Skip to main content
Normal View

Dáil Éireann debate -
Wednesday, 31 May 2023

Vol. 1039 No. 4

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

I ask Members to adhere to the one-minute limit for questions and answers.

On the watch of this Government, workers and families have been put to the pin of their collars. Yesterday, the Society of St. Vincent de Paul warned that many are being forced to take out loans or get help from charities to cover school costs and so-called voluntary contributions. The Government has failed to do anything to tackle sky-high energy costs, unlike other European countries, refused to introduce mortgage interest relief despite thousands of families paying thousands of euro more every year just to keep a roof over their heads, has done nothing to tackle price gouging by large retailers, which it has acknowledged. Tonight, in fact, the Government will increase the cost of putting petrol or diesel in the car for those on their way to work in the morning. When will we see a coherent plan from the Government to ensure household costs come down and stay down? How, in the middle of doing little to reduce other household bills, can the Government justify increasing the price of petrol and diesel at midnight tonight?

The Government is already recognising the challenges many face with the cost of living. For example, in June, an additional €100 payment per child will be available through a bonus child benefit payment, we are making a further increase in the back-to-school clothing and footwear allowance, the hot school meal is being extended, we have made efforts to reduce school transport costs and an additional payment has been made available through the working family payment. Those are all things we have done. The finance Bill to which the Deputy referred will lead to an increase in excise duty tonight. It is being done because those excise reductions were brought in in an environment in which the prices of petrol and diesel were above €2.20, heading towards €2.30 and €2.40. As we speak, it is significantly less than that. Sinn Féin did not vote against the finance Bill that contains those excise changes so I ask that they do not come into the House today and suddenly discover a newfound concern about them.

The health committee heard today of the shortcomings in abortion provision in Ireland. One woman in the west had to contact seven GPs before being able to access a termination. Another migrant woman, who is a victim of sexual assault, had to attend the same GP three times but was unable to receive care. These obstacles compound the trauma of a crisis pregnancy for far too many. I commend Marie O’Shea, who chaired the independent review of our abortion law, and ask the Minister if the Government will agree to take up her recommendations and the calls made in submissions to the consultation on the legislation, including in the Labour Party submission? Will the Government take those up and act now, to deal with logistical shortfalls and problems with, for example, only 11 out of 19 maternity hospitals offering the service and the lack of availability of GPs providing abortion services across many counties? Will it also move to make the legislative changes necessary, in particular to remove the paternalistic mandatory three-day waiting period?

We are all aware of the huge importance of this as a healthcare policy. We are also aware of the important report the Government and Oireachtas received on the matter. On the operational points the Deputy raised, we in the Government appreciate their seriousness. We have requested that the HSE put in place an implementation group to respond to the important operational issues raised in the provision of this vital healthcare service to women. Regarding legislative changes to which the Deputy referred, the Government has decided - which I think is appropriate - to allow the Oireachtas to consider the report, after which the Government will reach a considered response to the report.

The census revealed a sharp drop in the proportion of the population who view themselves as Catholic. Between 2016 and 2022, it fell from 79% to 69%. There was also a 62% increase in the number who said they had no religion. We all know people who kind of go along with it and baptise their children to get them into a particular school or so they are not left out of communion; the figures are probably higher than what was in the census. Despite this, nearly 90% of primary schools remain Roman Catholic. People should not be forced to go to a school with an ethos in which they do not believe because of a shortage of multidenominational schools. However, this does happen because of the failure of the school divestment programme. Some 400 schools were supposed to become multidenominational by 2030 but, to date, only 14 have. Last year, just one school divested. The divestment programme, it is safe to say, is not working. The near-monopoly control of the Catholic Church in primary schools is like something from another era. It cannot be allowed to continue. Will the Government conduct a review of the divestment programme as a matter of urgency?

The census to which the Deputy refers reminds us all of the scale of change under way in our society and economy. From my experience of divestment programmes and procedures, I have seen the reason they do not happen or happen slowly is that the school community takes time to consider this process and does not always reach a view that a change in patronage is appropriate. We need a more diverse primary and secondary educational system to support the needs of children of families the Central Statistics Office, CSO, report indicates.

It is one of the many reasons I am delighted to have seen my local Educate Together school in Dublin 7 move into an amazing new building. This is a sign of the Government's support for that important ethos in our education system.

This week, Professor John Crown raised concerns regarding cancer patients with private health insurance in respect of not getting timely access to vital cancer medicines. There were major discrepancies regarding timely interventions by private health insurance companies. There were some waiting periods of up to two years in respect of these vital medicines. The Irish Cancer Society has stated there needs to be fairer access to drugs via standardisation through Sláintecare. Is it Government policy to standardise access to these vital medicines, whether patients are public or private?

The Government wishes to provide all the access we can to important medicines that we know make such a difference to the lives and health of those battling cancer. I am aware of the report referred to by the Deputy and I believe it is the case that the only treatments approved by the HSE have been ones eligible for credits from the high-cost claims pool within the risk equalisation scheme that underpins the community-rated market. There is a lot in this, so I will ensure that the Minister for Health, Deputy Stephen Donnelly, is made aware the Deputy has raised this matter. I know he wishes to ensure as much accessibility as possible to these important medicines. I will make sure he writes to the Deputy with a fuller update on this issue.

Previous governments promised to rectify the errors that resulted in the CervicalCheck scandal of 2018 involving several women, including Vicky Phelan, Eileen Rushe and Lynsey Bennett, receiving incorrect smear test results for cervical cancer. For reasons that must be obvious, many women in Ireland have lost confidence in the outsourcing of lab tests to the United States. Yet cervical screening, human papilloma virus, HPV, and cytology-sample processing at the State’s only lab, the recently opened national laboratory at the Coombe university hospital in Dublin, has been paused due to accreditation suspensions and outsourced to the US.

Not only has the screening been outsourced again, but the screening service has also been downgraded. If abnormal cells were detected through smear testing ten years ago, a colposcopy biopsy would have been carried out and the affected cells would have been removed to prevent them from turning cancerous. Aftercare then included yearly smear tests for the patient for ten consecutive years. We all know that finding abnormal cells early is the best preventative of cancer.

I thank the Deputy.

We all know that not everyone who develops cervical cancer will have HPV found at screening.

The time is up, Deputy.

Why then are we not testing for abnormal cells while we are testing for HPV? Is this a money-saving initiative?

I thank the Deputy for raising what we all know is such an important matter. In the aftermath of the loss of life and health he referred to, the Government and the Department of Health took many steps to try to improve the level of confidence patients will have in the cancer screening procedures. This is because we know that a successful cancer screening health programme is so important in the prevention of the loss of life. I am not, I am afraid, aware of the specific issue the Deputy referred to in respect of the testing programme. Given the seriousness of the matter, I am not going to develop an answer for the Deputy based on information I do not have. What I will do, therefore, is follow up on this matter with the Department of Health and the Minister and ensure the Deputy gets a full answer in this regard. I do confirm, however, the general point that the Government is fully committed to taking all the steps needed to maintain the confidence that women have in what is a vital health programme.

I ask the Minister to support the relief road or bypass for Tipperary town. Jobs4Tipp, March4Tipp, Chambers Ireland, Councillor Annemarie Ryan and everybody want this bypass because it is not possible to live in the town with the congestion. The N24 project is being planned, but why will the Government not do what it did in Cashel some 25 years ago when there was the vision to construct a section of the road first? I refer to bypassing Tipperary town and doing the connectivity later. We must get the trucks and heavy goods vehicles out of Tipperary town because of the pollution, congestion and the dangers to pedestrians. Everybody wants this project to proceed. The Minister has had control of the purse strings for almost the last decade. He is still the Minister for Public Expenditure, National Development Plan Delivery and Reform, so I am asking him to provide the funding to give us a proper link road or bypass for Tipperary town that will be adequate to alleviate its current traffic chaos.

I know road projects like these are extremely important and the role they can play in the prevention of congestion and in making transport on our roads safer. I am, indeed, responsible for the funding the Department of Transport has but I am not involved in decisions it makes concerning individual road projects. I am, however, familiar with the project the Deputy referred to. Government Oireachtas Members have also been raising this issue, so I will raise it with the Minister for Transport, Deputy Eamon Ryan, to seek to understand further the status of this project and how we can make progress on it.

Baineann mo cheist le Gaillimh agus go háirid leis an tascfhórsa tithíochta a bhunaigh an Rialtas deireanach chun dul i ngleic leis an ngéarchéim tithíochta ar an talamh a bhí go dona ag an am agus atá i bhfad níos measa anois. Tá breis is 248 duine gan dídean i nGaillimh - sin cuid den fhigiúr ollmhór de 12,259 - ach níl tásc ná tuairisc ar an tuarascáil ón tascfhórsa sin.

In the few seconds I have left, I am raising the issue of Galway and the housing emergency that has existed there for many years. In view of this situation, the last Government set up a task force in 2019 and four years later there is no sign of a report being published. No analysis or report has gone back to the Government to tell us the cause of the problems and, more importantly, the solutions to them. This is the situation on a day when there are 12,259 homeless people nationwide and 248 in Galway.

I am not aware of the status of that specific report. It does sound unusual that a process would have been put in place to address such an important matter in 2019 and that it would not yet have reached a conclusion. I do know, however, that record levels of funding are being provided to Galway County Council, as is the case with every local authority, to help it respond to the housing issues in the city and county the Deputy is referring to. We know the human cost of the inability to provide housing in the way we all want to. It is worth saying, though, that if we look at where we are with the number of commencements for the first quarter of this year, this is at an extremely high level, as is also the case with planning permission applications.

On the task force report, please

Progress is being made, therefore, but we know more needs to be made. I will follow up on the specific matter of the task force reporting its status.

Go raibh maith agat.

Following on from the question posed earlier by Deputy Gino Kenny, my query concerns a related matter. I again raise the issue of rare diseases. Earlier this month, an article was published in The Lancet Oncology review journal by Professor Mark Lawler of Queen's University Belfast on Ireland's excessive waiting times for the reimbursement of the cost of medicines. Ireland's excessive approval times were compared with those in other countries, such as the UK and Germany. Accessing new cancer medicines here took an average of 20 months. In the UK, it took nine months, while in Germany, which admittedly has far greater resources, it took an average of four months. I know we have invested significant funding into the treatment of rare diseases over the last three budgets, and I hope this will continue in future, but it is the process here that needs to be overhauled. It is this process that I continually raise here. It is not the issue of funding that is the problem but of how we reimburse the costs of these medicines and how we can save people the agonising waiting times we have here.

I thank the Deputy. The Minister, Deputy Stephen Donnelly, is working on this issue now. It has been the subject of discussion at our Cabinet subcommittee which deals with health policy. As the Deputy acknowledged, it is no longer an issue of the funding of new drugs. The Deputy will also appreciate the trade-offs and balances involved in this context. A patient and a family desperately want a new form of treatment to be made available, but at times the cost of such a treatment can be so high that any Government across the world would grapple with the trade-offs in this respect. The Minister is examining this matter at present. He brought forward an initiative to the Government this week regarding how we can make greater use of biosimilars, which I think is the phrase used, that is, generic drugs. In tandem with this approach, he is looking at what steps can be taken to step up the process the Deputy referred to. We are aware of the anguish and difficulty patients face as they are waiting for an outcome from the current procedure.

We have had an independent review of the operation of our abortion legislation. Indeed, it is being debated this morning at a meeting of the Joint Committee on Health and there will also be votes in this regard this evening. While these aspects have highlighted the challenges and the need for reform of the legislation, the most perfect legislation we could have would be useless if people cannot safely access these services.

I ask the Government to tell us when the safe access zones legislation will come forward and when it will come before the House to be debated. It is essential but we have that, along with the other changes.

I know that legislation is currently being drafted. We appreciate the importance of ensuring that there is a safe and appropriate environment outside hospitals that are providing this health service. In answering a question on another aspect of this from Deputy Bacik, I reference the fact that a group has now been set up in the HSE to deal with all of the implementation and operational issues that are being raised in the report that is being discussed today.

There were 12,000 home help workers employed directly by the HSE in 2008, and now there are just over 5,000. I am glad that Minister of State, Deputy Butler, is here. The system is broken in many ways. What true evaluation has been done of the impact of the policy of outsourcing and privatisation? We can do all of the advertising in the world, but the system is now broken to an extent that we will not attract the workers we need. Current workers are going from Billy to Jack and do not know what they are doing from one week to the next. We have to re-examine the system and go back to what was being done in 2008, when we had a system that met people's needs. I know of elderly people in Mayo who are being put to bed at 5.30 p.m. on a summer's evening because they have to fit in with the system that is broken.

The system is far from broken. Today, as we stand here in Leinster House 56,000 people have received home care and will receive it at lunchtime and in the evening. We are challenged in areas where we do not have staff. I had a budget of €723 million this year, a phenomenal amount of money, to deliver home care. We are challenged from the perspective that approximately 3,000 people are waiting for home care. They are funded, but we cannot get the carers.

The second issue is that about 3,200 people have a partial package. They may not get supports at weekend. I put in place a strategic workforce advisory group last year to examine how we could make these changes. I worked closely with the former Minister of State, Deputy Damien English, on making sure that we could introduce permits for those who are living outside of the EU. To date, of the permits issued on 1 January, 68 have issued. We are also running a rolling recruitment campaign across all nine CHOs. The main reason why more private capacity is being used is because we have increased the level of home care to people by over 3 million hours since the Government came into office. When there is more demand, we have to go to where there is someone to provide the supports.

Over the weekend, a story broke in the Business Post that a deal between the Department of Housing, Local Government and Heritage, Dublin City Council and Lioncor for homes on the Irish Glass Bottle site is imminent. I met the Irish Glass Bottle Housing Action Group. It is shocked by the deal. It is not the deal it campaigned and got cross-party support for. The residents of Ringsend and Irishtown will not accept a deal that prices them out of homes in their own community. Will the Government transfer the 20% equity held in the SDZ by NAMA to Dublin City Council in order to deliver genuinely affordable homes for the residents of Ringsend, Sandymount and Irishtown?

Every effort is being made by Dublin City Council and the Department of Housing, Local Government and Heritage to provide social and affordable housing on what is a landmark site. I do not need to tell the Deputy the impact the proper development of the site can have on the availability of homes in the south inner city and the city overall. I will refer to the Minister, Deputy Darragh O'Brien, on the points the Deputy has made. The Government will make every effort we can to try to get the homes that will be built on the central site as affordable as possible.

Would the Minister of State agree with me that it is time to review urgently the means test for carer's allowance? The income limits are far too low. Furthermore, there is nowhere near enough flexibility when applicants are marginally over the income threshold. Time and again, carers who give every second of their day to look after loved ones are caught between a rock and hard place. There needs to be more flexibility shown by the Department.

I have to give the Minister the example of Dolores, who is from west Cork. She absolutely adores her son Timmy. She would do anything for him and gives every second of her day to making sure he is comfortable. However, she has been turned down for a full-time carer's allowance payment. She has appealed the decision time and again and she continues to be turned down. In essence, she has inherited an asset which is of no monetary value to her whatsoever. She needs support. Could the Minister work with the Minister, Deputy Humphreys, so that someone from her office can reach out to Dolores and help her? If the system was ever intended to benefit anyone, it is Dolores.

I thank Deputy O'Sullivan. In all of our constituency work, we meet a Dolores and Timmy and are reminded of the huge sacrifice and care that is delivered in looking after loved members of families who need additional support. I am sure after the Deputy has raised this matter that efforts will be made to contact Dolores and Timmy, in conjunction with the Deputy, to see if help can be given. Regarding his point on a review of the means test limit for carer's allowance, that is looked at in every budget. It is regularly raised with my Department by the Department of Social Protection. I am sure that will happen in the forthcoming budget, where it will be assessed in light of the issues the Deputy has raised.

Can I raise the shortage of radiation therapists? I understand there is a 34% shortfall and, as a result, four machines, which are extremely expensive, are not being used. Will the Minister work with the Minister for Further and Higher Education, Research, Innovation and Science, Deputy Simon Harris, to increase the number of training places? There are currently only 30 training places in Trinity College Dublin. A postgraduate course in UCC has 12 places. Only 12 people at any one time are in training in this country on a yearly basis. Having only 42 places available is totally insufficient for the demand that is there. Can the number of training places be expanded in third level colleges that are prepared to take this on and work with the health service to make sure they get the expertise and experience in order to provide the service? I also understand that in a survey, 60% of radiation therapists indicated they intend to retire within the next five years.

I was part of a discussion earlier in the week on the general point the Deputy raised on how we can work with our colleges of higher and further education to meet the skill needs that are health service has. As part of that, the issue of radiation therapists was included. I thank the Deputy for raising this important issue. In light of equipment that is not working because staff are not available, I will raise this matter with the Ministers, Deputies Harris and Stephen Donnelly, to see if progress can be made. I know they are aware of the general issue the Deputy has raised and are trying to respond to it.

I raised the issue of unsewered communities with the Taoiseach last week. He pointed to the new €50 million pilot scheme, which is very welcome. That €50 million could be used in Clare alone. There are unsewered communities in Carrigaholt, Doolin and Spanish Point. Broadford and Cooraclare have applied for the scheme. Larger counties like Cork would need a multiple of that figure.

We are in breach of environmental standards across the country. Sewerage is not the responsibility of local authorities. Uisce Éireann does not want to know; if it is not sewered already its attitude is that it has enough difficulty dealing with what it has and will not do any more. Does the Minister think it will get cheaper to provide these sewers? If not, what actions will be taken on a multiannual basis to ensure that every settlement in the country is sewered. I am not referring to one-off houses, but where there are settlements or villages we need a sewer and wastewater treatment. What is the Government going to do about it?

There is not much capital investment that is getting cheaper at the moment, as the Deputy knows, due to inflation and the rising cost of raw materials, as well as the demand created by the economy that is performing so well. In recognition of the issue the Deputy has raised, that is why the fund was put in place in the first place. I take his point that the demand for it is probably many times bigger than the nature of the fund itself. I will work on this matter with the Minister, Deputy Darragh O'Brien, in the context of budget 2024 and beyond because I accept for communities which do not have access to sewers, namely towns and villages rather than one-off houses, it is a very serious issue.

One can get an eye test or dental treatment through PRSI contributions. I propose that people who have PRSI contributions would get an annual visit to their GP for an annual check-up. We have seen people who have not gone to the doctor and then have a serious illness. I think it comes under the Department of Public Expenditure, National Development Plan Delivery and Reform. There could be a measure in the budget to make an accommodation for people who have PRSI contributions, whereby they have an annual visit to their GP, through the PRSI contributions, have their bloods done and have an annual check-up. It would ensure people check their health and it would encourage people who are predominantly very healthy to go to their GP for their annual check-up.

We know how important access to one's GP is, for the reasons raised by Deputy Michael Moynihan. It is why we aim to provide a GP-only card for a further 700,000 citizens in the time ahead. The Deputy raises an important point. Prevention, as we all know, is the best possible cure. A regular check-in with one's GP is an essential part of that. We would have to engage with the GP community about such a measure, but I am sure the Minister, Deputy Stephen Donnelly, will consider it.

I raise an issue about which I have been contacted by countless families, as Sinn Féin's spokesperson for older people. These families carry the anguish and distress of the tragic loss of their loved ones due to Covid in nursing homes. They cry out for a comprehensive inquiry, as promised by the Taoiseach in January. This is not merely a policy matter; it goes to the heart of their fundamental human rights. Therefore, will the Minister commit to a clear timeframe for the inquiry before the onset of the summer recess? We know the HSE cannot perform such an inquiry. I urge the Minister to act on this now in order that the grieving families can get the answers they absolutely deserve.

The Taoiseach is really aware of the importance of an evaluation or assessment of how our State performed in dealing with the Covid-19 pandemic, for many reasons, not least of which is the loss of life many experienced, especially in our nursing homes and the sober reality that we may have to confront another pandemic at some point in the future. We urgently need to learn from our experience of dealing with the last one. I am afraid it is not for me to speak on behalf of the Taoiseach and lay out a timeline for when that will happen. The Taoiseach is personally committed to the issue and wants to ensure it is done properly. I am sure he will lay out what will happen later in the year, if not sooner than that. I could not, however, speak on behalf of the Taoiseach about a matter we accept is so important.

We are out of time. I will take 30-second questions from the remaining Deputies.

I have to use this slot again to raise the lack of emergency accommodation for homeless people and families. Thanks to the Residential Tenancies Board, we know that 4,700 notices to quit have been issued in quarter 1. We can broadly assume that the Government's so-called non-cliff-edge ending to the eviction ban will result in a further deluge of notices to be served on tenants throughout the country. This does not fill the 27,000 adults and children in care who rent with confidence. Where is the additional capacity? The mid-west has the highest number of families who access emergency accommodation and I am yet to get a straight answer as to whether buildings have been identified.

On Monday, through the medium of Twitter, we learned of the Minister for Health's capital plan to spend €1 billion largely in Dublin. It means just one eighth of the funding will be given to the other eight model 4 hospitals, including Waterford. Our Parliament was not consulted in any way in advance. I wonder what democratic parliament on earth would tolerate the spending of such a sum by one man and his thumb. Should spending not follow the will of the people? Should a plan as significant as this not be placed in front of the House before being approved and announced as a fait accompli?

I welcome the announcement the Minister, Deputy Foley, has made about a €5 million pilot project for counselling and mental health support services in primary schools in Cavan-Monaghan. We are thrilled about that and we know it is much needed. I take the opportunity to ask the Minister of State, Deputy Butler, whether she will consider my plea for a Jigsaw service for Cavan-Monaghan. I acknowledge the incredible work of Mr. Martin Tynan in Virginia, who has raised funds for SOSAD. As the Minister will be aware, Cavan-Monaghan has one of the highest death rates to suicide. Will the Minister and the Minister of State put their heads together to find a solution to give us a Jigsaw service, which is so badly needed in Cavan-Monaghan?

The Government is committed to the expansion of our emergency accommodation by a further 2,000 beds across this year. Work is under way to identify properties in which this can be done. Given that the issue of the mid-west has already been raised by the Deputy, I will see if I can get further information about her own constituency and the mid-west overall.

With regard to the capital programme that was brought forward by the Minister for Health, he is in front of the Committee on Health on a regular basis, as is the HSE. It is, respectfully, a matter for the Oireachtas to decide and vote upon the budget proposal brought forward. The appropriation Bill and the Estimates that each Department has to present are voted upon by the Oireachtas. That democratic legitimacy happens when Estimates are voted upon. We handle these matters in a pretty transparent way, when Estimates are brought forward and debated in the House. It is then a matter for the Minister to determine, in consultation with his Department, where those Estimates are allocated, both by geography and different layers of policy. I know the Minister, Deputy Stephen Donnelly, is well aware of the needs of Waterford University Hospital and that working with the Minister of State, Deputy Butler, great efforts are being made to respond to the health needs in that hospital and the communities that Deputy Shanahan represents.

With regard to Deputy Niamh Smyth-----

I can take that question.

I will leave it to the Minister of State to deal with the Jigsaw issue. I know how important the service is. We have one in Dublin Central. I can see the amazing work it does. The Minister of State will give the Deputy a more specific answer on the issues she has raised.

The initiative brought forward by the Minister of State, Deputy Butler, yesterday, is much needed. Rather, it was the Minister, Deputy Foley. I will get in trouble for that now. I fear those who suffered the most during the pandemic were our youngest and our oldest. An initiative such as this, to support our youngest at primary and secondary levels, is valuable.

I thank the Deputy for her question. I am delighted to hear Cavan-Monaghan has one of the pilot projects. We have 67% coverage of physical Jigsaw services throughout Ireland to provide youth mental health supports for those aged 12 to 25. However, there are some glaring areas that do not have Jigsaw provision, including the Deputy's area, community healthcare organisation, CHO, 5 and Kildare. I will meet with Dr. Joseph Duffy of Jigsaw in the next fortnight to discuss this. Jigsaw moved to provide many supports online during the Covid pandemic, but I wish to progress some physical premises and I will focus on these three areas.

Cuireadh an Dáil ar fionraí ar 1.18 p.m. agus cuireadh tús leis arís ar 2.18 p.m.
Sitting suspended at 1.18 p.m. and resumed at 2.18 p.m.
Top
Share