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Dáil Éireann debate -
Tuesday, 6 Dec 2022

Vol. 1030 No. 5

Saincheisteanna Tráthúla - Topical Issue Debate

Emergency Departments

Last Saturday there were chaotic scenes at Our Lady of Lourdes Hospital in Drogheda, which is one of Ireland's busiest hospitals. A total of 11 ambulances were parked outside the emergency department and could not leave because there were no beds or trolleys for the patients inside. At the same time the HSE wants to divert more ambulances from Navan to Drogheda. Some paramedics were left waiting for five hours before their patients had a place at the hospital. It is understood there was extreme overcrowding and every bed and trolley in the hospital was taken up. The ambulance crews treated patients in the ambulances while others were brought inside on the ambulance trolleys. None of the ambulances could leave and respond to other emergency calls until they had their trolleys back. According to a newspaper report:

One furious paramedic said:I have never seen anything like it in my life, absolute total chaos. Eleven ambulances at one stage were lined up outside the A&E at the Lourdes hospital and none of us could go anywhere. There were no beds and no trolleys. The place was full. We minded our patients as best we could in the back of our vehicles until we could get them inside. The whole thing was complete madness.

Why in the name of God are we still talking about diverting people from Navan to Drogheda?

This is an outrageous situation and simply cannot go ahead. I am disappointed the Minister, Deputy Donnelly is not here and that is no disrespect to the Minister of State. This is an issue that has been on his desk for many months. The reality is that he simply does not have a plan for Drogheda. The Minister of State has seen, heard about and read about the letter from the 16 hospital consultants in Drogheda. No additional resources whatsoever are being made available for Our Lady of Lourdes Hospital in Drogheda to accommodate the changes the Minister seems to want to steamroll through next Monday. This is simply unacceptable. Drogheda has had enough problems over recent years. It needs additional resources anyway outside of the fact this decision will be steamrolled on Monday. This needs to be addressed now and it simply cannot go ahead.

There is a recognised risk associated with a small number of patients attending at Navan hospital. It will probably come as no surprise that the HSE's plan is to make matters worse. In June, 17 consultants at Drogheda wrote to the Minister to state that transferring risk from one hospital's accident and emergency department to another will lead to poorer clinical outcomes for patients. They obviously have no trust in the HSE. They noted the divergence of acute stroke patients from Navan to Drogheda two years ago was done without clinical engagement or adequate resourcing. Despite this warning, six months later it looks like the HSE is intent on pursuing this agenda. It makes absolutely no sense. It will put patients' lives at risk.

Huge resources have been given to the hospital. Since 2015 the number of beds has gone from 357 to 478. A total of €60 million has been spent. It is wrong to say the hospital is under-resourced. It is not. Nobody is applying for the jobs that are being advertised. This is the difficulty. We need to examine the management in Our Lady of Lourdes Hospital and Our Lady's Hospital Navan. Can a new synergy be found in terms of corporate governance and medical governance to allow patients to be kept in Navan and dealt with by the experts with a higher level of knowledge who are in Our Lady of Lourdes Hospital? This is the way forward. It will keep patients in Navan and make sure they are properly looked after. It would also relieve the pressure on Our Lady of Lourdes Hospital, which is obviously significant at this time of the year.

I thank Deputies Nash, Guirke, O'Rourke and O'Dowd for raising the matter of the ambulance bypass protocols at Navan hospital's emergency department and for providing me with the opportunity to update the House on behalf of the Minister, Deputy Donnelly.

There are a number of ambulance bypass protocols in place throughout the country at this time and they are important to ensure patients receive the right care in the appropriate hospital, depending on their clinical needs. Our Lady's Hospital Navan provides a range of inpatient and outpatient general medical, elective surgical and orthopaedic services, with a 24-hour emergency department service to which patients may self-present or be brought by ambulance. The emergency department at Our Lady's Hospital Navan has an ambulance bypass protocol in place for patients who have suffered a stroke, heart attack or major trauma and also those in need of paediatric and obstetric care.

From the week commencing 12 December the HSE is enhancing this ambulance bypass protocol to include patients who are critically or seriously unwell, or likely to deteriorate. Following the update, this cohort of patients will bypass the emergency department at Our Lady's Hospital Navan and be brought to the closest appropriate hospital for their needs. The decision to convey a patient to, or bypass, the emergency department at Our Lady's Hospital Navan will be made by the attending National Ambulance Service teams. The National Ambulance Service teams will assess patients, treat them as appropriate, and transport them to the nearest appropriate hospital depending on their clinical condition. This change is expected to affect only a small number of patients. However, this small cohort of patients, who are critically and seriously unwell, require appropriate treatment urgently. This update to the current ambulance bypass protocols will ensure that these patients receive the most appropriate care as quickly as possible in the most appropriate hospital.

Following this update to the ambulance bypass protocols, ambulances will continue to bring patients outside of the critically and seriously unwell categories to the emergency department at Our Lady's Hospital Navan. The National Ambulance Service has put an additional 24-7 emergency ambulance and an additional intermediate care vehicle on the ground in Navan to support this change. This updated ambulance bypass protocol at Our Lady's Hospital Navan is important to ensure patients receive the right care, in the right place, at the right time.

I confirm that no decision regarding the HSE's proposal for the transition of the emergency department at Our Lady's Hospital Navan has been agreed by the Minister for Health. This matter remains under consideration. The Minister for Health and the Government are clear that several important issues would need to be fully addressed before any proposed transition by the HSE could be considered.

I have listened intently to what all four Deputies had to say. I was in Navan last week with regard to the new early intervention psychosis unit and the Cara suite which will support people with outpatient mental health needs on a 24-7 basis. I have heard about the 11 ambulances that were queued at the weekend in the other hospital. I have taken on board what Deputy O'Dowd said about management and synergies. I will certainly pass all of his thoughts and reflections to the Minister.

Why are we not looking at the option of investing in Our Lady's Hospital, Navan? There is a review that has been completed, but we have not yet received the results of it. That review never even looked into the option of investing in, protecting and enhancing services that are already in place at Our Lady's Hospital, Navan. Why are we not doing that?

I do not believe that a plan is in place. I have been seeking a meeting with senior representatives for months about the impending changes that the Minister for Health is considering. I have been stonewalled consistently. I do not believe that a plan is in place. The Minister of State referred to several important issues that need to be fully addressed before any transition might occur. There was a significant transition signed off on by the Minister that will come into effect on Monday. It is a significant transition that will affect patient care and that will result in the transfer of risk from Navan to Drogheda. If the Minister of State does not want to listen to me, she should please listen to the consultants. It has been said that six extra patients a day will be affected-----

I thank the Deputy.

-----but that is laughable. It is not true. The consultants counter that, and they do not agree with the Minister of State in the context of that assessment. They are the people we need to listen to.

Our Lady Of Lourdes Hospital, Drogheda, does not have the capacity to take any additional patients, regardless how small the number might be. That is a statement of fact, and it has been confirmed by the 17 consultants. The Minister of State indicated that no decision has been made, as though that is a badge of honour. The Minister has had the report since 8 October. There needs to be a plan in place to resource the region and to ensure that there is safe acute and emergency care for people. That involves investing in Our Lady's Hospital, Navan. It is incredibly frustrating that the Government stands in the face of that very clear solution.

I welcome the Minister of State’s comments on the updated ambulance bypass protocols. I do not doubt the credibility or the integrity of that decision, nor do I doubt that it will include patients who are critically or seriously unwell or whose condition is likely to deteriorate. This is not a matter of closing the accident and emergency department in Navan. It is a case of moving seriously ill patients to the appropriate place. I welcome that. I also welcome the Minister of State's comment to the effect that the Minister has not made a final decision on that matter. I further welcome the fact that the Minister is prepared to give consideration to ideas that I and other people have put forward about a new synergy in the management of both hospitals. This can leave both hospitals safe and can ensure that patients will be able to get the best care nearest where they currently reside.

The Minister of State to conclude.

I thank the Deputies for their contributions on this matter. I know how important it is. I also know that the Minister shares a concern to ensure that patients in Navan, County Meath in general, the north east and any other part of the country can access urgent services when they need them. As I mentioned earlier, there is currently an ambulance bypass protocol in place for Our Lady's Hospital, Navan, in respect of paediatric patients, obstetrics patients, major trauma patients, heart attack patients and stroke care patients.

From the week commencing 12 December, the ambulance bypass protocol will be updated to include patients who are critically or seriously unwell or who are likely to deteriorate. This bypass is expected to affect a small cohort of patients who will be brought to the closest appropriate hospital for their needs. This is not a full ambulance bypass. Ambulances will continue to bring patients outside of the critically and seriously unwell categories to the emergency department at Our Lady's Hospital, Navan. This update is important to ensure that patients receive the right care in the right place at the right time.

I reiterate that no decision regarding the HSE’s proposal for the transition of the emergency department at Our Lady's Hospital, Navan, has been agreed by the Minister for Health. This matter remains under consideration.

Health Service Executive

It has taken the heart-breaking case of a seven-year-old boy to bring the need for paediatric palliative care in the south-east region into focus. Last week, I raised the circumstances surrounding the wish of this little boy to return home, as well as his family's efforts to bring him home from hospital to receive end-of-life care. His parents wanted their little man to be in the familiar surroundings of his home, to be with his two brothers and to have precious time surrounded by those he loves and with those who love and cherish him.

Last January, in response to parliamentary question from Deputy Cullinane, HSE south east community healthcare officials wrote “there are a range of services available to support children with palliative care needs ... in the HSE SE region”. The fact is that when this family reached out to avail of that proposed service, they were told that it is not available to them. The reason they were given is that these services are not in place in the area in which they live. They were told that such a vital service has not been available in south Tipperary since 2017. In that same response to which I refer, HSE south east outlined in impressive terms what a paediatric palliative care service provides. The letter refers to primary and social care that is tailored to meet the specific needs of each child. It also refers to a model of care for children having been developed to support children with life-limiting conditions in their own homes. It emphasised that the South/South West Hospital Group and the south east community healthcare group had supported the recruitment of staff to fill additional posts, including a paediatrician with an interest in palliative care, and an expanded outreach nursing service.

Can the Minister of State explain where this service was when it was needed? No family should be forced to publicly plead for palliative care for their child. I would like to know why this happened. I want an honest and straightforward explanation. More important is what the family needs at this time, namely, a solid guarantee that what happened to it will never happen to any other family. Glorified descriptions of what a paediatric palliative care service should provide is cold comfort to families who cannot get that care for their children when it is needed. This is care that a seriously ill child needs and is entitled to receive, regardless of their Eircode postcode.

This courageous little lad is now at home and is receiving the medical and supportive care that he requires. My contention and that of the family is that no parent should have to fight the system to obtain end-of-life care for their child. This little lad received the best possible medical, and eventually palliative, care during his lengthy stays at Children's Health Ireland in Crumlin and in the paediatric ward of Tipperary University Hospital. It is only now, at the most crucial point on his journey, that the system has failed him. Why was a palliative care service not available to this child in the area in which he lives? What is the current situation with paediatric palliative services across the south east, including in south Tipperary? Can the Minister of State say with certainty that every family who is in need of such a service will have it available to them in the future?

I want to thank the Deputy for raising this important issue. I want to thank him for the work he did to advocate for that family. As the Deputy said, his parents wanted to bring their little man home. If the Deputy had not raised the issue here, that might not have happened. That little man is at home tonight with the comfort of his parents and his two brothers, I am thankful that it is happening. Why did this happen? I cannot tell the Deputy that, but it should not have happened. At this most difficult time in their lives, nobody should have to be fighting for that care.

If one speaks to any older person about where they want to age, they will say that they want to age well at home. It is no different for a younger person. I was aware that the Deputy had raised this matter last week and I have followed it. I come from the same area as Deputy Lowry, more or less. Waterford and Tipperary are covered by community health organisation 5.

Across 2021 and 2022, funding has been allocated for the recruitment of 12 and a half additional whole-time equivalents to enhance the provision of children's palliative care services across acute and community settings. These include additional posts for six and a half clinical nurse co-ordinators for children with life-limiting conditions, four consultant paediatricians with a special interest in palliative medicine, one paediatrician in palliative medicine and one clinical nurse specialist. These posts will support the provision of specialist palliative care to children as close to home as possible. That is the point, namely, it must be as close to home as possible. In addition, since 2021, €1.5 million in annual funding has been provided to support the services provided by the LauraLynn children's hospice, including in-patient symptom control, respite, end-of-life and bereavement care.

More recently, through budget 2023, an allocation of €3.7 million will be provided for new measures in palliative care. The new measures will enhance the provision of adult and children's specialist palliative care services throughout the country and will include funding to support bereavement services for parents and families who have experienced the death of a child, as well as increased funding for LauraLynn children's hospice.

The specialist palliative care team for children is based in Children's Health Ireland in Crumlin and works in close liaison with medical teams providing care to children in need of palliative care throughout the country. With regard to children's palliative care provision in the south Tipperary and south-east area, which the Deputy specifically mentioned, there are two clinical nurse co-ordinators for children with life-limiting conditions in the south east who support the provision of safe care in the home. When children are at end of life, they and their families deserve the best possible care and it is vital that such care is available when needed either in their home or in a hospital setting. The family needs to have the choice and decide as to whether it is the hospital or home setting, working with their consultant. Primary care services in south-east community healthcare, in conjunction with south-south-west hospital group, work to ensure a care plan based on patient need is in place.

A sustainable, long-term solution for the provision of paediatric palliative care services in the south east is under development and the south-east community healthcare organisation is actively working with Children's Health Ireland to progress the required supports in line with the model of care for children with life-limiting conditions. The Department and the HSE will continue to progress developments for children's palliative care services in Ireland, working towards the highest possible quality of end-of-life care and support for children with life-limiting illnesses throughout the country.

The most important line, from our perspective in the south east and south Tipperary, in the Minister of State's response is, "a sustainable, long-term solution for the provision of paediatric palliative care services in the south east is under development". Will the Minister of State explain what that means? What is the timescale involved? When can we expect to have a wide-ranging full palliative care service available to the people of south Tipperary? We were told in 2020 it had progressed and now we find ourselves, at the end of the year 2022, still talking about developing the services. Will the Minister of State, please, put a timeline on it?

I will put on the record that this family's ordeal brought forth the best in people while also highlighting, as the Minister of State admits, the glaring gaps in what is a vital service provision. My concern and that of the family involved here is that the trauma inflicted on this family can never be allowed to happen to another family. It can and will happen if the services are not put in place. If we, as elected representatives of the people, cannot ensure the needs of terminally ill children are fully provided for, none of us deserves to sit in this House. It requires urgent attention. I know the Minister of State empathises with the problem and I ask her to make sure these services are brought on stream as quickly as possible.

Palliative care is a core component of healthcare provision in Ireland. We have to make sure it is available to every child and adult when they need it, whether it is at home or in hospital. We do not think often enough about it until we hear the story of a young child whose parents were heartbroken because they did not have the opportunity to bring their little man home. The Deputy said he was told in 2020 the service had progressed. The specialist palliative care team in Children's Health Ireland works in close liaison with medical teams providing care to children throughout the country. In the south east of the country, two clinical nurse co-ordinators for children with life-limiting conditions support the provision of safe care for children in the home. A care plan is put in place once the referral is received from pediatric community palliative care.

The HSE is working to develop a robust long-term solution for the provision of pediatric palliative care services in the south east and to progress the required supports. No timeframe is provided here but I will give the Deputy my guarantee that I will keep on top of this. It does not matter whether it is the south east, the north west or anywhere else, any child who is at end of life and for whom the parents and consultant agree he or she can come home for his or her last days of life should be able to get the support needed. It is hard to believe we are even having the conversation. I give the Deputy a commitment to keep on top of it. I thank him for raising this very important topic.

Special Educational Needs

I will discuss the very important issue of the urgent need for extra special needs assistant, SNA, allocation for Scoil Eoin in Innishannon, which is a village to the east of Bandon, between Bandon and Cork. It is a terrific national school which 306 students attend. It has a fantastic principal and staff. There is a great team. I visited in November and received a royal welcome from the staff and kids. It was fantastic. I went to visit the special classes and I spoke to the SNAs and the teachers who taught me a bit of sign language. It was fantastic to communicate with these incredible students but they desperately need extra SNA allocations. There are two special classes in Scoil Eoin. One is a junior class attended by four students which has one teacher and one SNA. The other is a class for moderate intellectual disabilities of six students with one teacher and 1.6 SNAs.

It is important to describe the difficulty the teachers and SNAs are experiencing with the lack of extra SNA provision. The four students in the junior class have high needs. They cannot feed themselves. They are not toilet trained and cannot use the toilets independently. Thus, one has situations where, between one teacher and one SNA, the SNA has to bring one of the children to the toilet or feed one of them and the teacher is left to manage the class. The considerable difficulty is that it then becomes a management role rather than one of teaching them the moderate curriculum which is what the teacher wants to do and should be doing. That is a clear example of why exactly the school needs extra SNA provision. It is similar in a second class where there are six students. There is one teacher and 1.6 SNAs. It leads to a situation in which, for the vast majority of the time, the teacher and the SNA are caring for the students' needs rather than what they really should be doing which, in the case of the teacher, is teaching the moderate curriculum.

As recently as today, I have engaged with the National Council for Special Education, NCSE. I am very happy with the response it gave in that it assured me it would give the issue in Scoil Eoin its immediate attention but this needs to move fast because the mental and physical health of the teachers and staff is suffering. There are incidents of slapping and choking. The situation is quite serious and needs to move fast. The special educational needs organiser, SENO, was due to visit in October. Unfortunately, the school has had to reapply for a SNA assessment which is just gone in as recently as 25 November.

The reason I bring this up is that the situation is serious. Scoil Eoin is a terrific school of 306 kids but those incredible children in its moderate intellectual disability classes need to start engaging with teaching instead of what is happening at present, that is, a kind of management issue. I know the Minister of State, Deputy Madigan, is not here today but I urge the Minister of State, Deputy Browne, to convey the urgency of the situation. An urgent SENO visit on site is needed to experience what I saw and experienced when I visited in November.

I thank Deputy Christopher O'Sullivan for raising this important issue as it gives me an opportunity, on behalf of the Minister of State, Deputy Madigan, to outline the current position regarding the SNA allocation at Scoil Eoin National School in Innishannon, County Cork. I stress that enabling students with additional needs to receive an education appropriate to their needs is an ongoing priority for this Government. In 2022, the Department of the Minister of State, Deputy Madigan, will spend over €2.3 billion, or over 25% of the Department's budget, on providing a wide range of schemes and supports for children with special educational needs. In 2023, this spend will be substantially increased by over 10%, meaning that the Department of Education will spend over €2.6 billion on special education. This level of educational funding and support is unprecedented and represents more than 27% of the Department's total allocation for 2023. This includes funding for new special classes, new special school places, additional special education teachers and special needs assistants.

The NCSE has responsibility for planning and co-ordinating school supports for children with special educational needs, including the allocation of SNAs and reviews, and the school should liaise with the NCSE directly in the event that additional supports are required. The Department of Education does not have a role in making individual school determinations. The special needs assistant scheme is designed to provide schools with additional adult support staff who can assist children with special educational needs who also have additional and significant care needs. Such support is provided to facilitate the attendance of those pupils at school and to minimise disruption to class or teaching time for the pupils concerned or for their peers and with a view to developing their independent living skills.

SNAs are not allocated to individual children but to schools as a school-based resource. The deployment of SNAs within schools is a matter for the individual principal or board of management of the school. SNAs should be deployed by the school in a manner which best meets the care support requirements of the children enrolled in the school for whom SNA support has been allocated. It is a matter for schools to allocate support as required and on the basis of individual need, which allows schools flexibility in how the SNA support is utilised.

The NCSE confirmed that the school has an allocation of SNA support to provide support for children with primary care needs. The school got an increase in its special class allocation of SNA support this year of 0.83 to bring it to 2.66 and there was no change to its mainstream allocation of 3.83. The following arrangements for the allocation of SNA support in respect of students in mainstream classes for 2022-23 will apply. The SNA allocations for mainstream classes in schools on 31 May 2022 will be maintained. This will provide greater certainty for schools. There will be a process for schools to engage with the NCSE if they consider their SNA allocation is in excess of the required care needs. Schools should contact their local NCSE special education needs organiser to commence the process.

The exceptional review process undertaken by the NCSE will remain in place throughout the 2022-23 school year, where schools can seek a review of their SNA allocations, which will result in one of the following outcomes whereby no change in the level of care need, an increase in the level of care need or a decrease in the level of care need may be identified in the school. It is expected that schools will review and reprioritise the deployment of SNAs within mainstream settings and allocate resources to ensure those with the greatest level of need receive the greatest level of support.

I thank the Minister of State for the response. I appreciate that the Minister has no role in determining the extra SNA allocation for a school. That is not what I am looking for. I am not looking for the Minister to make a determination but for an instruction or some communication with the NCSE to expedite the visit of the SENO. That is all I am looking for. The SENO needs to be on-site and to visit the school to see what I saw first-hand. As I said earlier, I have engaged with the NCSE as recently as today and I am happy that it will give this its urgent attention. This needs to happen quickly. SNAs and teachers love their jobs. Teachers want to teach and to be given an opportunity to engage with the moderate curriculum which they are given to teach, but they do not have the opportunity to do that because of the reasons outlined in my first contribution. When an SNA is dealing with an individual child, the teacher then becomes a de facto SNA. The teacher should be teaching. That is what we need to get back to and focus on. It all comes down to individual needs. I appreciate the unprecedented level of funding the Minister of State outlined at the start. The funding and resources that we are providing are extraordinary but we need to see them make a difference on the ground. The key point is that we need to cater for students' individual needs.

I thank Deputy Christopher O'Sullivan for raising the important matter of SNA allocation for Scoil Eoin National School, Innishannon, County Cork. I assure the House that the Department of Education is committed to ensuring that all children can access an education suitable to their needs. I reassure the Deputy that the Department of Education will continue to support the NCSE and schools through the provision of the necessary funding and capital investment to ensure all children are successful in accessing the education supports they need. I hear the Deputy's specific request about the need for a visit of a SENO on-site as soon as possible. I will certainly raise that matter with the Minister of State, Deputy Madigan.

Domestic, Sexual and Gender-based Violence

On 19 January this year, this House stood collectively behind the community of Tullamore and the family of Ashling Murphy following her untimely and violent death at the hands of a man in plain sight of onlookers. The good, decent people of Ireland stood, as we stood inside this House, in every town in Ireland in solidarity, in a massive public demonstration against violence against women. Violence by men against women was a theme universally condemned in this House. The Taoiseach and Tánaiste alike said we would do everything possible to prevent a crime of that kind from ever happening again. However, the reality is that violence against women of one kind or another is an all-too everyday occurrence. There is a spectrum of violence, from harassment to sexual assault, physical and emotional violence, to femicide. This remains grounded in a culture where women still make changes to their lives that do not need to be considered by men in the same way. These include changes to exercise plans, commuting plans, fear of the stranger, fear in their own community and fear in their own home.

In January this year, I took the opportunity to read into the record of the Dáil the names of the other women who we know lost their lives at the hands of a man over the past 27 years. I said then and will say now that it does not matter where women live or what they do, since, by their simple existence, women's lives are at risk from men who they know and do not know in a way that is just not replicated for men. It is an everyday problem which requires an all-of-society, everyday response by us, the Minister of State, Deputy Christopher O'Sullivan and Deputy Alan Farrell, who has been an ally on this and stood with me on so many evenings to raise this important issue again and again.

Throughout this year, I have sought to try to keep this issue alive, not just in January, but throughout the year, by being consistent in recognising it and naming in this House all of the women who we know died at the hands of men over the past 27 years, as identified by Women's Aid. I have sought to give them equivalent recognition, insofar as we can, to the recognition that this House gave to Ashling Murphy and her family in January of this calendar year, though it seems so long ago at this point. Many of those women were migrants. Many were of different ages, colours and communities, but all of them died violently and needlessly. For the final time, I draw the House's attention to those women who died in the last two months, November and December, over the past 27 years.

The 17 women who died in November in that period are Kitty Fitzgerald, Regina O'Connor, Fabiole Camara De Campos, Carmel Breen, Mary Cully, Mary Kelehan, Ciara Ní Chathmhaoil, Noeleen Brennan, Alicia Brough, Sarah Hines, Dearbhla Keating, Baiba Saulite, Yvonne O'Shea, Marie Dillon, Susan Dunne, Marguerite O'Dwyer and Eileen Costello O'Shaughnessy.

The 25 women who died in December in that time are Marilyn Rynn, Sophie Toscan du Plantier, Belinda Pereira, Geraldine Diver, Siobhán Hynes, Sheila Lynch, Jean Reilly, Jennifer Wilkinson, Sandra Collins, Susan Prakash, Sr. Philomena Lyons, Lisa Bell, Christine Quinn, Ann Flynn, Colleen Mulder, Sylvia Roche Kelly, Celine Cawley, Rebecca Hoban, Sharon Whelan, Sara Staunton, Angelique Belling, Valerie Greaney, Rose Hanrahan, Nadine Lott and Zeinat Bashabsheh.

This year, 2022, has itself been a year of significant violence against women. There has been significant progress from the Department of Justice, but despite our efforts in January to call it out in the way this House so collectively did, it has still been a very difficult year for women suffering at the hands of men, largely, and there is still much yet to be done. That is why I have raised the issue of funding in particular with the Minister of State.

I thank Deputy Carroll MacNeill for raising this important matter of funding for domestic, sexual and gender-based violence, DSGBV, services. As the Deputy will be aware, Zero Tolerance, the new national strategy to combat domestic, sexual and gender-based violence was launched earlier this year. It is an ambitious five-year programme of reform and a whole-of-society plan of action. Implementation of the strategy is a whole-of-government priority that is backed up by a substantial funding commitment under budget 2023. An extra €9 million for 2023, which is a 22% increase, and record funding for combating domestic, sexual and gender-based violence was secured. This extra €9 million includes increased funding of €6.8 million for organisations funded by Tusla, and this is being made available through a targeted funding call.

The Government has been clear it is our intention that every person who needs a refuge space will have access to one and that victims have access to supports when and where they need them. This extra €6.8 million will be used to maintain existing services, address existing acute demand, and for the enhancement and development of new services. Approximately €1.1 million for safe accommodation will be focused on the priority locations identified under the third national strategy. Under the funding call there is an emphasis on supporting projects to address geographic need for those with additional vulnerabilities or complex needs and for supports for young people who have experienced sexual violence.

There is €2.3 million available to domestic violence services to address acute sustainability and service demand pressures, support organisations to provide greater coverage in rural areas and for children's support services. There is €900,000 available for sexual violence services to meet the needs of younger people and address geographical gaps in provision. This brings the total allocated to Tusla up to €37 million for funding DSGBV services.

Separate to the funding of DSGBV services, the Department of Justice has allocated €6.09 million for other measures to tackle DSGBV, including through awareness-raising campaigns and funding for perpetrator programmes, which are targeted intervention programmes to hold perpetrators to account and which work to prevent future reoffending. The Department of Justice has also allocated a further €5.8 million to promote and assist the development of specific support services for victims of crime within the criminal justice system, and this includes victims of domestic and sexual crime. These services provide important information and support, such as emotional support, court accompaniment, accompaniment to Garda interviews or sexual assault treatment units, and referral to other services.

I thank the Minister of State for his response, but on 8 March, which is International Women’s Day, there were 744 women available for sex purchase on Internet sites in this State. Somewhere between 15% and 100% of those were trafficked migrants. There remains no refuge in Dún Laoghaire. We have a massive cultural problem with this issue. It is a systemic historical cultural problem but it remains a cultural problem. Most of the women I have mentioned were killed by men they knew, men they lived with, men they were in an intimate relationship with or with whom they had had a child.

I thank the Minister of State for being here and doing this. It is not the first time he has acknowledged this with me and I am grateful. I am not completely sure, a Leas-Cheann Comhairle, what the value of this is here at 11 p.m. on a Tuesday, with yourself, myself, the Minister of State, Deputies Alan Farrell and Christopher O’Sullivan, along with Oireachtas staff, but there is some value over the year in doing this. My team and I certainly learned so much more about the various women, including who they were, their age, how they died, the circumstances and something of their family, where possible. It has not always been easy and I thank in particular my staff who helped with research but, more importantly, conscientiously marked the anniversaries, and there were sometimes multiple anniversaries on a given day, on my social media and allowed it to be tracked in that way. I hope we have not upset any family in doing so but it was an effort to try have these women's deaths marked beyond this House and into the community. Sometimes though, when I look at the reactions in the emails and the comments, I feel it perhaps does have significance to try to create remembrance beyond the pain of the family, which is obviously unquestioned, out in the wider community. This is the same community that stood up against violence in January 2022 and will do again, I hope, in January 2023 and, indeed, every year thereafter until this scourge is no more.

I again thank the Deputy for raising a very important matter. She has been consistent in raising this important and serious issue since she became a Member of Dáil Éireann, and I am very conscious of that. I am confident combating domestic, sexual and gender-based violence is a priority that is not going to drop off the agenda, and I have no doubt the Deputy will ensure focus on it is maintained. That commitment is evident in a number of areas, including the unprecedented funding of €363 million underpinning the strategy and by strong oversight and co-ordination at central government level.

Last week I attended the launch by Ruhama of its latest report, heard some of the harrowing stories from women who have been trafficked and heard about the violence and dehumanisation they had to suffer as a result. The importance of ensuring the supports are put in place was mentioned. I also had a chance to visit the Aoibhneas refuge out in Coolock, and only today I was talking to the Wexford Rape Crisis Centre about trying to secure additional funding for it. This is happening throughout Ireland. We must all make a collective effort to ensure not only that violence is prevented and stopped but also that it remains at the top of the agenda for the Government and for this Dáil to ensure there continues to be additional funding and that the plan for the roll-out of domestic, sexual, and gender-based violence refuges is implemented as quickly as possible so that supports are in place where and when people need them.

Cuireadh an Dáil ar athló ar 10.57 p.m. go dtí 9.12 a.m., Dé Céadaoin, an 7 Nollaig 2022.
The Dáil adjourned at 10.57 p.m. until 9.12 a.m. on Wednesday, 7 December 2022.
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