Dáil Éireann debate -
Thursday, 26 May 2022

Vol. 1022 No. 7

Saincheisteanna Tráthúla - Topical Issue Debate

School Enrolments

Deputy Darren O'Rourke

I welcome the Minister of State. I know that the Minister for Education is not available, but the Minister of State, Deputy Thomas Byrne, is my constituency colleague and the Minister's party colleague. I know he is familiar with this issue, but I will lay out some of the detail here. We need to discuss the need to secure the future of the site and buildings of Clonalvy national school. This was a national school in rural County Meath that was closed in 2019. It is important to say it was not closed due to a natural lack of demand or need or lack of children of school-going age in the area. There were artificial reasons. The demand is there for a primary school. It was there and it still is there.

My understanding is that the diocese divested of the school in February 2022. The Minister of State might confirm that. I have a concern about the nature of the pre-closure consultation by the diocese or by the Department. My sense in all of this is there was never support to maintain the status quo or to return to the status quo before 2019. However, there was always, in my opinion, the opportunity if the right proposition was put forward for the continuation of a primary school. There is a lack of diversity in the area generally in terms of patronage. It is now the case that the school is on the open market. It is for sale. A proposal was made after some time from the community after significant with ourselves as public representatives and particularly within the community. They have confirmed that the Louth and Meath education and training board, LMETB, is interested in acquiring the site for a community national school and an education campus. I think there is huge potential there.

I attended a public meeting - the Minister of State sent his apologies - that was very well attended. The demand is there. People are interested. They will avail of it. The LMETB as a patron is confident that it would make a success of this. It has done similarly elsewhere. The question is how to join those pieces together with the Department and the Minister. I believe the Minister and the Department need to lead on this. Is it a case of a sale or a transfer? What will the nature of the transaction be? Ultimately, it is important that action happens quickly. Time is of the essence here. The site and buildings are for sale. The price is probably going up day by day. It is important that we have action on this.

Minister of State at the Department of Foreign Affairs (Deputy Thomas Byrne)

I want to thank Deputy O’Rourke for raising this issue. As he rightly said, I am very familiar with it. I did give apologies to a public meeting that I could not attend last year. I fully support the Deputy’s proposal. I was at a public meeting three years ago when I put forward the exact same proposal. I tried to get action on it then. Unfortunately, people were not listening at that time, when the school was open. At that time, it could have been saved. It is a disgrace that it was allowed to close. I completely agree with Deputy O’Rourke.

St. Finian's national school at Clonalvy is a former national school which closed on the basis that no pupils were enrolled for the 2019-20 school year. The Bishop of Meath took that decision at that time. If I may be honest, this is a pattern that I fear in other areas where there are two or three schools in a parish, one becomes the dominant or popular school and pupils start to peel away from the other school. That puts pressure on the school that pupils have peeled away from. That is exactly what happened in Clonalvy. People started moving to the other school in the parish in Ardcath, which extended its buildings. There are also other schools close by in Naul. I see that happening in other areas too and I am very concerned about it. The problem is that I do not see the church’s patrons dividing the catchments within parishes to protect all the schools. The Department of Education tends not to deal with those issues at that grassroots level. It is really left to boards and management. However, we all need to keep an eye on this. As the Deputy rightly said, St. Finian’s National School is not in the ownership of the Department. On that basis, the Department accepted the termination of a small charging lease, which dated from 1953 in respect of the former school property. I do not have further details on that.

The Government and the Department divides the country into 314 school planning areas to try to plan for school demands. To be fair, that has been working much better in recent years. Project Ireland 2040 also has population and housing targets. They inform the Department’s projections of school place requirements. At national level, primary enrolments peaked in 2018 and are forecast to decline overall by 20% in the next ten years, despite overall population growth. However, there will of course be local variations. We all know that. Indeed, the arrival of Ukrainian children has added to the pressure on school places. It has added to primary school places and has allowed for more teachers to be employed in certain areas.

Clonalvy, as it happens, is in the Ashbourne school planning area. The Department’s most recent demographic projections indicate a decline in primary enrolments in that planning area over the next ten to 15 years. This is on the basis that the national and local plans are looking towards Drogheda, Dunboyne and Navan as areas of population growth. The village, as we know, is close to the Balbriggan school planning area and to Stamullen. Again, the forecasts for that are similar.

In the school planning area of Ashbourne, for example, which I know is not directly adjacent to Clonalvy but it is part of the planning area, new schools are being opened to cater for demand. The Department will continue to keep the primary school place requirements in the area under review. This will be informed by current and planned residential development, the housing and population targets and the enrolment of children from Ukraine. The Department engages with a range of stakeholders in this respect. I personally undertake to work with the Deputy on this, because I think the school should not have closed. There was an opportunity three or four years to keep it open. I thought it was a perfect candidate for divestment from the Church. At the time, I did not seem to be getting interest in that.

Deputy Darren O'Rourke

I know the Department prepared some notes for the Minister of State on this topical issue. That is the bit I am hanging on for.

Deputy Thomas Byrne

The official script.

Deputy Darren O'Rourke

Exactly, yes. The mood music is not great. It says that it will keep the demand under review and it mentions the potential implications of incoming Ukrainian refugees. The Minister of State knows that time is of the essence in this. If we are going to do something, it cannot be a case that we keep it under review. It will either happen or it will not. If it is going to happen it needs to happen soon.

We need to see something from the Minister and the Department. I wrote to the Minister seeking an engagement with local Deputies. I will put on record my commendation of the local community, especially Mr. Nick Reilly and Ms Patricia Rogers from the Ardcath Clonalvy Heritage Society and the Clonalvy Revival Programme. It is clear that this can be a success story. It is only a matter of whether the will is there. There are details to be worked out and technicalities. If people want to hide behind those technicalities they can, but I firmly believe if there is a will to make this happen, it can be a success story. All the ingredients are there in the community and the education system locally. The Minister of State knows the potential of it. I am available at any time, day or night, to play whatever helpful role I can in this regard but time is of the essence. I ask him to take that back to the Minister and update us as best he can on what the next steps are as the Minister of Sate understands them. I cannot say it any clearer than that. Time is of the essence. We need the Minister and the Department to lead on this.

Deputy Thomas Byrne

I thank the Deputy for mentioning the Ardcath group. I had good engagements with Mr. Nick Reilly, who I have known for a long time. I will engage with the Minister next week and will inform the Deputy in advance of that. We need to work on this together. It is something that can happen. There are things going against it because the school is closed. It is for sale so, presumably, money is being sought. It is a lightly populated area but has major potential for multi-denominational education. It is in the Ashbourne planning area but it is not very close to multi-denominational school. Special education is another potentiality because, quite frankly, we are looking for premises for special education schools. I undertake to work with the Deputy and the entire committee. I again thank him for raising the matter. We will see what potentialities come from the Department of Education next week. I have discussed this with the Minister for Education. I have no doubt we will all do the same next week.

Special Educational Needs

Deputy Paul Murphy

I will raise the issue of the Government plan for special education centres as an emergency response to the shortage of appropriate school places reported in The Irish Times last night. It caused significant alarm to the organisations representing parents and children with special needs, and the parents who have been campaigning very hard to get their children the places in school they need, which may be supports in mainstream classes or special classes in mainstream schools. The idea people will just be put into these special centres caused a lot of alarm. There is also the worry that will be they will be forgotten about and this will be institutionalised. There is a meeting with the Minister today that includes groups such as AsIAm. I am interested in hearing about that.

I will go through the concerns the groups and I have. The first is there was no consultation before this was announced. It seems very strange. It has been only a matter of weeks since we had an indication from the Minister of State at the Department of Education, Deputy Madigan, that we would be going the route of section 37A of the relevant Act by directing the schools to open classes. That was generally welcomed by parents because that is what they feel needs to happen, but all of a sudden these special education centres were announced, which seems to be a 180-degree policy turn with no consultation.

The second major point is the real concern that what is presented as an interim measure becomes permanent. We know of circumstances like that too often in this State. Many things still with us today - direct provision is perhaps one of the worst examples - were interim measures. There is also concern about the numbers included in the plan. It states there will be five schools with 24 pupils each, which amounts to space for 120 pupils, but there are 80 children in Dublin waiting for a special class at this stage and those numbers relate to Dublin. That also gives rise to alarm about why we have an extra 40 spaces. Is it because they will be filled over a number of years? Is this how long it is planned to be for?

Another important point is the danger this will be a move away from integrated education for students. Where will these buildings be? Clearly, if they are meant to be in use by September, they will not be new buildings and they exist somewhere. If they are not existing schools, we will not have potential for integration time for students without additional needs. That is a very important and recognised thing that is necessary for students. The Tánaiste stated earlier that some students need special schools. I acknowledge that and have no problem with it, but The Irish Times story certainly does not refer to those students and their needs; it refers to those children who are waiting for a special class in Dublin, that is, a special class in mainstream schools. That is what has been diagnosed for those children as most appropriate for them and that is what would represent a vindication of their rights.

The fundamental point I will make is this is a way of not doing what is necessary to vindicate these children's rights, including under the UN Convention on the Rights of People with Disabilities and the route of going down section 37A by directing schools to open places. It is then about resourcing the schools appropriately, but that is what is necessary. This is a way of getting away from the pressure by saying at least people have a place - it may not be the best place but at least they have a place - and we avoid this question of needing to get many more special classes opened in mainstream schools in primary and post-primary education.

Deputy Thomas Byrne

I very much thank the Deputy for raising this issue. I am glad the Minister of State with responsibility for disability, Deputy Rabbitte, is present to listen to his comments. There was not much we disagreed with on the substance of his points, quite frankly. In fairness to the Minister of State, Deputy Madigan, there was not much she would disagree with either. The bottom line is no decision has been made about this. I apologise on behalf of the Minister of State that she is not present. She is attending the Middletown Centre for Autism today, which is another place that does essential work on a North-South basis. It is very important to remember that.

Enabling children with special educational needs to receive an education appropriate to their needs is a constitutional right and a priority for this Government. This year, the Department of Education will invest €2 billion, or more than 25% of its budget, in the area of special educational needs support. The truth is the number of special education teachers, special needs assistants, SNAs, special classes and school places are all at unprecedented levels. In budget 2022, we provided for the creation of 287 additional special classes. There are many more special classes then there were. I accept there are not enough but there are a lot more and significant progress has been made. I thank those schools that have co-operated with the Department in looking for these classes, which will provide 1,700 new places this year. That brings the total number of special classes to 2,435. In 2011, there were 548 special classes in mainstream schools and there are 2,148 in this particular school year.

In line with the demographics and as part of forward planning, it is envisaged that special classes will be required at most, if not all, post-primary schools in Dublin. A range of measures to meet additional special education needs capacity demands have already been put in place, including the utilisation of spare capacity in existing schools and the delivery of additional capacity within the scope of existing school building projects. Additionally, it is now general practice to include a special educational needs base in the accommodation brief for new school buildings unless there are exceptional local circumstances. However, the extent of provision made at these schools is informed by the level of demand in the area as well as the size of the school.

The NCSE is currently engaged in a process of establishing new classes for next year and beyond.

Acting Chairman (Deputy Bernard J. Durkan)

The Minister of State's time is up.

Deputy Thomas Byrne

I had better continue this because it is the important part.

Acting Chairman (Deputy Bernard J. Durkan)

The Minister of State will have a chance to speak again.

Deputy Thomas Byrne

Yes, but this is important. One of the options being discussed-----

Acting Chairman (Deputy Bernard J. Durkan)

It is important that we keep to the deadline as well.

Deputy Thomas Byrne

I accept that, but this is the nub of the issue. One of the options being discussed by the Minister of State, Deputy Madigan, is to open-----

Acting Chairman (Deputy Bernard J. Durkan)

I thank the Minister of State.

Deputy Thomas Byrne

As I said, it is a proposal, not a decision.

Deputy Paul Murphy

Yes. The line is that the proposal is a temporary option for those who are waiting. It is a draft, etc. I get the message. Nonetheless, there is a proposal. AsIAm put a statement up on Facebook after the meeting saying that, like here, the Department had sought to assure it that no decision had been made and that the Department had listened to the concerns, but AsIAm makes the point that the current proposal - which means there is clearly still a proposal - is not something that its organisation could ever support. The Department needs to go back to the drawing board and examine how this proposal was devised.

I welcome section 37A and it needs to be used, although that is not easy to do. It has only been used twice, but the need is great. I will use the example of Dublin 24, which is part of where I represent. The situation with post-primary schools there is phenomenal. A couple of weeks ago, the Taoiseach described it to me in the Dáil as "crazy". There are 17 primary schools with a special class but only one - it will increase to two - such schools at post-primary level. Generally, the ratio across the country is 2.2:1 or 2.3:1, so this area is out of whack. I was in touch with a campaigner who told me that she had a list of six families without a school place for next September. They all applied for schools across Dublin and received multiple refusal letters. That there are this many secondary schools without ASD classes is not on.

The proposal is one of putting people in special education centres as opposed to saying that they have to be educated in schools and providing the resources to ensure that happens. It cannot be a case of only getting an ASD class when a new school is built. It is great that there will be a class in every new school, but we are not building schools quickly enough to deal with the situation.

Deputy Thomas Byrne

As the Deputy noted, the draft proposal is an option, not a decision. That is what the Minister of State emphasised to me today. This is very much at an early stage and subject to further engagement. I am glad that some engagement has already happened, with strong views being expressed at the meeting and in public statements. Clearly, further significant work is required to progress this matter.

The key goal is for the constitutional right to education for children with special educational needs to be fulfilled. That must be our guiding objective in all of this, alongside our international obligations under the various UN charters, as the Minister of State, Deputy Rabbitte, has reminded me. She is committed to that. A school is not just somewhere to go, but a constitutional right and an international obligation of the State. The Government takes that seriously, as does the Minister of State, Deputy Madigan. We will see where this goes. Serious concerns have been expressed, so I want to be clear that no decision has been made.

Acting Chairman (Deputy Bernard J. Durkan)

The next Topical Issue matter is in the name of Deputy Pádraig O’Sullivan.

Deputy Thomas Byrne

May I propose that the fourth Topical Issue matter be heard next? I am taking that as well. I believe I have agreement from the Deputies.

Acting Chairman (Deputy Bernard J. Durkan)

Is that agreed? Agreed.

Deputy Thomas Byrne

I thank the House.

Water Quality

Deputy James Lawless

I thank the Minister of State for taking this Topical Issue debate, which relates to the quality and contents of the water supply in Kilteel, County Kildare. In the constituency of Kildare North, Kilteel borders counties Wicklow and Dublin. It is in an important corner of the constituency where there are decent people and strong communities.

Sixty houses connect to the group water scheme that services the area. The scheme has been in place for a considerable time. In January, what was effectively a “Do not use” notice was issued by Kildare County Council due to suspected arsenic poisoning in the water. It seems incredible that something as nutritious and necessary for life as the water that comes into our homes is would have poison in it, but that is what appeared to be the situation.

Some temporary measures were taken, including tankers being sent to the area and water being made available on a temporary basis, but we are now into May and rapidly approaching June, which is almost six months into the year, and those 60 households and all belonging to them are still grappling with this poisoned water in their homes. I spoke to Ms Kathleen Lambe this week. She is a decent lady who is involved in the local arts and creative scene. More in hope than expectation that the issue had died down, she had consumed the water, perhaps mistakenly. She ended up in Naas hospital with suspected arsenic poisoning. Others have complained of being sick, with symptoms ranging from nausea to more serious complaints. Some have been hospitalised. We often discuss rural areas like Kilteel getting access to broadband and other services, but one of the most fundamental services of all is water for drinking, cooking and people’s day-to-day needs.

Engagement is ongoing with Kildare County Council and Irish Water. I have also been engaging with those bodies. However, I believe a Government direction will be required. Perhaps the Environmental Protection Agency could be directed to get involved and carry out an investigation. It is possible that Irish Water could connect the group water scheme to a wider scheme, allowing for continuity of supply and for the old supply to be rerouted from the poisoned well. This would require funding, as the residents cannot be expected to fund all of this under their own steam, particularly after being badly let down by State agencies. I ask that the Government consider a subvention to Irish Water, Kildare County Council or both to remedy this situation.

This situation has been ongoing for nearly six months and people are facing into the summer with its droughts and weather changes and when water is a scarce commodity. Decent, clean and non-poisoned drinking water seems like a fundamental requirement. The Minister of State’s constituency of Meath East has many similar rural areas that are reliant on such group water schemes, so he knows how important they are. I look forward to his response and what guidance and solutions he can offer as regards this problem.

Deputy Thomas Byrne

Gabhaim buíochas leis an Teachta as an ábhar seo a ardú agus an deis a thabhairt dom, ar son an Aire Tithíochta, Rialtais Áitiúil agus Oidhreachta, déileáil leis. I thank the Deputy for raising this issue and giving me an opportunity to address it on behalf of the Minister for Housing, Local Government and Heritage, who cannot be present but who sends his apologies.

Group water schemes are independent community-owned enterprises and an important means of providing piped water to rural areas where no such supply exists. In the interest of public health, Kildare County Council, as the supervisory authority under the drinking water regulations for private water supplies, issued a "Do not consume" notice to the Kilteel group water scheme earlier this year. The notice prohibits the use of the water supply for either drinking purposes or the preparation of food.

As this is a private supply, primary responsibility for its resolution rests with the management of the supply. The Department's multi-annual rural water programme provides capital funding under a number of measures, including for group water schemes, to enable the resolution of infrastructural deficiencies, in particular those that are causing or risk causing water quality issues. The council has informed my Department that it continues to work with the management of the supply to assist it in addressing its water quality issue.

Given the public health concerns, the Department has asked the council to examine and report back on the most appropriate approaches for resolving the issues with the supply by examining solutions in the short, medium and longer terms. In the short term, the council is examining the options for the supply and providing a temporary water supply for the area by using a tanker. As a medium-term solution, the Department has asked the council to examine the feasibility of providing a supply using an alternative groundwater source. The council, after obtaining expert advice, will provide the Department with an initial assessment on the feasibility of doing this in the coming weeks.

Of course, the more sustainable long-term solution for the supply appears to be its interconnection to the public network and taking in charge.

To progress this, the council submitted a connection application to Irish Water on 4 May last. Given the public health concerns with the supply and following the Deputy's representations, the Department separately requested Irish Water to prioritise the request. The Department will continue to engage with the council on the matter of this supply and it will be providing my Department with regular updates on progress.

Deputy James Lawless

I thank the Minister for the reply and welcome the progress. I have been in touch with the Minister's office on this throughout and I welcome that those representations are beginning to bear fruit. I note the commitment that the Department will receive an initial assessment on the feasibility of an alternative groundwater source arising from tonight's debate and the representations in the next couple of weeks, as well as the fact the Department has instructed Irish Water to prioritise that request for the connection to the mains. I want to be positive and I want to welcome the progress that is being made. There is an urgency about it, naturally, given the type of issue it is. There was a situation where people had to buy bottled water for themselves in the shops and a tanker was occasionally being sent up, although perhaps not as frequently in recent days.

As an observation, at the outset of his reply, the Minister of State said it was a private supply and, effectively, was a private issue. I know he went on to explain that the State will intervene, which I acknowledge. However, it is only a private supply because of the lack of an alternative. If people could connect to the mains, they would have done so years ago, in particular if that had been an option when they were building their houses. Some have access to private water wells but many do not. Therefore, while it is a private group water scheme, it is only so because of necessity. I commend the community on organising itself in this manner and making these provisions for itself. It has stood them well for many years but, unfortunately, no longer.

In conclusion, I will keep in touch with the Minister and I look forward to those actions being taken. The long-term solution really is the connection to the mains supply, albeit it is a somewhat rural and isolated area. It has to be done and we have to find a way to do it. I recognise that the Department will now prioritise that through working with Irish Water. I also look forward to a progress update on the ground water supply. All of these things are necessary and important. As I said, we cannot allow 60 households in a rural community to just grin and bear it for any longer than is necessary. I thank the Minister of State and his office, and the Minister, Deputy O'Brien, with whom I have been working, for their inputs. I look forward to a swift resolution.

Deputy Thomas Byrne

Gabhaim mo bhuíochas arís leis an Teachta as an obair atá á dhéanamh aige i gCill Chéile i gContae Chill Dara maidir leis an uisce lofa atá ansin agus chun dul chun cinn a dhéanamh agus feabhas a chur ar an uisce sin.

I thank the Deputy again for his comments. His interest and representations are very much appreciated in the Department. The Department will be announcing funding for its multi-annual rural water programme and we will see details of that shortly. I urge the Deputy to, as he said he would, keep in touch with the Department because there are actions listed that will start to happen. I know his interventions are highly appreciated.

Medicinal Products

Deputy Pádraig O'Sullivan

I thank the Minister of State, Deputy Rabbitte, who has been here on more than a few occasions to answer questions in regard to rare diseases and orphan drugs, and now this issue pertaining to the establishment of the medicines agency. As the Minister of State is aware, this is a commitment in the programme for Government. We are over two years into government and while I can probably guess the answer that has been given to the Minister of State, very little work has been done in this area. The purpose of the question is to see exactly what has happened up to now in terms of delivering this agency and the Minister of State might give a timeframe for the establishment of such an agency. I know the Minister of State is well aware of the issues in this sector, particularly with regard to the question of access to drugs for rare diseases.

I would like to acknowledge the work the Minister, Deputy Donnelly, has done in this area. He has provided the largest budget over the last two years in terms of approval of new medicines, which is to be welcomed. However, I must preface that commendation by saying that in this sphere the Government has made very little progress, and we need to acknowledge that and be truthful about it.

It is welcome that the programme for Government allows for the establishment of the national medicines agency but it is regrettable that the focus seems to be solely on lower pricing and reimbursements. Obviously, this is important. The National Centre for Pharmacoeconomics already has this job and continues to conduct assessments of new medicines and getting the State bang for its buck. However, a national medicines agency needs to be more ambitious, to my mind. It needs to take on the entire reimbursement system and make sure patients get quicker access to the drugs they require. It needs to ensure greater budget predictability. I mentioned that the Minister has supplied the largest budget in this space over the last two years but at various times in the past decade, no money was given over to the budget in this space. Greater budget predictability is a must.

We also need to ensure greater patient involvement. I have met a number of patients groups which complain about the lack of transparency in decision-making for approval of these medicines. They do not feel involved in the process and there is not very much interaction between them and the National Centre for Pharmacoeconomics. We need to develop a specific pathway for orphan drugs because no such pathway exists at present.

The Minister of State, Deputy Rabbitte, attended a cross-party grouping on rare disease day on 28 February last, so she is quite aware of the issues. Going forward, this agency needs to focus in particular on consulting with various stakeholders, patients, patient groups, clinicians, the industry and health economists. Ultimately, this is part of the wider picture in terms of rare diseases and orphan drugs. As I have said in the House in the past, one of the hardest conversations I ever had was to sit down with somebody face-to-face. We can make all the excuses in the world but I want to give some statistics to the Minister of State. In Ireland, the latest data from the European Federation of Pharmaceutical Industries ranks Ireland 24th out of 39 countries in terms of timely access to medicines for all diseases. The same report ranks Ireland 29th out of 39 for access to orphan drugs and 27th for oncology medicines. The most galling thing about all of this, as we noted previously, is that all the large pharmaceutical companies that are providing these drugs worldwide are here on our doorstep. We are shipping drugs to every corner of the Continent and of the planet, yet we are one of the laggards when it comes to approving and getting reimbursement for those drugs. I am interested to see if the Minister of State can give me an update on the establishment of the agency.

Minister of State at the Department of Health (Deputy Anne Rabbitte)

I thank the Deputy for raising this issue. He is right when he says the 2020 programme for Government includes a commitment to establish a national medicines agency which will seek to reduce the cost of medicines for the State and for patients. As the Deputy is aware, the existing pricing and reimbursement process for medicines involves the work of a number of individual bodies and agencies. The collective contributions of these agencies are crucial to the HSE executive management team's decision-making with respect to medicine reimbursement.

First, the Health Products Regulatory Authority, HPRA, is responsible for the regulation of health products, including medicines, in Ireland and maintains a register of authorised products. Under the Health (Pricing and Supply of Medical Goods) Act, reference pricing involves the setting of a reimbursement price for a group of interchangeable medicines. This has enabled greater cost-effective dispensing and continues to contribute to cost avoidance. The Health Products Regulatory Authority's role under the 2013 Act includes the maintenance of a list of interchangeable medicines. This supports pharmacists to substitute medicines prescribed, provided they have been designated as interchangeable by the Health Products Regulatory Authority.

The National Centre for Pharmacoeconomics advises the HSE on the cost-effectiveness of new medicines. The National Centre for Pharmacoeconomics carries out health technology assessments in order to make recommendations on reimbursement to assist HSE decisions.

The HSE's corporate pharmaceutical unit is an important interface between the HSE and the pharmaceutical industry on application for reimbursement and the pricing of such medicines.

The HSE drugs group is the national committee that makes recommendations to the HSE's executive management team on the pricing and reimbursement of medicines. Such recommendations are based on the outputs of the entire assessment process. As part of that assessment process, the national cancer control programme technology review committee, which was established in 2011, reviews funding proposals for new cancer drugs. It then makes recommendations on the reimbursement of new drugs to the HSE drugs group based on clinical need and cost-effectiveness. In 2018, the rare diseases technology review committee was established by the HSE leadership, with similar responsibility for reviewing proposals for funding of new drugs for rare diseases. That committee also contributes to the development and implementation of clinical guidelines for relevant drugs.

The establishment of a national medicines agency would require a significant body of work to be undertaken to integrate all these various work streams under a single function. It would also require extensive consultation and primary legislation. That work has yet to commence because the priority and focus of the Department up to now has been on tackling the Covid-19 pandemic. I am acutely aware of the Deputy's involvement in, and knowledge of, rare drugs. Sometimes when I read replies such as this, I feel I know very little about the subject at hand and perhaps less than the Deputy who is asking the question.

Deputy Pádraig O'Sullivan

The real answer to my question was near the end of the Minister of State's response, when she said that "a significant body of work" needs to be undertaken and it will "require extensive consultation and primary legislation". Halfway through the life of the Government, if there is substantive work to be done, we really need to start doing it. That is the reality. If legislation and extensive consultation are needed, we are looking at needing a couple of years to do it when we are already halfway through the Government cycle. The message must go back to the Department of Health that we need to get real and that action on this issue needs to be instigated immediately.

I have looked at other responses that have been given to questions on this subject. I knew the Covid crisis would rear its head as an excuse at some stage. Surprise, surprise, there it is at the very end of the Minister of State's reply. However, the pandemic did not have an impact on some of the great announcements the Minister, Deputy Donnelly, has made over recent weeks, including, for example, in respect of women's health services. Nor did it have any impact on this week's announcement of the expansion of the human papillomavirus, HPV, vaccine programme in schools. When it comes to the issue of orphan drugs, however, the Covid crisis is given as a reason for lack of action. It is very frustrating to see the pandemic being used as an excuse in this regard.

As I said, we need to get real. We are talking about people's lives and their quality of life. The statistics I roll out every now and again about Ireland being a laggard in the European context should be a source of embarrassment to us nationally. Those statistics are referred to so often now that they roll off the tongue and seem to matter very little. It is embarrassing that Ireland, which is one of the largest pharmaceutical-producing nations in the world, ranks 24th out of 39 countries in Europe in terms of our provision of these drugs.

Provision regarding the health technology assessment, HTA, process is the substance of the Bill I am trying to progress. It is currently on Committee Stage. We are using an antiquated, outdated system and pretending it is achieving all these savings, as the Minister of State referred to in her response. The reality is Ireland spends a higher percentage in comparison with countries like Germany, Scotland, Sweden and many others on the drugs that are claimed through our reimbursement system. In those other countries, the medicines are supplied upfront, but we make patients wait a torturous 800 to 1,000 days. I would argue with the statistics claiming we are saving €700 million or €800 million because we are such great negotiators. It is a load of codswallop in my view.

Deputy Anne Rabbitte

I am happy to share some of my time to have allowed the Deputy to get in his last few words. He is correct in what he said. We must move away from the practice of saying why we are not doing a particular aspect of work. There is no denying that action on this issue is included in the programme for Government. As Minister of State, it is something I would like to see commencing, for all the reasons the Deputy outlined. First and foremost, orphan drugs make a significant difference to the lives of individuals. Second, what we all should be about is ensuring longevity for people. The fact we have access to these drugs in this country makes the current situation unbelievable.

Having said that, the Deputy will be interested to know that as of the start of May, the €30 million provision that was allocated in budget 2020 has enabled the HSE to approve 24 new medicines. The executive's robust assessment process and commercial engagement ensured as many new medicines as possible were made available to Irish patients in that period. This shows it was possible to access the budget quickly. I would love if my budget for disability services could be spent in June or July each year. The speed of expenditure in this case shows the great need in respect of orphan drugs and in terms of bringing more medicines on stream, which has a great benefit for the wider population. I will take the Deputy's remarks back to the Minister, who sends his apologies for not being able to be here this evening.

May I ask the Ceann Comhairle's indulgence to speak for a further 30 seconds?

An Ceann Comhairle

Of course. I am always happy to facilitate the Minister of State.

Deputy Anne Rabbitte

As the Ceann Comhairle knows, I spend a lot of time in here on a Thursday evening.

An Ceann Comhairle

The Minister of State does indeed, and a lot of time on other days as well.

Deputy Anne Rabbitte

I thank the Ceann Comhairle for his indulgence. I welcome Bill O'Brien and Ming Chang O'Brien, who are accompanying my sister, to the Visitors Gallery. They are visiting from the US and have called in this evening to have a chat.

An Ceann Comhairle

It is good to have the Minister of State's guests with us.

Following on from the Minister of State's response to his question and with a view to being helpful to Deputy O'Sullivan, it appears to me that targeted questions focusing on the final part of the Minister of State's response and addressing the leadership, progression and timescales around the establishment of a national medicines agency could be very helpful to him. Any such questions should be carefully targeted.