Ceisteanna ó Cheannairí - Leaders' Questions

The housing crisis is deepening and Government efforts are failing to impact significantly on it. The cost of housing is growing at twice the rate of average earnings across the country. Rent prices have soared by 8% nationally. In Dublin, the cost of rent makes up more than half of the minimal living costs. At 68%, which is a stark number, the rate of home ownership is now the lowest since 1971. The younger generation, essentially, have been locked out of home ownership and have lost confidence in ever being able to afford to buy a house. Thirty five years of age is now the new average before people can buy a house. In the 1990s it was 26 years of age. When Deputy Varadkar become Taoiseach two years ago the number of children homeless was at 1,881. Today, the figure is over double that at 3,794. I recall the then Minister for Housing, Deputy Coveney, promising in June 2016 that child homelessness would be over by the end of that year.

This, by any yardstick, is a litany of failure. Plan after plan has been produced and they have not worked in accordance with the targets set in each plan. There was an over-reliance on the free market, the private market, to solve all the issues. I suggest that over-reliance has backfired and failed.

There have been attempts to engineer a change from home ownership to rental. The current budget alone in terms of rental schemes is anywhere up to €900 million, an extraordinary figure. It is in the billions of euro when one goes back over the last five or six years. In terms of house building, either council houses or affordable houses, it has dwarfed any of that. That was a clear policy to engineer and to contrive people to move away from ever owning homes to renting. All the initiatives that were announced from rapid build, the affordable rental schemes, the repair and leasing scheme to the home loan scheme have failed spectacularly in the targets they set. They have not reached their targets. They have been bedevilled with bureaucracy, lack of urgency and delayed delivery. Rent pressure zones have now been extended to 19 areas but rents continue to sore.

Will the Taoiseach answer clearly when does he expect we will have a situation where children will no longer have to live in hotel rooms or emergency accommodation and will have access to public housing? When will we see meaningful progress in the provision of affordable homes for people? Does the Taoiseach accept that home ownership is no longer attainable for young people under the current policies and that they have no confidence in ever being able to buy a house?

The Government acknowledges the enormous challenges we face as a country when it comes to housing. All of us feel particularly strongly about the fact that there are families living in emergency accommodation. While the family hubs are much better than hotels and bed and breakfast accommodation they are by no means a long-term solution. It is our objective to reduce the number of families experiencing homelessness, living in emergency accommodation, month on month, year on year. There was a slight fall in the number last month but we want to see it continuing to fall very month into the future. We want to minimise the number of people who end up in emergency accommodation and, if people end up in it, we want to make sure it is for a very short period of time, for weeks or maybe a few months but certainly not for years.

I do not think it is possible for anyone to say there will never be anyone who has to go into emergency accommodation. There always have been a certain number of people in emergency accommodation for one reason or another, particularly people who become homeless suddenly who were not on the housing list, but it should not be the type of figures it is now. We want to make sure it starts falling and continues to fall.

With respect to housing, I am somebody who is very committed to home ownership. This Government believes in home ownership. As the Deputy pointed out 68% to 70% of people in Ireland own their own home, which is much higher than in most European countries. I know others prefer a European housing solution based on renting for life, a public housing and social housing based solution. I believe in home ownership and that people should be able to own their own home, that that is a socially desirable thing. In order to deliver high levels of home ownership, we need the private market and the private sector because it has never been the case that Governments build houses for people to own. Governments build houses for people to rent-----

They eventually bought them out when matters improved. That was the model.

-----for those who are not able to own their own house. That is why we need the private market so that people can purchase and own their own homes. I want that 70% home ownership to be a reality for people in the 20s and 30s. As to what are we doing about it, there is the help-to-buy scheme which has already benefitted 10,000 people, mostly people in their 20s and 30s, helping them to get a deposit to buy their own home. It will help many more people in the future. Approximately 1,000 more people have been helped with the Rebuilding Ireland home loan to get a low interest rate home loan to be able to buy their own home.

The other area is supply. In the past 12 months, 22,000 new homes have been added to our housing stock. That is 22,000 new houses or apartments. We are meeting our targets in terms of supply. If there was a way to do it quicker I guarantee the Deputy we would do it. Given from where we have come with a collapse in the financial and construction sectors, we can only ramp up supply so quickly. This year we will see between 22,000 and 25,000 new homes built, with next year probably hitting higher than that again, and we will get to the point where the additional supply is meeting the demand. We are seeing some progress already because of the additional housing supply with house prices levelling off and even falling in this city.

The Taoiseach's comments regarding homeless children living in emergency accommodation are quite depressing. He said there was a slight fall in the number. I am not talking about the situation we had in the past where a very small number of people were homeless for a variety of reasons. We are talking about families who ordinarily in previous times would have had access to a council house within a reasonable period of time but who are now living in hotel accommodation for a prolonged period of time. We know the psychological impact of that on children in terms of their development. The Taoiseach has offered no hope here this morning in terms of making any significant dent in the numbers who are living in emergency accommodation with all of the societal damage and potential impact of that on those families and children.

At 68%, home ownership is at the lowest level since 1971. That is the reality. Despite what the Taoiseach said in terms of his stated position, the reality is there was a significant shift in the past five to six years towards the housing assistance payment, HAP, scheme model and various rental approaches which have absorbed huge amounts of money with less emphasis on house building, particularly the building of council houses in terms of broader social housing areas. The delayed delivery on all of those has been quite shocking given the urgency of the situation. Rent prices have continued to soar. There is no point in saying we aspire to homeownership if the nuts and bolts that govern that are not dealt with by Government.

To date, they have not been dealt with in the context of people's capacity to afford to buy homes. The Taoiseach might indicate the progress that has been made in terms of the affordable homes scheme.

The Taoiseach to respond. We have exceeded the time. We cannot continue like this.

I will ensure that the Minister for Housing, Planning and Local Government, Deputy Eoghan Murphy, provides the Deputy with an update on the affordable homes scheme.

The Minister will be providing one for himself first.

As the Deputy will be aware, the scheme is going towards a shared equity model. We will provide the Deputy with more information on that.

Has the Taoiseach not had it?

I am advised that the level of home ownership fell faster under Fianna Fáil than it has under the current Government. It is worth referring to that point. We really should not forget from where we are coming. We should not forget what happened ten to 12 years ago on Fianna Fáil's watch. When Deputy Micheál Martin's party was in office, we had a boom-and-bust cycle in construction. As a result, the industry was totally destroyed and hundreds of thousands of workers left their jobs and had to emigrate.

Eight years later.

That was a long time ago. We do not need a history lesson.

The banking sector collapsed and was unable to lend people mortgages for a prolonged period.

The banks still are not working.

We had, on Fianna Fáil's watch, ghost estates, Priory Hall, problems with mica, hundreds of thousands of people in negative equity-----

Fine Gael builders.

-----and hundreds of thousands of others in mortgage arrears. Deputy Micheál Martin is not in a position to lecture or advise anyone on housing.

Fine Gael was asking them to spend more at the time.

Let us think of the children.

What was Fine Gael doing at the time?

Not a word about the children.

(Interruptions).

There has to be some order. If there is, Deputies may get an opportunity to contribute..

The Taoiseach does not care about the children.

It is all just politics. There is nothing about the children. Suffer little children.

If they are orderly, they might have a better chance of getting it.

He must remember that he is the Taoiseach.

The living wage technical group published its assessment of the living wage for 2019 this morning and its report makes for a sobering read. They have found that the living wage - the rate of pay that a full-time worker requires in order to enjoy a socially acceptable standard of living, in other words, an income floor of such a level as to allow him or her not to live the high life but, rather, a decent one - has risen to €12.30 an hour. The increase is of the magnitude of 40 cent per hour and is largely accounted for by increases in the cost of living in particular and in the cost of housing and, more especially, because of runaway rental costs. The Taoiseach will be aware that the living wage - now set at €12.30 - is considerably more than the minimum wage in this State which stands at €9.80 an hour. The gap between the two is sizeable. Workers deserve to be treated fairly and paid fairly for their work. People who are at work have every right to expect that they can have a decent standard of living. As a result, it is not acceptable that tens of thousands of workers and their families endure poverty, uncertainty, stress and substandard living conditions as a result of low pay. We are not talking about a small number of people. According to the most recent figures from the Central Statistics Office, CSO, 140,000 individuals are in receipt of the minimum wage. The majority of those 140,000 are women, and the vast majority of them work in the services sector.

There is also another big group of people who earn just above the minimum wage. Their income lies between the minimum wage and what the living wage ought to be. All of these are hardworking people. They are childcare workers, members of the Defence Forces, hospitality workers and shop assistants. They are people with whom we interact and on whom we rely on a daily basis. The situation of poverty at work in which they find themselves is simply not acceptable. We need to start moving to ensure that all workers in the public and private sectors are paid the living wage.

The State should lead from the front on this matter and that the Taoiseach should introduce the living wage for all civil and public servants. The latter has been a pre-budget proposal from Sinn Féin for many years. Last year, it would have cost just in excess of €35 million, as per costings provided to us by the Department of Public Expenditure and Reform. This is a minor and modest sum in the greater scheme of things, particularly when one considers the benefits that it would bring to workers and their families. Will the Taoiseach move to ensure that the State is a living wage employer in the next budget? When will the Government legislate for the living wage? When will it legislate and ensure that workers can enjoy a wage that will afford them a decent basic standard of living?

The Taoiseach to respond.

We are well behind the curve. Often one hears tributes to and, on occasion, one sees people shed crocodile tears for low-paid workers.

The Taoiseach to respond to the Deputy's question.

These workers do not need not soft words, honey-coated words or tributes, they need to earn at least the living wage.

The answer to Deputy McDonald's question is "No". We negotiate public sector pay with the trade unions. That is done under the terms of pay deals that happen periodically and that do not require legislation. We have a pay deal with the public service trade unions. When that comes to an end, I imagine that we will have another pay deal with the public service unions. That is how we decide on pay levels within the public service.

The living wage, as the Deputy will be aware, exists in the United Kingdom. It exists in Northern Ireland where Deputy McDonald's party was in power for ten years. The living wage in the United Kingdom is actually lower than the minimum wage in Ireland. I would not like there to be a living wage that is lower than our national minimum wage.

That says much about the State and the cost of living.

The national minimum wage is calculated by the Low Pay Commission, taking into account the views of workers and unions and also employers in the business sector. It is now the second highest in the European Union. Far from being behind the curve, we are well ahead of it. We have the second highest national minimum wage in the European Union. Even when one accounts for the fact that we have a high cost of living, we still have the sixth highest minimum wage in the world. We are well ahead of the curve, not behind it.

The living wage to which Deputy McDonald refers is drawn up based on research by NGOs without any input from employers and business. The Vincentian Partnership for Justice does good work. I have studied much of its work over the years. I studied it when I served as Minister for Social Protection. One of the interesting aspects of its research is that were it not for housing costs or rental costs, it would be proposing a reduction in the living wage because they state that the cost of living, other than that part of it relating to housing, has decreased in the past five years. The research assumes that everyone is paying rent. Of course, most people do not pay rent. Most people pay mortgages or own their own homes outright. In many cases, those who are on the minimum wage are students or those who are bringing a second income into their homes. That also needs to be taken into account.

The Low Pay Commission, the Government body that draws up the national minimum wage, takes into account the need to ensure that people get a decent wage. However, it also takes into account the views of businesses and employers. That needs to happen we do not want a situation whereby businesses close. Those in the Border region would be the ones most at risk in this regard given the much lower living wage that exists in Northern Ireland. We do not want to end up in a situation where workers lose their jobs or lose hours, thereby ending up worse off. That is why we have a system that works. It is headed up by the Low Pay Commission, established by the Fine Gael-Labour Government, and it takes into account the bigger picture and the need for people to get decent wages. It listens to employers and unions and recommends an increase every year that will push up wages but that will not cost jobs or cause workers to lose hours and thereby ending up worse off.

The Low Pay Commission should be looking at a living wage, not the minimum wage. The Taoiseach is wrong to state that those on the minimum wage are simply people who are working for pin money or to earn supplementary incomes. Almost half of those on the minimum wage are full-time workers. The minimum wage stands at €9.80 per hour. Everyone here, including the Taoiseach, earns multiples of that.

At least the Taoiseach gave a straight answer. He said "No" and indicated that he is not interested in improving the living standards and the quality of life of low-paid workers. What is proposed here is not a ransom, it is not a fortune. It is €12.30 an hour. The State ought to lead by example. It should be a matter of shame that the State has in its employment public servants and some civil servants who work for less than that. Shame on the Government. No wonder he is dragging his heals in respect of the soldiers, those who work in the Naval Service and the Defence Forces. As the Taoiseach just acknowledged, he does not care and the answer is "No".

Legislation for a living wage would make provision for the health and financial circumstances of business.

Of course that is the case. The Taoiseach knows full well that the minimum wage has latitudes like that; of course the living wage would have to take account of the financial state of health of any enterprise. As a matter of public policy and basic standards, people at work should expect that they can live a basic, decent life and that work actually pays. I have a document here laying out Sinn Féin's position on the living wage. I am very happy to share it with the Taoiseach. I hope he will read it and, more importantly, act on it.

I did give the Deputy a straight answer-----

-----but unfortunately she chose to misrepresent it and put words in my mouth. While I give the Deputy straight answers, there is nothing straight about her whatsoever in the way that she responds to my answers when I give them to her. The Government is acting. The Deputy should look at the facts. We have more people at work in Ireland than ever before.

Thousands more living in poverty.

We have an unemployment rate that it is at its lowest in 15 years.

Bogus self-employment and part-time work.

Poverty and deprivation rates have been falling for four years in a row and we have cut child poverty by 30% and we have increased the minimum wage every year for the past four years after it was cut by others. That is our record. It is a good one-----

It is not. It is terrible.

-----and we are going to continue to build on it but we will do it in a way that is sustainable and not counterproductive. The risk of Sinn Féin policies that are not responsible is that they will be counterproductive.

Sinn Féin will look after workers. How utterly counterproductive.

We would end up in a situation whereby people rather than getting an increase actually end up having their hours reduced or losing their jobs altogether and that is no good to anyone.

The Taoiseach should read the document.

I wrote to the Taoiseach and other Ministers at the end of May following the appalling series of gun murders in Dublin Bay North and asking what steps the Government was going to take. I detailed the outstanding work of our schools and a wide range of Dublin Bay North community bodies in fields like employment and enterprise, childcare and elder care, youth work and sports and drug rehabilitation. At that time, many community leaders who admired the Mulvey report on the north inner city, Creating a Brighter Future, believed that a similar programme and implementation board should be established for Dublin Bay North. The north inner city initiative, which my colleague, Deputy Maureen O'Sullivan, was heavily involved in bringing forward, includes tackling crime and drugs; maximising education and training; integrating social services; and improving the physical landscape. There is a strong belief that we need a co-ordinated response involving all the existing local agencies, perhaps led by Northside Partnership, An Garda Síochána, Dublin City and Fingal County Councils and key Government Departments. It should be fully resourced to tackle all the issues which gave rise to the recent upsurge of crime.

Is there a case for a national programme of support? Seven or eight of the 40 constituencies are particularly badly affected; the Taoiseach's own constituency is one of them. Will he launch a new national strategy to support investment in all areas experiencing cumulative disadvantage, perhaps led by a high-level interdepartmental group? I know that Departments are engaged on their own in carrying out important work. The Department of Children and Youth Affairs is carrying out a major reform of youth services but funding in the sector for most of our constituency was less than €2 million in 2018. The Department of Rural and Community Development, whose Minister is seated beside the Taoiseach, runs the social inclusion and community activation programme, SICAP. However, as the Minister knows, the community enhancement programme only allocated €700,000 for Dublin. There is also continuing criticism of Seetec in respect of employment and youth employment.

With regard to legislation, after eight and a half years the Government has not brought forward the housing (regulation of approved housing bodies) Bill or reformed the Housing (Miscellaneous Provisions) Act 1997 to strengthen estate management. Despite the €1.76 billion 2019 Garda budget, people still feel generally that there needs to be much greater visibility of gardaí, especially in the evenings, with a doubling of community gardaí. When is the Government going to publish the long-promised policing and community safety Bill? The national recorded crime statistics for quarter 1 of 2019, which are statistics under reservation, show shocking increases across a whole range of crimes, including sexual offences, attempts or threats to murder and assault, kidnapping, robbery and extortion, fraud and deception, and controlled drug offences. All these are happening on the Taoiseach's watch and affecting all our constituencies, rural and urban, with seven or eight constituencies particularly badly affected.

What is the latest position with regard to the report of the working group chaired by Mr. Justice Sheehan? It is considering decriminalisation in respect of small amounts of drugs for personal use, which would allow the Garda to focus on very serious crime and drugs pushing. I understand the Taoiseach has the report but has not yet brought it to Cabinet.

There are a lot of specific questions there. I will do my best to answer them in the time allocated. I did receive the Deputy's letter and have read it. I am not sure if he received the response-----

Not from the Taoiseach himself.

-----but it is in train. In respect of legislation, we would expect to have the public and community safety Bill next year, which will bring into law many of the recommendations made by Kathleen O'Toole in the commission she led on the reform of policing. It is being worked on at the moment by the Minister, Deputy Flanagan, and the Department of Justice and Equality. Ideally, I would like to have the heads of a Bill this year and the legislation published and enacted through the course of next year.

On the housing Bill the Deputy asked about, I do not have a timeline but will ask the Minister, Deputy Eoghan Murphy, to communicate with the Deputy and update him on it. I do not yet have the report from Mr. Justice Sheehan. I have not seen it. I know it is quite advanced and once I get it and have a chance to read it, I will bring it to Cabinet and publish it thereafter. As the Deputy will be aware, it is examining whether we should change our approach to dealing with drugs, moving away from one that is founded on criminal justice and enforcement to one that is more based on treating it as a health issue. I look forward to receiving that report once it is ready.

Our response to crime has to be twofold. As a former British Prime Minister once said, we need to be tough on crime and also tough on the causes of crime. We are tough on crime by increasing Garda resources. There are unprecedented resources now for the Garda and they are continuing to increase all the time. Additional gardaí were allocated to the Dublin stations quite recently, as the Deputy will know, reflecting the need for that to be done given the high levels of crime in Dublin. There has also been investment in ICT and equipment and vehicles, which will continue into next year and into the future. In terms of being tough on the causes of crime, that means tackling some of the underlying issues that cause people to choose a life of crime when others may not. Those are issues particularly related to social and educational disadvantage. We are doing that as well.

The north-east inner city initiative is a very good one. We have yet to see whether it has had good outcomes. What has been done has been very good. It is probably too early to judge whether the outcomes have been good because we cannot assess that at the moment. Unfortunately, as is often the case with a very targeted, very specific initiative, it would not be feasible to do that nationwide. We just would not have the capacity, the people, or the finances to do that in the ten or 20 other places that have been proposed, including places in my own constituency. Perhaps we can do something similar in those areas of deep disadvantage, including in the Deputy's constituency and in mine. We do have the community enhancement programme. One of the things we are examining is whether we should relaunch something similar to the revitalising areas through planning, investment and development, RAPID, programme which existed in the past, and identify ten or 20 areas of particular disadvantage around the country on an evidence basis and target them to do something similar to but not the same as the north-east inner city partnership.

Unfortunately, the Taoiseach is not tough enough on crime or on the causes of crime. We have a reasonably good social infrastructure in Dublin Bay North. Surely this is a moment when we need to be thinking about a national strategy. Some 25 years ago, the trade union movement led by Peter Cassells inspired the development of the whole local partnership approach. Surely there is a need at this time to do something similar. I am aware of budgetary matters and, indeed, will be meeting the Minister, Deputy Donohoe, at the Committee on Budgetary Oversight at 2 p.m. However, this is the kind of initiative we need.

Dublin Bay North has long been awaiting a new divisional Garda headquarters. I wrote to Commissioner Harris about that and urged him to consider a location for the headquarters in the greatly expanding north fringe. There is one site in particular just north of Darndale-Belcamp parish that would be a good site for that headquarters. In respect of the legislation available to An Garda Síochána, my former colleague on the Committee of Public Accounts, Deputy Durkan, has proposed that we should simply proscribe organised crime gangs and their members, because they are enemies of our State and our Republic.

Many of us would agree with Deputy Durkan that we should take that initiative.

What is the Taoiseach's response to the recent Supreme Court decision on mandatory minimum sentences, where the court struck down part of the Firearms Act?

The answer to the Deputy's initial question is "Yes". We are considering a revised and new approach to target areas of particular disadvantage in the State. There are a lot of programmes already, as the Deputy is aware, such as the local drug and alcohol task forces, DEIS in education, the school meals programme and the community enhancement programme. There is also €2 million set aside in the new GP contract to provide extra resources for the first time to GPs who are working in areas with high levels of disadvantage. This recognises there is a link between disadvantage and poor health. This will be the starting point for having a system such as DEIS, but for healthcare. I believe this will make a big difference. What we probably do not do well enough is joining it all up together. This is what we need to do and I have asked Ministers to work on this over the next couple of months.

I want to raise with the Taoiseach today the crisis in healthcare staff recruitment, specifically the crisis in recruitment of hospital doctors, and the serious implications for patient safety and the future of the health service.

Currently there are 450 vacant consultant posts. Even if all of these posts were filled we would still have the lowest number of consultants per capita in the OECD. Downstream there are also more serious problems that need to be addressed very soon.

Ireland trains high numbers of doctors at very high cost. The vast majority of these doctors emigrate. In 2014, for example, there were 684 medical graduates, 627 of whom left Ireland. In 2017, 700 medical graduates who left the country. A key contributor to the deplorable waiting lists is the shortage of hospital doctors. Nearly 1 million people are waiting on hospital care of one kind or another. In the last few days we heard that 30,000 women are waiting for gynaecological hospital services.

It is also a major contributor to the dysfunction within our health service. There are many reasons why Ireland cannot hold on to its hospital doctors. The unmanageable workloads and the inevitability of burnout is a key factor for a lot of doctors. There is also the hierarchical nature of the career structure for consultants and the lack of career prospects. Pay is undoubtedly an issue and the two-tier health system, as in many other careers, is hugely damaging with regard to hospital doctors and should be addressed urgently. The convoluted two-tier recruitment system in operation is also inexplicable. There is a lack of reform of the health service. Hospitals are stressful places for doctors to work and there is no indication that the Government is serious about a reform programme.

Getting timely access to care has a significant bearing on this because it means there are increasing difficulties for patients. This is also depressing for doctors. Knowing that delays have resulted in conditions becoming more serious for patients, knowing that treatment is less successful due to those delays and knowing that the system is failing patients, with doctors constantly having to apologise, is very stressful.

On top of all these issues is the recent HSE report that has pointed to serious problems around the importation of doctors with many doctors coming from developing countries, with questionable practices in relation to whether that is ethical or not, issues about the qualifications of those doctors, inadequate clinical oversight of those doctors and the transient nature of those foreign doctors, who are basically propping up our health system currently. We know that 50% of the non-consultant doctors are now called "non-training scheme doctors". This is a new category. Non-training scheme doctors are mainly foreign doctors and in some hospitals 80% of the non-consultant hospital doctors fall into this category. I call on the Taoiseach to publish that report and let the House know what action the Government will take on the crisis in the recruitment of hospital doctors.

I am sure the Minister for Health, Deputy Harris, will publish that report in proper order. The Government very much acknowledges that we have real difficulties in our health service when it comes to recruiting and retaining staff, not just doctors but also nurses, midwives, therapists and others. Notwithstanding that, it is not acknowledged, and it should be acknowledged, that there are more people working in our health service than ever before. There are 115,000 people now working in our public health service, which is 10,000 more than three years ago. The impression is sometimes created that more staff are leaving than are joining but that is not the case. It is not the case for the health service in general and it is not the case when it comes to doctors. There is a record number of doctors now working in our public health service. We have never had more doctors working in our public health service than today and there have never been more doctors registered in Ireland. The Deputy just needs to check the register of the Medical Council if she does not believe me. This is the true picture. Yes there is a real problem around recruitment and retention but never were more people working in the health service and never had we more doctors working in Ireland or on the Medical Council register.

The Deputy referred to 450 consultant post vacancies but this figure is not verified. The Pubic Service Pay Commission examined that and was not able to verify the correct, exact number of consultant vacancies. Often when the term "vacancy" is used the impression is created that nobody is doing the job but very often there is and the role is filled through a temp or locum doctor, which in some cases are long-term temps or locums. Last week I checked on publicjobs.ie and saw there were only 20 vacancies being advertised. I appreciate that the voluntary hospitals advertise positions in a different way but there are only 20 vacancies advertised. It begs the question whether there are jobs that historically have not been filled and will never be filled, and whether we need to take a more comprehensive look at what positions will actually attract staff and applications. I am aware of many registrars and doctors who are waiting for a job to be advertised. They are very keen to work in a particular area or hospital but the advertised jobs are in branches of medicine they do not want to be in, or for places they do not want to work. It is difficult to grasp that nettle but we do need to grasp it and advertise positions that will get applicants, rather than advertising for positions that, sadly, we know will not.

Deputy Shortall spoke about medical graduates emigrating. It is important to bear in mind that a very large number of medical students in Ireland are from overseas. When they emigrate they are actually emigrating back to the country which they came in the first place. That was always their intention. A very large number of Irish medical graduates who were born and brought up in Ireland leave and come back. Not as many come back as used to but going away for experience is not a bad thing. It is a good thing.

Reference was also made to non-training scheme doctors. It is true there are a lot of doctors working in peripheral hospitals, what were called county hospitals, throughout the State who are not in training schemes. They are not on training schemes because the medical colleges no longer recognise those hospitals as being training or teaching hospitals. In the past we were able to attract people to work in those hospitals from Ireland and overseas because it counted towards their training. Medicine has moved on, however, and those hospitals are no longer recognised for training purposes and may never be again. We must also face up to this. It is not an easy one.

The Taoiseach seems to be in denial about the facts of the matter. Ireland has the lowest number of consultants per capita but is the highest exporter of doctors. We are the highest importers in the world of foreign doctors and there are huge problems associated with this. A number of those problems have been identified in this high level HSE report, access to which we have had only through leaks to The Sunday Business Post and The Irish Times. I put it to the Taoiseach that it is undeniable there are serious problems with recruitment in the health service. There is a report with a detailed analysis of those problems. The report has been with the Government since last January. Why is the Government not publishing the report? Will the Taoiseach give a commitment today to publish this report as a matter or urgency so these serious problems can be addressed?

The Deputy mentioned the HSE report. It has not gone to Government yet so it could be difficult for me to answer that question as it is not a Government report and has not gone to Government yet.

That is Jesuitical.

I will certainly make inquiries about it. I do not see any reason it cannot be published, although there may be a reason I am not aware of as it is not a Government report.

Will the Taoiseach commit to publishing it this week?

I cannot make a commitment on behalf of the Government to publish a report that is not a Government report. I will have to find out if there is a reason it has not been published yet.

The Government is in charge of the HSE.

To answer the Deputy's question further, I think she accused me of being in denial about the facts. What we both did is this: the Deputy gave some facts which are true and I gave other facts that are also true.

This is Trumpian.

I would ask Deputy Shortall to bear in mind that there is a bigger picture and, when we take her facts and my facts, we get to the truth. The Deputy is only talking about one set of facts.