Dáil Éireann debate -
Tuesday, 20 Jun 2023

Vol. 1040 No. 3

Ceisteanna ó Cheannairí - Leaders' Questions

Deputy Mary Lou McDonald

The children of Ireland need a national children’s hospital. It is an essential piece of infrastructure. Families’ hopes are on this hospital opening its doors and providing the state-of-the-art healthcare their children need. We all want to see this hospital opened without further delay. The project has been mismanaged from the start. It is already cited as the most expensive hospital in the world. Its opening has been pushed back time and time again.

Today, The Irish Times reports on information obtained by my colleague, Deputy Cullinane. We have discovered that there is a major problem with no fewer than 11 operating theatres at the hospital. These problems were known to the board in May 2022, 13 months ago. The board has admitted these facts today. Remarkably, it took the board more than a full year to respond to this situation despite further warnings in November of last year.

I will quote from the report of an independent expert appointed by Children’s Health Ireland that the board received in November of last year on these matters. I ask the Taoiseach to listen carefully because the report sets out the seriousness of what it calls "major generic faults", saying:

These are not snagging lists but rather indicative of major generic faults and non-compliances. The longer that these issues take to get resolved, the more expensive and time consuming it will become.

It goes on to say, “If the present approach [...] is not corrected, the systems will fail the final validation and will not be fit to be taken into use.” Indeed, these independent experts expressed huge disappointment that no action had been taken since these major generic faults had been brought to the attention of the board months earlier. As a result of the failure to act, I can only assume that these theatres failed the quality checks in March of this year. I would like the Taoiseach to clarify that matter today.

Despite all the warnings, a process to work out how to fix these major generic faults is only now being put in place, more than a full year after they came to light. The Minister has today acknowledged that the hospital will not now open in March 2024 as promised. Children and families wait and wait while vast sums of taxpayers’ money is spent with carelessness by a Government that is asleep at the wheel. Tá ospidéal náisiúnta na leanaí riachtanach do teaghlaigh ar fud na tíre. Theip ar an Rialtas ceannaireacht agus maoirseacht a thaispeáint. Ba é an t-ospidéal is costasaí ar domhan cheana féin. Anois, de bharr lochtanna móra, feicfimid costais ag ardú arís agus tá moill ar oscailt an ospidéil.

This is not the first time that we have had such problems with this hospital. Massive cost overruns, massive delays and a lack of transparency have become synonymous with this project, as has massive disappointment for children and their families. The Taoiseach has said in the past that lessons would be learned but it is clear that this is not the case.

Lessons have not been learned. Indeed, this morning, I heard the Taoiseach quoted as saying that he is satisfied with the board’s response to the matters that I have set out. I have to say that the independent experts do not share the Taoiseach's view. The board knew all about these serious problems as far back as May 2022, 13 months ago. When did the Taoiseach find out?

The Taoiseach

The new national children's hospital will transform healthcare for children on our island. Elements of it are already open, including the ambulatory care centres in Blanchardstown and Tallaght. People who have taken their kids there will know quite how good healthcare can be when we have modern facilities. The main building has been under construction for quite some time, next to St. James's Hospital. We anticipate that it will be completed and handed over next year, and will be commissioned in the months after that. Contrary to reports in some headlines this morning, work on the new children's hospital has not stopped or paused. I am advised that the National Paediatric Hospital Development Board, NPHDB, which is the State body charged with building the new hospital, is undertaking a review relating to 11 of the 22 theatres. As we all know, theatres are critically important rooms. That is why it is important for the NPHDB to check and correct any potential deviations from plans. There can be no suggestion that any additional work on these 11 theatres, should it even be needed, could have any effect on the completion or opening of the hospital. Any works, if needed, can be done in parallel.

This review is par for the course in construction, and no different from several reviews to investigate more significant changes in design proposed by the main contractor across the project. The NPHDB informs me that the review is not indicative of any wider design issues. The reality is that no works have been asked for, so it is unclear how they could possibly be costed or scheduled. The NPHDB and the employers' representatives have been engaging with the contractor for months, seeking a programme outlining how it will successfully complete the final 20% of the hospital. This has not been forthcoming. The Government believes this is an unhelpful distraction, aimed at shifting the focus from the contractor and its responsibilities to others.

To answer the Deputy's question, I was first informed of this matter this morning. I am not sure if what she is informing me of is even accurate. It is disputed by the board. I would like to know from the Deputy who these independent experts are that she has referred to. Has she checked that they are independent experts? What is the source of these allegations that she has put on the record of the Dáil?

Deputy Mary Lou McDonald

The Taoiseach might answer my question on whether these 11 theatres complied with or failed the validation test in March. That is an important question and I would like him to answer it. These are 11 theatres, not 11 "rooms". They are not cloakrooms; they are operating theatres. We are talking about 11 theatres. That is 50% of the theatre capacity of this state-of-the-art hospital. Did they or did they not fail validation in March? Can the Taoiseach answer that question? I find it extraordinary that he only became aware of these matters today. These matters were known to the board more than 12 months ago. The independent experts are independent and expert. They were appointed by Children's Health Ireland. They were very clear in May 2022, and again in November, that there were serious generic faults - not minor matters or snagging list issues. There were major faults, and yet the board did not act and this situation was allowed to drift. Here we find ourselves now with a very serious situation that will no doubt be costly and no doubt will extend the delay. Can the Taoiseach give me a more fulsome and, frankly, a less ridiculous answer to the questions I have put to him?

The Taoiseach

I do not know if a validation exercise was carried out in March, but I do know that snagging and checking-----

Deputy Mary Lou McDonald

Well, I do. I have the documents here.

The Taoiseach

-----is par for the course in any construction project.

Deputy Mary Lou McDonald

It is not snagging.

The Taoiseach

The Deputy has not told me who the independent experts are. If she would give me the copy of the report, I would welcome that. Like I say, this is-----

Deputy Mary Lou McDonald

You have to get this from me.

The Taoiseach

-----something that we have only heard about, as a Government, today.

Deputy Mary Lou McDonald

Wow.

The Taoiseach

If the Deputy has this independent expert report, I would be happy to receive a copy so that we can verify whether the claims she is making, here in the Dáil, are true.

There is no point in being facile about these things. An operating theatre is a room. In the US they call them operating rooms and emergency rooms. Let us be a bit grown up about these things.

Deputy David Cullinane

I do not think the Taoiseach has been briefed. This will come back to haunt the Government.

Deputy Ivana Bacik

I want to raise with the Taoiseach the stark reality of Government failure to deliver on housing. This is a failure acknowledged even within the ranks of Government. On Saturday, The Irish Times reported the comments of a Fianna Fáil backbencher who described the Minister for Housing, Local Government and Heritage's multitude of half-baked schemes as follows: "They make great headlines, but they’re simply not backed up by volume." I could hardly put it better myself.

Deputy Darragh O'Brien

Thirty thousand houses last year.

Deputy Ivana Bacik

It seems that the Minister for announcements and glossy pamphlets over there is so preoccupied with repackaged launches that he has lost sight of the need to deliver real homes. What we are seeing is a chronic failure of delivery which has compounded housing distress for so many people and so many families. I am thinking of two particular families I am dealing with at the moment. One comprises a father and daughter who is a wheelchair user. The father is renting a second-floor studio that is inaccessible. He has to carry his daughter up a narrow and unsafe staircase each time they come home. He has answered several hundred advertisements on daft.ie but cannot even get a viewing.

The other family is a mother and her two young children. She says her mind has gone to a very dark place due to her inability to secure a safe, affordable home for herself and her children that is near to her parents for whom she is a carer. These are just two of the families. I know all of us in the House hear from families with similar distressing stories and experiences because the chronic housing shortage is causing real suffering.

Upon taking office in December, the Taoiseach pledged to go all out and take a "let's do everything" approach to housing. The Tánaiste said we have turned a corner on the crisis. The Taoiseach is on record as saying that we are at least on the cusp of turning a corner. The reality is that the Government is nowhere near the corner. It continues to move at a snail's pace with a real failure to deliver. It is more focused on policy launches than the physical delivery of homes.

I will give some specific examples. Last August, the Government came under pressure when leaks exposed the lack of measures for renters in the budget. In response, the Minister announced a €500 renters' tax credit. The Government was warned then that this would not deliver the affordability and security of tenure that renters need and that would have been better brought about by, for example, the Labour Party's renters' rights Bill, which the Government did not oppose. It went ahead with the credit and news broke last week that half of renters have still not claimed that credit. Clearly it was not the measure that renters needed.

In March, the Government lifted the temporary no fault eviction ban without any evidence or any contingency plan in place. It then announced another sticking plaster, a first refusal scheme for renters where the landlord is selling. It was warned that it would do nothing for the majority of people who receive an eviction notice. Incredibly, three months later, we still have no detail on how the scheme will work. I am still hearing from families desperate to buy their homes and they cannot do so. We continue to see missed building targets, unspent departmental budgets and rising homelessness.

Will the Taoiseach accept that the renters' credit was the wrong measure and instead pass legislation to protect renters? Will the Taoiseach say when the first refusal scheme will actually come into effect? When will the legislation even be published? What is the blockage on delivery in the Department of Housing, Local Government and Heritage?

The Taoiseach

I acknowledge that we have a very significant shortage and deficit of housing in Ireland and that the country is experiencing a very deep housing crisis that affects people in many ways, whether high rents, rising homelessness or the difficulty many people face in being able to buy their first home. The housing crisis is a reality for many reasons. These are a rapidly rising population, smaller household sizes which mean we need more homes and a prolonged period during which very little housing was built after the crash in 2008. We are catching up on that deficit now and I will give a few examples. Last year 30,000 new homes were built, more than any year in ten or 13 years. There has been very significant progress there. We expect to meet our housing targets again this year. Last year more social housing was added to the housing stock than in any year since the 1970s. The recent census figures show the percentage of households benefiting from social housing increased in the past ten years and did not go down. This totally destroys the argument that this Government and the previous Government were somehow uninterested in social housing.

Some 40,000 more families are in social housing than there were ten years ago. The percentage of people benefiting from social housing has gone up, not down, which proves that this Government and the previous one have been committed to social housing.

We are making progress on homeownership too. More than 1.2 million families now own their own homes in Ireland. About 400 first-time buyers are buying their first homes every week. That is because of the actions the Minister, Deputy Darragh O'Brien, has taken. For example, the help-to-buy scheme helps people to get their deposit. The local authority home loans help people to get a loan if they cannot get one from the bank. There is huge interest in the new grants that are being offered to bring derelict properties back into use as new homes. There are other measures, particularly championed by this Minister, such as first home, a new scheme that bridges the gap between the mortgage one can get from the bank and the cost of buying the home one wants to buy. All of those things are making a difference. That is why we are seeing more people buying their first home every week than at any period since the Celtic tiger. We are catching up on a huge deficit and it will take time for us to get ahead of it.

The rent credit was in the budget. It is €500 for a single person, €1,000 for a couple and €1,500 if there are three people renting. As is the case with any tax credit, people have up to four years to claim it. It is hard to know exactly how many are entitled to it. We think about 400,000 people are entitled to it. About half have claimed it. Others can claim it too. We will be advertising it and putting out further information for the Revenue Commissioners to make people know that is available.

Deputy Ivana Bacik

The Taoiseach has listed a multitude of schemes but we see a yawning gap in the delivery of homes as a result of those schemes, which is the issue. It is an issue for everyone, including for renters and, as the Taoiseach has acknowledged, for those who wish to buy homes too. We see the report today that single first-time buyers must earn at least €67,000 a year in order to even qualify for a mortgage. We see single people locked out of homeownership and we see renters in crisis, yet the Government is failing to spend the full budget for housing. Last year, it failed to spend 25% of the social and affordable housing budget. The total spend on housing amounted to €1 billion less than the budgetary allocation. Given the scale of the crisis, which the Taoiseach has acknowledged, why are these budgets going unspent? Will he redirect funds into, for example, recruiting more construction workers to ensure increased capacity? Will he cut the red tape and enable local authorities to build homes, as they did before at a time when we saw really serious numbers of homes being built every year?

The reality is that the housing crisis is not improving under the Taoiseach's Government despite the multitude of announcements of new schemes. We still see money going unspent and homelessness figures rising. I ask the Taoiseach again where the blockage is in the Department of Housing, Local Government and Heritage and why we are not seeing delivery.

The Taoiseach

I heard the Deputy say that single first-time buyers have to earn €67,000 to buy their first home. The Deputy may have misread it or there may have been a different interpretation. I think the figure is that the median or average income of people buying their first home is €67,000. That, by definition, means that at least half of the people who bought their first home earn less than €67,000. These things are often very poorly reported but if the median is €67,000, at least half have to earn less than €67,000 for that to be true.

Deputy Ivana Bacik

I think it is nitpicking.

The Taoiseach

It is true. I am sorry. I know I will be criticised for explaining these things but sometimes when things are factually untrue, it is legitimate to point out what is actually meant by average and median for people who may not fully understand it.

The €3.5 billion budget for housing is the biggest budget ever. If there is any reason that we are struggling to spend it, it is because the budget is so large. That is evidence of the Government's commitment to dealing with the housing crisis.

There are 9,000 apprentices this year, which is the highest in a very long time. The Minister, Deputy Harris, is leading on that and making sure we increase the number of apprentices. Work permits and visas are being issued to allow people to enter the State and work in construction. Planning rules are being changed so local authorities can build social housing more quickly.

Deputy Richard Boyd Barrett

Over the weekend, President Higgins rang the alarm bells about the dangerous drift in Ireland's foreign policy away from neutrality and raised concerns about the composition of the Government's consultative forum. The President has to be somewhat constrained and diplomatic in what he says.

However, what he said echoes what we have been trying to say for the past number of months, namely, that the Government has seized on the tragic, brutal, unjustifiable war of Putin in Ukraine to try to move Ireland away from neutrality and towards greater involvement with the project of EU militarisation and NATO. This consultative forum is part of that campaign by Fine Gael, Fianna Fáil and, tragically, the Green Party to soften up public opinion against neutrality and towards closer alignment with EU militarisation and NATO.

We held our breath a little, despite our scepticism about what the forum would look like, but then we saw the list of moderators and speakers for the forum that will take place in what is supposed to be a balanced discussion. It is dripping and packed to the rafters with NATO employees, people who have worked with NATO, people associated with the military-industrial complex, generals, brigadiers, lieutenant commanders of the military, and academics who have published records - these are not personal points - of being pro-NATO, pro-EU militarisation and pro-NATO, US, UK and western foreign policy agendas. In contrast, there is one speaker who has a record of pro-neutrality, anti-war activism. For example, there are three speakers for the module on Ireland's engagement with NATO. One of them is the director of security policy for NATO, one is a member of our military personnel who has been seconded to NATO, and the third is an academic who has a published record of arguing in favour of EU militarisation and closer alignment of Ireland to NATO. That is typical of what this forum is about.

Will the Taoiseach acknowledge that this forum is stacked with pro-NATO, pro-militarisation and anti-neutrality propaganda, and that what we actually need is a balanced debate and a referendum on Ireland's neutrality, in respect of which there has been five Bills in this House over recent years, every one of which Fianna Fáil and Fine Gael voted against?

The Taoiseach

I confirm once again that Ireland will remain militarily neutral. We are not going to apply for NATO membership, or membership of any military alliance, nor will we sign up to any mutual defence pact or clause. The Tánaiste has made that very clear on a number of occasions, as have I.

However, the security threats facing our country have changed. There are cybersecurity threats, threats related to international terrorism and espionage, and hybrid threats. We have to think about that as a country. The Tánaiste has established this forum to do exactly that. The kind of things we will do, which we have been doing for some time now, include increasing our budget for defence, co-operating with our EU allies through permanent structured co-operation, PESCO, of which we are a founder and now full member, and co-operating with allies, such as the US, UK and Canada, through the NATO Partnership for Peace process, which we have been a member of for more than 20 years.

The forum will begin this week, on 22 June, in University College Cork, UCC. There will be another meeting on 23 June in University of Galway and on 26 and 27 June in Dublin Castle. The forum is not a binary discussion on neutrality and was never intended to be. As I said, there is no intention to change our policy of military neutrality. It is, however, the fundamental duty of the Government to rise to the challenging global situation we face today. Since Russia's invasion of Ukraine in February last year, which blatantly violated the UN Charter, every country in Europe has examined and re-examined its foreign and security policy and defence policies. It is very positive to see that more than 900 people have already registered to take part over the four days. We have already received 300 written submissions. Eighty people are moderating or speaking on panels over the four days.

They are people with expertise in this area, people who have been involved in peacekeeping, peacebuilding and conflict resolution internationally. Moderators and panellists include many Irish people with on-the-ground experience of UN and EU operations in places like Chad, Afghanistan, Iraq, Ukraine, Georgia, Kosovo, Bosnia and Lebanon. It includes academics from Ireland, as well as Sweden, Finland, Norway, which is a neutral country, Poland, Denmark and the UK. There are senior Irish officials, as well as people from NGOs such as Oxfam and Concern. Of the 18 panel discussions over the four days, only one is about NATO and only two about neutrality.

Deputy Richard Boyd Barrett

Any fair-minded person who looks at this will see it is dripping and stacked to the rafters with pro-NATO people and people associated with the military-industrial complex. For example, there is not a single speaker from the Non-Aligned Movement. For people's information, that is the biggest movement of states in the world that do not associate or identify with the big military powers, whether Russia, NATO or China. It has 120 members but not a single representative on the forum. NATO has 33 members and the forum is packed with representatives of NATO, people who work with NATO and NATO members. It is stacked in a way designed to condition opinion in a particular direction.

We have had NATO military commanders in Cork assessing our troops. We have signed up to PESCO, which is all about interoperability with NATO. Yet the Taoiseach is seriously suggesting the Government is not by stealth trying to drag us into NATO. He mentioned breaches of the UN Charter which Russia has clearly committed, but says nothing about breaches or violations of human rights by states supported by the US and UK, whether Israel, Saudi Arabia or God knows who else. It is all biased because the Taoiseach is trying to move us away from neutrality. Why will he not support a referendum on the issue of neutrality and a real balanced debate?

The Taoiseach

There is no hidden agenda here. I have told the Deputy exactly what we intend to do. We intend to increase and improve our Defence Forces and defence capability. We are founder members of PESCO, which is European foreign and security structured co-operation. For more than 20 years, we have been part of NATO’s Partnership for Peace. Interoperability is there to protect our troops and make sure they are safe and can act effectively in peacekeeping missions, being able to use the same equipment and to engage in joint operations with countries such as Poland and Estonia, which we do in Lebanon. There are no secrets here. We are very clear about our policy. We will not be joining NATO or any other military alliance; we will be investing in our Defence Forces. We are founder members of structured co-operation at a European level in security and defence and for more than 20 years we have been a NATO partner for peace.

Deputy Michael Lowry

Recently, I met the Tipperary representatives of the INTO to discuss the organisation's pre-budget submission. I was dismayed to learn there had been a 40% increase nationally in the number of primary school-leaving kids requiring behavioural and emotional assistance during the pandemic. That is a significant increase in the number of children under 12 years who are seeking help. Securing the appropriate assessments for these children was justifiably viewed by parents and teachers as urgent. However, waiting lists for specialist services prevented many of them from accessing the help and support they needed. The lack of mental health services for children and young people across County Tipperary and the country is a fast-growing crisis. Children in their formative years are being left languishing on waiting lists at a critical time in their development. Services are underfunded, underresourced and unable to cope with demand.

Child and adolescent mental health services, CAMHS, has waiting lists in all parts of the country. In February of this year, numbers had risen to 4,500. These children's inability to get appointments with mental health professionals has resulted in hundreds of them now taking prescribed antidepressant drugs from their GPs. These medications will mask the symptoms but not address the problem. Statistics show that last year 15,000 prescriptions for antidepressant medication were given to children under 15 years of age.

It is widely acknowledged that children and young people are exposed to mental and emotional overload more than ever. We live in a news-saturated world. Every day, there are stories beamed into our homes of war, death, hunger, conflict, natural disasters, murders and attacks. Many young people are seeing horrendous things happening in their communities. At home, there can be problems over a lack of money, abuse, neglect, domestic violence and drug and alcohol misuse, and sometimes the death of a loved family member. Children are also dealing with day-to-day issues such as bullying at school, cyberbullying, body issues and exam pressure, and also a myriad of other matters that can overwhelm a young mind. When a child is suffering mentally, putting him or her on a waiting list can have detrimental consequences. Such consequences can in fact have a lifelong impact on a child. Our children deserve better than this. We, as adults and elected representatives, have an obligation to our young people to guide them through childhood and support and protect them. Urgent investment is needed in child and adolescent mental health services to expand capacity significantly and reduce the waiting lists.

The Taoiseach

I thank the Deputy for raising this important issue. His experience will be similar to that of many in this House who have been talking to parents, teachers, doctors and psychologists and who will be aware of the increasing demands on young people's mental health, in part due to the pandemic and in part due to other challenges and pressures they face. That is why we are investing very significantly in mental health services. The total allocation for mental health services this year is €1.2 billion, which is the highest ever. It is needed because of the very high level of demand. Of that, about €137 million is provided to CAMHS. About €80 million was provided to community-based mental health organisations last year, with a significant proportion of that dedicated to services for children and young people.

In addition, recruitment is under way for a new post of a youth mental health lead at assistant national director level in the HSE and also for a new clinical lead for youth mental health. The Minister of State with responsibility for mental health, Deputy Butler, has recently completed a series of round-table talks bringing together officials from the Department of Health, the HSE and other stakeholders in youth mental health to drive improvement in CAMHS, with a focus on leadership and clinical expertise. The Deputy will also be aware of the announcements made recently by the Minister for Education, Deputy Foley, and the Minister of State, Deputy Madigan, on counselling being provided in schools.

With regard to CAMHS reforms, the Deputy is particularly interested in the north Tipperary team, based in Nenagh and which also has clinics in Roscrea and Thurles. All service users in north Tipperary, but also those in south Tipperary requiring inpatient care, are referred to Éist Linn in Cork. Jigsaw Tipperary, which is based in Thurles, opened in 2021 and currently has a waiting time of around four weeks to access a first appointment. I am glad to say this is currently the shortest waiting time in the State.

Deputy Michael Lowry

I appreciate and acknowledge the Taoiseach's interest in the subject and his commitment to addressing what is a very serious problem. I know the services that operate in Tipperary and meet the people involved regularly. They tell me that despite the investment the Taoiseach has mentioned, there is still a huge shortage of resources, particularly personnel. I ask the Taoiseach to examine the INTO's pre-budget submission. It is asking for an increase for the National Educational Psychological Service, NEPS, and it is also looking for the reinstatement and expansion of in-school and early-years therapy supports. The staff of the INTO and the teachers it represents are on the ground and see what I am referring to happening every other day. They know exactly what is required. They are also calling for on-site counselling and a national framework to monitor the development of the services. The INTO has said that the cost would be approximately €11 million annually. This is a small price to pay for the mental well-being of our children. We have an obligation to protect them but are failing too many of them at present. No child should be left waiting indefinitely for professional mental health support.

The Taoiseach

I assure the Deputy that we will take the INTO submission very seriously. We certainly have done so down the years. The ideas and advice it gives to the Government have very often been taken up by the Government.

It is not always possible to do everything we want to do in any one given year but we can certainly do more over the years ahead. Again, I know the Minister, Deputy Foley, is very committed to improving psychological services in schools and has some ideas on that which we hope to advance.