Saincheisteanna Tráthúla - Topical Issue Debate

Health Services

I thank the Minister of State, Deputy Rabbitte, for taking this matter. I acknowledge it is an issue the Minister of State is aware of but it is important to raise it again. I am far from being the only person who has raised it. I know that Deputies Brendan Smith and Cahill previously raised this issue. The Minister of State will have met a constituent of mine who highlighted to me the issue. One hears about waiting lists and about difficulties in the health system but it really brings it home when one sees the impact that it has on people. Perhaps I am not very good at understanding situations until I see them. The waiting lists that exist in Ireland for scoliosis and similar problems that children suffer from are simply unacceptable in any First World country. We are talking about a relatively small sum of money - and I appreciate that we are often talking about such small sums of money - but it is probably not a small sum of money, as it is €72 million. In normal times, that would be a very large sum of money. In Covid-19 times, however, money almost becomes no object when we just throw money at problems. I am not here to talk about Covid-19 or waste in that regard but I am here to talk about the very significant impact that these procedures have.

The constituent of mine that the Minister of State met was one of the lucky ones because he was one of those who were most severely affected. Because he was very severely affected, he eventually received treatment. He spent the first number of years of his life unable to walk or stand. It is simply unacceptable that we vest that upon our children because we take extraordinary measures to try to protect people from that from which we cannot protect them, which is something like a pandemic, but we take such few measures to try to deal with that which is eminently treatable in the most countries.

Just last week, the surgical procedures for children on that waiting list were stopped again in Temple Street Children’s University Hospital. This is not a criticism of Temple Street in any way. I appreciate that resources are greatly stretched.

I visited a children's hospital recently. There has been a significant increase in respiratory virus, RV, which would not have a particular impact on me or the Minister of State, but has a significant impact on children. It is simply not good enough that the treatment of children is being stalled in this way, given the impact it has on their lives.

I thank the Deputy for the opportunity to discuss Cappagh hospital and orthopaedics. I acknowledge my colleagues, Deputies Brendan Smith, Cahill and McAuliffe, who brought me to Cappagh hospital and gave me the opportunity to see at first hand what the Deputy has articulated to me. The Deputies also gave me the opportunity to meet the mother of the Deputy's young constituent, and I also met one of Deputy Cahill's constituents.

Deputy McNamara is right. It is not until one comes face to face with a parent who can very clearly outline the exact impact this has on the development of the child and his or her opportunity of attending school that one fully appreciates it. It prevents the child from being equal with his or her peers, whether in the community or just in the course of the ordinary accessing of services. What I discovered from Cappagh hospital was the opportunity to progress and have development.

In speaking about Cappagh hospital, it would be remiss of me not to reference Mr. Connor Green and the phenomenal work he has done with the tools at his disposal to work between the various hospitals. When I was out at Cappagh hospital, I visited Cappagh Kids. We in this House may talk about separate rooms and isolation and everything else, but that is not what is afforded to the patients in Cappagh Kids. Those involved in that initiative actually provided space to be able to carry out those surgeries.

It is my understanding that in 2021 €1.64 million was provided to Cappagh hospital under the access to care plan to assist with some of those who have been waiting for a long time. I know the hospital has an application in this year for €2.6 million to address that as well. It may be the case that some departmental officials and others need to understand how Cappagh hospital works. It does not have enough high-dependency units to drill down and do more of those surgeries. The ask of the hospital is that it would be supported with €88 million to provide two extra theatres and nine high-dependency beds. By having those sorts of beds, the hospital could become the centre of excellence for orthopaedic surgery not just in the Ireland East Hospital Group, but a centre of excellence in delivery for all of Ireland because we have some of the best physicians there. That also supports hospitals such as those at Temple Street and Crumlin, as well as Children's Health Ireland.

While votes were taking place in the Dáil earlier, I spoke to the Minister for Health and asked him to accompany us on a visit to Cappagh Hospital to see it first hand and to see Cappagh Kids in operation. He would meet Mr. Green and the clinical team there to understand why the hospital should be a stand-alone elective hospital for orthopaedics and a centre of excellence on the east coast. I plead with the HSE, in the context of its capital plan and the applications it is sending in, that while consideration is being given hospitals in Cork and Galway, when Dublin is being considered, perhaps there is a need for Cappagh hospital to be a centre of excellence in orthopaedic care on the east coast. It is structurally located near an exit off a main motorway and there is access land, so even if a modular unit is not going to be built straight away, it could be converted. It is important to acknowledge the recruitment challenges within the HSE.

I thank the Minister of State. I am glad to hear that the Minister for Health will go with her. I have often wondered whether we should have a Minister for Health and a Minister for Covid response. I do not agree with the Minister, Deputy Donnelly, but I appreciate that he must be completely overwhelmed with the Covid response and the requirement to restructure and refocus the healthcare system still exists and pertains. I am delighted to hear he is able to find the time to go to Cappagh hospital and see what they do. I think one needs to see the children who are being treated, but also the children who are not being treated, to understand the priority of this issue. When mentioning Deputies Brendan Smith and Cahill, I did not mean to exclude Deputy McAuliffe. All I can say is that I hope the Deputies are able to prevail on the Minister for Health and impress on him how important this issue is and that maybe something good can come out of it. It is important that those at Cappagh hospital be able to continue their important work and it is very important for the development of children that they are not suffering from debilitating conditions that are so eminently treatable.

I appreciate that it is a lot of money, but it is not a huge amount in the context of even the general health budget, much less the health budget we have now. It is good news that the Minister is at least going to the hospital and I hope he will be as struck as the Minister of State clearly has been by the impact this investment might make. Ultimately, in a Department such as the Department of Health, the Minister holds the purse strings. I hope he will be able to announce something positive.

It is important to state that, as with all capital projects, this project must progress through the various stages of public spending code and the HSE's capital project manuals and approval protocols in the first instance. The project is currently at a strategic assessment stage and its progress is subject to approval and availability of funding. It is also important to state, however, that decisions are currently being made in respect of elective hospitals. The National Treatment Purchase Fund, NTPF, funding does not support these children because we cannot outsource them across the border or send them to other countries for care for the simple reason that the HSE has clearly stated that the outsourcing of spinal patients to external providers in the UK and Europe has not been overly successful as spinal patients often require additional follow-up and management of post-operative complications. These factors are compounded by the difficulties associated with travel overseas by patients, especially now during Covid. Although the Government is committed to the NTPF and wants to ensure the waiting list can come down, there is no short cut to supporting these families apart from having an elective service providing start-to-finish delivery of care under one roof. That cannot be on an ad hoc basis. I look forward to the Minister, Deputy Donnelly, joining me. I thank all the Deputies involved for their support on this. It is one of the topics on which Deputies from all parties and none are united in wanting to get a solution.

Dental Services

I thank the Acting Chairman and the Office of the Ceann Comhairle for giving me the opportunity to raise this issue. In the past year or so in particular, many of my constituents who have a medical card have contacted me regarding their inability to access dental care. It seems that dentists have moved away from medical card patients. Obviously, dentists are overwhelmed by the volume of work they are doing and all dental practices, which do great work, are overloaded with case work. However, an issue has arisen, which is that some dental practices do not have the capacity to take on medical card holders. Right through, people have been ringing my office to say they cannot get a dentist because the dentists no longer take medical cards. I thank the Minister of State for taking this issue. I want to understand why dental practices throughout the country, not just in my area, are moving away from taking on people with a medical card. Those with a medical card can access GP services through their card. The medical card is means-tested and, as such, holders may not have the funds to access serious dental treatment when in crisis or severe pain.

They also want routine dental treatment. This is not only for adults but for young people as well who have to get dental treatment. The Government needs to first of all acknowledge that there is an issue throughout the country with dental practices being unable to take on medical card holders and to understand the reason for this. I am always asking why treatment is not available for this group. The Government needs to forcefully look at this issue which is developing up and down the country. People are travelling long distances to dentists who accept the medical card. It is leading to major anxiety and challenges and storing up problems, even on the routine side of dental treatment. If that is not done properly, it will store up more problems down the line and the Government, through the Department and the HSE, will have to deal with it.

Will the Minister of State acknowledge the crisis and that something needs to be done? We need to understand why dentists have moved away from accepting the medical card. What does the Government or the HSE intend to do to resolve this issue? It is fundamental that everyone is able to access dental treatment whatever his or her income level. We are a republic and we should ensure everybody gets the treatment they deserve, be that acute or routine dental treatment. I ask the Minister of State to acknowledge this issue and see can be done to resolve it. It is a problem in my area and throughout the country.

I thank the Deputy for raising this important matter, which I am taking on behalf of the Minister for Health, Deputy Stephen Donnelly. The Minister is acutely aware that access to dental services for medical card holders under the dental treatment services scheme, DTSS, has become an ever-increasing problem during the pandemic. The problem is that too many dentists contracted by the HSE to treat medical card patients have chosen to leave the scheme. This has led to difficulties for medical card patients in accessing dental care. There is the added problem of medical card patients being displaced by the abundance of private work. I know some parts of the country have been particularly affected and the Minister is very concerned about this.

The Minister has listened to the dentists and the Irish Dental Association and has heard their frustrations with the scheme. They are firmly of the view that the range of services available to patients under the scheme and the fees payable to contracted dentists are out of kilter in today's environment. The Minister does not disagree with them. He fully accepts there is a need to align the scheme with best international evidence and practice, as outlined in Smile agus Sláinte, the new national oral health policy which was published in 2019. Regrettably, the Covid-19 pandemic caused the roll-out of the policy to be delayed and the proposed reviews of the DTSS to be deferred. However, the Minister has given a commitment that there will be a root-and-branch review of the scheme, and his officials and the HSE expect to be in a position to begin that work early in the new year. In the meantime, he wants the contracted dentists and their representative association, the Irish Dental Association, to work with him and his officials to address the immediate issues of concern and ensure we have an abundance of dentists available to provide services to medical card patients.

The Minister has also heard what the dentists had to say about the viability of the scheme, and he wants that addressed too. He secured an additional €10 million in budget 2022 to address that problem and he hopes an agreement can be reached very quickly on how that money can be used to address some of the immediate problems with the scheme, pending the full root-and-branch review.

I am aware that a preliminary engagement with the Irish Dental Association was held in June this year and that the Minister's officials and the HSE will invite the Irish Dental Association in for further talks in the coming weeks. The Minister hopes the association will respond positively to that invitation in order that we can put in place immediate solutions for the benefit of patients and the dental community. In the meantime, his officials are engaging with the HSE public dental service, the in-house salaried service, which is seeking to provide cover for any medical card patients who are experiencing problems in accessing a service from their local dentist.

The issue here is that dentists have withdrawn from the scheme. I gather from the Minister of State's reply, for which I thank her, that an engagement was held in June. That is almost six months ago. This is a crisis. What has happened during those six months? Extra funding has been made available in the budget. What is the commitment? I fear the words "early in the new year". There are a number of weeks left in 2021. The urgency of this matter does not merit waiting until the new year or four, five or six weeks for serious engagement with the Irish Dental Association to take place. During the meetings held in June, the Department and HSE were obviously made aware of the issues on the dental side that were making the scheme unworkable. The dentists are only withdrawing because the scheme is unworkable. What are the issues that caused them to withdraw from it?

I implore the Minister of State to ask the Minister and the HSE to arrange immediate discussions with the Irish Dental Association, not in a number of weeks' time but this week and next, to try to find a solution for this. Deputies are being contacted by many people in acute pain who have been looking for help and support to get dental treatment. That is not acceptable in this day and age.

I ask the Minister of State to impress on the Minister the need to immediately start talks with the Irish Dental Association and to put a resolution in place that will bring dentists back into the scheme and ensure people with medical cards can access dental treatment. This is a matter of extreme urgency.

I take on board everything the Deputy said and I will liaise directly with the Minister, Deputy Donnelly. It is important to say on his behalf that his officials have been engaging with the dental profession. He has secured funding. I will speak to the Minister about taking immediate action and engaging with the Irish Dental Association. All Deputies are contacted by constituents who are severely impacted by this, such as a 17-year-old who needs to have her teeth cleaned before she gets orthodontic treatment and cannot access treatment. It is creating delays and causing a crisis of confidence for young people. People are in extreme pain. The confidence issue has a huge impact on young people. In that regard, I will take the matter up with the Minister, probably tomorrow.

Road Network

I am seeking confirmation that the N20-M20 road project from Cork to Limerick will proceed with urgency in view of the fact, as reported in The Irish Times recently, that 62 people have died on this road in the past 25 years. Between 2016 and 2018, 87 collisions were recorded on the N20, seven of which involved the death of road users, and a further 13 collisions led to serious injuries, with the remaining 67 resulting in minor injuries to road users.

The route of this project was to be announced in September. Even if the route was announced in the morning, we should consider the case of the bypass for Ringaskiddy. Although it was announced in 2014, it took six years before it was finally signed off on as the route. There is huge pressure locally to allow the existing route, especially the stretch from Cork to Mallow, to continue to be used but that it be upgraded and widened.

Bypasses are to be constructed around Mallow, Buttevant and Charleville. A new road will obviously have to be built from Mallow to Charleville because a section of this route is extremely dangerous and not suitable for the volume of traffic that uses it. To give the Minister an idea of this volume of traffic, 25,000 cars pass the section from Waterloo Road and Blarney to Cork City every day. Some 17,000 pass the section around the Mallow area. The figure is the same for the section in the Limerick area. Some 13,000 cars a day use the section from Charleville to Buttevant on what is an old country road.

I will give the Minister an idea of the challenges this presents. There are 625 access points onto the N20. Some 216 of these provide access to fields, 295 to houses and 114 to public roads. That is the challenge faced by anyone travelling on this road. Someone may suddenly decide to turn right and leave the road while one is behind them. There is also the danger of having to cross the path of oncoming traffic.

We face a major challenge. There is a massive volume of traffic comprising both cars and commercial vehicles. As the Minister will know, the Port of Cork has been upgraded and now has additional capacity. We will, therefore, have further commercial freight traffic using this road in the coming years. I ask that this project be prioritised and not postponed again because, if we decide to start in the morning, we will still have a long journey to travel before we turn the first sod on this project.

I thank the Deputy very much. I am taking this issue for the Minister, Deputy Ryan. Obviously, as Minister for Transport, Deputy Ryan has responsibility for overall policy and Exchequer funding in respect of the national roads programme. Once funding arrangements have been put in place with Transport Infrastructure Ireland, TII, under the Roads Acts 1993-2015 and in line with the national development plan, NDP, the planning, design, improvement and upgrading of individual national roads is a matter for TII, in conjunction with the various local authorities concerned.

TII ultimately delivers the national roads programme in line with Project Ireland 2040, the national planning framework and, of course, the NDP. In the new NDP, which was launched in Cork in October, approximately €5.1 billion is earmarked for new national road projects up to 2030. This funding will enable improved regional accessibility across the country as well as compact growth, which are both key national strategic objectives. The funding will provide for the development of numerous national road projects, including the completion of projects which are already at construction stage and those close to it and the development of a number of other projects. The N20-M20 project is included on the list of projects to be progressed during the period covered by the NDP.

The existing N20 is a national primary road which, as the Deputy mentioned, connects the cities of Cork and Limerick. Buttevant, Croom, Charleville, Mallow and Blarney are all major towns along the route. The N20-M20 project is included in the list of projects to be progressed in the NDP and it is being actively progressed. This year alone, TII allocated €5 million to Limerick City and County Council to progress the scheme. The N20-M20 road corridor options to augment or replace the existing N20 Cork-Limerick road are currently being evaluated by TII. These options include a new motorway, the M20, or the upgrading of various sections of the N20. These road options largely follow the existing N20 corridor.

As part of the evaluation, rail scenarios are also being considered as potential solutions in improving Cork-Limerick connectivity. The two rail scenarios being considered by the project team cover the existing Cork to Limerick rail line and a new rail line spur from Charleville to Limerick. Overall, this project has the potential to improve safety - the Deputy spoke about safety issues - and journey time reliability for passenger and freight traffic using the route. More generally, it has the potential to provide economic benefits to the region.

With regard to the next steps, an online public consultation on the possible route options, carried out by the N20-M20 project team, had a high level of public engagement. The closing date for submissions was extended to 15 January 2021. The scheme is currently at route option selection stage, where all the road and rail options I have mentioned will be considered. The preferred transport corridor is expected to be announced by TII in the first half of next year. Subsequent to this, work on design and environmental evaluation will be undertaken by the project team, in addition to the scheme business case required under the public spending code. The business case is expected to be submitted to the Department of Transport and the Department of Public Expenditure and Reform in early 2023 for Government decision. Subject to its approval, the submission of any necessary statutory documents for the project to An Bord Pleanála will follow thereafter.

I am concerned that the Minister has spoken about the first half of 2022. It was my understanding that planning for this project was to start in January 2022, in other words, the route would have been identified by that time. Consideration has already been confined to two possible routes with regard to bypassing Mallow and so on. The Minister is now talking about the first half of the year. I am a bit concerned about that. When he speaks about the first half of the year, does he mean January or June? There is a huge difference. As I said, the volume of traffic on this road will not decrease. We need work to be carried out. I highlighted what occurred in respect of the Ringaskiddy bypass, which is in the constituency of the Taoiseach and the Ministers, Deputies Coveney and Michael McGrath. From the day the route was announced, it took six years before the route was finally agreed and all of the court proceedings and so on concluded. We still have not turned a sod on that project. I ask that this issue be given priority and that there be no further delays.

I take the Deputy's point with regard to clarity on what is meant by the first half of the year. I cannot deliver that clarity right now. I will engage with the Minister, Deputy Ryan, and ask him to come back with some more clarity on that particular point. It is important to note that the route selection element is being progressed. TII is actively progressing it and is engaging with Limerick City and County Council and providing money to undertake those design and research elements of the project. It is recognised that this project has the potential to address the safety issues on the route, issues of connectivity between our second and third cities more widely, and wider issues in respect of economic development. The project will form part of the further development of the Atlantic economic corridor and further subsequent connections to west Cork and Kerry. As I have said, that route selection element is to take place in the first half of next year. We will seek further clarity on that for the Deputy. The business case is coming to Government. Even in my own Department, when we have these big projects we have to make business cases. Of course, that is appropriate to ensure that public money is used wisely. Everyone recognises that the N20 is a strategically important route. It is recognised that the route is not fully fit for purpose at present. We have to address those safety issues and make the route more efficient with regard to journey times. Those goals will be progressed through the strategy outlined.

Child Abuse

I thank the Acting Chairman for staying to this hour. I appreciate it. I also thank the Minister for coming in at this hour and giving me the opportunity to discuss this very important matter. Most people will be well aware of the work St. John Ambulance does and the services it provides. We are all used to seeing its presence at a wide range of sporting events including GAA, soccer and rugby games, in the RDS and at various community events. The vast majority of people who are well used to seeing St. John Ambulance personnel will not be aware of the dark history of the organisation or of the dark influences that seem to linger within it. I am speaking of the child and adult sexual abuse carried out over a number of years by senior members of the organisation.

I commend the bravery of three survivors, Mick Finnegan, Paul Mulholland and Martin Hoey, who have spoken out publicly of the horrific sexual abuse they experienced when they were members of the organisation. Mick Finnegan was only 14 or 15 when the abuse started. Some of his testimony is harrowing, distressing and sickening.

Since this independent review into historical child sex abuse within St. John Ambulance began, the leadership of that organisation has effectively refused to take part in this review. It is nine months since the review began and I have been informed that St. John Ambulance has provided no material to Dr. Geoffrey Shannon to aid his review. Mick Finnegan recently met Dr. Shannon and showed him some documents that he had from the St. John Ambulance and this was the first time that Dr. Shannon had seen documentation from the organisation. St. John Ambulance is effectively stonewalling the review process. I have a deep concern that the organisation is closing ranks to protect rapists and sexual abusers who may still be active members of St. John Ambulance.

Every week St. John Ambulance continues to provide medical support to sporting and community events throughout the country. We cannot be passive observers of an organisation with a history of sexual abuse that refuses to comply with a review into that abuse. If St. John Ambulance were serious about this process, it would be more active in engaging with the process. It would be writing to older members, which it has not; it would be putting out public notices, which it has not; and it would be using its social media platforms to look for more information, which it has not.

No real action has been taken against any organisation like St. John Ambulance. We need action. We need the Minister to push it to ensure it engages in a meaningful way because clearly it has not. An organisation that has closed ranks and has not engaged with the review into sexual abuse is providing medical support to sporting and community events every week. I ask the Minister to address this as a matter of urgency to ensure that those who have carried out these horrific sexual abuses are held to account. Those who remain silent in the full knowledge that senior members of St. John Ambulance were doing what they were doing need to be held to account.

I thank the Deputy for raising this important matter. Reports of historical sexual abuse in St. John Ambulance in the 1990s have been highlighted over recent years. Initially the case concerned three men who made allegations against one named adult. Two of these individuals were under 18 at the time of the abuse.

All three people and the accused were volunteers with St. John Ambulance. A fourth man came forward in November 2020 and a fifth in recent months. It is my understanding that a Garda investigation is under way into all these allegations and also that a number of civil cases are in train. As I am sure the Deputy is aware, the Charities Regulatory Authority, under the aegis of the Department of Rural and Community Development, is Ireland's statutory regulator for charitable organisations, including St. John Ambulance. Neither my Department nor I has any role in the governance of St. John Ambulance.

Nevertheless, my role and that of the Department of Children, Equality, Disability, Integration and Youth in collaboration with Tusla, the Child and Family Agency, is to protect children now. I met the board of St. John Ambulance in late 2020, and I am satisfied that the organisation in its current form is now taking the matter of child protection seriously. The organisation has worked with Tusla to ensure compliance with its obligations under Children First and has accepted the recommendations of Tusla to arrange an independent review of the issues raised.

Dr. Geoffrey Shannon, an internationally recognised expert in child protection, was subsequently commissioned by the board of St. John Ambulance in March 2021 to conduct an independent review into the handling of historical child sexual abuse within St. John Ambulance. Dr. Shannon is a leading authority on child protection and child and family law. During three successive terms as special rapporteur for child protection, he produced 12 annual reports as well as a range of reports on matters relating to child protection.

The terms of reference of the review, as fully agreed by Dr. Shannon, set out that he will examine how St. John Ambulance handled past allegations of child sexual abuse relating to the individual in question and any other allegations made. The review is also tasked with examining the current standard of child safeguarding at the organisation.

I understand that given the sensitive nature of this review, Dr. Shannon believes in-person interviews are the best way to proceed. Covid restrictions have led to some initial delays in those interviews taking place, but it is the preferred method. Nevertheless, if in-person interviews cannot be facilitated, arrangements will be made for secure remote meetings between survivors and him. I also understand significant progress has been made in commencing these interviews.

I have personally met one of the individuals who has come forward on a number of occasions. I commend them and all others who, sometimes at real personal cost to themselves, have had the courage to share the horrific experiences that occurred to them in their youth. I encourage them and anyone with any knowledge of issues within St. John Ambulance to come forward and speak to Dr. Shannon. He has provided a dedicated website for people to get in touch and it can be accessed at stjohnambulancereview.ie.

While the findings will initially be presented to the board of St. John Ambulance, it is my expectation that St. John Ambulance will ensure publication of the review report and I will be looking for this to happen.

It is important to give Dr. Shannon the opportunity to undertake this review and go through the various steps. He is a person of the highest credibility nationally and internationally and it is important to give him the opportunity to do this work.

I know the Minister is absolutely on the survivors' side; that is not in question. The difficulty is that Dr. Shannon has had no contact from St. John Ambulance. Its representatives talk about engaging in the process but they do not actually do it. If organisations with a clear history of sexual abuse refuse to co-operate with reviews and investigations into these crimes, we need more than speeches and words; we need action with sanctions imposed. We need firm action to force their hand to engage with the relevant reviews and investigations. While not directly, St. John Ambulance is receiving thousands of euro of State money every year through various sporting national governing bodies and community groups to which the State provides funds. It does not sit well with me to know that State funds are ending up in an organisation that has closed ranks in the face of a review into sex abuse.

It is deeply concerning that some of those in senior leadership positions in St. John Ambulance knew of these abuses when they were being committed. Even more disturbingly, at that time these same people made jokes and even had songs about these horrific crimes of abuse being carried out. This culture of tolerance of abuse needs to be rooted out. Survivors of sexual abuse should not have to face such barriers in their pursuit of justice. The State should be providing these survivors with the support and resources they need to get that justice. I call on the Minister to take decisive action if St. John Ambulance continues to stonewall this review into child sex abuse. I go so far as to ask him to instruct sporting and community groups to withdraw from using St. John Ambulance at events until this review is carried out in the correct manner. I also appeal directly to sports organisations not to use St. John Ambulance at events they are holding until there is compliance with this review.

I want the record to be clear. My Department provides no funding to St. John Ambulance as a youth organisation.

I met a survivor who explained his experience. I subsequently met the board of St. John Ambulance to discuss both its current child protection procedures, which Tusla has assured me are in compliance with Children First, and a review of the historical cases. I encouraged and put pressure on the board members to undertake that independent review of historical practices. That independent review is now taking place. I subsequently engaged with them to ensure that is properly publicised, recognising that St. John Ambulance is an organisation that has been in existence for a long time.

Many people have passed through it. Since that, there has been better publication of it on its social media, Twitter and Facebook. I have also published a number of press releases from my Department speaking about this review and encouraging people to participate and to come forward. Through other sources, other complainants or other questions about St. John Ambulance have been made known to me. I have made sure to put them through to the right connections to get in touch with Professor Geoffrey Shannon.

I have absolutely confidence in Geoffrey Shannon to get to the bottom of this. I also think that if he believes he is not getting the co-operation he needs, he will say that. He will not allow himself to be messed around by any organisation. He is far too experienced. If we get to a situation where this organisation is not co-operating, this will be called out. We have to give the person who is an expert in undertaking these sorts of investigations the discretion to undertake the work he is doing. This is a detailed piece of analysis, talking to people some who as we know have been deeply impacted. These are not phonecalls and it is right that these take place properly. I have confidence in Geoffrey Shannon, but if he comes to me or to my Department and says there is a real problem, I will be happy to engage on that point.

The Dáil adjourned at 11.22 p.m. until 9 a.m. on Friday, 3 December 2021.