Saincheisteanna Tráthúla - Topical Issue Debate

Wind Energy Guidelines

I want to raise issues relating to the siting of wind farms, particularly on mountainsides and largely on peaty soil. I will begin with some general points about wind farms, their siting and how we do business in this regard. In addition, I will focus on two proposed wind farms, one at Dough Mountain near Lissinagroagh, Manorhamilton, County Leitrim, and the other close to the top of Corry Mountain, which is near Dromahair.

The first point to make is that we are still awaiting the publication of the new wind energy guidelines, which were signed off by the then Ministers, Deputies Coveney and Naughten, in 2017. We were told, although we have not seen them, that they give due regard to the concerns of local communities and individual families within the vicinity of turbines. The new standards were opposed by vested interests. The guidelines would mean, in effect, that, in line with the WHO standard, a turbine louder than a bird would be shut down. Four and a half years later, the standards have not been implemented. We are now told the noise aspect is once again under review. It seems to me this is being done simply to allow vested interests to submit planning applications under the 2006 guidelines, which are hopelessly out of date, without having to adhere to the WHO standards. How often do Ministers, quite rightly, come into this House and tell us we must follow the science? In this matter, we need to follow the science from the WHO.

Why are we not following those guidelines when it comes to wind turbines?

I am also referring to turbines that are 185 m high. Given that many will be placed on mountain sides, they will be among the highest in Europe, with some of them at 300 m above sea level. These are monsters. They are twice the size of the Statue of Liberty and 50% taller than the Dublin Spire. No matter how far I put back my head, I could not see the top of them. In answer to a question from the former Minister, Deputy Naughten, the Minister of State said we need wind energy onshore and offshore, and he is right. In truth, would he or I be happy with a 185 m monster towering over our homes on the side of a mountain less than 1 km away?

In respect of Corry Mountain, Coillte said in its environmental impact study that the site is predominantly blanket peat overlying glacial subsoil, with depths of somewhere between 0 m and 6 m of peat, averaging over 2 m. Some 30% of the site is very steep, with streams entering the River Bonet. Last weekend, we were in Drumkeeran with the Minister for Agriculture, Food and the Marine, Deputy McConalogue, at the site of the Shass Mountain landslide. Everybody agreed that there will be more landslides because of heavy rains and forestry plantations. We can add to that the siting of wind turbines on peatland sites. If we do that, we are looking for trouble. Will the Government publish the guidelines and re-examine how we are dealing with the siting of wind turbines?

I thank Deputy Harkin for raising this issue. Under the Planning and Development Act 2000, as amended, all forms of development, unless specifically exempt under the Act or associated regulations, require planning permission. This includes wind farm developments which are also subject to dedicated detailed planning guidance, that is, the 2006 wind farm development guidelines, which developers are required to have regard to in drawing up their proposals in the first instance, and the development of their proposals at construction stage after the granting of planning permission. Furthermore, all wind farm development comprising more than five turbines having a total energy output greater than 5 MW are subject to a detailed environmental impact assessment and appropriate assessment requirements, as mandated by the EU, EIA and habitats directives, as transposed into national legislation under the planning and heritage legislative codes.

These obligations are required to be adhered to as part of the planning consent process. The 2006 wind energy development guidelines are particularly important in offering advice to planning authorities on planning for wind energy through the development plan process, for instance, in determining appropriate areas or locations in the local development plan where wind farm development may be considered, as well as in subsequently determining applications for planning permissions.

It is acknowledged that peatlands, in particular, can be damaged by the inappropriate siting of wind energy developments on associated infrastructure, including the construction of new or improved access roads. Accordingly, in considering applications for wind energy developments, planning authorities should ensure that an assessment is made as to whether proposed works are liable to have significant effects on the environment, including peatlands, and, accordingly, should consider requiring developments to undertake peat stability assessments when developing project proposals for wind energy development on peatlands.

With regard to the construction phase of wind energy developments, the guidelines outline a number of measures to minimise the impact on peatlands, including minimising habitat disturbance and hydrological disruption. These measures generally include: undertaking a thorough ground investigation, including hydrogeological investigations, where appropriate, and a detailed evaluation of the nature of the peat and associated risk of instability during the construction or operation of wind farms; avoiding construction in wet areas or easily eroded soils; avoiding the excavation or blocking of drains, where possible; constructing roads to take the required vehicular loadings having regard to overall stability; undertaking a geotechnical analysis to identify the optimum location for each turbine; and the placing and storing of excavated material to ensure it does not give rise to slope or site instability.

The guidelines further advise that the project supervisors for design and construction phases should be appointed to be responsible for co-ordinating the design of the project, designing out risks at source so as to minimise risks to the construction of operational phases, undertaking peat stability risk assessments to identify zones of high risk on the site to help ensure the site remains stable during construction, safeguarding the risk of peat slides and co-ordinating the work of all of the contractors engaged on the site.

Notwithstanding the detailed advice outlined in the guidelines, there have, unfortunately, been a number of well publicised peat slides over the past number of years so, including Derrybrien in County Galway and Meenbog in Donegal in late 2020. The Derrybrien case, for which Ireland has been subject to fines by the European Court of Justice, has been well documented. It is fair to say lessons have been and should be learned from that particular experience.

The more recent Meenbog case is still the subject of detailed investigation for the purposes of asserting the actual cause of the slide, be it construction works on the site, extreme and sustained weather events over a short period of time or other factors, or a combination of factors. An interagency investigation into the slippage involving the Loughs Agency, Donegal County Council, the EPA, Irish Water, NPWS and the Northern Ireland Environment Agency is ongoing.

As the Deputy said, we were on Shass Mountain last week. The report of the interagency group will probably be available to us in March or April next year and will give us an account of different peat slide events. The one in Shass Mountain was most likely caused by forestry but also different weather events. It is critically important that we learn from these events, whether it be forestry or wind farms in the wrong places.

I thank the Minister of State for his response. He said peatlands can be damaged. He and I know that peatlands will be damaged by wind turbines. The Minister of State saw peat stability and the side of Shass Mountain. We built homes on floodplains in this country, thinking that we had ways and means of directing the movement of water. We cannot. The same is true of peat on the sides of mountains. The Minister of State knows it and I know it. People who say otherwise are lying through their teeth. I am not referring to the Minister of State, but rather anyone who says that.

I am also concerned about the developer-led approach to supplying wind energy. Why not have a community-led approach where we can generate goodwill and buy in and people feel part of the solution? All we have is people objecting. People do not want to object. They know that we need renewable energy, but when faced with the possibility of a monster of 185 m just 850 m from their homes, what can they do but object?

It is also worth noting that this is not just about scale. Leitrim already produces 64% of its electricity through wind energy. It already has lots of wind turbines. As a Green Party Minister of State, I ask Deputy Noonan to get involved and engage with communities as happens in Denmark and Germany. They have wind farmers. People feel part of the process and that they are contributing to mitigating the worst effects of climate change. Pitting the Government against communities and driving communities to the High Court for judicial reviews will simply stall the process and stop what the Government wants to achieve in the first place.

I agree wholeheartedly with Deputy Harkin. Our Department is currently undertaking a targeted review of the 2006 wind energy development guidelines. In line with the programme for Government, it is committed to concluding the review of the guidelines as soon as possible with a view to striking a better balance between matters of importance to local communities and the need to invest in indigenous renewable energy projects, having regard to our challenging renewable energy targets in the context of our EU commitments on climate change objectives.

The review is addressing a number of key aspects, including visual amenities, setback distances, sound or noise, shadow flicker, community obligations and dividends and grid connections. However, having regard to the peat slide incidents mentioned, consideration will be given to the possibility of further strengthening the provisions and guidelines relating to peatlands, with a view to ensuring, insofar as is possible, that these types of incidents will not be repeated in the future. We said last week on Shass Mountain that incidents like this will happen again.

Our report will inform a lot of our land use planning regarding this. There is no point in putting wind farms in the wrong place and then having a bog slide incident that will release far more carbon than will be gained in the short term. I would say the same for forestry. It is critically important, as the Deputy quite rightly said, that communities have a say and are part of this story.

That is why we have the public participation directive and why we are signatories to the Aarhus Convention. The public participation element of it must happen at pre-planning, well before any of these projects are put forward. I say that for any proposers of a project, be it a wind farm or whatever the development is. Communities must be engaged with in a meaningful way, not in a token, box-ticking consultation process. I hope that answers the Deputy's questions.

Defective Building Materials

Cuirim fáilte roimh an Aire Stáit. Perhaps this is third time lucky. It is good to have the Minister of State back in the House. I know that at this stage he has a good and deep understanding of this issue, as do his colleagues in government. We hear that Tuesday next week might be the date, although it is not yet confirmed, but if it is, let us get the scheme right this time. We have to be ready from the get-go for implementation. There will be a very heavy workload and resources will have to be in place. I am working on the assumption that much of the preparatory work is already in place. Proper implementation is key, as well as dedicated staff in the Department. I have spent time in five Departments over the course of the past six years, and one thing departmental officials are used to is fire fighting and dealing with daily issues that might arise. I know what is needed. We will need dedicated officials who will work on this scheme, because it will be a big and important scheme.

Local mechanisms to meet delivery needs sound like jargon. It is jargon, but I will explain what I mean. For example, if the Housing Agency is going to have a role in the delivery, which I believe it should have, it cannot be done in Dublin or by setting up a small, decentralised hub in Donegal, Mayo or any other affected county. There has to be a fully resourced office, right down to having somebody at the end of the telephone line to listen to people when they make contact. Another element of what must happen in the roll-out of this important scheme is that trust must be earned. There has been a fracturing of trust over recent months. We must have the homeowner at the centre at all times. The Mica Action Group has earned that trust through simple communicative mechanisms, such as doing a daily video and keeping people informed. Trust is earned through communication. I believe we can learn from that group and the work it has done. There is no need to create new wheels in terms of what has to be done, but we must look at what the Mica Action Group has achieved over recent months.

There must be implementation by the delivery team focusing on all aspects or the holistic aspect of the problem and challenge we have here. Yes, it is about construction and ensuring we get the right scheme in place for accessibility and affordability. Those issues are very important, but there are other issues in terms of the holistic, psychological supports that will be needed as well. Collaboration is key and critical, whether it is with the engineers, the contractors or the local authorities. Ultimately, a scheme will only be as good as the scheme that works.

Finally, let us get it right when the memorandum on the scheme goes to the Cabinet. Make sure there are no last-minute inserts in the scheme that will make it unworkable. Let there be no more obstacles, le do thoil. For example, the 25% retention of payment is not working and will not work. We must be careful about the square footage cost as well. The Society of Chartered Surveyors Ireland, SCSI, calculator refers to €138 per square metre, but is that accounting for inflation and the real cost of building houses today, which would be approximately €150 per square metre? There also must pathways for houses such as second homes that potentially could be excluded. They must have pathways. Ultimately, the key to all this is ensuring we keep the homeowner at the centre of the delivery process. That is very important.

I thank Deputy McHugh for keeping this matter consistently on the agenda and doing so in a constructive manner, which is important.

Following the conclusion of the working group report and building on the cross-party Dáil motion of June 2021, the Minister, Deputy Darragh O'Brien, wrote to Opposition spokespersons on housing to seek their views and input into potential changes to the scheme. The Minister has sought their views on major documents such as Housing for All, and has accepted Opposition amendments to legislation such as the Land Development Agency Act and the Affordable Housing Act. This initiative by the Minister and the approach he takes have to be commended in terms of trying to garner amendments and changes from Opposition spokespersons to help with the work he is doing. Deliberations and consultations are ongoing in respect of the range of issues identified in the report of the working group, and the Department has engaged with all stakeholders on the matter with a view to ensuring any proposed changes can be implemented as quickly as possible. It should be recognised, however, that the scheme is complex and there will be a lead-in time for implementation, with some potential changes requiring either amending regulations or perhaps new primary legislation.

The Minister intends to bring a memorandum to Government in the immediate term, setting out proposals for improvements to the scheme, its future administration and various other matters raised in the report of the working group. Once the decision on improvements to the scheme is made, further information relating to the sequencing and timelines will be available. Overall, there are three key principles which inform consideration of improvements to the scheme, namely, that they are timely, reasonable and consistent. I believe that is what the Deputy is requesting as well. I am confident the improvements to the scheme can meet these key objectives.

I appreciate the Minister of State's reply. Perhaps we could add "realistic" to "timely, reasonable and consistent". It has to be realistic. The previous scheme was not the scheme I signed up to, but it became inaccessible to many people. It has to be realistic.

I acknowledge the role of the Minister, Deputy Darragh O'Brien, in this. He is a busy Minister. The Minister of State, Deputy Noonan, is in the hot seat here and he knows how busy ministerial work is. The Minister has a lot in hand and many challenges, but he got involved in the scheme. He rolled up his sleeves and stayed in touch with the group - I acknowledge that - as did my county colleague, Deputy McConalogue, who is also around the table and working closely with the Minister. Sometimes departmental officials can get bad press; we do that in here quite often. However, I believe a considerable amount of work has been going on behind the scenes. I have no evidence to support that, but from what people are telling me, that has been ongoing for the past number of months. That is important.

As regards the Mica Action Group, people have been watching and monitoring its progress over recent months. It is more public than what the group has been doing in the last ten years. It is on the road a long time. It has brought this issue to a deeper level of understanding by creating that awareness. It has been a well-managed, thoroughly disciplined, well-oiled and non-political campaign, and I know people will be looking at researching its work in the time ahead.

Last but by no means least, the homeowners who are hearing those cracks grow louder on stormy nights in the middle of the winter must be allowed something that I certainly used to take for granted, which is peace - peace of mind, peace to live their lives without fear and peace to face into their first Christmas in a decade without fear but with hope.

The Deputy has summed it up eloquently and I thank him for his acknowledgement of the work the Minister and his officials. I assure him that they have worked tirelessly to try to find an equitable solution through the defective blocks grant scheme, which was benchmarked against the previous scheme regarding allowable costs in qualifying works and homeowner contributions. It takes on board the homeowner demands and needs relating to the cost of removal and refitting, retrospective payments, etc.

Considerable work has been done since the working group was established. I pay tribute to the mica campaigners for their work. They have been patient but they have campaigned well to try to ensure an equitable solution is found to this. It is expected that significant changes will be made to the scheme. Progress has been made to date through the working group.

It is also expected that improvements to the scheme will involve a commitment in excess of the current estimated cost of €1.4 billion. By comparison with international models, we have one of the most comprehensive packages in the world for homeowners in similar situations. The Government is committed to working with homeowners to find resolutions to the issues under review. It is the intention of the Minister to bring the matter to Cabinet imminently in order to provide clarity and certainty for homeowners on what has been agreed and the timelines for implementation to allow them to move on with their lives.

I take on board the points the Deputy made about dedicated staff within the Department, the local mechanisms for delivery and earning the trust of the homeowners at the centre of this scheme. That is what we are trying to achieve. I know other issues have been raised in the Dáil about modular builds and affordability; those are for another day. I reassure the Deputy that the Department and the Minister have done phenomenal work on this issue. I again thank the Deputy for consistently raising this matter in the Dáil.

Primary Care Centres

I thank the Minister of State, Deputy Rabbitte, for coming to the House. I have been given the time to raise this important issue and the people of Tullow in County Carlow are depending on me to get answers. In April 2016, a parliamentary question was submitted to the then Minister for Health, the current Tánaiste, on a proposed primary care centre for Tullow, County Carlow. In the reply, the then Minister stated: "The HSE proposes to deliver the primary care centre for the Tullow, Rathvilly and Hacketstown area using the direct/owned-build mechanism." In 2016, the HSE was going to build it. In a reply at the time, the HSE stated that its capital plan would fund the centre.

Following several questions I submitted on the issue since then, I was contacted by the agency to tell me that Tullow had only this year been identified as one of the areas for the development of a new primary care centre which will also serve the local communities in Hacketstown and Rathvilly. The new centre will provide a single point of access to a broad range of much-needed services for the people in Tullow, but only now has the HSE identified a number of interested developers and finalised a list of accommodation.

I have raised this issue again because I am really concerned. The initial information came from the then Minister for Health in 2016. It is now near the end of 2021. In April 2022, six years will have passed. I am no further on than I was in April 2016. Despite having been in contact with the HSE, I cannot even find out where in Tullow this facility will be built. I have only been told that it has identified a site in Tullow but I cannot find out the site location. I do not know how big it is and I certainly cannot find out how long it will take.

A primary care centre is important particularly in towns like Tullow and Bagenalstown in a mainly rural county. During the Covid pandemic waiting lists have increased with delays in people trying to get appointments. Nearly six years later, I am not able to tell people of Tullow, Hacketstown and Rathvilly where in Tullow their centre will be located and when it will be built. I thank the Minister of State for coming in and I hope she has good news for me tonight. It is not acceptable to have to wait six years.

I thank Deputy Murnane O'Connor for raising this issue. I acknowledge her work in advocating for the people of Carlow-Kilkenny. I am taking this matter on behalf of the Minister for Health, Deputy Stephen Donnelly.

I can confirm that a preferred site has been identified close to Tullow town centre for the construction of a new primary care centre. The new facility will not only provide community services to the people of Tullow, it will also serve the local population in the surrounding areas of Rathvilly and Hacketstown. Subject to the established procurement protocols and planning approvals, it is expected that works should commence on site early in quarter 1 of 2022. I must ask the Deputy this question. Has she seen a planning application submitted to Carlow County Council? If she has seen it, the planning application will show the identified site and we all know how long the planning application process takes. If she has not seen it, I will need to take the matter up with the HSE to see where it is at with submitting the application.

The centre will complement and build on the work already being done by the HSE's south-east community healthcare services in delivering primary care, mental health, social care, and health and well-being services in Carlow. It will provide a broad range of services, including GPs, public health nurses, occupational therapists, physiotherapists, dentists, podiatrists, speech and language therapists, and psychologists.

To ensure that access to all these services is as straightforward as possible, the centre will contain a number of multidisciplinary bookable rooms for visiting healthcare professionals, while the required car parking facilities will also be provided. In addition, the centre will serve as a base for one of the 30 multidisciplinary specialist teams for chronic disease being developed under the enhanced community care programme. These teams will target four ambulatory care-sensitive conditions, namely, diabetes, asthma, chronic obstructive pulmonary disease and congestive heart failure, and will allow patients to access care in the community, close to where they live rather than having to travel to hospital.

I am sure the Deputy will agree that this is an especially welcome development, and a concrete example of how the Government's significant investment in health services is benefiting local people and individual patients. In my role as Minister of State, I know the challenges that we face in building up services in the community and in tackling waiting lists. I certainly do not pretend that things are perfect. What I can say is that the development of this centre will improve services in Tullow and the surrounding area by providing: access to a greater range of health and social care services within the community; better integration between hospital and primary care services; an holistic approach to community needs with enhanced capacity for primary care in the areas of disease prevention, rehabilitation and personal social services; and shared care arrangements for the management of chronic conditions.

This is a welcome development, and another step on the road to implementing Sláintecare and transforming how we deliver health services in our community. I hope that answers the Deputy's question. I know it does not give her a specific site location. However, as the HSE expects this to come on stream in quarter 1 of 2022, I would assume that the planning application is in the offing.

I thank the Minister of State. I regularly check planning applications to Carlow County Council. We have a good news story coming from Carlow. I have seen a planning application for a 140-bed hospital and I will be speaking to the Minister in respect of that matter. I have not seen a planning application for this primary care centre. While I welcome this, and I assure the Minister of State that I monitor planning applications at all time, I have concerns that the HSE has not responded to me with more information.

I am constantly addressing the matter here and I am constantly in contact with the HSE. I welcome this. It is important now that the planning application goes through as soon as possible. I will do anything I can to help because Tullow has waited nearly six years for this.

The Minister of State indicates this will happen in 2022, which is really welcome, although we are looking at another year and a half or two years before this will be built. We must be practical. The Minister of State knows there is an eight-week period in the planning process and people might put in submissions or whatever. We do not have a timescale but this information is welcome. I will ensure I promote this as best I can. I am sure the people of Tullow, Hacketstown and Rathvilly will do the same because this service was needed years ago.

I know the Minister of State is stepping in for the Minister, Deputy Stephen Donnelly, and I thank her for that. I have major concerns, however, as trying to get information on certain projects from the HSE can sometimes be impossible. People from these areas come to me and want to know when such projects will happen and a primary care centre for Tullow, Hacketstown and Rathvilly is vital. This news is really important and I will stay in contact with the Minister of State. I thank her for that good answer.

I can assure the Deputy that the Minister, Deputy Donnelly, and I are absolutely committed to delivering the investment and reforms required to improve our health service. This very much includes the continuing development of primary care centres right across the country. Significant progress has been made and there are now 146 operational centres throughout the country, up from 70 at the end of 2012. Looking to next year we are targeting the opening of another 24 centres, so we have real momentum in the building programme. These facilities are key to enhancing and expanding capacity in the primary care sector and delivering high-quality integrated care to people in their own communities. I am happy to be able to confirm the people of Tullow will be able to avail of a primary care centre in the not too distant future.

I have no doubt the Deputy and, I dare say, the local community are waiting for building works to begin. I understand there would be some impatience and the desire for things to move more quickly. However, there should be no doubt there is a commitment to building a primary care centre in Tullow and, ultimately, the local community will be able to access health and social care services from a well-equipped, high-quality and purpose-built facility.

Hospital Services

I wish to raise a very important matter relating to the diabetes clinic at Portlaoise hospital, which services a very large area not just in County Laois but also Offaly, north Tipperary and south Kildare. Currently it is blocked from providing full services and it cannot provide insulin pump services because there is no adult dietician in place for the adult clinic, which is required for it to function fully.

I have spoken to staff and some of the families affected by this. There is a wonderful children's diabetes clinic at the site but unfortunately diabetes has become very prevalent. We must deal with that and prevention is better than cure but we must also deal with the here and now. A high number of people suffer from diabetes in this country and although we must get better at prevention, this is where we are. There are hundreds of adults and children attending the Portlaoise clinic. I hear nothing but praise about the children's clinic but, unfortunately, the adult facilities do not provide full services. There are also many teenagers caught in a position where they should be transferring to adult services but cannot do so; they have come of age but the service is not there so they cannot move on.

People are currently travelling to Dublin for insulin pump services and many are paying for a private service. Some of the people are on low incomes from work or a mixture of work and social welfare. It is putting huge financial pressure on families. The Minister of State understands community care as well as the Minister for Health because of her interest in these matters. I know we cannot have a service at every crossroads but we must regionalise services and ensure we have a strong range of services because where people can access them, they are more inclined to use them.

This is really important and my understanding is the hospital management has made the case on no fewer than three occasions in the recent past to try to get an appointment to the post. I hear the Minister of State is responsible for good news and she had some earlier for Deputy Murnane O'Connor. This is one post and it is important that diabetes is treated properly.

The families had a protest outside the hospital last Sunday week, that is how strongly they feel about this. They have conveyed to me in no uncertain terms that this must be sorted out. The hospital staff and management are on board with this request. Portlaoise hospital is making good strides and there is new investment going in, which is all to be welcomed. I always complain when something does not happen but I will always acknowledge when something does, and that is important. We must recognise what is happening and the new respiratory assessment unit will be great when it is built with the other facilities. This piece is missing from the adult services for diabetes.

As I said, there was a protest last Sunday week, on 14 November. If we can get this over the line it would be really good for the area, not just in Laois but the surrounding counties as well.

Again, I am taking this matter on behalf of the Minister, Deputy Donnelly. Diabetes is a complex condition that can have a profound impact on the quality of life of people living with the condition. If not well managed, it can lead to debilitating complications. The increasing prevalence of diabetes poses a major challenge to our health service, with increasing costs driven primarily by hospitalisation and treating associated complications. Management of the condition is required across the entire spectrum of healthcare delivery, including self-management support, as well as care delivered through general practice, community specialist care and hospital inpatient specialist care. Diabetes services at Portlaoise hospital provide care for patients with paediatric, adult and gestational diabetes. The services provide treatment for.patients as part of a multidisciplinary team comprised of consultant endocrinologists, dieticians, clinical nurse specialists in diabetes for adults and children, an advanced nurse practitioner and a podiatrist.

Portlaoise hospital services have been providing insulin pump therapy service to patients since 2017. Insulin pump therapy supports patients to improve their glucose control and improves their quality of life. Currently, 86 children with type 1 diabetes are attending the hospital, with 49 patients receiving insulin pump therapy. At present, approximately nine new patients require access to this therapy each year, which is guided by the paediatric model of care for children and young people with type 1 diabetes.

As patients reach 16 years, diabetes services hold a transitional clinic where paediatric patients are supported to transition to the adult diabetes service. The Deputy was speaking about that transitional care piece. In the past two years, eight patients have transferred to the adult service, five of whom continued to receive insulin pump therapy. It is estimated that approximately 11 patients will transfer to the adult service in 2022 and a further 14 will transfer in 2023.

Portlaoise hospital recognises the importance of this service for diabetic patients and their families. The hospital is working to support the dietetic service in meeting the increasing demand for insulin pump therapy as patients are transferred from the paediatric to the adult service. Currently, six adult patients receiving care are on insulin pump therapy and four adult patients are on the waiting list. Portlaoise hospital has employed an advanced nurse practitioner in diabetes to support the diabetes service and has recently approved an additional 0.5 whole-time equivalent to meet immediate needs in the dietetic service. I do not know how recently that was.

The HSE is committed to working with Portlaoise hospital to maintain and improve diabetes services, including through further development of the adult insulin pump service. This response indicates there is active management involvement in ensuring we can recruit the staff to meet the needs of the growing population transferring from paediatrics into adult care. The first response has been the recruitment of the 0.5 whole-time equivalent.

I thank the Minister of State for her response. I wish to clarify this. Having spoken to staff and families, they are clear that at this point, unless the situation has changed in the last day or two, a dietician is required for the adult services to operate fully. A senior dietician is needed to provide instant pump services. That is the issue I want clarified. The HSE can often explain matters in medical terms; we are lay people. That is the missing piece here.

The importance of providing that proper treatment to people with diabetes cannot be overstated. It is for their health. All medical practitioners, nurses and GPs, will say it is really important that it is maintained and monitored properly and that they have the proper care. Failure to look after it properly leads to a whole range of other health problems down the line. We have all seen that in the community with people who are diabetic and do not get proper treatment. While cost should not be the biggest consideration, it can lead to extra cost on the health system because if prevention is not addressed, one will end up with greater health problems, higher costs and sicker patients, which is the real issue here.

We are talking about this one position. We are not talking about millions of euro. A relatively small amount of money is needed to facilitate the full service. I appeal to the Minister of State to put that in place. There are huge demands on the health system currently and we all understand that. However, while that is happening, I am sure the Minister of State would admit that there are many gaps in our health services at the front line. HSE management might talk around it and the Minister of State could be as confused as ever when finished talking to them. I do not mean that in a derogatory way. The public needs access to good local services. Will the Minister of State clarify exactly what she said in relation to the dietician for that clinic?

Let us be clear on the response. Portlaoise Hospital has employed an advanced nurse practitioner in diabetes to support the diabetes service and has recently approved an additional 0.5 whole-time equivalent to meet the needs in the dietetic service. In reference to the dietetic service, a 0.5 of a whole-time equivalent has been approved and that was shared in my initial response. I will seek further clarification to give the Deputy a comprehensive answer from the Minister, Deputy Stephen Donnelly. This Government is completely committed to improving services for all those living with chronic disease, including diabetes. If this has not been answered wholesomely enough, we will get confirmation from the HSE and I will forward an answer to the Deputy though the Chair by tomorrow.