Saincheisteanna Tráthúla - Topical Issue Debate

Private Rented Accommodation

I am mindful that I have come into the Chamber to talk about illegal evictions. While the Department of Housing, Local Government and Heritage is most definitely tasked with the reduction in the number of evictions generally, and we will try to get through it today, this might be more of an issue for the Department of Justice. That is the Department I had in mind when I tabled this matter.

It is very much on the record of this Dáil that I have more general thoughts on the need for evictions but what I want to talk about now is the way in which they are carried out. In the past year or so in my constituency, there have been evictions on Slaney Road, Summerhill Parade, Berkeley Road and St. Joseph's Place. There are two issues that come up in these evictions, which have a huge impact on our community in Dublin Central. One is the occasional presence of masked third parties who sometimes act as supporters to the landlord and sometimes as enforcement agents. To be clear, this is an issue that has gone on much longer than the Covid-19 crisis. The covering of faces is not necessarily a Covid measure but one assumes it is to either obscure somebody's identity or is an act of intimidation. The second issue is the engagement of An Garda Síochána with the issue of evictions more generally.

I point out to the Minister of State that we tend to think of evictions as an issue between two parties and a commercial transaction but when somebody is being removed from their home, including his or her possessions, there is a balance of power that lies with the landlord. That tenant is in a vulnerable position. He or she deserves the full protection of the law and the support of An Garda Síochána.

I welcome the Private Security Services (Amendment) Bill that was debated in the House earlier. That will afford enforcement agents at least the same kind of oversight that we have for nightclub bouncers and night watch security men, which is very welcome. Concerns remain around the unpaid friends and supporters of landlords who might arrive at evictions that we have witnessed happening in Dublin Central. That remains uncovered by this legislation and not really addressed.

An Garda Síochána would say that the matter of an eviction is a civil matter between two parties and that it has no role to play. To enter somebody's home forcefully, the place where they live, sometimes with children present, remove his or her belongings physically and sometimes damage those belongings in that process is very serious action to take. At a minimum, I propose that An Garda Síochána should ensure that illegal evictions are not being carried out.

There was an incident on Berkeley Road last August which gave rise to a review of the Garda conduct during the incident. I would very much like to know what that review found. The most recent eviction in Dublin Central was on St. Joseph's Place and it was during the Covid restrictions and the moratorium on evictions. That resulted in a stand-off involving the tenant, the landlord, the landlord's eviction agents and the supporters of the tenants that lasted for seven hours. Thankfully, a senior Garda had the diplomacy skills and the knowledge to de-escalate the situation and the tenant was able to stay in the accommodation.

I ask the Minister of State - he might work with the Minister for Justice on this - to provide procedures within An Garda Síochána around de-escalating those stand-offs of the kind to which I refer, put in place procedures that recognise the human element at play during evictions and the real issue around the illegal carrying out of evictions where gardaí should have a role to play. Procedures should also be put in place to protect vulnerable tenants.

To be helpful, it might be useful in future to indicate the Department the Deputy is directing the particular issue towards.

I think I did but it may be that somebody was not available.

I agree. In terms of the effectiveness of these questions, it would be useful to have the question directed at the particular Department. We will give a response in terms of the responsibilities and the role of the Residential Tenancies Board, RTB, but I acknowledge the fact that this is a question that is better directed at the Department of Justice.

The RTB was established as an independent statutory body under the Residential Tenancies Act of 2004 to operate a national tenancy registration system and facilitate the resolution of disputes between landlords and tenants. The RTB takes the matter of illegal eviction very seriously because such evictions can potentially leave tenants homeless. The RTB actively intervenes when requests for supports are received in the context of illegal evictions and its interventions are usually successful. While a request for tenant support can be in respect of access to property and return of belongings the focus of the RTB's intervention is on the maintenance of the tenancy. The RTB engages with landlords to advise on the serious consequences of illegal evictions, including the possibility of being directed to allow the tenant re-entry into the dwelling and the possibility of being required to pay substantial damages if a dispute case is referred by the tenant to the RTB for resolution.

As the RTB has replaced the courts in residential tenancy dispute resolution it has a responsibility towards all parties to ensure that a fair hearing is conducted and that each party will have the opportunity to set out their case. Any RTB decision is based on the facts and evidence in the case. Where a landlord is determined, under an RTB dispute resolution process, to have engaged in an illegal eviction the landlord may be directed to allow the tenant to re-enter the dwelling. Furthermore, a landlord may also be required to pay substantial damages of up to €20,000, depending on the circumstances of the case.

In the vast majority of cases, the immediate threat of eviction is abated through RTB intervention and dispute resolution cases. Where a resolution cannot be found and a tenant has been forcibly removed from a property, the RTB may seek a court injunction under section 189 of the Residential Tenancies Acts to have a tenant reinstated until a dispute resolution case is concluded.

The Residential Tenancies (Amendment) Act 2019 provides the RTB with enhanced powers of investigation and sanction regarding improper conduct by a landlord. A sanction of up to €30,000 may be imposed on a landlord, if warranted. Significantly, investigations can now be triggered by the RTB in its own right rather than depending on a complaint or a referral for dispute resolution from the tenant.

The programme for Government contains a commitment in respect of improving the security of tenure for tenants through increased RTB investigation and enforcement activity, and appropriate resources are available for this function. The RTB is examining the issue of illegal evictions and will be submitting a report to me this quarter. Any further action that is warranted will be progressed. The various acts relating to residential tenancy are kept under constant review and any necessary legislative refinement in this area will be achieved. I hope that goes in some way towards responding to the Deputy's question. It certainly outlines a case for the RTB to have a strong role, although I recognise the question is more about the role of the Garda in addressing illegal evictions.

I thank the Minister of State. That was very helpful. I am very happy to hear that the RTB is considering the issue of illegal evictions and reporting to the Minister of State on it. This is very useful. I realise the matter is dealt with in the programme for Government. I am delighted to hear about it.

What the RTB can do is very much about process and will be after the fact. What we see happening on the streets in my constituency is people turning up on a particular day and asking tenants to leave their homes. While I hope and am sure that the RTB will have a robust answer to the question of how we deal with the illegal evictions, I believe An Garda needs proper procedures for engaging with evictions in general to ensure they are carried out legally on the given day. It is as much about An Garda having clarity on its role as it is about the tenant having clarity. It is incredibly difficult for gardaí to engage in positive community policing the day after being involved in the kinds of evictions in question when the ramifications of the incidents I have described are so far-reaching. I thank the Minister of State for his answer and I appreciate his work on this.

The Residential Tenancies Acts 2004 to 2021 provide strong protections regarding the lawful termination of tenancies. In any notice of termination served after six months of a tenancy commencement, a landlord must state a reason for the termination in accordance with the limited allowable grounds under the legislation. The legislation also provides for specific notices periods to be served before the notice of termination becomes effective. The longer the tenancy, the longer the notice period. In some cases, these notice periods were more than doubled under the Residential Tenancies (Amendment) Act 2019. For example, a tenant who lives in a dwelling under tenancy between three and seven years is entitled to 180 days' termination notice, or almost half a year, except in limited circumstances, such as where antisocial behaviour occurs. A tenant in residence for eight or more years is entitled to 224 days' notice.

A tenant can refer a case of unlawful eviction to the RTB for dispute resolution and reinstatement of a tenancy, and damages of up to €20,000 can be ordered. In extreme cases, the RTB can seek a court injunction where unlawful eviction has occurred and no other effective intervention or resolution is available. Enhanced powers of investigation and sanctions were provided to the RTB in July 2019, and appropriate resources have been provided. The Deputy will acknowledge that these are significant deterrents and should help in addressing the issue of illegal evictions. I ask that the other aspects of the question she has raised this evening be referred directly to the Department of Justice.

School Meals Programme

The second matter has been tabled by Deputies Joan Collins and Costello, who wish to discuss joint applications for the hot meals scheme. The Minister of State at the Department of Rural and Community Development, Deputy Joe O'Brien, is dealing with it. Is Deputy Joan Collins present?

Deputy Joan Collins could not make it, unfortunately, so it is just me. I am happy to speak on the Deputy's behalf. She and I both want to highlight concerns that were raised with us by the board of management of Mary Queen of Angels 2 boys' national school. It is a local issue but it has the potential to be a much wider one that would be very beneficial to address. Mary Queen of Angels 2 applied for the hot meals scheme. An interesting anomaly is that Mary Queen of Angels 1 boys' national school, which shares the site, was selected for the scheme but Mary Queen of Angels 2 was not. Essentially there are two schools on the same site serving the same community but it is as if only half a school is being allowed to avail of the scheme. I appreciate that there was oversubscription. It is a very popular and worthy scheme. Funding was allowed for only 179 schools but close to 300 applied. Mary Queen of Angels schools 1 and 2 are essentially one school on the same site. I can think of plenty of other cases in my constituency where a boys' national school and a girls' national school are on the same site, or where junior and senior national schools are co-located. It makes sense to treat these pairs of schools as one, thereby maximising the economies of scale that can be achieved as a consequence. The biggest advantage of treating the two schools as one is that more students who need a hot meal will get one in school.

The scheme provides an incredibly important service. A warm meal is provided that supports children nutritionally and enhances their ability to engage in school and education. It provides social and educational support. It is an incredibly important programme and should be rolled out nationally to all schools as quickly as possible. There is an anomaly whereby there are two schools on the same site that could be treated as one and that could both benefit from the scheme. The communities attached to each school could benefit so I ask the Minister of State to review the hot meals scheme as it stands, ascertain how many applicant schools are co-located and address this matter so that as many pupils as possible from the community in Ballyfermot and other communities can benefit from it.

I thank the Deputy for raising the issue. The school meals programme provides funding towards the provision of food to some 1,557 schools and organisations, benefiting 227,000 children. The objective of the programme is to provide regular, nutritious food to children who are unable, due to lack of food of good quality, to take full advantage of the education provided to them. The programme is an important component of policies to encourage school attendance and extra educational achievement. The Government has provided €65.1 million for the school meals programme this year.

As part of budget 2019, funding was provided for a pilot scheme from September 2019, providing hot school meals in primary schools at a cost of €1 million for 2019 and €2.5 million for 2020. The pilot involved 37 schools, benefiting 6,744 students for the 2019-2020 academic year, and was aimed primarily at schools with no on-site cooking facilities. The funds for the initial pilot programme were made available in budget 2019 and the pilot was carried on into 2020. Given that a proportion of the pilot took place during the first lockdown of the pandemic, we were not in a position to escalate the scheme as quickly as we would have liked. During the pandemic school closures, my Department continued to provide meal assistance to schools.

In budget 2021, the Government announced that an additional €5.5 million would be provided to extend the provision of hot school meals to an additional 35,000 primary schoolchildren, who were at the time in receipt of the cold lunch option. My Department issued invitations for expressions of interest to 705 primary schools in November 2020 and a total of 281 expressions of interest were received, in respect of 52,000 children. The 35,000 places were allocated to each local authority area based on the number of children applied for by local authority area as a percentage of the total. A minimum of one school in each local authority area was selected. Thereafter, a process of random selection was used for each area. As a result of this process, 189 of the 281 schools that submitted an expression of interest were selected.

Both schools referred to by the Deputy submitted an expression of interest for the hot school meals scheme. Despite being located on the same site, the schools have separate roll numbers and are two separate entities. Unfortunately, one of the schools was not selected and I appreciate this was very disappointing for school 2. The school received €42,000 for the current 2020-21 school year to provide a cold lunch and snack club for pupils attending.

The Department has contacted all schools selected for the hot school meals scheme to confirm their involvement in the scheme. Following this process, in the event that some places on the scheme become available, consideration will be given to how best we can use any excess spaces to accommodate those who wish to avail of the scheme. Any further extension of the provision of hot meals will need to be considered in the upcoming budgetary context.

The Minister of State said "the school" is receiving funding of more than €42,000 for 2020-21. Which school? Is it the school that is not getting the hot meal allowance?

School 2 receives the cold lunch option at the moment. That is what the €42,000 is for.

One school is being funded for hot meals and the other is being funded for cold meals.

As the Ceann Comhairle pointed out, one school is being funded for hot meals and the other is being funded for cold meals, and they are located right beside each other. I appreciate there are resource limits and it is a pilot scheme but it seems we are missing a trick here in being able to provide cheaply and easily an extension by simply treating the two schools on one site as one unit. I have no doubt there are many other schools, both in and outside the scheme, that could also benefit from this. Treating them as one unit would allow an expansion of the scheme with very few additional resources and facilities.

As the Minister of State said, this is a very important meal scheme for enabling people to engage in education, which is very important for enabling them to reach their full potential. This is why Deputy Collins and I raised the issue. We want the children of Mary Queen of Angels 2 to be able to reach their potential as much as the children of Mary Queen of Angels 1.

I have no doubt there are many other co-located schools. Extending provision to these schools seems to be a quick, easy and relatively cheap way to expand the scheme. I appreciate that, as the Minister of State indicated, budgetary constraints would need to be taken into account but surely expanding the scheme to co-located schools is the quickest and cheapest way to extend this very worthy scheme to needy communities.

I appreciate the disappointment and frustration for all 92 schools that submitted an expression of interest to access hot school meals and were not selected, including the school in question. The level of demand for the programme is a clear sign of the need for its expansion. I will raise the matter with the Minister.

Officials from the Department have contacted all schools selected and are in the process of considering responses. If schools that have been selected decide not to proceed, we can reallocate the places. Further consideration will be given to the use of any excess capacity once we have confirmed the position with the selected schools. Any further extension of the provision of hot meals will need to be considered in this year's budget process.

As Minister of State with responsibility for the implementation of the roadmap for social inclusion, I recently announced the establishment of a working group on food poverty. It is my intention that this working group will bring together key stakeholders from various Departments and State agencies, as well as the NGO sector, to share information and assess the myriad different schemes and programmes currently under way that have a connection to the wider issues of food poverty, including the school meals programme. It is my intention to have the group meet with a view to identifying the key drivers of food poverty to maximise interventions that adequately address the underlying issues.

Fishery Harbour Centres

I thank the Ceann Comhairle for selecting this Topical Issue matter and the Minister for taking it in person.

Post Brexit, the harbour in Dunmore East has been removed as a port for British and Northern Ireland-registered fishing vessels to land their catches. Since then, seven ports have been redesignated, six on the west coast and one, Howth, on the east coast, but Dunmore East is not one of them. In response to my colleague Deputy Mac Lochlainn, the Minister previously stated that other areas were not designated because of lower landing figures but that he would keep it under review and his ears would be open to challenge. I hope they are open to challenge during this debate.

Deputy Mac Lochlainn has also engaged with the Sea Fisheries Protection Authority, SFPA, on this matter, which is the body that will be responsible for operating the landing measures. The SFPA advised Deputy Mac Lochlainn that no additional resources would be required by it to reintroduce the limited hours' landing schedule that was in place previously.

This is an easy fix. It requires the Minister's agreement and signing-off. It would be very beneficial to the economy of Dunmore East and I ask him to consider it as a matter of urgency.

I submitted a parliamentary question to the Minister on 20 January and his response did not provide a resolution. I thank him for the invitation to engage with him on the issue of south-east fishing on 11 May. As Deputy Cullinane has highlighted, this is a significant economic issue for Dunmore East. The travel time to Dunmore East for fishing vessels that access the fishing grounds known as the Smalls is five or six hours. However, they cannot access the port and are forced to go to either Castletownbere, which is 17 or 18 hours' travel distance, or Howth, which is ten or 12 hours' travel distance. This has obvious emissions, economic and even safety impacts. Will the Minister review this matter? There are fisheries protection officers and facilities at the port to allow Department officials to check landings. This is an issue of rural regeneration and support for our fishing ports, in particular Dunmore East. I ask the Minister to give this matter favourable consideration.

I corresponded with the Minister as far back as 19 January and I have raised it with him personally since then. The decision made by his Department to designate five additional ports for Britain and Northern Ireland-registered vessel landings for both illegal, unregulated and unreported, or IUU, and North-East Atlantic Fisheries Commission, NEAFC, purposes, while omitting Dunmore East, means that, in effect, there is no designated port to serve UK-registered boats anywhere between Castletownbere and Howth, as my colleagues have pointed out, leaving the entire south-east coast unserved. This has an impact not only on the port of Dunmore East and the fish processing services that rely on the port but also on the fishers through higher operating costs and carbon emissions, as Deputy Shanahan mentioned. Furthermore, I worry about the risk to the safety of ship crews, who may choose in the event of bad weather to make for a port where they can land their catch over the nearest safe harbour. In conjunction with my colleagues, I ask the Minister to find a resolution to this issue, if possible.

I thank the Deputies for raising the issue and for their contributions. That the three of them are coming together, as Waterford Deputies, to raise the issue shows the importance they place on it. The Minister of State, Deputy Butler, has also been raising and discussing the matter with me. I welcome the opportunity to address it in the House.

As the Ceann Comhairle will be aware, in January 2021 five additional ports were designated for landings by Britain and Northern Ireland-registered vessels, namely, Greencastle, Rathmullen, Burtonport, Ros a Mhíl and Howth. The five ports join Killybegs and Castletownbere, which continue to be designated for landings by vessels of any third country origin. I designated these five additional ports having regard to the level of activity by Britain and Northern Ireland-registered vessels in the recent past.

Any Britain or Northern Ireland-registered boat landing into any of the seven designated Irish ports must comply with additional documentary and procedural requirements as a result of the changes brought about by Brexit. The designation of ports is within the states' authority but all requirements and protocols are subject to EU and international law and must be strictly adhered to in order to gain entry to such ports.

The designation of the five additional ports was an important decision that allows fishers and small vessels in particular to continue landing at Irish ports following Brexit. The SFPA has undertaken significant work in putting in place the arrangements necessary, including additional staff, to provide for these port designations. I am glad the outcome will mean many of those fishers will now have the opportunity to access a number of additional ports.

There are significant practical and cost implications for the State in the designation of EU ports for third country landings as, under EU regulations, such designations represent an entry point to the European Union, following which food is free to circulate within the full EU Common Market. On this basis, for any ports designated, Ireland is obliged to ensure that it has in place a meaningful control presence.

As outlined by the Deputies, Dunmore East has not been designated at this point but this will be kept under review. In 2018, there were 15 landings by UK-registered Northern Ireland vessels into Dunmore East. This reduced to nine landings in 2019 and reduced further in 2020. Over the two years, 2018 and 2019, the total landings amounted to 318 tonnes into Dunmore East by UK-registered Northern Ireland vessels. I understand that these were landings of nephrops, mainly from the Smalls. I included Howth as a designated port at the beginning of the year and this provides a landing option for UK Northern Ireland-registered vessels fishing for nephrops in the large fishing grounds in the north Irish Sea and may also provide an option for such vessels fishing in the Smalls or Labidine. I designated Howth because, unlike Dunmore East, there were 26 landings by UK-registered vessels into Howth in 2018 and this increased to 28 landings in 2019.

I can also assure the Deputies that the current ports designated and the opening times and days for those ports were decided to allow UK-registered Northern Ireland vessels to continue to land into Irish ports, while ensuring that the Sea Fisheries Protection Authority, SFPA, has the capacity to continue to perform its vital control functions effectively. I reassure the Deputies that the designation of ports for landings does not preclude vessels from coming into ports for force majeure reasons such as the need to reach a safe harbour.

I thank the Minister for his response and the clarification that he will keep all of this under review. This makes sense. It would also make sense to designate an additional port on the east coast. I listened very carefully to what the Minister said as to the reason Howth was picked over Dunmore East, but I do not believe it should be a case of one or the other; it could be both. I invite the Minister to visit the harbour at Dunmore East when restrictions are lifted. I have been in correspondence with him on a number of different issues relating to the harbour, its development and the development of ancillary businesses in the Dunmore East area. It is not just about boats landing for force majeure purposes. Regardless of the numbers the Minister cited, every boat that lands creates opportunities for businesses. When they are gone, those opportunities are gone, which represents a loss to the harbour and surrounding areas. I ask the Minister to look at this again and to visit the port at some point, when travel restrictions and his own commitments permit.

I too welcome the Minister's statement. The one point I would make is that the comparison is not valid. If one looks at the size of Howth Harbour and the level of activity there and compares landings at Howth with those at Dunmore East, one will see that the landings are quite a lot more important to Dunmore East relatively. I ask the Minister to take that on board. Deputy Cullinane made a very good point about supporting and progressing commercial activity. We have had a lot of issues in the south and particularly in Dunmore East in trying to expand the fish processing sector in the region. There are obvious benefits to be obtained. We will again be debating the climate Bill in the House next week and we will be discussing emissions and so on. If one adds up the emissions of those boats being forced to go to Castletownbere or Howth, that metric alone represents a fair argument for designating Dunmore East Harbour.

I thank the Minister for coming in to take this question. I also welcome the fact that he is going to meet with us on 11 May. That is very welcome. As I understand it, the staff and infrastructure are there. I do not see this as involving any great additional cost. Deputy Shanahan has outlined the additional travel time involved in travelling in from, for example, the Smalls and the increased carbon emissions involved in doing so. It is a matter of cost efficiency. Fishers are already operating on very small margins. We should not make them travel this extra distance and incur those extra fuel costs to land their catch. Even a cursory look at a map of Ireland shows one that there is a massive swathe of our coastline between Castletownbere and Howth, which obviously serves a massive swathe of our offshore. This makes sense. This issue is easily solved without incurring any great cost. I welcome the Minister's commitment to keep this matter under review.

Is the Minister going to visit the sunny south east during the summer?

I look forward to it. I thank Deputies Ó Cathasaigh, Shanahan and Cullinane. As I said earlier, it is good to see the Waterford Deputies working together. The Minister of State, Deputy Butler, has spoken to me personally on this matter, as have the three Deputies. They have all also spoken to me on a number of fisheries issues pertinent to the county. I acknowledge all of their representations in that regard. I certainly look forward to visiting the county whenever time and the easing of restrictions allow. It has unfortunately not been possible as yet due to the Covid restrictions. I will have virtual engagements with the fisheries community and with Oireachtas Members over the two or three weeks with a view to engaging and connecting with all fishers and with representatives and stakeholders in coastal areas and the marine sector. I look forward to that.

The argument has been well made. The strategic importance of Dunmore East is very relevant in this regard. Certainly, when one looks at the map of Ireland, it is a strategically appropriate place for any additional designation. As I said, when I made the initial designations after Brexit, I did so in immediate response to the Brexit situation. I had to take into account the various pressures on the control authority at that time. I also took a significant look at the various landing patterns in different ports in making my designations. That was central to the assignments and designations I made. As I pointed out in my contribution, the number of landings by Northern Irish-registered UK vessels at Dunmore East is small and has been so over the last two or three years. Nonetheless, it is a strategically important location and, in coming to review it, I will certainly keep that in mind. The point was also made that there is Sea Fisheries Protection Agency, SFPA, infrastructure and offices in place, which is also an important consideration in this regard.

I thank the three Deputies and my ministerial colleague, Deputy Butler, for bringing this to my attention and for working together on behalf of the county. I will certainly continue to engage with them in seeking to make progress on this matter.

Hospital Facilities

I thank the Ceann Comhairle very much for giving us the opportunity to discuss this very important issue. The National Orthopaedic Hospital Cappagh treats patients from all over our country for a broad range of orthopaedic conditions. The hospital has worked very hard over the years to improve access to treatment and to increase patient numbers. In Cavan-Monaghan and the neighbouring counties, there are many patients of all ages who are on long orthopaedic waiting lists. In many instances, people are in pain and immobile. These waiting lists are not acceptable.

I know from speaking to patients and people who have supported the hospital in Cappagh over the years, that it has the space to facilitate the provision of much-needed additional theatre and bed capacity. I understand that detailed and costed proposals are with the Department and the HSE. If implemented, these plans could be transformative for orthopaedic care nationally. In addition to new accommodation, some existing accommodation needs to be replaced. There are also additional requirements arising from Covid. The changing demographics in our country have also increased pressure on orthopaedic provision.

I have a particular interest in the hospital in Cappagh as I had an operation on my back there years ago. I am forever grateful for the treatment and care I received at that time. I know that many other patients of the hospital are very conscious of how excellent the care they get within it is. That is the message I have received constantly over the years from people who have attended the hospital in Cappagh.

It is heartbreaking to see children and teenagers immobile and in pain due to not getting appropriate treatment and surgical intervention.

In this day and age, that is not acceptable. I know of young people who are in dire need of orthopaedic surgery yet are on long waiting lists. In the meantime, their conditions continue to deteriorate. The State has an obligation to ensure that no child is denied unduly the treatment and surgery he or she needs.

I thank the Ceann Comhairle for picking this Topical Issue and giving us an opportunity to discuss it, and I thank the Minister of State, Deputy Rabbitte, for attending.

I visited Cappagh hospital earlier this week and received a briefing from its chief executive, Ms Angela Lee, and one of its surgeons, Mr. Connor Green. Its excellence, capacity, figures and results are phenomenal but it is an old-style structure and there are issues with meeting HIQA's standards. Its high-dependency unit greatly restricts its capacity to operate its five theatres.

The hospital has three key demands: a new ten-bed high-dependency unit; 76 single occupancy rooms; and three additional operating theatres. If this infrastructure is put in place, we will have a great opportunity nationally to reduce waiting lists. Each of us has many people in our constituencies who are constantly contacting our constituency offices trying to get orthopaedic operations done. It is particularly galling to see young people waiting long periods for essential surgery.

The hospital has a 30-acre site. I will not raise the issue of the children's hospital or the long debate on same, but the hospital in Cappagh has the room for this new infrastructure. It believes it can double the number of surgeries it performs if this investment is made. As Deputy Brendan Smith stated, the hospital has produced detailed figures, which are with the Department of Health now. In a modern context, the contribution it is seeking from the Exchequer is not significant. For an investment of €34.5 million, it could provide this infrastructure, although that would only be for the building itself and would exclude VAT and professional fees, for example, architects' fees. It has had detailed discussions on financing the development through a public-private partnership.

The hospital's executive has put serious work into this plan and, for an investment that would be minimal in terms of the health budget, there is an opportunity to increase capacity in the orthopaedic sector greatly. The hospital has the will and capacity to do it.

I thank the Deputies for submitting this Topical Issue, which I am responding to on behalf of the Minister, Deputy Stephen Donnelly, and giving me the opportunity to provide an update to the House on waiting lists in National Orthopaedic Hospital Cappagh.

Regarding paediatric orthopaedic waiting times, there has been an increased investment in paediatric orthopaedics and scoliosis services in recent years, which has improved access to surgery and outpatient appointments. In 2018, Children's Health Ireland, CHI, was provided with an additional €9 million to address paediatric orthopaedic waiting lists, including the provision of scoliosis services. This funding supported the recruitment of approximately 60 whole-time equivalents in 2018 and 2019 to enable the expansion of paediatric orthopaedic services, including scoliosis services. The posts related to multidisciplinary teams at diagnosis, pre-assessment, during surgery in theatre and post-operative care.

In general, waiting times for scheduled appointments and procedures have been impacted in the past year as a direct result of the Covid-19 pandemic. Elective hospital care was further curtailed for the first quarter of 2021 in line with the rapid increase in Covid-19 hospital admissions, with only critical time-dependent elective procedures undertaken. This has affected activity in CHI.

Regarding orthopaedics, I am advised that Children's Health Ireland is expanding its activity in Cappagh hospital and is also running additional orthopaedic clinics in Citywest using a new active clinical triage model that is reducing the number of children waiting the longest for appointments. Children's Health Ireland proactively continues to work with the HSE and my Department to reduce waiting times for patients attending the scoliosis service.

I am advised that funding has been provided for additional paediatric orthopaedic clinics at Cappagh orthopaedic hospital and that additional outpatient clinics commenced on the 17 February. I am further advised that additional theatre capacity for day case surgery at Cappagh commenced on 26 April, which should have a significant positive impact through reducing long waiting times for general orthopaedic patients in addition to scoliosis patients.

The Deputies might wish to note that, in January, the HSE added for development a €1.65 million project of an outpatient paediatric clinic to the capital programme, which will be considered for progression subject to availability of funding next year. It is expected that this will further increase Cappagh hospital's capacity for paediatric orthopaedic services.

I thank the Minister of State for her reply. While I welcome the facts that she laid out, the additional funding will not be transformative enough to reduce the waiting lists dramatically. That is the sad reality.

As Deputy Cahill alluded, and speaking as a former patient myself, the ethos in Cappagh hospital is one of can do, will do. It wants to carry out more procedures and treat more patients but it needs additional theatre capacity and bed capacity. It has to replace some of its outdated existing accommodation and, of course, Covid imposes extra requirements. The hospital wants to meet all the necessary accommodation requirements.

I know some of the children who are on the waiting lists. I am conscious of their suffering and the distress and worry caused to their parents by the long waiting lists to access much-needed treatment. I spoke to the mother of a 14-year-old who was waiting for treatment. I discussed the case with that young boy's mother again last Sunday morning. She said that he had gone back to school. He is not mobile. His friends are participating in their sports but he is not because he cannot get the treatment and surgery he needs. Sadly, there are hundreds of other children in the same predicament. Cappagh hospital has top-class clinicians and support staff who want to treat them, carry out their procedures and give them the quality of life they need, the quality of life that we want to see every child in the country have.

As Deputy Cahill stated, a detailed and costed proposal is with the Department. It could be transformative if the additional capacity was provided. Cappagh hospital is not crying out for additional staff. Rather, it is crying out for additional accommodation in order that it can do more work to ease the pain and suffering of children and adults throughout this country. It is the national orthopaedic centre. It treats patients from every county in our State. We need to give it the resources and capacity that would allow it to reduce waiting lists dramatically. None of us wants to meet in our clinics or talk on the phone to people of all age groups who are suffering and immobile. It is not good enough.

While we know the hardship and suffering that the pandemic has brought to this country and to so many families, the Taoiseach has rightly suggested that it might transform how we deliver healthcare. Let us be transformative and put in place the investment and facilities to ensure that a better quality of life is provided to these people, in particular the children waiting for treatment.

Deputy Brendan Smith has put it well. Detailed plans have been drawn up for a modern unit. Unfortunately, the current infrastructure will not meet HIQA's standards in future. Investment is essential. The hospital has a tremendous record. It breaks even every year and sees a significant throughput. Its figures are the envy of other hospitals within the health service. We can make a dramatic impact on the waiting list for orthopaedic surgery by investing in Cappagh hospital. It has the necessary space, which is something other hospital sites do not have. I saw its high-dependency unit on Tuesday morning. It is old-fashioned and not fit for purpose. The hospital's single-bed units are not fit for purpose either. An old building, the hospital used to be a convent.

It needs significant investment. We have a golden opportunity to reduce waiting lists. As Deputy Brendan Smith said, it is galling for all of us when people come to us and we cannot get them the operations they urgently need.

I appeal to the Minister of State and I know her heart is in this. We have an opportunity to work with Cappagh, which is the national centre for orthopaedic surgery. It has the plans there. We can use the window of opportunity provided by the Covid pandemic to get planning permission through in double quick time and we should not let that opportunity pass. A modular unit can be put up very quickly. It should stand as a monument to us all, showing we did something to reduce the significant waiting lists. It can be done but not at great cost to the Exchequer. A total of €70 million would deliver what we want to deliver in Cappagh, and it would be a great achievement for the Government, of which I am proud to be a member.

The two Deputies have made a compassionate and compelling case.

It is a very good case. Yesterday I met the Minister, Deputy Donnelly, to discuss children and waiting lists. Every week, I sit beside Deputy Smith, because that is where my normal seat in the House is. Every week I discuss with him access to children's rheumatoid services. I am acutely aware of the conversations we have had. Every evening I see posts on Twitter about children who cannot access orthopaedic services. I talk specifically about Down's syndrome when I have this conversation.

I will take on board the compelling pleas both Deputies have made today. I hear exactly what they are saying. We want to leave a legacy showing we can do it differently in health, we can make priorities and we can provide access to care. Yesterday, I spoke to the Minister, Deputy Donnelly, about funds for access to care and how the money can be used to make a difference to young people's lives. How will we prioritise? How will we clear our waiting lists? How can we ensure the parents, many of whom come to our constituency clinics and who are waiting for far too long, can access it?

I would like to see Cappagh, as Deputy Cahill has done this week. Everybody speaks very highly of the services it delivers. It would be wonderful to see how it can put an action plan in place to deliver on the assessments and if the investment could be made there. I would like to attend it and perhaps Deputy Cahill could set that up for me.

The car is on its way for the Minister of State already.

Written Answers are published on the Oireacthas website.
The Dáil adjourned at 8.53 p.m. until 12 noon on Wednesday, 5 May 2021.