Saincheisteanna Tráthúla - Topical Issue Debate

Public Transport Provision

I thank the Minister, Deputy Ross, for coming to the House to respond to the issue I raise. As the Ceann Comhairle said, I wish to deal with issues concerning public transport, in particular in north Kildare. Public transport is socially inclusive. Negotiating traffic in Dublin for car users is becoming increasingly impossible. We need a service that is regular and reliable for the public to engage with and to use. We need sustainable modes of transport. The Government should highlight the environmental benefit of public transport. If we have a regular and reliable service, people will use it. Greater tax relief must be provided through the taxsaver commuter ticket scheme. Dublin fares poorly in terms of traffic congestion when it comes to our European counterparts. It was rated among the worst in a new global report. Improving public transport is the best way to address the issue as, currently, Dublin is an unfriendly place to drive due to congestion.

The commuter belts need better public transport. That includes Kildare North, which I represent, and the need for facilities such as park and ride services. We fought hard to get a park and ride service in Kilcock, which is working very well. I was instrumental in delivering that. However, Kilcock needs a better bus and rail service. It does not have a reliable bus and rail service and the town is expanding. We need greater focus on that and there must be improvements in that area.

Maynooth and Kildare rail services, which service Hazelhatch and Sallins, also need extra capacity. There is a growing requirement for extra capacity, and with the current housing developments and future planned housing, extra capacity must be provided. Currently, those trains are leaving people on the platforms in the morning.

The need for orbital bus routes linking villages such as Straffan, Ardclough and Clane to Dublin Bus, Bus Éireann and Irish Rail services is critical. About a year ago, I was involved in implementing and advocating for the 139 orbital service, which connects Naas all the way to Blanchardstown via Sallins, Clane, Rathcoffey, Maynooth and Leixlip. That service is working exceptionally well and has proven to be a success. That is the reason we need more of those type of services connecting to the main services.

The BusConnects proposal is generally acceptable. However, it is proposed that Riverforest in Leixlip will lose a direct service to Dublin. That is not the way to encourage people to use public transport. BusConnects should be about adding to the current services to supplement and complement them, not removing existing services. For example, the BusConnects proposal on the W8 route, which connects Maynooth, a university town, and Celbridge, which together have a population of more than 50,000 people, to Tallaght, needs to be implemented as a priority. That route connects important services such as hospitals, colleges and the Luas lines. We need those services as quickly as possible. The 259 service connects Celbridge and Leixlip, another populated area of more than 40,000 people.

Celbridge has a population of 22,000. It does not have a direct service to Dublin. The 67X service runs in the morning and in the afternoon. All of those are at capacity. I have met Dublin Bus representatives on that and what is needed is two additional services to the morning and evening 67X service. Currently, people are being left behind. The last 67X going to Celbridge leaves Dublin at 5.50 in the evening, which is far too early. The 67, which services Celbridge, also services Lucan and Chapelizod. The problem that arises in that respect is that when the buses are leaving town, the people from Celbridge cannot get on them, and when they leave Chapelizod and Lucan they are only half full. They are serviced by other bus services but, unfortunately, the Celbridge people are left on the footpath at the bus stops because they cannot get on those buses. When they are leaving Lucan, they have capacity but that is no good to the people who are left behind. As a result, people are late for appointments, whether it be college, work, medical appointments or whatever, and it is causing major issues.

I thank the Deputy for raising this matter, which I know is very important. I acknowledge the fact that he is a superb advocate for the Celbridge area. He has constantly been making representations, not just about transport but about other requirements for his area, which have been effective. I propose to outline some of the benefits that have arisen recently for the Celbridge area, particularly in terms of BusConnects.

As the Deputy will be aware, the National Transport Authority, NTA, has statutory responsibility for the planning and delivery of transport infrastructure and services in the greater Dublin area including Kildare. The NTA’s Greater Dublin Area Transport Strategy 2016-2035 provides the overarching framework for the planning and delivery of transport infrastructure and services in the greater Dublin area, GDA, over the next two decades. The strategy sets out an ambitious range of improvements across the area of bus and heavy rail. These improvements include the establishment of a combined core bus network, new bus station facilities to provide for intercity and regional buses which serve Dublin city centre, continual replacement and upgrading of the bus fleet, the DART expansion programme which will see the DART system expanded providing fast, high-frequency electrified services to Hazelhatch on the Kildare line and Maynooth on the Maynooth-Sligo line, and the Phoenix Park tunnel link, which connects to the Maynooth line and links Heuston and Connolly stations. We are now trying to implement that strategy. That is the reason I secured the funding allocations under Project Ireland 2040 to allow for its implementation over the next ten years. For 2019, the capital allocation has increased by €1.325 billion or just over 22% above the 2018 allocation.

Project Ireland 2040 confirmed BusConnects as one of a number of key investment priorities to deliver a comprehensive public transport network over the next decade. BusConnects will improve bus journey times that will benefit many millions of passenger journeys per year, provide a bus service that is easier to use and understand, enable more people to travel by bus than ever before, and provide a network of cycling infrastructure that will enable more people to cycle across the city. As the Deputy is aware, the NTA launched a public consultation last summer on the proposed redesign of the bus network in the GDA. By the time the consultation closed at the end of September, more than 30,000 submissions had been received. The NTA will publish revised proposals later this year taking into account the views expressed in all of those submissions.

The proposals included extensive changes to the routes serving Celbridge, including ten-minute peak time services on the proposed C4 route that would continue into Leixlip, and a peak period route 324 providing a frequent express service from Celbridge to southern parts of the city centre and University College Dublin. Celbridge is a main beneficiary of the new orbital route, W8, from Maynooth to Tallaght, which operates every 30 minutes all day. Finally, outer parts of Celbridge will be served by a new local route to which the Deputy referred, the 259, which would feed every 30 minutes into Hazelhatch-Celbridge station at the south end and Leixlip Confey station at the north end.

The interchange with the rail network will be of huge benefit to Celbridge residents as the enhancements to the heavy rail system provided for in the NTA’s transport strategy will create an integrated rail network which will provide the core high-capacity transit system for the region and will deliver a very substantial increase in peak hour capacity on all lines from Drogheda, Maynooth, Hazelhatch-Celbridge and Greystones. The electrification of the line to Hazelhatch-Celbridge and remaining infrastructure to complete the link of the Kildare commuter route to the city centre will be delivered as part of the DART expansion programme as envisaged in the national development plan, NDP.

I thank the Minister. I acknowledge, as I did in my original contribution, that we agree with much of what is contained in the BusConnects proposal but the problem for a town like Celbridge is that it cannot wait until BusConnects delivers on that. There has to be some intervention in the interim. I have met the NTA and Dublin Bus representatives and the reality is that because Celbridge has a population of 22,000 and there is so much development happening in that area, on the 67X service people are being left at bus stops in the morning. What is needed to deal with that issue now are two additional Xs in the morning and in the evening servicing Celbridge and then leaving Dublin a little later. If we have to wait for BusConnects, which I am aware through public consultation is coming out in June, this problem will get out of control because it is already very difficult for people and, as a result, they are not using public transport because of the problems I have outlined.

The Minister said the 67 service will be replaced by the C4. The problem with that is that it is going into Leixlip and Lucan, therefore reducing the direct service from Celbridge to Dublin. When that bus is returning, unfortunately, Celbridge people cannot get on that bus to come home whereas the buses servicing Lucan and Leixlip have other services available to them. People travelling to Lucan, Chapelizod or Leixlip have three or four options whereas Celbridge has only one, so if a person does not get on that service, he or she does not get there. Our proposals to the NTA and Dublin Bus and through the BusConnects system was that every alternative 67, or C4, would go direct from Celbridge to Dublin and then every second one would go in via Lucan and Chapelizod. That needs to happen to have an immediate impact to try to deal with the problem.

I have acknowledged that the W8 and the 259 the Minister mentioned are positive developments but they need to be implemented as soon as possible. Waiting for that to happen until after the BusConnects proposal is approved, which will be much later this year, is way too late. This is a problem now. We are at capacity, there are major issues, and we would appreciate the Minister's intervention. Is it possible for the Minister to have a meeting with the NTA and Dublin Bus to discuss these issues and come up with practical solutions to try to deal with the current stalemate?

I understand what the Deputy is saying and the fact that he is making a special plea for Celbridge. As he correctly said, there are major problems with congestion in Dublin traffic and Celbridge suffers as a result. However, it should be acknowledged that we are making great strides. We are making enormous commitments to sorting out the problem of traffic in Dublin and the suburbs. While BusConnects might be imperfect in some ways, as it will not suit everybody in every way, it will increase the frequency of public transport coming into the city centre. It is not just the orbital routes that will improve it but also the new bus corridors. In almost all cases that will be accompanied by 200 km of dedicated cycling lanes, which will obviously accommodate some of the people the Deputy mentioned who are currently not able to get onto some of the buses in his area.

It must be acknowledged that there have been great improvements, and not just in rail, Luas cross city, cycling and BusConnects. The Deputy should acknowledge, and I do not take away from the fact that he has been lobbying on its behalf, that there have been great improvements in the routes serving Celbridge. The ten-minute peak times is one. The orbital routes will also benefit Celbridge, as will the interchange with the rail network. In the long term, the electrification of the line to Hazelhatch will benefit the Celbridge area. I understand what the Deputy is saying but, to be honest, the area is not doing badly. The Deputy should claim some of the credit for that as he has been a thorn in my side, or a great asset to his area, for a long period of time. Perhaps he should now sit back and say to people, "Look at what we have got. We are doing quite well".

I am sure that message will be transmitted to the citizens of north Kildare.

Bus Services

Thank you, a Cheann Comhairle, for the opportunity to raise the important issue of the replacement of bus services that are urgently required in County Laois. I am speaking on behalf of the people of Mountrath, Castletown, Pike of Rushall and Borris-in-Ossory, who rely each day on the JJ Kavanagh & Sons bus service.

People received shocking news last week when they were told that from next Tuesday, 16 April, JJ Kavanagh & Sons will be withdrawing from the route through those towns. There are eight buses travelling in each direction each day and JJ Kavanagh & Sons has provided an excellent service over the years. However, the company has made a commercial decision and people are very disappointed. People use these services to go to work in the morning and return home at night, to do their shopping and daily business in Portlaoise and to go to hospital and medical appointments. Students use them to get to third level colleges. Other people use them to see their family and friends. Many people plan their lives around the public transport bus services and, as public representatives, we are here to serve those people. To put it in context, this is the Dublin to Limerick return route and the people in Moneygall, Toomyvara and Birdhill are also impacted by this decision. However, the people in Laois are primarily affected. JJ Kavanagh & Sons wishes to operate mainly on the motorway and to skip all the local towns because it says it is losing business on the motorway routes if it is taking the longer route through those small towns.

The issue is that a replacement service is required when this service is withdrawn next Tuesday. An application was made to the National Transport Authority and it approved the change of licence. It did not have much choice in the matter, but obviously it has known about this for some time although the news only broke locally a few days ago. The authority has had ample time to ensure a replacement service is put in place. I will quote from what appears to be a very good press release from the authority last Friday, and I hope it will deliver on the good intentions contained in it. That is all we want. I have no wish to have an argy-bargy on this, just to have confirmation before the Dáil gets up tomorrow that there will be a replacement service. The NTA stated "where commercial operators withdraw or curtail services, the Authority examines whether, in the absence of any commercial services, a public service obligation (PSO) exists to provide socially necessary but commercially unviable public transport services". The authority has examined this as a result of the change in the licence, which it would have known about as it has been dealing with the application. It stated "The Authority has completed an examination of the affected locations and has determined that there is in fact a requirement to continue to provide services to meet the social need."

According to the statement, funding is not an issue, there is a local service requirement, there is a public service obligation and it must provide for that. To that end it has been engaging locally with Bus Éireann, Local Link in Tipperary and Local Link in Laois with a view to providing solutions for customers next week. I also received an email from the chief executive of the National Transport Authority in which she said that the NTA is doing this with a view to providing solutions for bus customers at local level both in the short and long term. People understand that to mean that next week there will be a short-term solution until a new procurement process is put in place for a long-term arrangement with another local operator. That is what we seek - a seamless transition. We understand JJ Kavanagh & Sons is leaving the route, but people will need a subsidised PSO service. Everybody agrees that should happen but I hope the Minister will be able to confirm that it is in place for next Tuesday. There is a willingness on the part of the NTA to do it but we must ensure it happens seamlessly from next Tuesday.

As Minister for Transport, Tourism and Sport I have responsibility for policy and overall funding in respect of public transport. I am not involved in the day-to-day operations of public transport. The operation of bus services is a matter for the transport operators with oversight by the NTA.

Route 735, the bus service to which the Deputy refers, is a commercial service which operates between Dublin Airport, Dublin city and Limerick and is licensed by the NTA. Licences set out the nature of the service and conditions under which a licensed public bus passenger service must operate, such as the point of origin and destination, as well as a detailed timetable and stopping places. By their nature, commercial services cannot and do not receive any PSO funding from the Exchequer. All commercial bus operators will only provide services where it is commercially advantageous for them to do so and are free to pull out or curtail their services. Where operators pull out or curtail commercial bus services, the NTA will grant such amendments as it has no legislative powers to refuse.

Under the terms of the new licence, the private company, JJ Kavanagh & Sons, will only serve Portlaoise, Roscrea and Nenagh from April 16. It will no longer serve Borris-in-Ossory, Mountrath, Castletown or the Pike of Rushall in County Laois. I understand that the NTA has arranged a briefing on this issue with Deputies from Limerick, Laois, Offaly and Tipperary at 12.30 p.m. on Thursday in Leinster House. I am sure the Deputy will be there as I am sure he was instrumental in arranging it. I will not anticipate what will happen at the meeting but presumably it is being held to be constructive.

In circumstances where commercial operators withdraw or curtail services, the authority examines whether, in the absence of any commercial services, a PSO exists to provide socially necessary but commercially unviable public transport services. Such examination includes an assessment of the demand for public transport services and options to either reconfigure existing PSO services or to competitively tender for the provision of services. In either event, the NTA's ability to provide such services is subject to the availability of funding, which, as the Deputy noted, is not an issue in this case. To that end, the NTA is already engaging with Bus Éireann, Local Link in Tipperary and Local Link in Laois with a view to providing solutions for bus customers at local level, both in the short term and the long term. Timetables of services are currently being drawn up with the aim of not only meeting the social need but also improving levels of service to a wider area.

The Government is acutely aware of concerns about the proposed withdrawal of certain commercial services in rural areas. The reality is that commercial operators are continuing to take advantage of the major improvements to the national roads network in order to offer improved journey times between Dublin and regional cities by providing more direct services with fewer intermediate stops. The NTA has a key role to play in assessing, within available funding, the appropriate response to changes in services that have an impact in rural areas. The NTA has contracted for the provision of bus services for commercially unviable but socially necessary services in rural areas. As a general principle, PSO funding for all public transport should be allocated to ensure that socially necessary services, particularly in rural areas, are provided to the greatest extent possible.

I thank the Minister for his reply, which is substantially along the lines I indicated arising from my direct contact with the NTA since last Friday.

I asked it to arrange a briefing session in Leinster House for tomorrow morning, which it agreed to do. I have notified the Deputies in all of the counties affected by the decision to be present. We hope it will be constructive and have a good outcome to enable us to get on with the rest of our lives. Nobody wants to see a gap in service and it would be dreadful if there was to be a gap for a day or a week or two. People will completely believe the plug has been pulled on small towns and villages. That is avoidable. Whatever has to be done to ensure a replacement service next week will, I hope, be done. As the Minister indicated, there have been contacts with local operators, including Bus Éireann and Local Link services. There is a good town link service running along part of the route and other private operators who could enter the fray might perhaps tender to operate a service on a long-term basis. What we need is a short-term measure to be in place from next Tuesday and to last probably for a couple of months. When the timetables are agreed to, the contract will have to be put out to tender. Tenders will have to be assessed and approval given to whichever organisation wins to commence its service and advertise accordingly. This process will inevitably take a number of months to complete. We need to get over the hump between now and then to ensure there will be continuity of service.

This issue does not just concern people in County Laois, whether in Mountrath, Castletown or Borris-in-Ossory, who travel to and from Roscrea regularly; it also affects people in County Tipperary and north Offaly in some measure. The service may have to cover the full route from Nenagh to Roscrea on what was the old N7 to Portlaoise, now that the motorway, as the Minister pointed out, is attracting intercity bus services.

I also make a plea which I will repeat tomorrow for good weekend and Sunday services. Kavanagh's bus services were available seven days a week. Some of the Local Link services only offer a five or six-day service. We also need a Sunday service to facilitate those attending college.

My final point is that there will be long-term implications. From now on people will not be able to take a bus directly from Mountrath to Dublin. One will have to take the bus to Portlaoise to link with the ample number of hourly services from Portlaoise to Dublin.

It is fair to say the Deputy has made a compelling case, but he would not expect me to give a commitment in respect of a specific route and times. He understands fully that I cannot and would not do so, as it is up to the NTA to decide that matter, but it is clear from what I said and have gathered from what has been happening in this area that the Deputy is pushing an open door. I support his sentiments. There is a real reluctance on our part to see routes in rural Ireland deteriorate or diminish in any way. I want to make that point absolutely clear.

Despite the narrative which is often peddled in this House, the Government is very committed to providing increased and better transport services in rural Ireland. One has only to look at the funding provided for Local Link services which has been increasing since 2016. With €14.9 million allocated in 2018 and again in 2019, there is additional public service obligation, PSO, funding provided for regular Local Link services. It amounted to €4.5 million in 2018, bringing total funding for Local Link services to €19.5 million. The total in 2019 will be almost €20 million. It represents a significant increase on the 2016 allocation of €12.2 million and in 2017 of €14.4 million. The increased funding has enabled the introduction of 66 new commuter services in the Local Link network since 2016, operating five, six or seven days a week. Key features of the new services include greater integration with existing public transport services and better linkage of services between and within towns and villages. Demand-responsive services continued to be developed nationally throughout 2018 in response to local needs.

I wish the Deputy well in his mission tomorrow when he can certainly say I have expressed support so as not in any way to infringe on or hinder the progress of public transport services in rural Ireland.

Autism Support Services

I raise with the Minister of State the issue of a centre in Dromavalla, Ballyseedy, County Kerry. It was furnished and officially opened in 2014 since when it has sat idle. No resident has moved into it. The project was spearheaded by Jim and Patricia Adams who, with many others and supported by various agencies, raised €1.3 million to allow it to come to fruition. Some €600,000 was provided by Kerry County Council, while €210,000 was raised by way of a cycle run in 2009, 2011 and 2013. Money was also raised on flag days, while other local charitable organisations helped along the way to complete the project.

Initially the centre was meant to be a home for nine residents, but under HIQA regulations, the figure was reduced to four in a congregated setting. The problem is that nothing has happened since. The centre is lying idle. The reason is no funding has been made available to develop a residential centre for autistic children. Many of the parents involved are moving on in years. Their children who are now adults are approaching 30 to 40 years of age and they fear what will happen to them when they pass on. Jim and Patricia Adams' son James, a potential resident in the facility, cannot live independently. That very fact exerts huge pressure on his parents. The Irish Society for Autism owns the building and the centre was constructed thanks to the various fundraising efforts.

In recent months Inspired Well-being, a Northern Ireland service provider, took the first steps to run the facility, but owing to a lack of funding, it had to pull out of the project. The national director of the organisation, Mr. William McAllister, said it had been in discussions with the HSE, the Irish Society for Autism, Kerry County Council, and others. It proposed to rent the building and that the HSE pay its costs as a service provider. However, the HSE has informed it that it does not have the funding available to pay for staffing and so forth. That is where we are at.

What is needed is a service provider, funded to meet its staffing and running costs. Obviously, the service has to be autism-specific. I look forward to hearing the Minister of State's response. I cannot over-emphasise the necessity for this facility, particularly on behalf of the parents, given what they are and have been enduring since completion of the building in 2014. It is a white elephant, although it is state-of-the-art, with furniture and everything in place in situ. Funding needs to be made available through the HSE in order that a service provider can help it to meet its responsibilities.

I thank the Deputy for raising this important issue and giving me the opportunity to respond.

The Government’s ongoing priority is the safeguarding of vulnerable persons in the care of the health service. We are committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide for greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. Significant resources have been invested by the health sector in disability services in the past few years. This year alone, the Health Service Executive has allocated €1.9 billion for its disability services programme.

As part of its ongoing service provision, the HSE will provide over 8,500 residential places this year for families in need across the country. In fact, residential services make up the largest part of the disability budget. Our policies are for people with disabilities to be supported to achieve their full potential in order that, where possible, they can live ordinary lives in ordinary places and doing ordinary things.

The need for increased residential facilities is acknowledged and the HSE continues to work with agencies to explore various ways of responding to this need in line with the budget available.

Residential placements for adults with disabilities are considered following detailed clinical assessments by HSE services. Access to places for those with the most complex needs is allocated on a priority basis and appropriate availability of service.

The Deputy mentioned a particular centre. I am advised by the HSE that the centre in question is a ten-bed house owned by the Irish Society for Autism that was developed independently by the society without the prior agreement of the HSE, including any agreement on a commitment to funding. As the Deputy will be aware, the current policy on residential services for people with a disability is that no more than four persons should be accommodated in any one unit. This is to avoid the institutionalisation of care delivered in any setting. This ten-bed facility is not in line with the HSE policy on residential settings, which has been in place since 2010.

Everyone in the House will appreciate that the HSE must focus its resources on the areas of greatest need and in line with agreed policy. I am keen to emphasise that significant progress has been made in recent years in orienting our health and social care services to a direction more appropriate for users with autism.

Deputies will be aware that my colleague, the Minister for Health, requested that the HSE carry out a review of health services for people with autism to identify examples of good practice that can be replicated more widely in the health service. There was a strong emphasis on consultation with stakeholders and service users during this process. Following the publication of the review, the Minister for Health requested that the HSE establish a programme board to implement the recommendations of the review and to publish an autism plan this year. This commitment is reflected in the HSE national service plan 2019. An initial meeting of the programme board has now taken place and work is under way to ensure people with lived experience of autism are represented on the board. Several actions by the HSE are planned or already under way. These include: the development of guidance for clinical practitioners working in the field of autism; standardising the autism assessment process; and planning of a communications and public awareness campaign.

Certainly, the response of the Minister of State is no comfort to the parents of autistic children in Kerry. The Minister of State said that the facility was built for nine people and that the standard regulation within HIQA is for four people. I have been told that the facility is capable of meeting the HIQA regulations limiting the number to four residents.

One thing that disappoints and frustrates me, along with other Deputies, is that we constantly raise issues regarding people with disabilities. I brought up the issue regarding a centre in Listowel where there are four parents in their 70s with four adult children with physical and mental disabilities. Yet there is nothing for them there. The parents are there facing death some time down the road but they do not know what will happen to their children afterwards. The case is similar with regard to the autistic children - they are autistic adults now. Their parents have provided an extraordinary service to the State. They have saved the State millions throughout the island but they now find themselves in their 60s or 70s. They are looking back at their adult children but they do not know what will happen to them.

I have heard the excuse that the HSE looks at every issue. The HSE is not delivering for these parents and adult children. Something has to be done. Some commitment has to be forthcoming from the Government to give assurance to the parents that they will be secure. The State can never repay them for what they have saved the State. The same applies throughout the island. Parents and other siblings who have been so good to the person with disabilities and who have brought them through find themselves in this position. I was hoping for a better response than the response given by the Minister of State. Although I do not blame him personally, I am certainly blaming the Government.

As is often the case, I am not familiar with the detail of the case as I am taking it for my colleague, the Minister of State at the Department of Health, Deputy Finian McGrath. However, the matter is under the community healthcare organisation that I represent and I am happy to have further conversations on the matter.

I must point out that the HSE has said there were no discussions with the HSE and no commitment was secured from the HSE for funding before the development of this particular centre. Without knowing any of the detail, I imagine and assume that would have been helpful had it taken place. Perhaps it did and, if so, the Deputy may want to correct some of the detail. I am only repeating the message I have been given and highlighting the point that it is not in keeping with the agreed policy.

The Deputy maintains that the facility can be transformed into a four-bed unit quickly. I cannot adjudicate on that but I am happy to have some discussion with the CHO management locally to see whether we can make progress on this issue. This is not a question of them-or-us. To the credit of the HSE it is delivering services, although Deputy Ferris said it was not delivering. I am not making the point defensively but rather as a matter of fact. The HSE is delivering residential services for 8,500 people but the demand is greater than that. That is acknowledged by the Government and the HSE. They acknowledge that there is greater demand for the service than the number of places available. Obviously, there is funding. We have a finite budget and significant challenges in the health budget on all fronts, as the Deputy is aware. That applies to disability services as well notwithstanding that we have committed €1.9 billion to disability services this year from the health budget. We accept that the demand exceeds this. I am happy to have further conversations with my colleague, the Minister of State, Deputy McGrath, and the CHO locally on the specific issue and on the case mentioned by the Deputy to see if we can make any progress in the interests of all sides and in the best interests of the parents and, most importantly, of the children with autism.

Hospitals Building Programme

Thank you, a Cheann Comhairle, for choosing this Topical Issue debate. It is an important issue not only for Cork but for the Munster area. As Minister of State at the Department of Health and as a Cork-based Deputy, Deputy Jim Daly will be quite familiar, I imagine, with this issue and will have an interest in it. I imagine the Government does not want issues around a children's hospital to be raised any further but this is an important issue for the people that we represent.

As the Minister of State is aware, the national model of care for paediatric services has identified Cork University Hospital, CUH, for development as the biggest regional unit for the care of children outside of the national children's hospital. However, this development is predicated on the centralisation of children's acute hospital care in Cork University Hospital. The infrastructure required is not currently in place. In fact, no upgrade of the inpatient facilities has occurred since the original Cork Regional Hospital, as it then was, was opened in 1978, over 40 years ago. A planned new inpatient unit has been stalled at the planning stage since 2015. Some believe it is now threatened by the significant overrun in the national children's hospital. That is the first reassurance I am seeking from the Minister. I want to know that this project will not be affected in any way by that.

This project has been known as the Munster children's hospital. The funding envelope for this project at Cork University Hospital is between €34 million and €38 million. The project includes two below-ground floors to accommodate four theatres and associated facilities.

CUH already delivers tertiary care across several specialties that other regional centres have to refer to Dublin. It is delivering specialist care as close to home as possible for paediatric neurology, respiratory, cystic fibrosis, endocrinology and diabetes, allergy and cardiology services. Children within Cork and Kerry have the lowest number of cases occupying secondary and tertiary beds in Crumlin and Temple Street hospitals. Over 90% of our children are cared for their entire treatment locally in Cork University Hospital. The national children's hospital cannot afford for this caseload to change due to a lack of local infrastructure. In fact, it has not been designed with such capacity in mind.

CUH has already had €9 million invested in its modern paediatric outpatient and day-case suite - I wish to acknowledge that. Other charity moneys raised by the staff of the unit are being used to keep phases 2, 3, and 4 of the project moving towards a planning application. It is hoped this will proceed later this year.

The ongoing erosion of surgical and anaesthetic skills is a genuine existential threat to the delivery of all paediatric medical care in Cork. This is what clinicians are telling me. It is not some politician making these claims - they come from clinicians. If these skills are lost, the hospital would have to be immediately closed to all acute admissions and the CUH emergency department would have to be closed to all paediatric cases.

Where would they go in that scenario? It is a red line from their perspective. No airway support means no acute medical care for critically ill children in Cork. Cork hospitals perform more than 5,000 operations on children under general anaesthetic per annum. Crumlin performs approximately 22,000. There is a significant differential in the complexity of the cases. The national children's hospital has been funded for 22 or 24 theatres to do that number. It could not absorb the numbers currently being provided for in Cork. I am looking for clarity about where this project stands. I have been trying to pursue it through parliamentary questions and with the HSE. I am not really getting much reassurance that this project will advance and I hope that the Minister of State can provide that.

I welcome the opportunity to update the House on the paediatric development at Cork University Hospital. A national model of care for paediatric healthcare services in Ireland has been developed by the HSE and sets out the vision for high-quality, integrated, accessible healthcare services for children from birth to adulthood with an emphasis on early detection and prompt treatment. The model aims to ensure that all children should be able to access high-quality services in an appropriate location, within an appropriate timeframe, irrespective of their geographical location or social background. The model of care explicitly supports the development of the new children’s hospital and an integrated national network for paediatrics, with strengthened and interconnected roles for local and regional paediatric units, including the regional unit in Cork University Hospital.

There are a number of distinct phases within the proposed paediatric development at Cork University Hospital. The HSE is responsible for the delivery of healthcare services, including infrastructure projects, and has advised that the phase 2 development, which includes 74 inpatient beds, is currently at the design stage and is funded up to the detailed design and planning stage in 2019. I understand that a capital submission for phase 3 of the development is currently being prepared in order to enable the "shelled" construction of this project during the construction of phase 2. The submission will have to be considered by the HSE's capital steering committee before it can be approved.

I am happy to confirm that the paediatric development at Cork University Hospital has been included in the Project Ireland 2040 policy initiative announced last year. This provides €10.9 billion for health capital developments across the country, including both national programmes and individual projects, across acute, primary and social care. The delivery of these projects and programmes, including developments in Cork, will result in healthcare facilities that allow for implementation of new models of care and for delivery of services in high quality modern facilities.

My Department and the HSE are currently engaged in a process to finalise the HSE capital plan for 2019. In developing its capital plan for 2019 and future years, the HSE must consider a range of issues including the expenditure that is contractually committed, the HSE's annual requirement with regard to meeting risks associated with clinical equipment, ambulances and healthcare infrastructure. The HSE capital plan will propose the projects that can progress in 2019 and beyond, having regard to the available capital funding, the number of large national capital projects currently under way, the cashflow requirements of each project and the relevant priority. Projects which are currently in construction and which are contractually committed will not be affected. Once the HSE has finalised its capital plan for 2019, it will then be submitted to the Minister for consideration.

The Minister of State has not given any additional reassurance that the project will be funded to phase 3 and beyond. He says it is included in the Project Ireland 2040 initiative. That is little comfort to those who are waiting for this investment. I assume the Minister of State is referring to the national development plan, which still has many years to run. Without this investment, paediatric care in Cork will continue to be delivered inefficiently across two sites, Cork University Hospital and the Mercy University Hospital, and surgical services for children will continue to be provided in a scattered away across three sites, including those two hospitals and the South Infirmary Victoria University Hospital. Children's surgeries are performed in the middle of adult lists, with no guarantee of having anaesthetic, surgical or theatre staff trained in the care of children.

This project must advance. I acknowledge that it is funded up to phase 2 but we need a capital commitment from the HSE and the Government to ensure that this project can move through detailed design, tender and construction and that the specialist care can be provided locally. The consequences otherwise are that more of the cases currently dealt with in Cork will end up having to travel to Dublin. That is not just an inconvenience but the national children's hospital, expensive though it is, is not designed to absorb additional capacity that is currently being met regionally in places such as Cork University Hospital. It is not often that clinicians come to us to explain the urgency of a project. For the children of Cork, Kerry and the wider area, the development of this paediatric unit is urgent and I hope that the Minister will lend his full support to get this over the line and make sure that it does not end up at the back of a long queue of projects.

I appreciate the attention that the Deputy is bringing to this. He has eloquently outlined the importance of this project to the future of not just Cork but to the entire Munster area. I assure the Deputy that I and many other Deputies in the Cork area are very anxious to see this progress, in line with a number of other capital projects that are committed to for healthcare in County Cork, both at a community and an acute level, for a different range of necessary services. We are all watching the capital plan as it progresses. The Deputy will appreciate that I cannot give any further commitment other than what I already have given. Detailed design and planning for 2019 are funded. We have to let the HSE work with the Department to finalise a capital plan for 2019. I cannot go outside that and confirm individual projects until it is complete. I assure the Deputy that I appreciate the chance that he has given to air the necessity and importance of this project. I will support him wholeheartedly to ensure that we have delivery for the people of Munster in the years ahead.