Ceisteanna ar Reachtaíocht a Gealladh - Questions on Promised Legislation

There are currently more than 200 children waiting on scoliosis procedures. That is up 25% in two years, and almost half of these children are waiting for more than six months. This makes a mockery of the promised made by Deputy Harris, as Minister for Health, some three years ago, that no patient would wait more than four months.

Serious delays in scoliosis surgery have been a huge problem long before the pandemic. As children wait for their surgery, they are not able to live a full life. Some live in pain from the time they get up in the morning until they go to bed at night.

Children with scoliosis should not have to stand at the Dáil protesting their situation but, sadly, that is what young Sophie Redmond had to do. I spoke to the Taoiseach about Ms Redmond last week.

The Taoiseach needs to face up to this problem now. These children and their families need real action. They need a plan from the Government and that means more specialists and nurses, and more beds to reduce waiting times.

I ask the Taoiseach to respond to those 200 children currently waiting on their scoliosis procedures. What is his message to them?

My message is that I am committed to doing everything I possibly can to reduce the times for children waiting for scoliosis surgery. There were 255 scoliosis procedures up to the end of October of this year. That compares with 319 spinal procedures for the same period last year. Unfortunately, in March, April and May, because of Covid-19, there was a collapse in the number of procedures and that has had an impact.

Funding is not the issue. Funding was provided for the recruitment of approximately 60 whole-time equivalents in the past 18 months to enable the expansion of paediatric orthopaedic services, including scoliosis services. Work is under way, for example, in discussions with Cappagh, if Cappagh can be of assistance to Crumlin, and also, in terms of the UK, Stanmore is a facility that is available as well for scoliosis. However, I will be engaging with the Minister for Health.

I have written back to Ms Redmond as well. It is difficult for the children concerned and I will do everything I can to try to help.

The prioritisation lists for the Covid vaccine were published yesterday. We need clarity on who are the key workers. Everyone is asking the same question.

We all support the European Medicines Agency, EMA, approval process for vaccines. Is it possible for the Taoiseach to check whether we can get our proportion of vaccines in advance of the nine-to-ten day differential between the time it will be approved and distributed, in other words, bringing it in advance of potential approval? Logistically, that might work well. I do not expect him to necessarily have the answer but he might look into it.

I will certainly look into it. The guidance, in terms of the sequencing and the prioritisation, will always be informed by the national immunisation committee, the National Public Health Emergency Team, NPHET, and the public health expertise. It is important that we all collectively adhere to that because I do not see how it can be managed otherwise.

Various sectors and groups will come forward saying that they want to be considered in advance. In terms of getting the vaccination, the priority has to be those, first of all, most at risk of serious illness or death because the vaccine is particularly effective in preventing illness and severe symptoms as a result of getting the virus. On the prioritisation, it is nursing homes, in the first instance, and the staff, and then health care settings after that.

That is a working document in the sense that, obviously, as more vaccines become available, more options become available because different vaccines have different requirements in terms of administering. For example, the Pfizer BioNTech vaccine is particularly onerous in terms of the measures that have to be taken to safely administer that, and who administers it, etc.

I will have the blueprint by Friday and go to Government next Tuesday, and I will look into the point that the Deputy has raised.

A constituent of mine from Wicklow has to present himself tomorrow for deportation. It is two weeks out from Christmas, we are in the middle of a pandemic and this man has lived in the country for 14 years contributing to his community during that time. It is inhumane to deport someone after 14 years of living somewhere.

Unfortunately, he and many others are being caught in this limbo land between an old system that we all agree is not fit for purpose and the Government has committed to reform and those reforms being formalised and being put in place. Does the Taoiseach agree that, unless in instances of national security, deportations should be stopped during the pandemic and that when people are being assessed under the current process the intent of the new Government policy and the recommendations of the Catherine Day report should be taken into consideration during that processing and assessment?

The Government's view is similar to the Deputy's in the context of Covid-19, that unless people represent a threat to national security they should not be deported at the present point in time. Deporting is a part of our wider migration management programme but in the context of Covid, we have obligations to the health of people, irrespective of status, for example, in terms of sending someone back to a red zone in respect of the prevalence of the Covid virus. In the context of the legislation before the Seanad this week, the Minister for Justice is making the point that whilst wanting to retain the capacity in terms of threat to national security or other factors, we would have a stay on deportations.

There are pay increases for judges, pension cuts reversed for ex-taoisigh and 4,000 top civil servants but still no pay for student nurses and midwives. I agree with the Fianna Fáil Deputy for Cork East who stated yesterday that this may do lasting damage to his party.

The Taoiseach spoke firmly earlier against paying student nurses but the point is student nurses are working in our hospitals. They will tell him that themselves. Does he doubt them? Even if they were in an apprentice-type arrangement, as he says he would like to see the situation, they would still be on the front line risking their health with the Covid situation and would deserve something in return for that.

The Taoiseach did not comment on two suggestions put forward by Solidarity-PPP Deputies and by the student nurses themselves, that, as a token of appreciation for putting themselves in harm's way and the work they have done, their student fees would be waived or that a generous bursary could be granted to them. I would like if he could address those points in his reply.

I am of the view that the Deputy's party are opportunistic propagandists and it is all about distorting the truth. In 2016, the Deputy wanted to reverse the financial emergency measures in the public interest, FEMPI, in their entirety. The higher earners and pensioners, that the Deputy is giving out about now, would have had their cuts reversed back in 2016 if he had his way. That is the truth.

In relation to nursing students, I do not believe the apprenticeship model is the correct model. I brought in the nursing degree programme in 2002 to professionalise and drag nurse education into the 21st century. That was the whole purpose of it. The entire nursing community, from trade unions in nursing right through to the education sector, and across the board, at the time wanted that. In subsequent years, it has been a basis for seeking pay increases as well.

The point I am making is I do not believe in going back to an apprenticeship model. I am open to reviewing that. If people want to go back to an apprenticeship model, we live in a democracy. I do not think it would be right for nursing or the nursing profession.

The Deputy seems to think it is okay for people to have to do menial tasks whilst they are meant to be learning in terms of the education programme. That is wrong.

I thank the Taoiseach. I am going to move on.

One should not be tolerating exploitation of student nurses.

Finally, we are committed to reviewing the allowances, and increasing the allowances, and in terms of the pay student nurses get in fourth year, to increasing that as well.

I ask Members for a little co-operation in order that everybody can be accommodated.

My question relates to Sláintecare policy, specifically in regard to resource deficiencies at University Hospital Waterford, which is a regional hospital serving 600,000 people. I received correspondence earlier this week from a medical professional who described how an immediate family member died in April at 49 years of age due to a heart attack. The catheterisation laboratory in Waterford was not accessible because it happened on the weekend. In recent weeks, a second immediate family member suffered a heart attack at age 47 and survived because the weekday catheterisation laboratory service was available. The person is questioning, as am I, what the Government is doing to deliver 24-7 cardiac care at University Hospital Waterford. The catheterisation laboratory hours are due to be extended to seven days a week, from 8 a.m. to 8 p.m., yet I can get no confirmation from the HSE that regional heart attack patients will be given access at the hospital or that ambulances will be referred from the region during the extended hours. I would appreciate if the Taoiseach could indicate what his Government is doing about providing a 24-7 service at University Hospital Waterford. Will he end this health discrimination?

The Deputy is aware of the Government's commitments and plans in regard to expanding the cardiology service at Waterford University Hospital in terms of a second catheterisation laboratory, expanding the hours as the Deputy outlined and, critically, the recruitment of key personnel. This is not a funding issue. Predominantly, it has been an issue determined by the various colleges in terms of cardiology and their view of what level of service should be in different settings. We have had that discussion and we are committed to expanding the service as quickly as we possibly can.

There are a lot of inconsistencies and anomalies in the Covid lockdown. I appeal to the Taoiseach to do something for yoga classes. I met with Lara Slattery of Sukha Wellness Centre in Cahir on Monday. She has a wonderful studio that would fit 14 people in pods safely, hygienically and everything else. The Irish Federation of Yoga Teachers held an online Yoga Supports Health day on 28 November to show the benefits of yoga. It not only helps with movement and so on but also helps people's mental health, which is under huge pressure, as we know. This lady employs four people in Cahir but there are thousands employed throughout the country. More important, there are tens of thousands of people who take part in yoga and they need this and it can be done safely in studios like that. I am appealing to the Taoiseach to look compassionately at this because it is for people's mental health and well-being. The studios are safe and are compliant. Where they can do so, they should be allowed. There should be some measurement of square footage so people, like those involved in dance, can operate safely. It is the same for pubs and for churches if they have space.

I would love to open up the whole of society again. There is nothing I would love more dearly to do. However, we cannot because of the Covid-9 virus. We are holding it at bay. We have the lowest incidence of Covid-19 in Europe. There is a reason why we have the lowest incidence: it is because of the balance of restrictions we have introduced. Yoga is extremely important-----

It can be done safely.

In terms of yoga I agree with the Deputy that it is very good for mental and physical health. However, where does one draw the line in terms of opening up various disciplines and areas across society? It is very difficult to draw the line, sector by sector. As I said, I would love nothing more than to be in a position to open up all the various sectors. We want to get to Christmas and January. We will assess where we are in January. There will be more mixing at Christmas. That is inevitable because of the festive season. We will have to see where we will be in the aftermath of that.

A couple of weeks ago, the Taoiseach met with his fellow European leaders to discuss the role of antigen testing, pursuant to the Commission's proposal. Antigen testing is not a medical diagnosis and it is not an alternative to polymerase chain reaction, PCR, testing, but it does offer benefits, particularly in screening. Everybody is concerned, particularly the Chief Medical Officer, CMO, about the potential effects of people mixing this Christmas. Will the Taoiseach consider State provision of rapid antigen tests that people can carry out themselves in advance of Christmas? This would allow people to screen to see whether they pose a particular risk and, if they do, to take the required measures. It offers a huge possibility of reducing the spread of Covid-19 over the Christmas period. I appreciate that antigen testing is not a magic bullet or an alternative to PCR testing. However, this kind of mass screening could have a huge advantage in curtailing hugely the spread of Covid-19 at Christmas.

The HSE and the National Public Health Emergency Team, NPHET, have been in discussions regarding the application of antigen testing in the context of healthcare settings initially. The plan is to test it in those settings, not just in the case of mass outbreaks but more generally. There have been various reports on the issue by HIQA and others and the European Commission has provided very helpful guidance in this regard to member states. I appointed the CMO, Dr. Tony Holohan, to the platform of advisers to the European Commission President. Dr. Holohan is well aware of what is happening across Europe and with the Commission proposals. Work is ongoing with a view to the application of the proposals and guidance from the Commission in an Irish setting.

I move to the list of names that I held over since yesterday, starting with Deputy Gould. I ask Members for their co-operation.

Yesterday, I sent the Taoiseach a petition with more than 1,150 names calling for the reopening of SouthDoc in Blackpool. He said last week that he would look into its closure. The Minister for Health has confirmed that the HSE has asked for a timeline for the service to reopen but has not received it. Will the Taoiseach intervene at this stage and ask SouthDoc to reopen? The people of the north side of Cork city need this facility, especially before Christmas. It is a vital service.

I am sure the Deputy will welcome the additional beds in the orthopaedic service, a very significant investment in the north side of Cork by the Government and it will make a very significant difference there. As I said to the Deputy last week, I introduced SouthDoc and it is a vital service. It is not just about opening the doors, as the Deputy knows. It involves personnel and ensuring there is back-up in capacity. The HSE is working on that and I will engage with it again to see where we are in this regard.

Last week, the Taoiseach, utterly correctly, gave the support of the Government and this House to an inquiry into the murder of Pat Finucane, a lawyer murdered in Northern Ireland in the late 1980s, as did a Seanad motion, the Oireachtas Committee on the Implementation of the Good Friday Agreement, of which I am a member, and the Alliance Party, as an absolute imperative for the rule of law. Will the Taoiseach join with me in acknowledging the anniversary this week of another lawyer murdered in Northern Ireland, Edgar Graham, a unionist lawyer and academic who was murdered on the grounds of Queen's University Belfast? It is just as important to acknowledge his death as that of any other lawyer in Northern Ireland.

It is indeed. Edgar Graham was murdered in 1983. It was a shocking murder. It happened between lectures. I think he was with Dermot Nesbitt at the time. It should be roundly condemned by all parties as a murder most foul. His family has received very little in terms of a report from the historical enquiries team, HET, investigations into his murder. It was callous, it was cruel and it was cowardly. He seems to have been singled out for his views and opinions as opposed to anything else. That is what the IRA said at the time - let this be a lesson to anybody who defends the policies of the British Government. It is a murder that deserves condemnation all around and it should be roundly condemned. Work should continue with the family by the authorities in Northern Ireland to give satisfactory replies.

I was contacted recently by a mother whose daughter, Brigid, was diagnosed with ASD in October. Brigid's psychologist said that she needed to be moved from her current school to one with a special unit that would suit her needs. Thanks to the assistance of a special needs officer, a school has been identified and applications were made for a SNA and transport for Brigid.

However, neither the family nor the school has heard anything back since these applications were made. Brigid's mother has said that while they are being left in limbo, Brigid is falling behind as time goes by. She has to be collected at noon every day because she is not managing well within her current school environment. In light of the programme for Government commitment to support continued investment in SNAs and the further commitment to inclusion and access as the foundation of a more just and equal society, this family should be treated better. What can the Taoiseach do to move this process on?

I do not have the details of the case. Is the Deputy saying that the family has heard nothing from the new school or the special education needs organiser? The family should be informed as to progress relating to their child in terms of the placement in the school in the first instance and the allocation of an SNA. That should happen. I do not have the details but if the Deputy forwards them to us, we will follow it through.

The income eligibility limits for social housing have not been increased since 2011. This matter was brought up recently by Deputy Ó Broin. I received representations in recent days about two families who have been on Fingal County Council's housing list for 11 and 12 years, respectively. Yvonne started on the list with two children. One of her children is now an adult and is in employment. The second has just left school and got an apprenticeship as an electrical engineering student. After 12 years, Yvonne has been told she is off the list. The other case involves two parents with five children. Both parents are working and they are just marginally over the income limit. After 11 years, they are now off the social housing list. Neither of them could afford the rent nor a mortgage. It was 2011 when the thresholds were last changed. Will they be changed and will this matter be addressed as quickly as possible for those people?

I agree with the point made by Deputy Paul Donnelly now and by Deputy Ó Broin previously. The cost of living and many other costs have increased significantly since 2011. Many local authorities such as Cork County Council, in whose areas rent and the cost of living are very high, are on the second tier where the maximum income for housing eligibility in a particular set of circumstances is only €30,000, as opposed to €35,000 or €37,000. One could be living in Carrigaline or in Mallow where the cost of living is quite high but one would not qualify for social housing. The Taoiseach will state that we need a spectrum of options. I agree and, I am sure, Deputy Paul Donnelly does too.

I thank the Deputy.

This is a specific issue that requires to be addressed but it has not been in almost a decade.

There should be review of the thresholds. We have long waiting lists as matters stand. In those cases identified by Deputy Paul Donnelly, in the first instance the people involved should appeal. It is difficult for those families and it is unfair, given that they were 11 and 12 years on the list. Due cognisance should be taken of the fact that they are so long on the list and that the children involved only got employment recently. There needs to be a bit of balance and common sense in the application of rules. That said, I accept the point the thresholds could do with being reviewed.

I know the Taoiseach is aware that there is great upset in respect of the renewed level 3 guidelines regarding live music at weddings. This decision affects not only couples whose plans have been in place for months, if not years, to be changed overnight but also the live music industry, which has been hugely impacted by this pandemic. The Government needs to clearly outline the rationale behind this decision. Are there any plans to review these guidelines as soon as possible?

These guidelines have come from NPHET and the Health Protection Surveillance Centre. Music, particularly singing, unfortunately, can, as a result of droplets and so on, act as a vector in the spread of the virus. It is a cautious guidance that was issued in respect of weddings. As with many other areas, our view all along in terms of the onset of the virus has been to adhere as close as we possibly can, within reason, to the guidance from public health authorities. That is the situation here.

I want to raise the issue of St. Brigid's community hospital in Carrick-on-Suir. An announcement was made this morning about the future of the hospital. What part will the hospital play in the HSE's future plans for Carrick-on-Suir? How much money will be invested in it? What plans does the HSE have to provide respite and palliative care beds in the Carrick-on-Suir area?

I thank the Deputy for raising this issue. Back in March, admissions to St. Brigid's hospital were suspended and it was designated as a Covid-19 step-down facility. It is proposed to utilise the existing premises as a base for a newly created community healthcare network in south Tipperary, along with it serving as a base for members of a chronic disease management team with a focus on diabetes. St. Brigid's is ideally located as it is adjacent to a primary care centre. As such, the co-location of these buildings would facilitate integrated and multidisciplinary working. Repurposing the use of St. Brigid's will provide us with the opportunity to develop the community healthcare network in south Tipperary, along with the chronic disease diabetes management team. Following some minor works, seven whole-time equivalent staff members will initially be based at St. Brigid's, including a community healthcare network manager, an assistant director of public health nursing, a clinical nurse specialist-----

I thank the Taoiseach.

-----a senior dietician, a staff dietician, administrative staff and a podiatrist. These individuals will provide enhanced services at St. Brigid's. This is a unique opportunity to change our approach to the prevention and management of chronic disease in the south east. I am happy to work with the Deputy if he has further ideas for the utilisation of the building.

The fishing industry is hanging on the edge at this time due to the Brexit negotiations and British insistence that all EU trawlers vacate UK waters on 31 December. On top of this, we heard at the Select Committee on Agriculture and the Marine last week that there will be a 5% reduction in whitefish fleet fishing next year. This will mainly hit fishermen from Castletownbere and the south west. On top of successive Governments being unable to obtain lucrative bluefin tuna quotas for Ireland while other European countries easily secure ample quotas, this all goes back to us having a weak hand in negotiations.

When negotiating the programme for Government, I asked for a stand-alone Minister for the marine. The Taoiseach's refusal in that regard is coming back to haunt us. Far more concerning is the fact that Michel Barnier, in his negotiations with the British, offered 18% more fish but this was rejected as not being enough. Last week, I asked a question of the Minister for Agriculture, Food and the Marine, Deputy McConalogue, and the Tánaiste but I did not receive a reply. They do now want to answer this question because, shamefully, they do not want to admit what is going on. I will ask the question again. Whose fish is Michel Barnier giving away in these negotiations?

This Government did not cause Brexit and is not responsible for it. We need less of the language about weak hands and all of that kind of nonsense. Brexit resulted from a decision taken by the British people. It was recommended to them by British politicians. In my view, it was the wrong move. Historically, it was the wrong move. It has implications for our fishing. If we had no deal, it would be a worse result for our fishing. We are on the precipice of a no-deal. It remains to be seen how the two principals, the UK Prime Minister, Boris Johnson, and the European Commission President, Ursula von der Leyen, can rescue the situation in their talks this evening. The matter is on a knife edge. As I have said previous, it is 50-50. There are difficult issues regarding level playing fields and our own fisheries.

I thank the Taoiseach.

I have met and engaged with the fishing organisations. There should be no doubt that we want to preserve and support our fishing industry in the strongest possible manner and as effectively as we can.

When will the Taoiseach bring in an auditing service in respect of the management of hospitals? University Hospital Limerick has had the longest waiting list for beds for a long time. The latter was not caused by the staff at the hospital, this comes down to a management problem. I said on the first day I came to the Dáil that there is an issue with the management of and the structure in place at University Hospital Limerick. I want a full audit carried out on management and on the progress of their work. This does not relate to the staff or the care they provide. We have a serious management problem. Nurses have left this hospital over issues of management. Our care staff are good but we have a serious problem with management.

I do not know whether the Deputy has written formally to the HSE senior management in respect of this matter.

I will engage with the CEO and relay the Deputy's comments to him. These areas are audited and evaluated. I will certainly engage with the CEO on the points the Deputy has raised with me.

I have been made aware of a situation in my home county of Carlow. While the HSE advertised on Monday that it wishes to recruit experienced consultant psychiatrists for an acute hospital setting in general adult psychiatry, no psychiatrist currently serves young people, children or adults in the public health system in Carlow. I have had calls from constituents who either had to travel to neighbouring counties to get help or had to battle to get someone to see them in Carlow. This is particularly the case with children and young adults. Some of these children have attempted suicide or spoken with suicidal ideation. There is a brief advisory service whereby parents and guardians of young people up to 18 years of age are offered advice and guidance for common issues related to their children. Adults can attend for advice on their own issues. This is only by phone because of Covid. I must question this when so many other operations are continuing normally. I ask the Taoiseach to do his best on this because it is very serious, particularly now with mental health issues and the way we are during Covid.

I appreciate the Deputy raising the issue. She is correct in identifying mental health as a key issue and a key priority for society and for the Government. There is, and has been, an issue with the recruitment of psychiatrists, particularly in child and adolescent psychiatry and particularly in the south east. It is something the Minister of State, Deputy Mary Butler, is very possessed of. At a recent Cabinet subcommittee meeting we discussed this, specifically with regard to the issues on the recruitment of consultants in psychiatry to our mental health service. I will follow this up with the Minister of State to give a response to the Deputy.

Yesterday, at a meeting of the Oireachtas Joint Committee on Children, Disability, Equality and Integration, we heard the Government is not meeting its statutory obligations on children obtaining assessments of need. It was proposed by witnesses at the meeting that a cross-party motion be tabled reaffirming the intentions and aspirations of the Oireachtas regarding assessments of need for children under the Disability Act. This motion would insist that these assessments are delivered in full and on time, as provided for, within the six-month period set out in the Act. This would be a very powerful response to the complete dereliction of the Government and the previous Government in the responsibility for children and their developmental needs. Will the Taoiseach support such a cross-party motion?

The Deputy is referring to 2005 legislation. With regard to assessments of need, we have provided additional funding in the budget. My view is we should do everything we possibly can to get timely assessments of need for children and meet our obligations in this regard. I have no difficulty supporting this.