide the services they should be expecting to receive.
As I said, Sophia does not appear on a list because, as her father said, the lists are a manipulation. As her surgery has been suspended, she does not appear in the figures the Tánaiste is presenting to the House.
I have not presented figures.
What is real is that Sophia and other children like her are in pain. They are in pain today and will be tomorrow until the surgery is provided. What we do know is that the Minister for Health, Deputy Simon Harris, gave a commitment in 2017 that no child would wait longer than four months for surgery. Sophia has been waiting in pain for a year and a half. We can collectively lift her pain if we make sure we will have a system that is fit for purpose and which will not allow children like her to go month after month living in pain and agony because of her condition. What assurances can the Tánaiste give to Sophia and the other 188 children who are waiting for spinal surgery? The Tánaiste did meet her father who wants to meet the Minister. Will the Tánaiste give a commitment that the Minister will do the right thing and meet him? He should not have to attend at the gates of Leinster House to try to flag down a Minister. I appreciate that the Tánaiste stopped for a moment to talk to him, but there are things that he wants to say and proposals that he has put forward. For example, he proposes the opening of theatres five days a week, up from three. He wants to ensure there will be intensive care unit beds available in order that his child can recover properly. These are measures that could be put in place, but the Government is failing the children concerned and breaking its promises. As all of this goes on, children are waking and suffering in pain.
I understand Sophia's family have a meeting in the hospital today.
They have just had it and there is no date for surgery.
I did not give figures for waiting lists, but I will. Waiting list figures at the end of August show that there are 188 patients on the waiting list for spinal surgery, of whom 109 are awaiting a spinal fusion. A total of 90 of the patients are actively waiting; 14 are come-ins, which means that they have a date for surgery; 40 have had surgery suspended; while 44 are on a planned procedure list. This represents a reduction from a figure of 299 last year, but it is still far too many. I am sure many of us in the House have worked with the families of children with scoliosis who need a spinal fusion procedure or rod extension, are waiting and should not be, given the fact that they are growing and need the extensions. I do not need to be told how difficult this is for families, with whom I have worked, as has the Deputy. What we need is a system that can provide services for all families in a much more effective and timely manner than is the case. The Minister for Health is setting about doing this and prioritising it in terms of a policy change and financial commitment.
It is at this time of year that the Government and individual Ministers start flying kites about what might appear in the budget.
One kite floated in the newspapers this week was that the Minister for Finance, Deputy Donohoe, is considering a capital gains tax break to charge less than half of the regular amount in tax due on the sales or development of vacant property. During the mismanagement of the economy in the 2000s, our tax system became riddled with special exemptions and inducements to private developers. It narrowed and weakened our tax base which collapsed in 2008. Tax revenue fell by 30% which is not normal in any developed economy, yet the Minister for Finance seems prepared to again consider the same failed strategy. He should not.
A second flaw in this approach is that tax breaks create perverse incentives. Instead of business investing on the basis of developing goods and services to meet people's needs in our society, tax breaks drive money to be invested in a tax product which offers the best return. We saw the results of this in poorly planned and poorly constructed buildings right throughout the Celtic tiger period.
The third problem with the Minister's approach, as published, is that it is all carrot and no stick. After 15 years of a prolonged housing boom from the 1990s, we still had a situation with trees growing out of crumbling derelict buildings all around our towns and city centres. This is only possible if it is more profitable to hoard land and to release properties and land slowly, one site at a time, to maximise speculative gain. There is no penalty for the owners of properties from doing just that.
The only way to end land hoarding and speculation is to introduce taxes and duties on property owners. All over Europe, social democratic market economies place stringent requirements on property owners to maintain and develop their properties. Put simply, owners of vacant property should use it or lose it. People's urgent need for housing cannot wait. Any serious economic analysis quickly reveals that tax breaks are the wrong way to boost housing supply. That was the failed strategy of the past.
Will the Tánaiste confirm that property tax breaks will not be proposed in the upcoming budget in order that we do not repeat the failed and disastrous policies of the past?
As the Deputy well knows, as a former Minister for Public Expenditure and Reform, the debate around the choices for a budget generally happen around budget day. There are all sorts of speculation and kite flying, mainly not from Ministers but from other people trying to provoke a response from the Government to get an idea what is and is not going to happen on budget day. I suspect this is another example of that.
Undoubtedly, the budget will be focused on housing and trying to help increase supply. The Government has committed a significant amount of capital resources to driving supply, and it is working. We have changed the planning system, and it is working. We have changed our approach towards student accommodation, and it is working. We are seeing a dramatic increase in supply of all types of housing, namely, affordable, social, student and others. That needs to continue and to accelerate to deal with the housing crisis and pressures that we have.
That goes for vacant sites and properties too. That is why we are introducing a vacant site levy which will increase after the first year. It will be a real driver to ensure sites are not purchased to be held on to for the medium term in a speculative way but, instead, will be used to deliver housing. I will not confirm or deny any decisions the Minister for Finance will propose to Cabinet. I certainly have not had any discussion on the issue that the Deputy raised. I suspect there will be much debate and speculation in advance of budget day. I am confident we have a Minister for Finance who is cautious, informed and will not do anything that would damage the property market but will, instead, focus on sustainable ways of increasing supply at the pace we need.
The Tánaiste is correct that I have experience of the run-up to budgets over time. It is my experience that Ministers do test run proposals to see how they will fly. We all have experience of that. When I see a particular proposal attached to a particular Minister's name, I know what it is, namely, test flying.
We need to be clear. If this budget is to be about housing, it cannot be about the policy platforms which delivered an economic collapse. The solution to housing we can debate separately but it is largely a question of supply. The Government has suggested giving public lands, which we had to defend to keep in public ownership in the past, to private developers and an approach whereby 60% of the housing will be, by definition, unaffordable if only 40% is going to be affordable. This is the wrong way to go. If that is to be compounded by giving further tax incentives and tax breaks to the developers, then we have learned nothing over the decade of economic collapse. Will the Tánaiste express his own view that this is not the way to go?
We have learned much over the past seven years. The Deputy will remember much of the debates and the hard decisions which needed to be made in difficult circumstances in the build-up to budgets, particularly five, six and seven years ago when he, as then Minister for Public Expenditure and Reform, had to make difficult choices. I am glad to say we are not in that situation any longer but we still have choices to make because we still have challenges. While the economy has recovered, society has significant pressures. Housing is one of those issues and health reform is another. We have other issues to which we need to respond in this budget, namely, Brexit and the challenges it poses.
The Government has learned the lessons of some of the policy mistakes of the past, especially those linked to property. We will not be repeating them.
In response to the unprecedented housing crisis which we are experiencing, I believe we are seeing the emergence of a grassroots campaign with large numbers of people increasingly saying enough is enough about the Government's failure to address this most basic issue. The Irish Congress of Trade Unions is spearheading the Raise the Roof campaign, which is supported by many housing charities, non-governmental organisations, NGOs, and several Opposition parties. In addition to that, over recent weeks we have seen a great number of young people mobilised under the banner of "Take Back the City". These are people who were protesting about the large volume of empty properties that we have in Dublin and in other cities.
These are predominantly young people who can be described as the locked-out generation. They are locked-out of the prospect of having independent housing, whether to rent or to buy. This young generation finds it impossible to access housing. Rents nationally are now 27% above the boom-time high. In Dublin, rent for a one-bedroom apartment, for example, for a single person represents over 50% of their take-home pay. It is entirely unsustainable. This is where much of the pressure is coming from for wage increases and the complaints about the cost of living. People simply cannot afford housing any longer and they certainly cannot afford rent. We are now in a never-ending upward spiral when it comes to rent. It seems the Government's measures to date have largely been ineffective.
As well as the unaffordability of rent, this crisis is in turn having two other major impacts. It is clearly driving the homelessness crisis. It also means homeownership is largely unattainable due to the impossibility of saving while paying high rents, especially in a situation where so much housing is completely overpriced. Earlier this week the Social Democrats called for an emergency two-year rent freeze.
We believe that this would at least stop the spiral but the Government has rejected this proposal. At a time when the availability of rental properties is at an all-time low, it is galling for people to get this kind of weak response from Government. Why will it not consider, as an emergency measure, introducing a freeze on rents so that there would be at least a bit of breathing space to allow some other measures to kick in? Can the Tánaiste explain his thinking in this regard and what exactly is his argument against a rent freeze?
The Deputy has raised a lot of questions there and I would like to spend a lot of time answering them because this is a brief with which I am very familiar and in which I am still very involved. To answer her direct question regarding a rent freeze, I do not think it is a good idea, not because I do not want to introduce measures that provide relief for renters but because the core of the problem is a lack of supply. We looked at this issue when I was the Minister with responsibility for housing and we decided, for the first time in the history of the State, effectively to introduce rent caps in Ireland, which now apply to about 65% of all rental properties in the country, whereby there is a limit of no more than 4% of a rent increase per year linked to those properties enforced by the system. We went through a long consultation process with all stakeholders listening to people who were under pressure in terms of their rent but also listening to people who want to invest in the rental market to provide more rental properties. We should not be making short-term decisions now that seem popular but which actually contribute significantly to limiting supply. Instead we need an appropriate response where rents are high to keep a cap on rental inflation, which is what is happening with rent pressure zones. That is getting the balance right between ensuring that while we build much more social and affordable housing and while the private sector also delivers much more housing, including affordable housing, we continue to see that momentum for supply growth and that we do not shut it off by introducing dramatic measures that will undermine the confidence in the willingness to invest in the property market.
The Deputy is now calling for a rent freeze across the country even in parts of it where rents are not particularly high. We need to target areas where there is real heat and pressure. That is what rent pressure zones and the criteria relating to them do and we know that it is working from the statistics. The real problem in this market is supply. We are addressing the supply issue but it is going to take some time because we cannot build houses overnight. We need to protect renters as we are doing and as we will continue to do while the pressure is as it is, but we also need to ensure we deal with the supply challenge because, ultimately, that is the solution.
Supply is an important issue but what the Government is completely ignoring is the issue of affordability. There are measures available to it to address the issue of affordability but, unfortunately, it is dodging those because it is too reliant on the market and is not prepared to intervene to the extent that it will make a real difference in people's lives. The Tánaiste, as the person who introduced the rent caps and rent pressure zones, knows perfectly well that they are of limited effect. They do not apply right around the country. In Limerick, for example, rents went up by 21% last year alone. In Waterford they went up by 19%. The Tánaiste knows there are plenty of loopholes in those measures which enable landlords to dodge their responsibilities. They are not effective in the way that I believe he intended and he should face the reality that they are not effective.
The Tánaiste also talked about the willingness to invest. There is not a willingness on the part of many developers to invest because they are sitting on landbanks waiting for prices to go up further, aided and abetted by the Government. The Tánaiste knows that rent pressure measures are not working. The derelict sites register is at a meaningless 33% in terms of vacant properties. The vacant site levy, introduced by Deputy Kelly when he was Minister, is not effective. In a situation where property values are going up so much and house prices are going up by 10%, what difference does a 3% levy make? It is time for meaningful action and less of the talk.
It is time for action and less talk and that is why we are implementing the Rebuilding Ireland plan, which is a five-year housing plan that is working. The Deputy said the vacant site levy is not working but that has only just started. It does not work overnight.
Exactly. Why was it not brought in a few years ago?
We cannot retrospectively correct things from two years ago. We are setting about-----
It is all a softly, softly approach with the Tánaiste.
Will the Deputy allow the Tánaiste to respond?
The Deputy does not want to hear the answers - that is the problem - because she wants to keep talking about the problems. The Government recognises that there are huge pressures on the housing market and that is impacting on families right across the country but, in particular, in Dublin, Cork, Limerick, Galway and Waterford and in other areas. We are setting about fixing those. There are specific responses around homelessness that are getting more and more money and resources, and that is what is needed, and a change in policy shifting towards Housing First models and so on, which we know are working.
Affordability is the issue.
Five thousand people were taken out of homelessness last year. We know that 7,000 new social housing units were added to the market last year. It will be 8,000 this year and 10,000 and 12,000 in the years ahead.
What is the Government doing about the issue of affordability?
We know that last year 14,500 new homes were built in Ireland. This year it will be over 20,000. Two years ago that figure was less than 10,000, so we are moving in the right direction.
Rents are going up.
While the transition is happening we need to protect renters, in particular, and people who need affordable properties-----
Rents and house prices are going up.
Which is why we have changed the rental market but the Deputy does not want to recognise progress because she wants to keep talking about problems.
Affordability is the issue that the Tánaiste is ignoring.
It is not, supply is.
If the Members want to have a chat about the matter, can they do so afterwards.