Dáil Éireann debate -
Wednesday, 11 Nov 2020

Vol. 1000 No. 5

Ceisteanna ó Cheannairí - Leaders' Questions

Deputy Mary Lou McDonald

The Government came to office four months ago promising to take major action on housing. The harrowing stories from people whose lives have been ruined by the housing crisis are well known to all of us: young couples who cannot afford a home of their own, some living with their children in the box room of their mammy's house; struggling renters who hand a chunk of their wages over to landlords every month; and families on council waiting lists for years, with no light at the end of the tunnel. For an entire generation, the security of having an affordable roof over their heads has been reduced to a pipe dream, and this is the devastating result of decades of bad housing policy from successive Fianna Fáil and Fine Gael-led Governments.

The lack of urgency from the Government on this matter is very concerning. The Minister for Housing, Local Government and Heritage, Deputy Darragh O'Brien, spent the entire summer on the media telling people that he would publish his affordable housing plan in September, but September came, September went and still no affordable housing materialised. The budget came in October and it, too, was a massive disappointment. The housing measures fell far short of what is needed to deal with the most serious affordable and social housing crisis in the history of the State. More new money will go to private landlords and private developers than will go towards genuinely affordable homes for working people. So long as housing policy in this State is directed by and for wealthy developers and landlords, we will never fix the housing crisis and our people will continue to suffer.

We see from the latest daft.ie report, published on Monday, that renters are still suffering because of a failure of the Government to act. The report shows that rents are rising right across the State, with increases of almost 3% outside Dublin in the past year. It is alarming to see rental increases of almost 5% in Cork, Galway and Waterford and hikes as large as 7% in counties such as Wexford. The average State-wide rent now stands at €1,419 per month. New Dublin city rents now average €2,028. There is no good news for renters here in the capital. This crisis is clearly getting worse. Just as when it comes to affordable housing, there is no response from the Minister. Budget 2021 contained nothing for renters, no action to stop rent rises, no measures to put money back in renters' pockets and no funding to deliver the volume of affordable cost-rental accommodation that our cities and our country desperately need. These are the measures and solutions that Sinn Féin has consistently urged the Government to adopt, and ignoring these solutions was a serious failure on its part.

In the midst of the pandemic, hard-pressed tenants are paying the price of this failure in the form of increasing rents. Surely an emergency of this nature should have been a catalyst to deliver secure and affordable housing. Instead, people got the opposite: higher rents and a higher cost of living, which is incredible. What does the Taoiseach propose to do about this? Does he now recognise and accept that there is an urgent and immediate need for his Government to introduce measures to stop rent increases? When will we finally see his Government's affordable housing plan?

The Taoiseach

The language used by the Deputy is quite propagandistic. To describe a €3.3 billion budget allocation as "massively disappointing" is extraordinary by any yardstick. Fianna Fáil has not been in power for ten years. That is just the reality and the facts, but Sinn Féin never allows facts get in the way of anything.

The bottom line is that we want to build social housing and we want to build it at scale. That is what this budget allocation does. We also want to build affordable houses. Supply is the key to the housing crisis. We know that over the past number of years there has been a crisis in housing supply and an issue in terms of affordability and the provision of social homes. That is why more than €3 billion was secured in the budget to provide the resources to get started on what will be the biggest social housing building programme in the history of the State. Next year, we will build 9,500 social homes as part of an overall delivery of 12,750 social homes. That is a 22% increase on the 2020 target of 7,736. Obviously, Covid-19 has impacted on housebuilding in 2020.

The budget also provides for a suite of affordability measures totalling €468 million. That will be spread out across the serviced sites fund, the local infrastructure housing activation fund, the Rebuilding Ireland home loan scheme and the Land Development Agency. Some €110 million has been provided for the affordable housing and cost-rental schemes and €435 million will go towards a new programme for funding the delivery of cost-rental homes. That will see funding made available to approved housing bodies in 2021. The new cost-rental equity loan will allow approved housing bodies to borrow up to 30% of the cost of cost-rental homes from the State and is modelled on, but completely separate from, the successful capital advance leasing facility model for funding social housing. In addition, the Land Development Agency has indicated its intention to include a significant proportion of cost-rental homes on its portfolio of sites over the coming years. This will further increase the scale of this new sector.

As the Deputy will be aware, Dún Laoghaire-Rathdown County Council has approved the next phase of the Shanganagh site which is Ireland's largest proposed social and affordable scheme to receive planning permission. That is important and is illustrative of the type of progress that is being and will be made. The Government has identified housing as its number one priority in the programme for Government. Over the next number of years, it is determined to deal with it and ensure, through a combination of measures on social housing, affordable homes and rental, that we allocate the necessary resources on a multi-annual basis so that certainty will be given to local authorities and approved housing bodies and that they can proceed with their plans.

We are also keen to accelerate and encourage new housing supply for rent and purchase in order to keep existing rental units in the market and to bring vacant homes back into use, including those vacated by fair deal participants. Significant changes to the criteria for rent pressure zones, RPZs, which were introduced in the Act to considerably strengthen those zones, remove a number of opt-outs and give new substantial legal powers and resources to the Residential Tenancies Board to enforce rent controls affectively. A key element of existing policy centres on the designation of RPZs in areas where rents are highest and increasing most, the effect of which is to limit the increase in rents to 4% per annum. At this stage, more than 73% of the 364,099 tenancies in the private rental sector are covered by RPZ designations. That type of approach on the part of the Government will continue. Those restrictions have had a moderating effect on rent increases and have given certainty to landlords and tenants alike. Essentially, however, the essence of our programme is not developer-related at all. It is designed to give the resources to local authorities and approved housing bodies to build more social homes than we have ever built before.

Deputy Mary Lou McDonald

How are these for some facts that the Taoiseach might acquaint himself with? Fact one is that RPZs do not, have not and will not work. Fact two is the evidence, if the Taoiseach cares to see it, that rents are rising. The average rent is more than €1,400 across the State. That is astonishing. By the way, this is not for the Taj Mahal, it is for a two-bedroom unit here in Dublin city. How is this for a fact? The Government has not produced its affordable housing plan. The Taoiseach should not accuse me of propagandistic speech when I simply present him with those facts. It is extraordinary that the Taoiseach could big-up his budget of all budgets of €3.3 billion for housing and yet deliver nothing, zilch, nada for renters. The Government delivers plenty for landlords because, despite what he says, that is still the focus of its policy. What is the Taoiseach going to do for those young workers and families who must find more than €2,000 here in Dublin city, or more than €1,400 elsewhere across the State, every month to hand over to landlords. Where is the relief and support now for those people and those families?

The Taoiseach

It would be useful if people compared and contrasted the Sinn Féin performance in government on housing to that of the current Government here in terms of protecting tenants. Under a Sinn Féin Minister with responsibility for housing, for example, the recent private tenancies legislation in the North simply extended the termination period to 12 weeks, with the courts starting to hear eviction proceedings from 31 August. The protections Sinn Féin brought in where it is in government are far less than what we have been doing here in the Republic, where there have been more comprehensive measures to protect tenants from eviction, particularly in the context of Covid-19. That is never acknowledged and the contrast is quite stark in terms of how people are treated under Sinn Féin where it is in government and the parties in government in the Republic.

We acknowledge that there is much work to be done here. The Deputy is correct in saying we have only been in government for a number of months. Budget 2021 puts its stamp on it, however, and states unequivocally that, with multi-annual funding, we want to engage in the largest social housing building programme over the next five years. That is our agenda and that is what we will do. There is also affordable housing, of course, and we have a suite of other measures to enable us to do that.

Deputy Alan Kelly

We obviously had good news regarding a Covid-19 vaccine in the past week from Pfizer and BioNTech who say they have a vaccine that will be 90% effective. Given the issues relating to storage, this may or may not be the vaccine that will be rolled out in the coming months. I understand that others will be coming on stream pretty quickly too, which will be fantastic. We cannot allow this to result in any form of complacency as to how we deal with Covid-19. I am sure the Taoiseach will agree and perhaps next week we can discuss the plan for December. We need an indication from the Government as to what will be the plan for rolling out the Covid-19 vaccine. There is no doubt we will have some form of vaccine very soon, whether it is from Pfizer or others. I understand that a task force has been set up. I presume this has been in place for some time so the Taoiseach might tell us when it was set up, how it will work and who is on it. That all needs to be made public.

The Taoiseach might also inform us about discussions with the European Commission regarding its contract to purchase 300 million doses of the current vaccine. When will it be available, how much is coming to Ireland and how quickly? We need to plan and we need a detailed plan from the Government very soon. We admit that this plan will change; we know it will change. Across society and particularly across health care, however, there needs to be co-ordination. Everyone involved needs an indicative working plan from the Government. The Taoiseach might outline that for us.

I hope we will be able to administer the vaccine much better than we are administering the flu vaccine. We need to dramatically improve on how we roll out the Covid-19 vaccine versus what we are doing in respect of the flu vaccine. Some 1.3 million doses of the latter were distributed. Last year, I asked numerous times on the floor of the Dáil and at committee that we would actually purchase enough vaccines to give to everyone for free. The Government refused and we are where we are today. Now we know that a certain amount of the vaccine has been withheld.

We also know that there are huge administrative issues with the procedure by which the vaccine is being administered. Why in God's name are we expecting GPs to have to log on to the PCRS system every single time they administer a vaccine in order to claim payment? In 2020, surely this is a ridiculous administrative burden and is creating more time for vulnerable people and others to be around one another?

I have a number of specific questions for the Taoiseach. First, what is being done to get more flu vaccine doses? How are we going to ensure that the current roll-out is made more efficient? Why are we using an archaic system? Above all, what is the plan for the roll-out of the Covid vaccine, when it is announced - admittedly, it will be a working plan - and how will we ensure we get it out in a more efficient manner than we are doing with the flu vaccine this year?

The Taoiseach

The Deputy raised a number of issues. Beginning with the Covid-19 situation, the bottom line is that we are part of a pre-purchase agreement with the European Commission. The latter has advance purchase agreements so far, and prior to this week, with Oxford and AstraZeneca; with Janssen, which is owned by Johnson & Johnson; and with Sanofi Pasteur. Those agreements will be formalised following completion of clinical trials and the Janssen vaccine is expected in late December. The emerging news is that the Commission is on the cusp of signing, if it has not already signed, a deal with Pfizer and BioNTech. The President of the Commission has been leading that process and I have been in contact with her on it. It has been discussed at European Council meetings. Ultimately, it is the Commission's target to have an agreement with seven consortia. There is enough funding across the European system for arrangements with six consortia and it will probably go to a seventh. We will need the full range of options throughout 2021 because the next issue will be manufacture. All of those agreements include specific dosage allocations that mean we would get approximately 1% of whatever the European procurement is. I will get the detailed figures for the Deputy. That will be very significant for us in terms of targeting the vulnerable and those who would be a priority in terms of the receipt of a vaccine. The Deputy is correct in identifying logistical issues around the Pfizer-BioNTech vaccine in terms of the requirement for storage at -70 °C.

In August, we set up a vaccine strategy committee under the chairmanship of the Department of Health. The HSE set up its own group at the behest of the Minister. We have decided now to set up a whole-of-government group that will take in expertise from outside government in regard to organising the logistical operation that will be required. The Cabinet took that decision yesterday and the group will be chaired by Professor Brian MacCraith from DCU. The Chief Medical Officer will be on this high-level vaccine task force, as will Paul Reid, CEO of the HSE; Liz Canavan, chair of the senior officials group on Covid-19; Barry Lowry, Government chief information officer; and Paul Quinn, Government chief procurement officer. In addition, there will be a nominee yet to be confirmed from the Department of Business, Enterprise and Innovation, a logistics cold chain expert and a project management expert. The high-level vaccine task force will be tasked with co-ordinating preparations in this area and ensuring the nationwide roll-out of a Covid-19 vaccine when one is safe and ready to be distributed.

The Deputy also raised issues in regard to the administration of the flu vaccine. He probably heard Dr. Colm Henry speaking about that this morning. I do not accept that the entire system around the flu vaccine is archaic. It is a very extensive programme this year. There has to be measuring of what is happening in communities and there has to be targeting and prioritisation. This year's programme is a larger programme than in previous years and the HSE is satisfied in terms of its effectiveness so far.

Deputy Alan Kelly

In regard to the flu vaccine, I have in my hand the form that must be filled in at the GP's office. The requirement to do so means that people are spending longer in there. What is happening is that GPs are putting the forms through in bulk. The figures quoted in the press today reflect the fact that they do not complete the forms and put them through straight away because they do not have time to do so. GPs are overworked, as we know, at this time.

The other issue the Taoiseach needs to be conscious of is the question of why we have a situation where anybody can order a flu vaccine in some pharmacies. I have got the flu vaccine every year and am a huge advocate of it. I have not got it this year because I am not a priority. I presume the majority of Deputies are in the same position. We are not priorities if we are fit and healthy. If a person has an underlying issue, that is a different thing. Why is it the case that people can get it from some pharmacies just by booking it? In fairness, some pharmacies are being very deliberate in focusing on target groups, but others are not. That is an issue.

I thank the Taoiseach for providing extra information in regard to the plan for the roll-out of the Covid vaccine. I ask that he update it because it is a working programme that will need to be updated. There are huge numbers of people across the logistics of this who need to be kept up to speed on a weekly basis. Will the Taoiseach undertake, on a weekly basis and through some process of communication, to update the public as to how this will be dealt with? It is a process that is going to change in intensity over the coming weeks and months.

The Taoiseach

I accept the latter point the Deputy made. Whether or not it is a weekly update, I would like the task force to get down to work on this. That is why we have established the task force and I am very determined to move ahead, notwithstanding the work that has already been under way, to be fair, within the normal channels around immunisation. That includes the work of the National Immunisation Advisory Committee and the work done by the Department of Health and the HSE. Given the precise issues in terms of some of the vaccines, particularly the Pfizer-BioNTech one, logistics are important and external expertise is important to be joined to the process. I will keep Deputies up to date on that. There is a bit of work to be done by the companies in terms of getting approval from the statutory authorities and the vaccines being adjudicated to be safe for distribution.

In regard to the flu vaccine, applications for reimbursement through the PCRS have been made in respect of 700,000 doses, which indicates that a substantial amount of vaccine has been distributed but has yet to be administered. The HSE is currently assessing where the greatest level of demand for the flu vaccine remains before issuing the next 50,000 doses. In tune with what the Deputy was saying, the HSE wants the remaining 50,000 doses to be distributed by the end of November and to be prioritised for those who need them the most. I am not sure that it is such a big deal to fill in forms. There has been a good working relationship between the HSE and GPs.

Deputy Alan Kelly

Why is it not done electronically?

The Taoiseach

I agree that it should be done electronically.

An Ceann Comhairle

We must move on to the next speaker.

Deputy Peadar Tóibín

In this Covid-centric world, much of non-Covid Ireland is being forgotten about. Many really important sectors of Irish society feel they have fallen off the world when it comes to Government priority. Some 150,000 cancer appointments have been missed this year. There are 200,000 women on cancer screening waiting lists who, despite the winter plan, will not be reached this year. Some 3,500 women have contacted domestic violence services for the first time this year. Child poverty rates are increasing at approximately 5%. There is a mental health pandemic sweeping across the country. Our domestic economy is being flattened, with 51% of retail currently online.

Another issue that has fallen off the priority list is homelessness. I have statistics from the Dublin Region Homeless Executive, DRHE, which give serious cause for alarm. The death toll among people who are currently homeless in our capital is spiralling out of control. So far this year, the number of homeless people in the capital who have died is more than 50. That compares with 34 people for the whole of last year and 35 for the whole of the previous year. That is an incredible statistic, first of all because it is from a smaller base of homeless people and, second, because the year is not even over yet. Councillor Anthony Flynn of Inner City Helping Homeless has expressed huge concern about the numbers given that homeless deaths typically peak from November to December in this country.

I urge the Taoiseach to read that report from the DRHE to examine the specific cases. One man, for example, was found dead the day after he was released from prison. It refers to young women in their 20s dying from suicide and drug overdoses. The list goes on. There was an incredibly tragic situation where a man was discharged from hospital, walked around the corner and hanged himself from a railing. This is a profound human crisis. These men and women are the same as any of us here. They just have had different life experiences. Their situations are being eclipsed by Covid. We need urgent help on this. These figures only relate to Dublin. The simple fact is we do not know what the figures are in the rest of the State. First and foremost, can we find out what is happening in this regard throughout the rest of the country?

Second, we cannot fix this if we do not know what is going on. There needs to be a proper investigation of these figures. The fact that these figures are spiralling out of control, far higher than previous years, means the State needs to investigate what is happening to people who are homeless in the capital and throughout the rest of the country to make sure that we can put the proper services in place so that lives are saved.

The Taoiseach

I thank the Deputy for raising these very serious issues. Without doubt, Covid-19 has had a significant impact on a range of services and activities and it has created much hardship and difficulties for many people.

The Deputy mentioned initially the screening programmes. In the first phase of Covid-19 and the first lockdown, screening programmes were not just scaled down but closed down. The emphasis of the winter initiative, but also the increased funding for health in 2021, is designed to resume a broad range of health services, including the resumption of national screening programmes. In particular, CervicalCheck resumed its services in July. It is estimated that all paused screening invitation letters will have been sent by the start of December 2020 and all women due a screening test in 2020 will have been invited by March 2021. Over 162,000 letters have been issued to date. BreastCheck resumed most recently, on 27 October. Approximately, 153,000 screening invitations were paused due to Covid-19. BowelScreen resumed issuing new invitations on a phased basis from 4 August. One hundred and twenty-three thousand invitations had been paused. Up to the end of October, over 39,300 new invitations had been issued with approximately 10,900 sample kits returned to the laboratory. In terms of diabetic retina screen, that service resumed screening on 1 July. Approximately 64,000 screening invitations had been paused due to Covid-19 and over 20,000 people had been screened at the end of October.

In relation to housing, first, we will, of course, conduct an assessment. Each case is different and what is essential here is proper cross-departmental co-operation, particularly in health and housing and the homelessness services, working hand-in-hand during the winter and the winter initiative itself. That is something that we are focused on.

It is very sad and distressing for the loved ones of people who die homeless. Homeless deaths are something we want to prevent and the most essential way to do that is to reduce homelessness. The homelessness figures are still too high but they decreased again in September. They were down 17% year on year.

Progress has been made on the wider homelessness front. Housing First is something we are committed to. It provides homes and the wraparound housing and health supports that are required to sustain a tenancy. The Minister, Deputy Darragh O'Brien, has prioritised addressing the homelessness crisis. He established the high-level homelessness task force in July. I will speak to the Minister about the points the Deputy raised. Particularly in terms of the current period, the cold-weather arrangements are in place now nationally for the winter period. The Dublin Regional Homeless Executive, which has responsibility for over 70% of all homeless persons nationally, activated its cold-weather initiative on Thursday, 29 October. That involves an increase in overall bed capacity, a 24-service and facilities, enhanced rough-sleeper outreach and increased contingency placements for families.

Deputy Peadar Tóibín

The Taoiseach's answer highlights why this is so worrisome in many ways because he correctly states the homeless figures are decreasing but the deaths among homeless people are going in the opposite direction. That is the key issue. The figures are already massively higher than they were in the past two full years. I believe there is a number of reasons for that. If a person is from outside of Dublin and he or she needs help in Dublin, that person is told to go home to his or her own county. Such people cannot go home to their own counties at present because of lockdown and many of them are going on the streets and as a result are coming under fierce pressure on the streets of Dublin.

There is also a problem with the standardisation of homeless services across the State. We have a situation where many providers are doing the best they can but do not have the resources to do it properly, but others need real oversight and to be regulated properly by HIQA.

The truth of the matter and the kernel of my question is, we have a tale of two countries. The most vulnerable are being left behind - people with cancer, people with mental health issues, people on low wages, people working in meat factories, homeless people, asylum seekers and those in nursing homes. In relation to people who are homeless, will the Taoiseach commit today to investigating why there is a significant spike in the number of people who have died homeless in our capital this year?

The Taoiseach

I ask the Deputy to send me the details of the cases that he has come across.

There is a number of key points here. For example, if someone is leaving prison, there should be a proper plan for that person before he or she leaves prison in terms of rehabilitation or work, and in terms of placement, and each case is different. Much work goes on within prisons to facilitate safe release that can lead to a sustainable life, free from addiction and with supports and wraparound services. That is very important.

Likewise, in terms of homelessness services in general, the HSE winter plan provides for this. When I was Minister for Health, I myself was involved where we provided mental health supports in the centres for easy access for people who are homeless and provided GP services and supports to homeless people who were in centres, in other words, that the services should go to the homeless person as opposed to expecting the homeless person to go to the services. I favour that type of approach. I will talk to both the Minister for Health and the Minister for Housing, Local Government and Heritage who have been engaged on this. The HSE is working with the Dublin Regional Homeless Executive and with other local authorities across the country to make sure that there is a proactive co-ordinated approach to help people in these situations and to understand the reasons such cases develop. These cases are unacceptable. They cannot be tolerated. We must do everything we possibly can to deal with them.

An Ceann Comhairle

We move finally to Deputy Mattie McGrath on behalf of the Rural Independent Group.

Deputy Mattie McGrath

Ar an gcéad dul síos, I want to be associated with the Ceann Comhairle's remarks of compliments and congratulations to the team here at the convention centre and, indeed, to the chairman of the board, an tUasal Uí Dhubhuir ón Bóthar Leathan in Tipperary. I compliment them and wish them well for the future.

I am quite concerned about the answers the Taoiseach has given to Deputy Tóibín. More than 450 cancer cases and 1,600 pre-cancer cases are likely to go undetected during the pause in screening during Covid but we have to deal with this. The Taoiseach stated he gets the point and he understands but I do not think he does. I am calling on his Government to sort this out urgently because it is not good enough for the people. It may well take years to comprehend fully the misdiagnoses and the hundreds of people who will have died due to neglect and not being seen in time. I do not say that lightly. Hundreds of people would have got life sentences. Professor John Crown, a former Seanadóir whom I have great respect for, has said that treatment delayed is treatment denied. The old adage was that justice delayed is justice denied. I salute the professor and his colleagues. Treatment delayed is treatment denied. It is shocking that cancers can be growing inside people and they are not aware of it. They are waiting and they might have attended their GPs. They are nervous and they are worried. The Government must swiftly address this problem. Pre-Covid-19 we were not meeting anything like the targets we had. We had targets of 95% for new patients attending rapid access breast, lung and prostate cancer clinics within the recommended timeframe - this is pre-Covid. Those are the HSE's own targets. Last year, however, the rate was only 71%. We were missing 24% of people in any case before Covid hit. It is alarming and it has to be dealt with.

Similarly, early intervention systematic breast disease clinics for urgent breast cancer patients and rapid-access clinics for prostate cancer patients were both 26% below the HSE target in 2019. The HSE, therefore, was not fit for purpose even before Covid hit and it certainly is not now. I ask the Taoiseach really to deal with this. There is no point in him telling Deputy Tóibín and myself he knows, he is aware and that we are going to catch up and about all the letters that have been sent out inviting people in. People are scared to go in now because the Taoiseach and RTÉ have frightened the life out of them by telling them morning, noon and night that they should cocoon and stay at home. People who want to go cannot go. They get the letters but they may not respond because they are so worried about going anywhere, especially elderly people. It is time that there was a balance in the Government's attitude to Covid and to the rest of the health service and to the economy, people's mental health, cancer diagnoses - you name it. It was already accepted internationally that we are way behind and under-resourced in our health system and especially in our cancer care treatments. Many recent graduates have looked outside the public service for jobs because of pay and conditions. We need to support them. We are short 500 consultants and they must be recruited. The Government needs to catch up quickly here. I do not believe that the Minister for Health, Deputy Stephen Donnelly, or his Department are capable of doing this. We are slipping backwards and hundreds of people will lose their lives as a result; not one but hundreds or maybe even thousands.

The Taoiseach

We all need to be careful with language and how we describe things. People are not scared to attend screening services. People are not scared to go to hospital and many are going. As we moved into level 5, one of the key objectives was to keep normal health services open. That has been one of the clear differences between this level 5 lockdown, if we call it that, and the first lockdown. That is understandable too because for a lot of people, the whole experience of this virus was that it was new, unprecedented and essentially whole wards were affected and Covid dominated the hospital experience. Yes, there were delays and backlogs have been created because of delays occasioned by the first lockdown. That is the reality but we have to deal with that. That is why an unprecedented allocation of €600 million was given for the winter initiative and the resumption of services and that has been followed through on with a €4 billion allocation - I repeat, a €4 billion allocation - to the health services for 2021, €2 billion of that to deal with Covid and €2 billion to deal with the health service system itself. That will lead to an additional acute bed capacity of over 1,200 beds. It will lead to additional procurement of activity from the private hospitals. It will allow for more intermediate care beds. It will allow for greater additional access to diagnostics for GPs. It will allow for additional community healthcare networks and community specialist teams, particularly for older people and those with chronic disease. All of the national screening programmes have restarted a phased reintroduction of screening services. If we take, for example, BowelScreen, over 39,000 new invitations have been issued, 10,900 sample kits have been returned to the lab and almost 400 patients have been referred for a colonoscopy. These are people who are using the screening services right now and who are responding to the services.

I take the Deputy's point that some people are obviously still afraid of getting Covid. They are right to be afraid of getting it because no-one should want to get Covid because it can damage a person's health. It is not fair to say people are on the television screens every night scaring the life out of people. They are not. It is important to keep the national effort to get the numbers down. The Deputy should look at what is happening on the Continent at the moment. There are real challenges and pressures on ICU beds right across Europe. Thankfully we have been spared that by timely intervention by Government in the form of going first to level 3 and to level 4 in some counties, by restricting household visits and then going into level 5. A combination of all of that has meant that Ireland now has the third-lowest incidence rate in Europe. We should all work together to maintain that low incidence of Covid right through to the end of the month because that will ensure we can retain the bulk of our hospital, community care and primary care capacity for non-Covid illness. It is the most effective way we can do this and we should all row in behind it.

The bulletins are not daily, I think they are twice-weekly. They are important to keep up the level of national awareness and alertness to the dangers of Covid-19.

Deputy Mattie McGrath

The Taoiseach does not get it. Almost 150,000 people have not been seen by the main cancer screening services in the last six months because of Covid. Over 12,400 more people are waiting for an inpatient day case endoscopy at the end of September compared to the same month last year. That is an increase of 56% in the number of people waiting, on top of the already bad situation we had. According to the Irish Cancer Society, social distancing has meant that capacity is reduced by 50% in hospitals. There are now 2,400 people on the urgent waiting list for endoscopy services, almost a quarter, 24% or 580 people of whom have been waiting more that three months. That is totally intolerable. The health services may be writing letters and inviting people back in but they are not coming in because it is a dysfunctional service and was previous to this as well. The Government can throw all the money it likes at it but it will not work.

We need 71 additional consultant oncologists over the next number of years. Have they been recruited? They will not come into the services because of the conditions there. I am very concerned, as are the people out there. We are listening and are supporting the situation but there has to be balance and there is no balance or logic to a lot of the decisions the Government has taken. Trying to get these people back into the hospitals to be seen is vital for their own health and that of their families as well. I repeat - I do not say this lightly - that hundreds of people will die because of this neglect.

The Taoiseach

As I said to the Deputy, Covid has had an impact. It has resulted in delays. The first lockdown resulted in very significant delays. I do not know what the Deputy's alternative is in terms of what happened in the last number of months. If we take diabetic retinal screening as an example, it resumed on 1 July. Some 20,000 people had been screened by the end of October, so people did come through and it is important to say that. People are turning up for screenings. People are turning up in our hospitals for elective procedures and diagnostic tests. The message we should send out is do attend for screening appointments or diagnostic tests and do go to hospital if not feeling well. It is important we send that message out.

(Interruptions).

The Taoiseach

The only issue is to start now affirming those working on the front line because Covid-19 is a once in a 100 years event. It is impacting all strands and strata of society. It is extremely important we affirm people who work on the front line as well. Restrictions have to be in place. Deputy Mattie McGrath attacks social distancing but it must happen. Have we any chance of reducing Covid-19 if people say we do not have to socially distance?

Deputy Mattie McGrath

I did not say that.

The Taoiseach

The Deputy said social distancing is reducing the number of operations.

An Ceann Comhairle

The Taoiseach's time is up.

The Taoiseach

There have to be procedures and protocols in place. The Deputy must accept that.

An Ceann Comhairle

That concludes Leaders' Questions. We are already running significantly behind time. On Questions on Promised Legislation, 20 Deputies have indicated.