Dáil Éireann debate -
Tuesday, 5 Mar 2019

Vol. 980 No. 4

Ceisteanna ó Cheannairí - Leaders' Questions

Deputy Micheál Martin

In January 2018 the Minister for Housing, Planning and Local Government, Deputy Eoghan Murphy, announced with great fanfare a Rebuilding Ireland home loan scheme which would be available to all local authorities as a solution for many people who were not in a position to secure finance to purchase a home. As we learned quickly and anyone with a busy constituency office would know, the scheme was extremely difficult to process, with many hurdles put in front of people and many delays. Far from four to six weeks, the process went on for months in many cases. At the time the Minister announced that a second fund would be created very quickly that would be demand-driven, given the overall state of the mortgage market, at a figure of €99 billion. He said it would be a demand-led scheme that would progress.

We learned this morning from Louise Byrne on the RTÉ "Morning Ireland" programme that in a briefing note to the Minister's press office the Department of Housing, Planning and Local Government stated it had been advised no further approvals should issue for now, that the Department was undertaking a review of the scheme and that the Departments of Public Expenditure and Reform and Finance were engaging on it. That was on 31 January this year and notwithstanding that Deputy Darragh O'Brien had tabled parliamentary questions about the issue and that Deputy O'Dea had been told in December by the Minister that he was progressing reforms to ensure the loan scheme could work for more people and more quickly. One month later he is advising his press office that no further approvals should issue.

I do not know what planet the Minister is living on, but the question I ask the Taoiseach is why was the scheme not extended. Why was there no public announcement to that effect?

If the Taoiseach tells his press office, surely the public deserves to know. Why was the Dáil not told in an upfront and honest way? Why is there this continuing lack of respect for the House in terms of being open, upfront and honest about what is going on with schemes of this kind? People are still applying, but no one save for the press office has been told that no further approvals will issue, according to RTÉ this morning following a freedom of information request. Why can the Government not just be honest with the people about these issues? Will the Taoiseach bring clarity to this situation? When will the scheme be extended and to what degree? The original limit was €200 million and the Minister alleged that 1,000 houses were to be accommodated. Approximately 1,550 applications, if not more, have been accepted. Will those people who have been approved be in a position to draw down their loans?

The Taoiseach

I thank the Deputy. This is a Government that believes in the view that everyone has the right to shelter and everyone should be able to aspire to buy his or her own home.

Deputy Timmy Dooley

In the meantime, the Government puts them in hotels.

The Taoiseach

We are a Government that is very committed to home ownership and that has taken many actions in recent years to assist people to buy their own homes.

Deputy Timmy Dooley

How is that working out?

Deputy Thomas Byrne

A non-practising believer.

The Taoiseach

Take, for example, the help-to-buy scheme, whereby people can get some of their income taxes back to help fund a deposit. So far, 10,000 people have used the help-to-buy scheme to help them get a deposit to buy their first homes. Ten thousand people today are living in homes that they were helped to buy by the help-to-buy scheme.

Deputy Timmy Dooley

That is a different scheme.

The Taoiseach

The Rebuilding Ireland home loan scheme is another way in which we are assisting people to buy their first homes. It is open to-----

Deputy Timmy Dooley

Fine Gaelers.

The Taoiseach

-----single people with an income of €50,000 or less and couples with an income of €75,000 or less where they have been refused a mortgage from the bank but could pay that mortgage back with this product because it is at a fixed low rate. It has been very popular. So far, 575 people have been helped with buying their first home with a Rebuilding Ireland home loan and a further 1,000 applicants have been approved but have not yet drawn down the funding. The scheme was initially limited at €200 million and that €200 million has been allocated, but as loans are not drawn down - they expire after six months if they are not drawn down - more finance does become available.

We now have to consider two things: whether we should increase the cap above €200 million, and that is under consideration by the Government, and we have to consult the Central Bank because this is a mortgage. It is a loan that is being offered to people who have been turned down by banks and building societies and it is at a reduced interest rate. We have to consider two things now: whether we should increase the €200 million cap and the need to consult the Central Bank as to whether it is comfortable with us offering more of these loans, taking into account the fact that it is a low-interest loan offered to people who were not able to get loans from commercial lenders.

Deputy Micheál Martin

When did the Taoiseach discover that the Government had to do those two things? The Minister said last year: "We are not going to wait for the fund to run out before we build up a second fund to allow a continuation of the scheme with whatever changes we might deem to be necessary". He said that there would be no issue here and he would continue with a second fund. He was saying that as late as December, when he stated in a parliamentary reply that he wanted more people and for them to be processed more quickly.

It is low-income people who are being let down again. Their hopes are raised with fanfare by the Government, but the dashing of those hopes is done silently. Why was what the Taoiseach just told the House not said by the Minister in his parliamentary reply? Why did the Minister not say that he was going to be approaching the Central Bank and that the Central Bank was going to place a limit on this? Why all the secrecy and silence around this? Why can the Government not just be upfront and straight with people about what it is doing instead of hoping that the problem will go away or that someone will not discover it?

An Ceann Comhairle

Time is up, Deputy, please.

Deputy Micheál Martin

The Government advises its own press office and tells no one else. We are all dealing with applications in our constituencies.

These are people who are desperate to buy homes. If they could get mortgages, they would be cheaper than the rents that they are paying. There have been higher rents for seven or eight years now and they could be paying much less if they could get a mortgage. They are all going through this charade, being asked for this note, that letter, and the other form. That is what is going on in the real world while the Government just prances about the place, going on about this and that. It is just not good enough.

The Taoiseach

While Deputy Martin is prancing about the place, wagging the finger and telling us off, we are actually doing things.

Deputy John Lahart

Doing what?

Deputy James Browne

Certainly not building houses.

Deputy Thomas Byrne

The Taoiseach is hoping for an election.

Deputy Dessie Ellis

The Deputies should not fall out with each other.

(Interruptions).

The Taoiseach

We are doing things in the real world that help people to buy their first homes. We have helped 10,000 people to buy their first home through the help-to-buy scheme.

Deputy Dara Calleary

There are 10,000 people in emergency accommodation.

Deputy Timmy Dooley

The Taoiseach should visit a hotel in the city one of these days.

The Taoiseach

We have helped 10,000 people. While Deputy Martin was wagging the finger, we actually did it for 10,000 people.

(Interruptions).

The Taoiseach

When it comes to the Rebuilding Ireland home loan, 575 people have been helped to buy their first home-----

Deputy John Lahart

What about the other 1,000 who have been approved?

The Taoiseach

-----and 1,000 more have been approved, many of whom will go on to buy a home.

Deputy Darragh O'Brien

Why did the Minister mislead the House on 19 February?

Minister for Housing, Planning and Local Government (Deputy Eoghan Murphy)

I did not mislead the House.

The Taoiseach

They have six months before the loan approval expires.

Deputy Micheál Martin

The Minister misled the House. He said he was going to extend it.

The Taoiseach

When the Rebuilding Ireland home loan was announced, we said that the scheme would be capped at €200 million and would run for three years.

(Interruptions).

Deputy Micheál Martin

That is wrong. He said that he was not going to wait for-----

The Taoiseach

Notwithstanding the fact that the Opposition has falsely claimed that it has failed, it has actually been a real success. There has been enormous uptake-----

Deputy Darragh O'Brien

The Minister misled the House on 19 February in an oral response.

Deputy Eoghan Murphy

I did not mislead the House. The Deputy can check the record.

Deputy Timmy Dooley

The Minister should put down his finger.

The Taoiseach

-----and we now need to do two things. First, we must consider whether we can lift the €200 million cap. We must find the finance for that, by the way.

Deputy Eoghan Murphy

The Deputy should be careful.

Deputy Darragh O'Brien

Why should I be careful? It is the Minister who needs to be careful.

The Taoiseach

The money will have to be found, as is always the case. Second, we must consult the Central Bank.

Deputy Thomas Byrne

All the Government is good for is high-vis jackets and hard hats. That is all.

(Interruptions).

Deputy Regina Doherty

The Deputies should calm their jets.

An Ceann Comhairle

Order, please, for Deputy Mary Lou McDonald.

Deputy Mary Lou McDonald

This morning the Society of St. Vincent de Paul published its Working, Parenting and Struggling report, which is an analysis of the employment and living conditions of one-parent families in Ireland. Its findings are an indictment of the Government's record on poverty prevention and alleviation among single parent families, many of whom are at work. The report finds that one in 11 working lone parents was living below the poverty line in 2012 but that number had jumped to one in five in 2017. The high cost of housing and childcare combined with low levels of income are making it impossible for families to make ends meet. The report finds that the living standards of lone parents in this State are among the worst in Europe. We have the second highest rate of income poverty, persistent poverty and severe deprivation among 15 other EU states. That is shocking. What is most shocking, however, is that the majority of one-parent families, the vast majority of whom are headed by women, are in work. These families are like others. They are people who get up at the crack of dawn but who still struggle and fail to meet their own and their families' basic needs. Our cost of living crisis is leaving hundreds of thousands of people struggling and living in fear of any extra financial burden like a car breaking down or a washing machine packing it in. These are people who work hard to provide for their families. They have a modest aspiration for a decent, happy life but they cannot plan for their future. How can they plan when they cannot make ends meet in the here and now?

Low pay, especially in the context of the soaring cost of living, is the real problem. Workers on low wages, in many cases in insecure employment, are being asked to find money to pay for extortionate rents, crazy insurance premia and crushing childcare costs. It is not good enough to brush all of this aside, as the Taoiseach does frequently, with the promise of a meagre tax relief at an ill-defined point in the future. These families do not need a handout but a hand up in the here and now. These are people who work and who want to continue working to give their families and their children a better life. What does the Taoiseach propose to do in the here and now to address the cost of living crisis that is crippling these families? When will he introduce a living wage?

The Taoiseach

At the best of times being a parent is an enormous challenge in having to provide for oneself and one's kids. It is particularly difficult for lone parents who do so without the support of a partner, without a second income and without someone to share in the burden, cost and time taken by childcare.

To answer the Deputy's question, we are helping all parents, but especially lone parents, to improve their living conditions by creating jobs. The number of lone parents who are working has increased. The rate of unemployment is down by almost two thirds and the Deputy will know that it is down again today. We are increasing welfare payments that had been cut back in the past. They are being restored with an increase kicking in to the one-parent family payment and the jobseeker's transition payment in a few weeks' time. We have introduced the working family payment to replace the family income supplement, which allows lone parents who are working to keep more of the money they earn and to have their income topped up so they can avoid poverty.

We have reduced the costs of childcare and we will further enhance that with the introduction of the affordable childcare scheme later in the year.

We are increasing pay. The minimum wage has increased and pay has been restored for people who are public servants. It is also increasing across the private sector. We are reducing the costs of medicines and prescription charges are being reduced. General practitioner, GP, visits, which are already free to all children under the age of six, will be extended to a further 100,000 people from April onwards. Those are the measures we are taking to reduce the costs of living, to assist lone parents into work and to ensure they have more money in their pockets.

We are also focusing very much on education. We have, for example, restored the costs of education grant, and as a result record numbers of people from non-traditional backgrounds are now participating in higher education.

I have immense respect for the Society of St. Vincent de Paul and have worked with it on many occasions; especially when I was the Minister for Social Protection, but I do not believe the report that was issued today tells the full picture. This morning I asked for the statistics from the Central Statistics Office, CSO, which collects the official statistics on poverty in Ireland. The CSO figures show that the consistent poverty rate - the official measure of poverty in Ireland - jumped from 18.4% in 2012 to 26.3% in 2013. Since 2013, however, for each of the past four years, consistent poverty and deprivation among lone parents has actually gone down. It fell to 23.1 % in 2014, there was a slight increase to 23.2% after that and then 20.7% in 2017. The most recent figures we have are for 2017 and they are less than those for 2013. This demonstrates that the policies we have implemented in helping people get back to work, helping them into education, improving welfare and reducing the costs of childcare are working. I predict that when we see the 2018 figures they will have improved again.

Deputy Mary Lou McDonald

The tone of the Taoiseach's response is not unexpected but it is almost depressing. The measures his Government is taking are clearly not working for hundreds of thousands of people across the State but in particular for those families headed by a lone parent.

The Irish Times carried a very interesting series on child poverty. If the Taoiseach has not read some of the articles I would recommend them to him. One of the articles compared the standard of living of a mother of two from the midlands with an appropriate counterpart living in another jurisdiction. The article made for incredible reading. The woman concerned is at work. Such are her struggles to ensure her family can get by that she rations the number of times the kids are allowed to boil the kettle. Can one imagine having to count the number of times that a family can boil a kettle in its house? I put it to the Taoiseach that this is how tight things are. Many of the interventions cited by the Taoiseach are, in effect, subsidies for low-pay employment.

An Ceann Comhairle

The Deputy's time is up.

Deputy Mary Lou McDonald

I am asking for additional time. I will not debate the ins and outs of parenting and the challenges of it, and I am not going to trade statistics with the Taoiseach. I will simply tell the Taoiseach something that he should already know, that is, more needs to be done because people are struggling and suffering.

An Ceann Comhairle

Please Deputy.

Deputy Mary Lou McDonald

What by way of addition is the Taoiseach going to do now about the cost of living crisis being experienced by families across the land? When will the living wage - not the minimum wage - be the floor and the basic income in this jurisdiction?

The Taoiseach

The reason the Deputy does not want to trade statistics is that she does not want to talk about facts.

Deputy Mary Lou McDonald

I want to talk about people.

The Taoiseach

No amount of individual stories, no matter how genuine they may be, will change the facts. It is a matter of fact that in each of the past four years, the rates of consistent poverty and deprivation have been falling in Ireland. Deprivation rates have fallen for lone parents and child poverty rates have fallen from 12.8% to 12.7% in 2014 and to 11.5% in 2015, 10.9% in 2016, and to 8.8%, which was one of the biggest falls, in 2018. They will fall again exactly because of the policies the Government is pursuing. There is more employment and-----

Deputy John Brady

Those in work are at risk of poverty.

The Taoiseach

-----better wages and better salaries. USC is being reduced and access to affordable and subsidised childcare is widening-----

Deputy Mary Lou McDonald

Which is sessional.

The Taoiseach

-----the cost of medicines is being reduced and we are capping rents. I accept that more needs to be done.

Deputy Pearse Doherty

What is it?

The Taoiseach

We are doing more and will continue to do more. On the Deputy's specific question, there is a living wage in the United Kingdom and in Northern Ireland, which is a place she will know well. That living wage is actually lower than our national minimum wage in Ireland. We have a minimum wage in Ireland which is the second highest in the western world. It is calculated independently by the Low Pay Commission.

Deputy Mary Lou McDonald

Does the Taoiseach have to restrict the number of times he boils his kettle?

The Taoiseach

Sinn Féin wants to change it in such as a way that it is calculated without any reference to employers. Sinn Féin wants to exclude small businesses from having any role in contributing to how the minimum wage is calculated. Sinn Féin wants to disregard the impact on the Border counties of a huge differential between minimum wages North and South. We have a minimum wage in Ireland, which is higher than the living wage in the UK and in Northern Ireland and it is calculated fairly.

Deputy Paul Murphy

I am sure the Taoiseach has heard about Greta Thunberg. She is the now 16 year old Swedish school student who started a worldwide movement of school student strikes and protests demanding action on climate change. At the Intergovernmental Panel on Climate Change, IPCC, conference in Poland, she stated:

For 25 years, countless people have come to the UN climate conferences begging our world leaders to stop emissions and clearly that has not worked as emissions continue to rise. So I will not beg the world leaders to care for our future. I will instead let them know change is coming whether they like it or not.

That urgency for action, that recognition that we cannot rely on convincing those in power to do what is necessary is absolutely correct. It is perhaps the reason the European Parliament groups to which Fine Gael and Fianna Fáil belong have blocked her from speaking to that assembly this week. The latest IPCC report warns that we have 12 years to avoid global warming growing over 1.5°C. After that, a further 0.5°C would have devastating consequences. Sea level rises would affect 10 million people, 99% of coral would be destroyed and many insects would be wiped out. The current level of commitments, which are not even being honoured, would still mean a rise in temperature of 3°C. In fact, given what is actually happening, we are heading towards a 4°C to 5°C increase in temperature, which will make large parts of the Earth uninhabitable. That is why young people have taken the lead. More than 300 cities have seen strikes by schoolchildren, while hundreds of thousands have come out on the streets in Belgium, the Netherlands, Australia, Sweden, Germany and elsewhere.

I note that 15 March has been named as the date for a global school student strike action. School students in Ireland will, hopefully, join that in large numbers. The contrast of those young people with the inaction of the world's leaders could not be starker. The contrast is stark not only with climate change deniers like Trump, but with those like the Taoiseach, who acknowledge that climate change exists and the role of human society in it but who do not want to do anything about it. As a result, Ireland is the second worst in the EU at meeting climate change targets. According to the Sustainable Energy Authority of Ireland, SEAI, today, Ireland is third worst in the EU at meeting renewable energy targets. The reason for this inaction is clear. Establishment politicians represent big business, including the 90 corporations responsible for 63% of cumulative global emissions and the oil, gas and big agribusiness companies pursuing the maximisation of profit. A mass movement on climate change is needed and the school students should be joined by others, in particular the trade unions, to demand investment in green jobs and a centrally-based eco-socialist programme to take control of the economy out of the hands of the polluters and profiteers and to place it under the democratic control of the public to enable the rapid just transition we need.

I have two questions for the Taoiseach. First, will he listen to school students when they strike on 15 March? Second, given that transport is the second largest emitting sector of the economy, will he agree that radical action is needed to get people out of cars, that the State should invest in properly funded public transport services and, furthermore, should make public transport free, as has happened in Estonia, Luxembourg and 100 cities around the world?

An Ceann Comhairle

The Deputy's time is up.

The Taoiseach

I thank the Deputy for raising the important issue of climate change. To reply to his first question, yes, of course, I will listen and I do. Second, we need to invest in public transport. One of the actions we are taking, for example, is that from the middle of this year Dublin Bus and Bus Éireann in the other cities-----

Deputy Michael Healy-Rae

Dublin again. Do not forget Dublin.

The Taoiseach

-----will no longer purchase high emission vehicles. They will all be no or low emission vehicles. As the Deputy is aware, we are implementing proposals for major investments in public transport through projects such as BusConnects, MetroLink and so forth, of which I hope he will be supportive.

I heard Greta's speech. The fact that young people are taking action, protesting and going to strike and take a break from school on 15 March is good. It is welcome. Unlike the Deputy, I do not see it as a party political matter. It is quite different and I have heard what they have said. These are young people who are standing up to adults. They are children, pupils and students telling all of the adults in all parties to get their act together and do more about climate change because it is their future that is in jeopardy. That is why I support what they are doing and we all must listen to what they are saying.

Among the people who must listen are those in socialist parties such as the Deputy's who are climate tax deniers and deny the fact that a carbon tax or climate charge must be part of the solution to climate change. We know that a carbon charge alone will not solve the problem of climate change, but we equally know and science tells us that without it we cannot achieve our objectives. It must be part of the solution.

Deputy Ruth Coppinger

Cut emissions.

The Taoiseach

That is why I ask the Deputy to listen to what the students are saying and why they say his policy on carbon charging is wrong. He should ask them what they think of it.

Deputy Paul Murphy

First, it is great that the Taoiseach supports the school students' strike on 15 March.

Deputy Ruth Coppinger

Brilliant.

Deputy Paul Murphy

School students across the country should take it as the green light to walk out next Friday week in protest against climate inaction. That is what the school students' strike is about.

(Interruptions).

An Ceann Comhairle

Order, please.

Deputy Paul Murphy

The Government has stated it supports them. If it is not to be a patronising pat on the back, it will support and defend the rights of the students who are protesting for their future and the future of humanity. I agree that it is not a narrow party political issue. However, the system and policies the Taoiseach defends are incompatible with dealing with the issue of climate change. An economy that continues to be based on the drive for profit of individual companies that treat nature and damage to it as an externality cannot deliver the rapid change needed. What is required is a democratically planned economy. That is why we need eco-socialist policies.

Second, using climate change as a green washing exercise to try to introduce more regressive taxation measures will not wash with people. They know that the polluters are the top companies which are responsible for 63% of emissions.

An Ceann Comhairle

The Deputy's time is up.

Deputy Paul Murphy

I return to the question I asked and ask the Taoiseach to answer it, as opposed to posing questions to me. Free public transport would have a major impact on emissions from the second biggest sector in the economy.

An Ceann Comhairle

The Deputy has made his point.

Deputy Paul Murphy

It would only cost €600 million, the same amount as the fines Ireland could be facing annually from next year. If the Government is serious about listening to students, will it give a commitment to invest in properly funded - properly paid and proper conditions for the workers - and free public transport?

The Taoiseach

No, we are not going to introduce free public transport. Many public transport services, particularly at peak times, are already operating at capacity; therefore, making public transport free would not enable any more people to use it.

Deputy Paul Murphy

Invest more in it.

Deputy Ruth Coppinger

They can stay in their cars.

The Taoiseach

Instead of using €600 million to make public transport free, we should use that €600 million to invest in public transport, to increase capacity, to have more buses and more trains more frequently, and to invest in rural public transport as well so that more people use it, not just so it becomes free. The solution to all our problems is not to tax everything and make it free. Rather, it is improving the quality of our services, including transport.

I will repeat what I said earlier. I am inspired and enthused by the fact that young people, students and school pupils are taking a real interest in climate action, that they are going to protest and that they are putting it up to all of us in all parties, and to all adults, to do more when it comes to climate action.

Deputy Ruth Coppinger

Why then is the Taoiseach not doing it?

The Taoiseach

I hear that and I am listening to it. I ask the Deputy to listen to it too because socialists are no friends of the environment. They opposed water metering and water charges and they now deny that a carbon tax is part of the solution to climate change. The Deputy should listen to students too and ask them what they think about water conservation-----

Deputy Ruth Coppinger

The Government missed all the targets.

The Taoiseach

-----what they think about carbon tax, and not tell them what socialists think they should think.

Deputy Ruth Coppinger

Did the Taoiseach not hear the news this morning? All of the targets were missed.

Deputy Michael Harty

I wish to question the Taoiseach on the lack of meaningful health reform in our health service. The consequences of not changing our model of care are plain to see. Fine Gael has been in power for eight years and this Government has been in power for the past three years. In those past three years, we have seen little or no health reform. In fact, the situation has deteriorated. The Taoiseach talks about health reform but he fails to implement what is glaringly obvious. Time is not in our side as demand for our health service continues to grow with our ageing population.

Sláintecare is now two years old. It still awaits transitional funding to trigger meaningful roll-out and delivery of better care to our patients. Sláintecare is stranded in the doldrums of inertia. There is much talk about implementation but no implementation. We cannot reform the health service from current spend. It is not possible. Specific independent, targeted funding is needed. Without this, Sláintecare will be just another report. Transitional funding is needed to shift the balance of care towards community care while at the same time delivering on unmet need. New models of data gathering, digital healthcare records and individual patient identifiers are essential so that we can gather data which will make meaningful progress in informing how we reform our health service.

The HSE service plan for 2019 indicates the HSE will struggle to maintain services at 2018 levels, which in themselves were inadequate, and will not deliver services as we require them in 2019. We still do not have multi-annual budgets. Without this, long-term planning is impossible. Unmet need will continue to grow as elective care will be limited by necessity. We will be providing only essential and urgent care in our hospitals. The expected increase in emergency admissions this year will diminish the ability to provide elective care.

Meeting current and future challenges within our service as it is currently designed is not sustainable. The service is facing extraordinary challenges and will need an extraordinary response. The capacity of our service is at maximum, with ever-increasing unmet need. Our hospitals are operating at 100% capacity which, internationally, is recognised as unsafe. We have a shortage of intensive care unit, ICU, beds, which limits elective care. We need 8,000 extra beds over the next ten years unless we engage in extraordinary health reform. Opening 200 beds this year is wholly inadequate. We educate our graduate nurses, doctors, consultants and general practitioners, GPs, for export. This feeds into inadequate quality in the services that we provide. The affect of this on our population is clear, with 100,000 people on trolleys, 70,000 awaiting elective care and 500,000 on waiting lists.

Will this be the legacy that this Government leaves behind? When will the Government deliver the extraordinary response that is needed to reform our health service?

The Taoiseach

I agree with the Deputy on the point that we need more health reform. I do not agree with his contention that health reform is not happening at all. I will give a few examples in response to some of the questions the Deputy raised. At the heart of Sláintecare is the view that health care should be affordable and that we should extend free GP care to more people and reduce the cost of accessing medicines.

That is happening. We have extended free GP care to all children under the age of six and all citizens over the age of 70, as well as to an extra 100,000 people based on income from April.

Deputy Brendan Howlin

That was all done by previous Governments.

The Taoiseach

In addition, we have reduced prescription charges and will do so again in the next couple of weeks. Sláintecare, which the Deputy advocates for and supports, recommends that we extend free GP care to an extra 500,000 people a year, that is, 500,000 this year, 1 million next year and 1.5 million the year after. I think that the Deputy's recommendation is a mistake because it is too fast. I do not think the capacity to increase free GP care as quickly as he advocates, that is, an extra 1 million in two years and an extra 2 million in four years, exists in our GP surgeries. I think he is mistaken in that regard, although I recognise that he is a strong advocate of the Sláintecare report.

We are also investing in primary care centres. There are now 120 primary care centres open throughout the country, while there were only 40 a few years ago. We have set aside a ten-year capital budget envelope for health, which is a multi-annual budget if ever there was one. It provides for €11 billion, which is double what it was for the past ten years. As a result, three new national hospitals are under construction, with one to go to tender quite soon.

There is investment in ICT. The medical laboratory information system, MedLIS, is now available almost across the board, allowing people to see blood results all over the place. There is also the picture archiving and communication system, PACS, and what replaced it in radiology, and there is the maternal health record, where women who attend maternity hospital now have electronic records which they did not in the past. We are introducing reforms such as a commissioning model, where the National Treatment Purchase Fund is used to commission operations and procedures, which is why the waiting times for those waiting more than three months for an operation or procedure has fallen for months.

We are increasing bed capacity, by 200 last year and approximately another 200 this year. I visited Clonmel the other day, where there is a new 40-bed unit under construction, while the Minister for Health recently gave approval for an extra 60 beds in Limerick. As a result, the number of patients on trolleys thus far this year, while still far too high, is at its lowest in four years, and let us hope that will continue.

The next large step is contractual reforms for GPs and we are in negotiations with the Irish Medical Organisation, having concluded talks with the nurses on a new contract for them. We are keen to get that done to provide additional resources for general practice, that is, not just additional money for doing the same things but rather for change, embracing medicines management and ICT, giving information that we need to plan our health services and providing new services, particularly in the field of chronic care.

Deputy Michael Harty

The Taoiseach referred to his and my discipline of general practice in respect of Sláintecare. As he will know, the continuation of financial emergency measures in the public interest, FEMPI, has devastated general practice and it will take years for general practice to recover. He referred to the expansion of primary care, which is an essential component of Sláintecare, and he was quite right that we cannot expand eligibility or services unless there is the manpower to do so. That is the very issue: we do not have the manpower in general practice to underpin Sláintecare. We do not have the capacity in general practice to supply the increased eligibility that the Taoiseach proposes and to expand the range of services if GPs are not available. We are losing GPs from our urban practices, not to mention from our rural practices, and we cannot recruit GPs to supply the extra services.

The Taoiseach has put the cart before the horse. If our health service is to be reformed, manpower in general practice needs to be expanded, which is the underpinning of Sláintecare. Unless we have an expansion of primary care, Sláintecare cannot progress. The Government is damaging general practice by the continuation of FEMPI and the failure to reverse it.

The Taoiseach

I followed with interest in recent days the debate about how moving towards multi-annual budgets would help us to improve our health services. I am broadly a supporter of multi-annual budgets, not just in the health service but across the board. Before there can be multi-annual budgets, however, one must demonstrate that one is able to keep within annual budgets. We already have a multi-annual budget in health, namely, a ten-year envelope for capital, but have the HSE and the health service managed to keep within that budget? Is there anyone in the House who believes that if there was multi-annual budgeting for current spending, the HSE, which has gone over budget every year for any number of years, would not also go over budget on its multi-annual budget?

I believe it would. It may burn up the money quicker than it does now and we have to take those concerns into account. We are training more general practitioners, GPs, have increased the number of training places and, thankfully, those training places are being filled. We are in negotiations with the Irish Medical Organisation, IMO, to restore funding for general practice and to link that to important reforms, including extending eligibility, moving to greater chronic care, medicines management and use of IT. Where I disagree with Deputy Harty in his strong advocacy for Sláintecare is that it is pretty unequivocal that it wants, as well as the 1 million people who already have free GP care, to have an extra 500,000 next year and 500,000 more after that. I think the Deputy is mistaken on that and that we need to do the other thing first.