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Dáil Éireann debate -
Thursday, 30 Jun 2022

Vol. 1024 No. 5

Ceisteanna ar Pholasaí nó ar Reachtaíocht - Questions on Policy or Legislation

The Mental Health Commission's annual report published today shows that there is a gap in the quality of care for people who are presenting with mental health issues, between private and public patients. There is clear evidence that independent private mental health service providers are providing care in superior standard premises than those within the public system. Treatment should not be based on ability to pay. It should be based on need. The report also shows an increase in the number of children being admitted to adult psychiatric facilities. The recent closure of 11 CAMHS beds in the Linn Dara unit probably means that this practice will continue. We need to get rid of this draconian practice. We need to ensure that our most vulnerable children are not being admitted to adult psychiatric hospitals. Will the Tánaiste give an assurance that the Minister for Health will engage with the HSE to ensure this practice is ended and adequate investment is provided to address the many deficiencies highlighted in the commission's report?

I am happy to give that assurance. That is very much what is happening at present. For the information of the House, if we go back to 2009, 55% of child admissions were to adult units. Last year, that figure was 6.3%. The job is not done yet but there has been a massive improvement, with those admissions going down from 55% to approximately 6% last year. Of course, we want to get to zero. While the Deputy's description of the report from the Mental Health Commission is correct, it is also incomplete. It is worth recording that the report shows that we are going the right direction, there has been a significant improvement in recent years and more than 80% of public units are now compliant. That needs to be 100%.

In the context of the cost-of-living crisis, I will raise the critical issue of childcare. We know that costs of childcare for parents are far too high, wages for early years professionals are too low and there is an abject shortage of places for children. Across my constituency, I hear all the time from parents who are worn out from trying to find a crèche or early years education place or who have been told there is no preschool facility available for their child until 2024. We need a guarantee - a Donogh O'Malley moment - to ensure that every child will have a preschool and early years place available to him or her. I know the new core funding model was published this week but we need the Government to take meaningful steps to achieve a universal public childcare system. I ask the Tánaiste and the Minister, Deputy O'Gorman, to indicate what steps are being taken to guarantee every child will have an early years place when he or she needs it, every early years educator will get decent pay and parents will have affordable childcare available to them.

In order to ensure that every childcare professional can get a fair wage, we have initiated a joint labour committee, JLC, and an employment regulation order, ERO, process. Two EROs are in negotiation. The first is for an entry rate of €13 per hour, which guarantees the living wage for childcare professionals for the first time in this State. The second is to look at higher levels of pay. All of that is backed up by core funding. We have been very clear that the payment of core funding is contingent on the ERO. If the State is to step up with €221 million of investment, it has to be guaranteed that childcare professionals who have worked so hard and demonstrated the huge value they gave to the State during Covid, we have to be assured they will get that additional investment and will see it in their pay packets. We are about to achieve that.

I am conscious that we are joined by the Minister of Health. Both he and the Tánaiste will be aware that hyperemesis is an excruciating and debilitating condition experienced by 1% of women and people experiencing pregnancy. In a response to a parliamentary question I submitted, it was revealed this week that 3,304 hospitalisations occurred last year through women experiencing this condition. Cariban is one step in the treatment plan for this condition that alleviates some of the excruciating suffering. It is not available on the drugs treatment plan or through the medical card. This matter has been raised on numerous occasions. I ask for an update on when Cariban will be made available free of charge, I hope, on the drugs treatment plan and, if not, through the medical card scheme. This could alleviate the suffering of thousands of women each year.

I fully agree with the Deputy. This issue has been raised with me previously and we are working with the Department of Health on it. We do not have exact dates but it is being looked at very closely for the reasons the Deputy has quite rightly raised. I will ask the Department to revert to him with a note on it shortly.

Mr. John Paul Ricken is a constituent of mine. He lost his wife, Susan, to bowel cancer. He is campaigning for improved bowel cancer screening programmes. I support his campaign.

Around 2,800 people are diagnosed with bowel cancer in Ireland every year and about 1,000 people die from it here each year. Early screening can prevent cancer from forming in the first place. In France and Germany testing begins at the age of 50 and in the US the Centers for Disease Control and Prevention has recently changed its recommended age for beginning screening from 50 to 45. In this State, screening starts at 60. Does the Minister agree with me that this State is way behind the curve on this issue and investment is needed to sharply reduce the age for screening to begin in this country?

The question of the correct ages for all our screening programmes is one the HSE keeps under regular review. There have been similar, reasonable and well-intentioned calls on BreastCheck and CervicalCheck. The current ages across the various screening programmes are based on the current best clinical opinion of the HSE. The Deputy has raised an important question and I am more than happy to raise it again with the clinical teams in the HSE to ensure the age we have set provides the best possible outcomes. I am sure the Deputy will agree that regardless of what the age is, we should acknowledge how important the screening programmes are and encourage everyone to use them when they come to the eligible age.

During Leaders' Questions last week, the Taoiseach described to me improvements in foreign direct investment, FDI, job creation into the south-east region. I can find no reference to his data. What I can find shows national IDA Ireland jobs growth of 6% but lacklustre growth in the south-east region of just 1.6%. Despite having 9% of the population, the south east has just 5% of IDA Ireland jobs and a mere 4.5% of IDA Ireland-supported companies in the region. That amounts to over 9,500 missing jobs. This deficit has more than doubled in the past decade, indicating a regional payroll loss of over €650 million annually. I have asked the Taoiseach before and I am asking the Tánaiste now if the Government will consider setting up and funding a structure akin to the Western Development Commission for the south-east region. This would allow the region to develop significant applied economic and demographic research to support cohesive regional strategic planning and development. This strategy has proven itself in the north west. Surely it is time the south east, the most underperforming region in the country, is similarly supported.

I see the south east as a region that is very much in catch-up mode. If the Deputy wants to look at statistics, he should look at the labour force survey statistics from the Central Statistics Office, CSO, which show that jobs growth in Ireland last year was at its highest in the south east and south west, not in Dublin or the west, which is a good sign of the south-east region catching up. There has been significant IDA Ireland investment, such as by State Street in Kilkenny and the announcement by IDA Ireland firms of about 600 jobs in and around Waterford city in the past year or so. On the Enterprise Ireland side, there was a positive development in the Port of Waterford, where the new Royal A-ware Glanbia Kilkenny cheese plant will be built. It will never be the case that because 9% of the population lives in a particular area, it will have 9% of FDI. That is not how it works. All over the world, FDI tends to gravitate towards cities for obvious reasons. Dublin has 25% of the population but it does not have 25% of the agricultural or tourism jobs. Different regions have different strengths and in every country in the entire world FDI tends to gravitate towards cities, while other things gravitate towards other regions.

The management boards at Coláiste Dún Iascaigh in Cahir and the Edmund Rice Secondary School in Carrick-on-Suir are aghast, hugely disappointed and bewildered at being refused DEIS status. All of the national schools in Cahir and Carrick-on-Suir have DEIS status so what is the difference? There is no clarity or reason given for their exclusion. They were refused, they appealed and the appeals have been unsuccessful for both schools. Siblings are coming in from national schools that have DEIS status and then they go to a secondary school that does not have that status. It is grossly unfair and unjust and we must get an explanation from the Department of how it makes these decisions. I welcome that Newtown Upper National School in Drangan got DEIS status, as did St. John the Baptist Boys' National School in Cashel. These secondary schools need DEIS status also. The feeder schools have DEIS status but they do not.

I thank the Deputy for his question. My understanding is that there has been a substantial increase in the number of schools eligible for DEIS status and the number of DEIS schools is almost double what it was previously. An appeal mechanism is available to schools that believe they should have DEIS status. If the Deputy gives me the details of the case, I will pass them on to the Department which may be able to revisit it.

For the third time in two weeks, I raise with the Tánaiste and Minister for Health the closure of the cath lab in Sligo University Hospital. As the Minister will be aware, the lab is closing its doors today and we now have no service north of a line extending from Dublin to Galway. I wrote to the Minister almost two weeks ago asking for an emergency meeting with all four Deputies in the constituency and I am still awaiting a response to confirm that meeting will take place. The current service is a private one and it closes its doors today. What temporary service can be put in place? Can Sligo University Hospital be included in the national review of cardiac services? It is my understanding that it may not be included and we must have a commitment that it will be included. There has been a failure until now to provide a proper cath lab service in Sligo. I am asking that heart patients in the north west be able to access those life-saving treatments.

I would be more than happy to meet all of the Deputies in the constituency. The Minister of State, Deputy Feighan, and I met on this yesterday to see what could be done. We are aware that the mobile unit, which I am advised is not for interventional cardiology but for angiograms, is now gone. I was speaking with hospital management just yesterday on this exact issue and it has proposals in place for a cath lab, be it for diagnostics, intervention or both. Clinical views are required on that and we are waiting on the national review. The whole country is included in the review in terms of diagnostics and intervention. I would be more than happy to meet the Deputy and other Oireachtas Members to discuss what can be done.

I am grateful for this opportunity. Will the Tánaiste consider introducing a programme of emergency measures for businesses and households to make them more resilient in the face of rising fuel prices? I have in mind switching to shallow refits; heat controls, which could cut energy by 25%; smart meters, which 750,000 households have not exploited; initiating measures on food waste and refurbishment; better sharing platforms to allow more efficient use; and better use of our stock of homes by addressing vacancy and right-sizing. I know the Opposition will pour scorn on such measures and say we are out of touch but the reality is we need structural changes to respond quickly to this challenge, which is unlikely to go out of sight in the near future. There is huge community interest in implementing and supporting such measures.

I broadly agree with the Deputy. The probability is that energy prices will fall back and ease, and I hope they do, but there will be an upward trend in the cost of energy over the next five or ten years. As a result, the solution cannot always be subsidies and tax cuts. We have to help businesses and householders reduce the costs of energy, make their homes and businesses more efficient and embrace solar and microgeneration to bring down their costs. On the business side, I had a look at this the other day and there are 20 different schemes available to businesses to help them reduce their energy costs. These range from advice to audits and helping with cattle costs and those investments. There are almost too many schemes. There are 20 schemes and in the round they are inadequate, which is something we need to work on, both for householders and businesses.

The programme for Government commits to supporting homeowners living with housing defects. I have been approached by residents of Carrickmines Green, an estate in Carrickmines owned by the National Asset Management Agency, NAMA.

Construction at Carrickmines commenced in 2005, with many residents moving in shortly afterwards. However, the developer went under in mid-2009 and the residents were left living in a so-called ghost estate for many years until the receiver McStay Luby and NAMA began to complete the project. In 2015, there was a fire in an unfinished block. A subsequent fire safety report raised issues and recommended extensive repairs to fire-stopping materials across the estate. I understand some of these works have taken place but many remain outstanding. The issue is now urgent as residents have been advised they cannot renew their insurance. Will the Tánaiste raise this matter with the Minister for Finance, Deputy Donohoe, asking NAMA to engage with the residents to find a solution?

I have a long note on this and, out of respect to other Deputies, I will give the Deputy the note rather than reading it out. The information I have is that Carrickmines is not owned or controlled by NAMA but there are units under the control of a NAMA-appointed receiver, John McStay of McStay Luby. The receiver has advised NAMA of his understanding of the current position regarding block insurance. I appreciate it is an important issue in the Deputy's constituency and perhaps the best thing I can do is give him the written note later.

The programme for Government states:

Family carers are the backbone of care provision in Ireland. They deserve support and recognition... We will [carry out a] Review and update the National Carers’ Strategy.

When will this review be completed? Will the Government support the extension of the National Treatment Purchase Fund, NTPF, to include psychology, occupational therapy, speech and language therapy and physiotherapy? At present, with the dire shortage of services, particularly in my county of Wexford, as well as the cost of living and long waiting lists, family carers have to take on these professional roles, which is causing carers to be run down, deeply distressed and financially drained.

I am afraid I do not have a date for the review of the strategy but I will get it for the Deputy and make sure it is passed on to his office. Among the things the Minister, Deputy Humphreys, is focusing on at the moment is extending eligibility for the carer's allowance, so more people qualify for it, which is welcome. She is working on proposals to ensure people who act as family carers for a prolonged period qualify for a State contributory pension. Those are the two big reforms under way on her side. I do not know if consideration is being given to using the NTPF. It might be a model that could work but I would have to check on that and come back to the Deputy.

During the first Covid wave in 2020, 23 elderly residents died in Dealgan House in Dundalk. Conditions there were appalling, inhuman, catastrophic and destitute of any compassion. The RCSI hospital group took over the operational control of that house. Since then, the families have been looking for truth, accountability and closure and believe only an inquiry will give them that truth, that closure and that accountability. They have met with the Minister for Health and with senior executives, including Mr. Reid, in the HSE but have had no contact, they tell me, since November with the Minister for Health to further this issue. We need this Government, which I support, to vindicate the human rights of the residents concerned. They cannot be ignored. If the Minister can give €135 million to meet the financial needs of 445 nursing homes, can he not find it in his heart to meet them and to have that inquiry to give them the truth and peace they need?

I thank the Deputy and acknowledge his ongoing representation on the issue. As he said, I have met the families involved. I have stated publicly at committee and am happy to restate that families whose loved ones passed away in nursing homes in some cases, including Dealgan House, have very legitimate questions and they must be given answers to those questions. We are trying to find a process whereby we can give them the answers they want without having to create a mechanism like a statutory tribunal or inquiry. In many cases, the only people who come out of those on top are the legal representatives. We are working to find a mechanism whereby the families can get the answers they need in a way that does not leave them bogged down in a legal process for many years. I am happy to revert to the Department and seek an update for the Deputy.

I ask the Tánaiste about progress on Future Mobility Campus Ireland in Shannon. I understand he will visit Shannon on 15 July. I look forward to welcoming him there. Huge work has been taking place on the development of autonomous cars. This has been looked upon as a real opportunity for the mid-west region. Will the Tánaiste elaborate on the progress made to date?

I am really looking forward to that visit. I have not been to the campus yet so look forward to seeing what they are doing. It is an area the Government is very excited about and interested in. It might be ten or 20 years away but the era of autonomous vehicles which drive themselves is on our doorstep and will change things and the way we live in so many ways, mostly for the better. It is a good thing that that technology is being developed on a global scale in Shannon, County Clare.

The special leave with pay scheme for Covid cases is ending tomorrow and many who have contacted me are front-line workers who contracted Covid in the workplace. They are worried that, on top of having lost their health, this will push them into poverty. I have asked the Minister for Public Expenditure and Reform, Deputy Michael McGrath, about this and he said the Department of Health is working on a proposal to deal with such cases. As no cliff-edge was promised to these workers, could the special leave be extended until the Department's proposal is finalised?

I am not directly involved in that but will speak about it to the Minister, Deputy Michael McGrath, and ask him to come back to the Deputy in more detail. I hear what she is saying about wanting to avoid a cliff-edge. We are trying to move away from the idea that Covid is a special illness that is treated differently to other illnesses. It will be with us forever and needs to be seen in the round in terms of what is offered to people when it comes to sick pay and other things. That process needs to happen in an orderly way.

I raise this issue on behalf of thousands of workers in the education sector, particularly personal assistants who work in further education and bus drivers, who have had to sign on for social welfare over the summer months. One query I have had, for example, concerns a lady who signed on on 20 May. To this day, she has not received one penny. That is unsustainable, considering everything happening in the world today, particularly with the cost of living through the roof. The response I got from the Department is that there is a huge backlog of applications waiting to be processed and a decision will be made shortly. Will the Tánaiste intervene so that whatever staff are needed are put in place in social protection, so these people are left waiting no longer for their payments?

I was not aware of that being an issue. It has not come through my constituency service yet anyway. I thank the Deputy for bringing it to my attention. I will speak to the Minister, Deputy Humphreys, and we will see what we can do to make sure people get the payments they are entitled to as soon as possible. They will get them in arrears but I am sure they would prefer them on time.

I raise the case of a seven-year-old girl from Tralee who was diagnosed with a rare form of cancer last July, seven days after her seventh birthday. She has been to Crumlin until Easter of this year and now is in shared maintenance care between Mercy University Hospital in Cork and University Hospital Kerry. She gets bloods in Kerry. She has to have her Hickman port dressed quickly and her mother, Lorraine, administers chemo three times per week. It is four chemos, plus bloods and dressings, which is physically and mentally very draining for her family. Will the Minister provide facilities for paediatric oncology maintenance in University Hospital Kerry, which will give more co-ordinated care for her? I know €81 million was returned to the HSE last year. Could that be used to provide that service?

I thank the Deputy for raising the case. It sounds awful and truly heartbreaking. Will the Deputy revert to me directly with the details? I will talk to the Department and the HSE and anything that can be done will be done. It does not mean they will be able to provide everything the family needs and in an ideal world would have, but we will look at it immediately and whatever can be done, we will act.

We are in the middle of a climate and cost-of-living crisis and need to do everything we can to offer alternatives to car journeys. People in south Kildare and Laois drive to Sallins, north Kildare, to avail of the short hop zone. An annual rail ticket from Newbridge to Dublin costs €1,900 while an annual rail ticket from Sallins to Dublin costs €1,500 but includes travel on trains, Luas and buses.

It is €400 more for an extra five minutes' journey. It does not make sense. Will the Tánaiste commit to extending the short hop zone to encourage people to make the switch to rail travel, which would help the environment and save commuters money?

This issue was discussed at a meeting of my own parliamentary party a few weeks ago at which we adopted a policy of extending the short hop zone to anywhere within 50 km or so of Dublin. It is quite anomalous at the moment. Kilcoole in County Wicklow is in the short hop zone but Drogheda and areas in mid-Kildare that are the same distance away from Dublin are not. We think that should be regularised but that work really has to be done through the National Transport Authority and the Minister.

The Tánaiste will be aware of the number of Aer Lingus flights from Dublin Airport that have been cancelled over the last week. Some passengers have told their stories in the media over recent days. They have said that they will not receive refunds because they were offered alternative flights two or three days later. Some of these families have saved for these holidays over the last two years and have not been on holiday since 2019. They have paid heavily for accommodation in sun destinations. Has the Department of Transport or the Minister been in contact with Aer Lingus on this issue to ensure that all passengers will receive full refunds swiftly? It is astonishing that other companies have not cancelled nearly as many flights as Aer Lingus. I understand that Ryanair is running at near full capacity.

I thank the Deputy for raising this issue. I am advised that, due to the spike in the number of Covid-19 cases, Aer Lingus has been forced to cancel three return flights and one direct flight today. I am also advised that, due to a mandate from the London Heathrow Airport authority, one return flight to Dublin from Heathrow has also been cancelled today. Aer Lingus has apologised to those impacted and the team at the airline is working to accommodate impacted passengers on the next available service as efficiently as possible. According to Aer Lingus, it anticipated the return of demand for travel once Covid restrictions were removed and included buffers in its plans to deal with reasonable levels of disruption. As the Deputy will know, European Community Regulation No. 261/2004 sets out the rights of air passengers and the resulting obligations on airlines in the event of cancellations, denied boarding and flight delays. In Ireland, the Commission for Aviation Regulation is the designated national enforcement body. The Minister, Deputy Ryan, and I will be meeting with airlines with regard to what is happening at Dublin Airport and will raise these issues.

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