Ceisteanna ar Reachtaíocht a Gealladh (Atógáil) - Questions on Promised Legislation (Resumed)

Four months ago, the Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019 came into effect. For the first time, this gave Irish-based doctors the opportunity to prescribe medical cannabis products. Since then, nobody has been prescribed any products whatsoever. I received a text message from a woman in recent days. In it she said:

Hi Gino, just to say thank you so much for campaigning for medical cannabis as I am going through chemotherapy at the moment and will have to buy cannabis on the black market. It is the only thing that stops the sickness and horrible pain that goes through my bones. This is so, so, so wrong.

What is wrong about this is that the cannabis-based products that could be helping this woman and many others are actually imported into the State but nobody can access them. When will the medical cannabis access programme commence which will allow people get proper access and stop having to go to the black market or even worse have to go abroad for medical cannabis products?

I genuinely acknowledge Deputy Gino Kenny’s constructive involvement with this issue for some time. The Deputy will agree that nobody should ever have to go to the black market nor should we be promoting that in this House.

It is happening, however.

As recently as yesterday, I signed a ministerial licence to grant cannabis to somebody. One needs a doctor to recommend it. The ministerial licence scheme is in place today. In my tenure as Minister for Health, I have signed well more than 20 licences for that. As to when the products will become available for the new compassionate access programme, six products have applied to the Health Products Regulatory Authority. Two of them are almost ready and I expect products to start flowing from that by the end of the year.

By the end of the year.

Due to new regulations pertaining to preschool crèches, small preschools will have to ensure they are compliant with regulations or face closure. As a result, in the Cork South-West constituency in Castletownbere, a privately run, HSE-approved, crèche, catering for a large number of children and employing five members of staff, will have to close its doors on 22 November. In Coppeen, a successful private playschool, serving a large rural area for over 25 years, will also face closure. These playschools have little time with only one month to either comply or close down. If closure is the end story, it will be a huge blow to the communities in question. In one of the cases, it will cost €50,000 to bring it up to new standards. These playschool operators fully realise regulations are of the utmost importance. However, will the Government review these new regulations with a view to rural-proofing them in such a way that new guidelines will not be detrimental to small schools in rural communities? This might mean ensuring grant aid is made available, as well as a longer length of time to comply with these guidelines, in order to incentivise and enable the playgrounds in Castletownbere, Coppeen and other areas to continue to provide a valuable service to hundreds of children in their communities.

I am glad the Deputy recognises that standards are important for crèches and children’s play areas. We must have a common standard and benchmarks below which we cannot fall. If there are individual cases and problems that the Deputy wants to raise, he might send me on the details and I will forward them to the Minister.

Will the Minister for Health provide an update on the independent review commissioned on the workflow management processes in the emergency department at University Hospital Limerick? Will he also provide a timeline of when it will be completed?

I thank Deputy Neville for the question. As far as I am aware, that report is nearing completion but I will revert to the Deputy directly in that regard.

On the second MRI scanner, which is badly needed in University Hospital Limerick, which I know the Deputy has been advocating for, I expect the tenders for that process to conclude this week. I hope we can get the second MRI scanner into the hospital very quickly.

In the context of the funding crisis in RTÉ and the job losses, the Broadcasting (Amendment) Bill 2019 does not provide for licence fee reform. Will the Government bring forward amendments on Committee Stage to address the issue or will it kick-it-to-touch for five years, as mentioned previously?

I understand that legislation has completed Second Stage. The Government is open to constructive amendments. The Minister for Communications, Climate Action and Environment, Deputy Richard Bruton, will meet RTÉ to discuss in detail its plans for reform, change and, in some cases, cost savings. The debate on the Broadcasting (Amendment) Bill 2019 will be in light of that conversation.

Earlier this week, St. Joseph's Shankill, a dedicated care home for people with dementia, made a decision to send a letter to the 150 people living with dementia who use this excellent facility, 600 family members, 100 staff and 100 volunteers advising them that from December this year they will have to stop the day care service. From next year, it will cease operation in full due to gross underfunding. The Minister for Health, Deputy Harris, is familiar with this excellent facility. Many of those who work and use the facility are from his constituency of Wicklow.

What will the Minister do to ensure the doors of this excellent facility remain open? Currently, in Ireland there are 55,000 people living with dementia and this figure is estimated to double over the next 20 years. We need to ensure that facilities like this remain open. What is the Minister doing to ensure that funding is forthcoming so the doors can remain open?

Time is up, Deputy.

The Minister met representatives of the facility last year and he told them that funding was forthcoming. We are now two months away from the closure of the day care facility. Can the Minister ensure that funding is forthcoming and that the facility will remain open into the future?

The doors will not close. The manner in which this issue is being handled is very unedifying because letters went to patients and the families of vulnerable patients before any letter was issued to the HSE. Like Deputy Brady, I know St. Joseph's very well. It is a superb facility with incredible staff. I know many of its residents and their families personally.

There are two parts to the facility. The day care centre is funded by the HSE. As we speak, the HSE is intensively engaging to try to agree additional funding to keep it open. The second part is a residential facility, the price for which is negotiated through the National Treatment Purchase Fund, NTPF, in respect of which there is also a mechanism in place. This facility will not close. The way to resolve the issue is to engage intensively. I hope that engagement can take place productively and constructively, rather than in the worrying way it is being conveyed through the media. St. Joseph's is a brilliant facility. It needs to be supported and it will be supported and remain open.

I ask the Tánaiste to request his colleague, the Minister for Communications, Climate Action and Environment, Deputy Bruton, to approach the RTÉ authority and ask it to delay its decision to close Lyric FM in Limerick. It almost inconceivable that the mid-west of this country, with a population of between 500,000 and 600,000, would be without a permanent presence from RTÉ. Will the Tánaiste ask the Minister, Deputy Bruton, to request that RTÉ at least do a cost-benefit analysis, or let us have sight of any cost benefit analysis it has done? I cannot understand how small mythical savings involving job losses from the immediate closure of Lyric FM in Limerick will secure the future of RTÉ.

We need to be careful about the detailed commentary we make because we are essentially reading a media report on an RTÉ decision.

Dee Forbes spoke on "Morning Ireland" this morning.

She did and she confirmed that RTÉ would not be closing Lyric FM and that RTÉ would maintain a presence in Limerick although I accept it would be a downsized presence. It is up to RTÉ to justify the plan which they signed off at board level and was only sent to the Minister this morning. I suspect there will be plenty of opportunities to debate that plan in the weeks ahead.

In May 2018, significant legislation introducing GDPR across all sectors was introduced. To my knowledge, the Department of Health was allowed to introduce separate guidelines around medical research. My information to date is that as we speak effective medical research is now almost impossible and many critical research projects are practically at standstill due to cumbersome and impractical GDPR regulations.

Professor Gerry McElvaney, president of the Irish Academy of Medical Science, has organised a briefing on 25 November in the Royal College of Surgeons in Ireland, which I hope the Minister or his officials will attend. This is a critical area. Without good medical research, developments in life-saving cancer research and so on is put in jeopardy. We need to grapple with this issue immediately otherwise lives will be put in danger.

I thank Deputy Brassil for raising the matter and for his expertise, knowledge and interest in this area. I know Professor McElvaney personally and I would be very happy to meet him on the matter. I will also ensure representation from my Department at the briefing in the Royal College of Surgeons in Ireland. We will work constructively to address any issues that need to be overcome.

Some months ago, if not a year ago, I raised an issue in regard to rent pressure zones with the Minister for Housing, Planning and Local Government, Deputy Eoghan Murphy. While rent pressure zones are not perfect, because they are not applied uniformly, some anomalies have been created. I raised with the Minister a particular anomaly in regard to Carrigaline, at which point he said that he expected it would be rectified. It has not been rectified. In the most recent review, the electoral area of Macroom was designated as a rent pressure zone. The Minister and I are familiar with Macroom and Carrigaline. There is no way that rents in Macroom are rising faster or higher in that part of the county than they are in Carrigaline.

It seems to me that this has been overlooked by the Department. I have followed up on it on a number of occasions and I have spoken with the Minister, Deputy Murphy. In the southern part of Carrigaline and the surrounding areas which are close to the city rents are high and rising rapidly. It is my suspicion, given that nothing has happened since I last raised the issue, that this is an anomaly that was not captured in the legislation and that the Department is not monitoring it. The Department does not have the ability to capture rising rents and, therefore, the areas that should be designated. I hope I am wrong.

I thank the Deputy for the question. The designation of rent pressure zones happens according to the legislation and the process set out therein, whereby following a quarterly index report from the Residential Tenancies Board recommendation is made to the Housing Agency in regard to what inflation has occurred in a particular area following which a recommendation is made to me, as Minister, to designate new areas as rent pressure zones. Designation happens in accordance with the process laid down in the legislation. It is conducted separate from Government so that I cannot, for political reasons, decide that a particular area might be designated a rent pressure zone and another area might not be.

Ba mhaith liom ceist a chur ar an Aire Sláinte. What are the Minister's plans with regard to the recruitment and retention of general practitioners, GPs? A well-run general practitioner practice in Bandon, which has a large client list and a start-of-the-art computer system, which has advertised two GP posts has received no applications. Thirty years ago, a vacancy in this practise attracted 70 applications. There are many problems when the town of Bandon cannot attract one application for a very good GP practice. I would like to know the Minister's plans in regard to GP recruitment.

I thank Deputy Murphy O'Mahony for the question in regard to Bandon. On GP recruitment, the two areas on which the Government is focused are increasing the number of training places each year for the number of GPs in Ireland, in respect of which we have a way to go, and ensuring we resource and support our GPs better. We have agreed with the IMO a €210 million package of investment in general practice. This effectively reverses all of the FEMPI cuts of the austerity years. It also provides more support for our GPs in terms of maternity leave, paternity leave, additional funding in respect of a practice in a rural area and, for the first time ever, funding in an area of social deprivation. The Deputy does not have to take my word for it that this is a good deal. More than 95% of GPs who voted in a consultative ballot voted in favour of it.

On Bandon specifically, I will ask that the HSE brief me in that regard following which I will come back to the Deputy on it.

In June of this year, the HSE agreed to make the drug Spinraza available for children with spinal muscular atrophy, SMA. Three weeks ago a number of colleagues raised the matter on the floor of the House because there was concern that none of the 25 children had received the drug. We had anticipated that we might get a note subsequently. The question remains the same. How many of those 25 children are receiving the drug and when will the remaining children get access to it?

I thank the Deputy. He has taken a particular interest in the Spinraza issue and has also spoken to me about boy called Sam on a number of occasions. I will get the Deputy a note because there has been some progress in this regard. As he knows and as I would have informed the House previously, it did require putting in place some quite complex service arrangements in respect of the 27 children, as I think the figure is now, who qualify clinically for the drug. I can tell the Deputy that the drug has started to be administered to children and there are a number of scheduled appointments during this month as well. All children who are clinically eligible will receive it. I believe there has been contact between the HSE and the SMA executive group, the parents' group. I will make sure there has been and will send the Deputy a written note.

The number of patients on trolleys in Cork University Hospital, CUH, this week alone has been in excess of 60 each day. All scientific evidence will show that the longer someone is on a trolley, the poorer the patient outcome. This is also the case when there is a shortage of nursing staff. There are 60 vacancies at present in CUH and the office of the HSE CEO, Paul Reid, has directed that no recruitment can continue without approval. The Irish Nurses and Midwives Organisation, INMO, is calling on the Minister to release the funding for the winter plan and to make funding available immediately for CUH in order that the vacant posts can be filled as soon as possible. There seems to be a difficulty in drawing down the €26 million for the winter plan and they have not received it yet. Is it possible for the Minister to contact Mr. Reid's office and make sure these 60 posts can be filled as soon as possible? It takes the pressure off the whole system.

On the same matter, I want to raise the issue of University Hospital Limerick. The Minister will not be surprised to hear me saying that. Last year 11,437 people were on trolleys in University Hospital Limerick. We have passed that out already this year. In October, 1,450 people were on trolleys, which was an average of 70 people a day. Unfortunately, 70 people are on trolleys now as we are in the Chamber. The Minister recently said to my colleague, Deputy O'Reilly, in a committee, that the modular unit of 60 beds will have no effect this winter as it will not be built or delivered by then. What specific plan does the Minister have for this winter in order that there will not be 70 people every single day? Will he give the people in Limerick the health service they deserve so they are not packed in like sardines as the Minister has seen himself?

I thank the Deputies. The €26 million for the winter has been released. I met the CEO of the Health Service Executive this week and have been in very regular contact with him, as the Deputies can imagine. I have also spoken to every hospital group CEO in respect of Cork and Limerick and all the other hospitals throughout the country. The winter plan will be published by the HSE next week. The special delivery unit, which is a national part of the HSE that goes into our hospitals and assists hospitals in difficulty, is on the way to Cork. It has already been in Galway this week where it has made some improvements.

On nurse recruitment, of course Paul Reid has not said that nobody can be hired or put any freeze on recruitment. It is just very simple. We can only recruit for a funded post. There are 600 more nurses working in the health service this year than last year, and I expect that number to continue.

My plan for Limerick this year, in addition to extra community supports, home care, transitional care and the likes, is also to try to get the second MRI in situ. As I said to Deputy Neville a few moments ago, the tender for that concludes this week. The 60-bed ward block is now well under construction.

The issue of home care packages and the availability of home help have already been raised. I have a very serious case whereby senior people in the HSE are trying to find funding for a particular family whose loved one is being discharged from the National Rehabilitation Hospital in Dún Laoghaire after a life-changing accident earlier in 2019. The recommendation from the occupational therapist and the people in charge in Dún Laoghaire was for a home care package of about 49 hours a week. That was sent to the southern region for assessment, which has come back very clearly saying there is no funding available. It means this person could be discharged from Dún Laoghaire into an acute hospital with all the risks that may entail in respect of infections and everything else. From a common-sense point of view, the HSE would be saving money by allowing this discharge to happen in December, but Dún Laoghaire is adamant that it cannot happen unless the home care package is in place for this applicant. It is very serious and should be looked at.

If the Deputy wishes to send me the details, I will certainly ask the HSE to look specifically at the case and report back to us both.

This morning we listened to a gripping and courageous interview on the Joe Finnegan show on Northern Sound with Leah. I am sure the Minister has seen Leah's video which has gone viral on social media. Leah is a young woman who has lost her father and her brother through suicide. She gave a heartbreaking account of how her family had been utterly failed, as she feels, by the mental health services. She spoke of her brother presenting himself at the accident and emergency department and how he was sent home because they did not have a bed. Leah described hospital wards for patients suffering with mental health problems as prisons - unfriendly and unfit for purpose. In Leah's own words, the Government needs to open its eyes. Leah spoke about her father and her brother trying to access mental health services but with no follow-up, no support and no continuity. The saddest part of her experience, as she revealed in her interview, is that she believed her brother did his very best to live. His mind was unwell but his body fought to live. The system has failed Leah's family, and as a result she has lost her father and her brother. I am asking the Minister to recognise the fact that there is a crisis in our mental health services.

I know Leah and her family very well. The family in Arigna has been devastated. Five years ago she lost her father to suicide and two months ago she lost her brother. They told me about the situation of going to the mental health services. Many others have similar experiences, where they go with suicidal tendencies and they are told, "Sit there for a couple of hours and we will talk to you", and then they are told, "Now you can go home and you will get an appointment." It could be a week or it could be a month before that appointment comes. I have a case of a young mother whose child, a teenager, has suicidal tendencies and who is told the same, "Go home and you'll get an appointment." This situation has really become a travesty for families, particularly in the north west but I am sure in every part of the country. We have raised it here on numerous occasions and there does not seem to be anybody listening. When nobody is listening, lives are being lost. These losses are very tragic and it is having a devastating effect on communities throughout the country. It really needs to be dealt with urgently.

I know Leah's family. They are from Arigna in County Roscommon. As Deputy Smyth said, the interview this morning on the Joe Finnegan show was certainly very disturbing. For a girl to speak about the loss of her father and her brother through suicide in the way she did and the way she gave the story was just so heartbreaking. It behoves every single person in this House to deal with this mental health issue. We have more stories coming in about tragedies like this and people are at their wits' end. I ask the Minister, the Taoiseach, the Tánaiste and everybody here to address this issue urgently. It is not being addressed urgently and we are going to have more and more cases like this unless immediate action is taken.

I thank Deputies Smyth, Kenny and Murphy for raising this. I assure Deputy Kenny that I am listening and the Government is listening but we are not just listening; we intend to act. I thank Leah for telling her story and extend my condolences and those of the Government to her for all that she has been through. It is an unimaginable pain and grief that she must be going through. I did not hear the Joe Finnegan interview but I will certainly make it my business to listen to it and learn from what Leah has to say.

We are acting and I want Leah to know that. The new Central Mental Hospital in Portrane will open next year, a state-of-the art facility replacing a very old, out-of-date building. The mental health budget is now above €1 billion for the first time ever. There are 144 assistant psychologists, a new grade, working in mental health. We have seen the child and adolescent mental health services, CAMHS, waiting list fall by 20% since last December. For the first time ever, there is a 24-7 helpline to signpost people in respect of supports. We absolutely have a lot more to do in respect of mental health. I would certainly be happy to hear from Leah and to learn from her.

There are a number of alleged irregularities with the assembly of a government site in Anne Street in Wexford. It is alleged that the dismantling of the title property was done without the knowledge of the property owners. It is alleged that the highly irregular purchase of the hotel caused a significant loss of space to the decentralised Revenue office. It is alleged that Wexford Borough Council never sought to have the planning amended to reflect the revised layout. It is also alleged that Wexford Borough Council arranged a compulsory purchase order, CPO, on the remainder of the hotel site, but excluded reference to the CPO process of the owner on behalf of the hotel site. The council carried out an investigation into this in 2016. However, the adjoining landowners are seriously challenging this.

I urge the Minister for Housing Planning and local Government to ensure that this is investigated properly and is resolved once and for all.

I am not aware of the individual planning issue but the Deputy is referring to and I cannot get involved in individual planning decisions. That said, earlier this year, the Government established for the first time in the history of the State the Office of the Planning Regulator. Niall Cussen is that regulator. That is the appropriate body to which the Deputy should relay his concerns, because it can then do an independent investigation of the local authority, of An Bord Pleanála, and of the other aspects of the planning system we have in place.

The problem of insurance for many businesses has been mentioned in earlier contributions. Senator Ó Céidigh brought forward a Bill, the Perjury and Related Offences Bill 2018, and it has passed through the Seanad. This will ensure that claimants are under an obligation to tell the whole truth, and if they do not there will be serious consequences. The Government has indicated its willingness to accept that Bill and bring it into the Dáil, but that has yet to happen. Last night the Dáil business finished at 7.45 p.m. and it was scheduled to run until 10.30 p.m. What is the delay and why is the Government failing to prioritise insurance reform? There is legislation there. The Government has indicated that it would facilitate the passage of this legislation in the Dáil, and yet we are still waiting to see that happen. When can we expect to have that legislation in the House? It will not alleviate the problem but it will help deal with some of the fictitious claims that are out there at present.

I am very pleased that this Bill will be enacted. I spoke to Senator Ó Céidigh last week, and I appeal to Deputy Troy that, when the matter comes before the House in the next few weeks, we can rely on his full co-operation to ease its passage through the House at the earliest opportunity. I expect that with the-----

Bringing the Bill into the House would be a start.

I expect that with the co-operation of Deputy Troy, we can have this Bill on the Statute Book by the end of this term.

I thank the Minister. That concludes Questions on Promised Legislation. Unfortunately, six Deputies were not reached today. We will give them priority on Tuesday.