Dáil Éireann debate -
Wednesday, 21 Jun 2023

Vol. 1040 No. 4

Ceisteanna ó Cheannairí - Leaders' Questions

Deputy Mary Lou McDonald

I wish to raise the governance review into allegations of sexual assault at a HSE-run nursing home, which was published today. It outlines harrowing failures to protect vulnerable people and is a very distressing story for us all. It reflects, again, that there is much work to be done to protect and safeguard vulnerable people. In 2020, a healthcare assistant who worked at the home was jailed for 11 years for rape. The victim, known by the pseudonym "Emily", was a resident at the home. The review into the handling of this case uncovered that other residents had made allegations against the same healthcare assistant in the past. However, their serious allegations were not followed up with a safeguarding report and some were dismissed as residents being confused or hallucinating. None were followed up, as should have been the case in line with HSE safeguarding policy. This is a devastating incident that will cause unimaginable distress and trauma for the victims, their families and all of the residents at the home; and my thoughts are with them today. Emily and the other residents who came forward to report attacks have been let down in the most horrific way. The review is damning but it is not the first damning report. The Taoiseach will recall the "Brandon" report in County Donegal, another case in which one person stepping forward exposed similar issues around safeguarding. Today’s report must be a watershed moment. The chief executive of the HSE, Bernard Gloster, said the HSE will do all it can to ensure that safeguarding for all people in care homes is at the highest level of priority. I welcome that because we all must ensure that vulnerable adults are never failed in this way again. Victims must be treated with the dignity they deserve.

Tá an t-athbhreithniú ar fhoréigean gnéis i dteach altranais an HSE millteanach. Éilíonn sé gníomh práinneach chun daoine atá i gcontúirt a chosaint. Tá dualgas ar an Rialtas a chinntiú go bhfuil cosaintí i bhfeidhm.

The National Independent Review Panel, NIRP, issued nine recommendations in its report, which must now be implemented without delay; I am sure the Taoiseach will agree. They include the establishment of a working group to examine and reform how residential facilities for older people operate to ensure they are in line with international best practice. It also includes putting in place a staff awareness campaign to ensure that older people who are victims of sexual abuse are believed and that safeguarding allegations are always taken seriously. It also recommends better management of patients’ notes to ensure that concerns or signs of abuse are recorded and identified early.

There are a number of steps the Government can take to improve protections for vulnerable adults. Adult safeguarding legislation is needed to put legal obligations on service providers to prevent such violence being committed and to hold organisations and individuals to account for failing to protect people at risk. The legislation has been pending for some years but the need for it is now critical; indeed, I heard the Minister for Justice speaking about it again this morning. I call on the Government to commit to the urgent delivery of this legislation. Can we all work together to ensure that vulnerable adults have the support and protections they need and that this review and its nine recommendations are taken seriously and prioritised? Can we work across the House to ensure that all of this is acted upon in order that such a harrowing incident is not repeated?

The Taoiseach

I thank Deputy McDonald for raising this important issue. I think we can all agree that it is a hugely distressing and shocking affair that strikes terror into the heart of anyone living in a nursing home or anyone who has a loved one in a nursing home. These are supposed to be safe places and they almost always are, but in this instance, that clearly was not the case. It is important to say that the man who committed these assaults is now in prison and is serving an 11-year sentence. He is in prison because of the cognitive clarity and emotional strength of "Emily", who testified against him. She has since passed on. The review by the NIRP was carried out to establish if there were warning signs, signals and complaints that were missed, which there were. There were other allegations, which were not followed up by staff, as they should have been in line with existing HSE safeguarding policies. All incidents were subsequently referred to the Garda and all of the families affected have been informed. I can only echo the words of HSE CEO Bernard Gloster in his statement today, in saying that our concern has to be with the family of Emily and the other families affected, who have been engaged with to date. We intended to engage with them further on wider safeguarding issues in this particular care facility.

We can only at this time unreservedly apologise, condemn what happened and do all we can to ensure that safeguarding for all people in alternative care is at the highest level possible. Neither the CEO of the HSE nor I are satisfied that we fully understand all of the issues in this facility or those arising in the wider care context. For that reason, in the coming days, a safeguarding expert from overseas will be appointed to assist us. Today, it is important, as custodians of care services for older people, that we say, unequivocally, that we failed Emily, regardless of how much we were deceived by any one individual employee. We are anxious to ensure that we also respect the wishes of Emily's family for privacy. Given that this was such a serious incident, we are obliged to look closely at the context, the safeguarding practices at the time and whether there are other issues of concern. Two examinations have taken place to date, which can be broadly described as the review by the NIRP, to which Deputy McDonald referred, and a local safeguarding team review, which was also carried out. There was also a safeguarding report to the Garda and, in this instance, both of the reports identified a number of issues of concern.

The draft national policy on adult safeguarding in health and disability sectors will build on existing policies and structures and will apply to all relevant public, voluntary and private settings and agencies in these sectors. It will be subject to public consultation in the coming months, but we should not lose sight of the fact that there were safeguarding policies in place, which were not followed. Subject to Government approval of the new sectoral policy, legislation will be required to underpin the policy, which will be prepared.

Separately, the Law Reform Commission is preparing a report on a regulatory framework for adult safeguarding and this is expected to inform future legislation across all these sectors.

The policies and laws are in place, therefore, and more work is under way to update and improve those policies and to strengthen those laws. I do not, though, think that laws are enough. Many of the things the Deputy mentioned will also have to be done, particularly the training of staff to ensure that where there are symptoms, signs and complaints, they are taken more seriously than they were in this case.

Deputy Mary Lou McDonald

Go raibh maith agat. We again thank and salute Emily, which is her pseudonymous name, and send our regards to her family and to all the families and all those affected by this. It strikes me that this is one of those issues where the House is of one mind. The clear objective is to keep people safe and to ensure we have the appropriate policies, practices, training and development in place. Equally, however, these must be underpinned in law. There must be a statutory basis upon which all of this is built.

My question to the Taoiseach is on the timing. I appreciate that work has been done and that there is more work to be done in respect of regulatory frameworks, but there is also an urgency around this. People who are currently in the care of the State and the HSE, along with their families and communities, need to know that the Government and all of us in political life are serious about this issue-----

An Leas-Cheann Comhairle

Go raibh maith agat.

Deputy Mary Lou McDonald

-----and that we will now put pace into the delivery of this legislation. I ask the Taoiseach to give us a sense of a timeframe for delivery on the recommendations and the law.

The Taoiseach

I thank the Deputy. At this point, we will do this as soon as possible. I do not want to give a firm timeline here in the Dáil and then not be able to honour it because of factors outside our control, but there is no time to waste here. We have existing patient safety and safeguarding legislation, but clearly it should be strengthened and updated. We will get this done as soon as possible.

I should put on the record of the House that the HSE's adult safeguarding policy includes a zero-tolerance approach that requires staff to report all abuse concerns, criminal or otherwise. Nursing homes are required today to have in place policies and procedures to ensure residents are protected from abuse. They are also required to provide training for staff to ensure they can recognise, respond to and report any suspected abuse allegations. If immediate risks to the safety of residents are identified, they are expected to take action and prevent a recurrence. This can also include, where required, a referral to An Garda Síochána. They are also required to notify the chief inspector of HIQA of any suspected or alleged actual abuse within three days. It is clear that did not happen in these cases. We must ask ourselves why and then take any actions we can to ensure there is no recurrence.

Deputy Louise O'Reilly

Excuse me, before we move on, will the Leas-Cheann Comhairle please remind Members to turn off their mobile phones in the Chamber? It is disrespectful-----

An Leas-Cheann Comhairle

No, Deputy-----

Deputy Louise O'Reilly

-----and disruptive.

An Leas-Cheann Comhairle

-----that is unnecessary. I was about to do a gentle reminder at this point in respect of phones for all-----

Deputy Maurice Quinlivan

We have mobile phones going off-----

An Leas-Cheann Comhairle

Please, let us have a little respect during Leaders' Questions. We have all been caught with phones. Could we now please just double-check that all the phones are off? Go raibh mile maith agat. Táimid ag bogadh ar aghaidh go dtí an Teachta Cian O'Callaghan.

Deputy Cian O'Callaghan

Go raibh maith agat. Yesterday, the Taoiseach said something quite extraordinary. He said the reason there is a struggle to spend the housing budget is because it is so large. He then said that the large budget, much of which is unspent, is evidence of a commitment to addressing the housing crisis. Therefore, the Government's failure to spend the housing budget is now being used as evidence of its dedication to resolving the housing crisis. How much longer can the Taoiseach keep trying to dress up failure as success? Does he really think anyone is buying this? This kind of bizarre and self-serving spin actually explains quite a lot about the Government's inability to deal with the housing disaster.

The Taoiseach is not alone in this. Pretty much every senior Minister in his Government repeatedly tells us that a record housing budget means the Government is serious about solving the housing crisis. We know that a whopping 25% of that budget, €1 billion, went unspent last year. Much of this underspend was in the capital allocation which was supposed to be spent on affordable housing. The failure to spend this budget is especially unforgivable when we know that a chronic lack of affordable supply is at the very heart of the housing disaster.

People on average incomes, many of whom are trapped in insecure tenancies and are paying extortionate rents, simply cannot afford to buy their own homes. The Threshold report, as published today, provides more evidence of this. Nearly 60% of renters are renting because they cannot afford to buy their own homes. After 12 years of Fine Gael in government, these people are increasingly losing hope that they will ever be able to afford a place of their own. They are relying on the Taoiseach's Government to meet its affordable housing targets but it is failing them. This is because those targets are not worth the paper they are written on and are being missed by a huge margin.

Last year, the Taoiseach's Government said that it would deliver 4,100 affordable homes but just 323 affordable purchase homes were actually delivered, in the midst of the worst housing disaster in the history of the State. This is pathetic. We know this Government is not short on money, so allocating large sums to housing is not difficult. What the Government is short on is a housing plan that will actually deliver for those at the coalface of the housing disaster. Is the Taoiseach worried about the failure to spend 25% of the housing budget last year? Is any analysis of the failure to spend such a large proportion of the budget being carried out? Does he expect the full housing budget to be spent this year?

The Taoiseach

I thank the Deputy for his questions. Context is important. The public want to know the full facts. It is fair enough to criticise the Government for the housing budget not having been spent fully last year. I do not think it is fair, though, not put this into context by saying the budget for housing was the largest ever last year and will be the largest ever again this year. The budget for housing has more than doubled in the last couple of years. This is an important contextual aspect and an important fact that should be acknowledged by anyone discussing this matter. I hope the Deputy agrees with this. It would be a very different scenario if the budget had been cut and we had been able to spend it all. Facts and context, therefore, are important. To talk about the budget being unspent without putting this into the context of the fact that it has increased massively does not give the full facts to the public. I think the public deserve the full facts.

If this were solely a matter of money, political will or care and compassion, the housing crisis would have been solved a long time ago because there is no lack of money, political will or care, concern and understanding from the Government. There are very real constraints to building new homes in Ireland. These range from planning objections to planning permissions to the availability of labour to the supply of materials. Notwithstanding these aspects, we built 30,000 new homes in Ireland last year and more new social housing than in any period since the 1970s. We will do as well, if not better, again this year.

We do not expect there to be an underspend this year and we are taking actions to ensure this will not be the case. For example, we are waiving development levies to bring down the cost of construction and the cost of building new housing. The tenant in situ scheme has funding for 1,500 homes to be bought from landlords to prevent people falling into homelessness. This initiative is going extremely well now. The Deputy will know that 250 purchases are in process in our county of Fingal alone. This means we will be able to increase the budget for this scheme and purchase more than the 1,500 homes we have funding for now. There has been a really strong take-up of grants to bring derelict buildings back into use and breathe life into them for new housing, particularly across rural housing, so we will provide more money for this scheme to ensure more homes can be brought back into use if needed. We can also provide money for the purchase of land because local authorities should be purchasing land for future social and affordable housing developments.

These are the actions we are taking. If we drill down into the underspend, we will see that it occurred for several reasons, but it was particularly down to local authorities not performing. Local authorities were provided with funding to build social and affordable housing but were unable to do so. This is precisely why we need to use a whole different set of actors when it comes to building housing. I refer to the local authorities, the Land Development Agency, affordable housing bodies and the private sector.

If we adopt the approach the Opposition advocates and rely entirely on the State and local authorities, fewer houses, not more, will be built.

Deputy Cian O'Callaghan

The housing disaster is taking a wrecking ball to the lives of tens of thousands of people across the country. The Taoiseach's responsibility is not simply to stand up in the Dáil and announce notional billions in spending on housing and then blame local authorities for a lack of delivery. His responsibility is to make sure the budget is spent in order to deliver the homes people desperately need.

I will give the Taoiseach some context. After more than a decade of Fine Gael being in office, homelessness and rents are at record levels. The number of people in their 20s and 30s stuck in their childhood bedrooms is at record levels. Homeownership rates have fallen to their lowest level in more than 50 years, yet somehow the Government is incapable of spending the housing budget in the middle of this housing disaster. Instead, it is coming up with more and more schemes to ensure the housing budget is allocated in the forms of subsidies and handouts for developers. I again ask the Taoiseach how, in the middle of a housing disaster, he can possibly justify leaving so much money unspent in the housing budget. Has a proper analysis been carried out as to why this has happened?

The Taoiseach

I do not seek to justify it. I explained to the Deputy what the major cause was and what we are doing to make sure there is not a recurrence of it this year. I do not dispute any of the facts the Deputy put across, but they are not the full facts. As a party, the Social Democrats preach honest politics, but that requires context and the full facts.

Last year, 30,000 new homes were built, more than any year for a very long time. When my party came into office, only 7,000 new homes were being built. There has been a more than fourfold increase in new home building since my party came into office. Under this Government, more social housing was built last year than any year since the 1970s. The number of families in social housing today is 40,000 higher than it was when my party entered office. The percentage of households benefiting from social housing is higher than it was ten years ago. That totally demolishes the false claim that the Deputy and people like him often make, namely, that my party is opposed to social housing. In percentage terms or raw numbers - however one wants to look at it - it has gone up in the past ten years, not down.

Deputy Noel Grealish

I have a number of issues that I want to raise with the Taoiseach today. Over the last number of weeks I have met businesses across a range of sectors in Galway, from developers to healthcare providers. One of the main concerns they all have in common is a difficulty in trying to recruit staff. A lot of businesses, in particular those in the hospitality sector, which includes small restaurants and coffee shops, are very worried about their future and the viability of their business. A significant number have told me that they cannot operate at full capacity as they do not have the required number of staff to do so.

The issues they raised are the restrictions in employment permits and accommodation for their workers. One businessperson told me the only way he could secure staff was to provide accommodation for them. He was in the lucky position whereby he was able to provide accommodation for six staff members. People who are applying for jobs are now asking potential employers if they can secure accommodation for them, but most of them are not in a position to do that. The accommodation crisis is compounded by the staff shortage problem.

I have met a number of contractors who cannot get qualified staff such as blocklayers, plasterers and carpenters. As a result, they are not in a position to build which, in turn, has a huge knock-on effect on the housing supply. This situation is likely to get worse.

In response to a recent parliamentary question I tabled to the Minister for Health, I was informed of over 800 job vacancies in Galway’s main public hospitals, including more than 170 nursing and medical professionals. A recent survey by the Manpower Group showed that four in five Irish companies are struggling to attract talent as Ireland endures its worst skills shortage for 17 years. These staff and skills shortages are across all sectors of society, not just the ones I have referenced today. This has a knock-on effect on many parts of our society, for example by limiting economic growth, causing delays in dealing with our housing crisis and increasing waiting lists in our health service.

There is a major problem in the work permit system. It needs to be simplified to enable qualified people from abroad to apply for work permits and fill the much-needed positions in all sectors of our society as quickly as possible. Homecare workers were mentioned in this morning's Private Members' debate. My colleague Deputy Berry mentioned that those who come here from the Philippines are brilliant workers in the health and homecare sectors. The permit system for them should be simplified. I ask the Taoiseach to look at the whole process, make it a lot simpler and try to get much-needed workers into this country for the hospitality, construction and health services.

The Taoiseach

I thank the Deputy. The fact is that we are now experiencing full employment in Ireland. Some economists say that we are beyond full employment and that there are more vacancies than there are people available and qualified to fill them. This is only the second time in our history that we have achieved that. While that creates real problems, some of which the Deputy has touched on, in the round it is something to be celebrated. There are 2.6 million people at work in Ireland. Unemployment is almost at an all-time low. Female participation in the workforce is at an all-time high. Youth unemployment is also close to an all-time low. That has some negative consequences. There is a cloud to that silver lining, namely the fact that recruitment and retention is a real problem in the public and private sectors, in urban and rural Ireland, in well-paid jobs and poorly paid jobs and in large and small firms. Almost nobody is not facing some challenges around recruitment and retention at the moment, and the Government needs to act on that.

The kinds of things we are doing include increasing the number of places in our universities and the number of apprenticeships so that more skilled people come through. We will have about 9,000 apprenticeships this year and will hit our target of 10,000 ahead of 2025. We are also investing more in upskilling and doing the best we can to enable people who are currently on welfare and are remote from the labour market to join it. Many people currently in receipt of social welfare payments could, with a little more support, enter the labour market. We are working on that through activation mechanisms, led by the Minister, Deputy Humphreys.

Another solution is work permits and work visas for people coming from outside the European Union. Those from the European Union do not even need a work permit or work visa; they can just come here. People from outside the European Economic Area need a work permit and a work visa. We issued 40,000 such permits last year, which is a very high number. The turnaround time for a work permit or work visa is now two or three weeks.

We have also relaxed the rules around who can come here. Pretty much anybody with construction skills can qualify for a work permit because we need them desperately in order to build more housing. For the first time, we allow people to come here for the purposes of working in home care. Those are the kinds of changes we have made. The list of eligible professions and occupations is currently being updated. That should be done by the summer. We are also trying to bring in a new category of work permit around seasonal work, which is particularly important in the agrifood sector as well as in tourism and hospitality. Action is being taken at every level to try to increase the number of people who are in the country already and have skills and are able to work, as well as opening pathways for legal migration into the country where people have skills we need.

Deputy Noel Grealish

I thank the Taoiseach for his reply. In connection with the housing crisis, another issue which has come up a number of times in my discussions with businesspeople and developers is the length of time it takes to get planning permission. Developers who want to build houses have told me it can take up to three or four years to get planning permission, which is far too long.

The delays begin when working with local authorities to design suitable sites. When applications are granted, they are then more than likely appealed to An Bord Pleanála for approval. One person told me recently that his planning application for over 40 houses has been with An Bord Pleanála for over two years, with no definitive date for decision. With the related issues of a housing crisis and a crisis in companies trying to secure staff, can a time limit be set for An Bord Pleanála to make a decision on large-scale housing developments, similar to the one put in place for local authorities? Local authorities have to make a decision on a planning application within eight weeks of it being lodged. I believe this would speed up the delivery of housing.

The Taoiseach

I thank the Deputy. The answer to his question is "Yes". We intend to do that. As he will know, local authorities have to make a decision - I cannot remember if it is within four or five weeks.

Deputy Noel Grealish

Eight weeks.

The Taoiseach

There is no statutory limit for An Bord Pleanála. Under the Planning and Development Act, we intend to introduce statutory time limits during which An Bord Pleanála has to make a decision on an appeal.

That also means staffing up An Bord Pleanála to ensure it can actually achieve that because we do not want the refusal rate to go up as a means of satisfying the timeline. That can happen sometimes. We are staffing up An Bord Pleanála, bringing in the extra skills it needs, appointing new board members and getting ready for the introduction of those statutory deadlines contained in the Planning and Development Act. We also need to ensure judicial reviews happen less frequently and when they do happen, happen more quickly. The Deputy will be aware of the additional judges we are appointing to the courts. In particular, the additional judges we are appointing to the courts will allow some judges to be asked to specialise in family law cases and planning cases so those cases can be dealt with more quickly and dealt with by judges who have built up a level of skill and familiarity with cases of that nature.

Deputy Michael McNamara

I wish to raise the ongoing need for consultation with communities which are hosting persons with temporary protection and international protection applicants. I want to give an example, which is the area where I come from and where I live, east Clare. Soon after the outbreak of the war in Ukraine last year, 40 Ukrainians arrived in Flagmount. Earlier this year, the east Clare holiday village was repurposed and 220 arrived. Very recently, the former hotel in Scarriff was repurposed and is taking up to 75 asylum seekers. Throughout that time the medical centre in Scarriff that serves all of those areas has received no communication whatsoever from either International Protection Accommodation Services, IPAS, or the HSE with regard to this. The Taoiseach will know that medical centres across Ireland generally, and particularly in rural Ireland, are under pressure. There are more GPs retiring than coming through for rural practice. There are difficulties around that. They obviously want to provide a service to everybody in their community, both people who have been there for a long time and people who have recently arrived. We simply cannot pretend that new people arriving does not create additional pressures in a community. It does. If people do not speak English fluently, or at all in some instances, it will create additional difficulties in that consultation periods are longer. I am not saying that IPAS can arrive with a new GP because people are being housed. I am not expecting the impossible but communities are entitled to know what the plan to develop services is because nobody is expecting the war to end tomorrow. Nobody is expecting immigration to end tomorrow. What is the plan or is there a plan?

I am not looking to blame anybody here but we need an all-of-government approach because we need to make sure that the people who are coming are integrated and receive the services they require, just as we need to make sure there is not a reduction or diminution in services in the communities which are receiving them. That would be profoundly unfair. Obviously, there is a disparity across the country with some areas receiving far more than others and some areas with the capacity to take more than others. There is a disparity and that needs to be matched with resources. Yes, the Minister, Deputy Humphreys, has moneys but it needs to be more profound than just arriving with a chequebook because arriving with a chequebook will not provide additional medical services where they are needed. Arriving with a chequebook will not provide the teaching of the English language to foreign students as a speciality because these are specialist services. I am not saying the Government should be able to provide those services instantly but there has to be a plan and communities are entitled to know what that plan is.

The Taoiseach

I thank the Deputy for his measured approach and for the very reasonable questions he asked. It is important we talk about this issue but in a considered way. We should never lose sight of the fact that what we are experiencing across Europe is the worst refugee crisis since the 1940s. Some 4 million people have been displaced from their homes in Ukraine and roughly 2% of them have come to Ireland, which is approximately 80,000 people. Of course, in addition to that people from the Balkans and outside of the European Union are seeking international protection, some of whom come to Ireland. That has created an enormous challenge for us. We have had to find accommodation for approximately 100,000 people in the past year or so, and we have. It might not always be the kind of accommodation that we want but we have been able to provide shelter, food, accommodation, education and healthcare for nearly 100,000 additional people in the past year. I think when history looks back on that period it will reflect well on us, not so much as a Government but as a country, that we were able to take in 100,000 people who were fleeing war and seeking international protection.

I want to acknowledge in particular the very real welcome people in County Clare have given people coming from Ukraine and for that reason €3 million was allocated to County Clare as part of the community recognition fund. But it does create pressures on schools and on GP services. When it comes to schools, heroic work has been done by the Minister, Deputy Foley, by the Department of Education and by teachers and principals. There are now 14,000 Ukrainian children in Irish schools who are generally doing very well. They are learning English, making friends and becoming part of the community. In my view, that is a big achievement. Yes, it has put pressure on GP services. When I was a practising GP one of my jobs was to go to a clinic once a week and look after the health needs of newly arrived asylum seekers in Kilmacud at the time. It is tough because the consultation takes two or three times as long as it would with an Irish person because of language difficulties, the need for a translator, and even cultural differences in how people describe their symptoms. That makes that consultation two or three times longer and puts huge pressure on GPs. There is not a quick fix to it but the kind of things we are doing, other than of course providing medical cards for people who need them who are coming to Ireland from Ukraine and elsewhere, is increasing the number of GPs we are training. That will be up to 300 per year quite soon, which is a doubling of the number of GPs we train every year. We are examining a very interesting proposal from the University of Galway to establish a new graduate entry programme into medical school for those who live in rural Ireland and who want to do remote and rural medicine. That would create a dedicated stream of people who are a little bit older going into medical school, who want to stay in Ireland and who particularly want to engage in remote and rural medicine. The University of Galway has a really interesting proposal in that regard but it does take time from when we start training people now for them to be available.

Deputy Michael McNamara

It does take time and I am glad the Taoiseach acknowledges there is a problem. We need to go further than acknowledging there is a problem and maybe establish a liaison between the HSE and IPAS. I am not blaming IPAS and I am not blaming the Ministers, who are both sitting there, at all but we do need a whole-of-government approach because what we cannot have is service providers, in particular vital services like GPs, having to choose between providing a service to their existing patients or maybe the growing families of existing patients, and new patients who are coming in. That will create division and resentment, and understandable resentment, and we just cannot have that.

During the recess we learned of difficulties in the work permit system around healthcare professionals. I appreciate it is slightly different but it goes back to what Deputy Grealish raised. We also need a vast improvement in the work permit regime. There are people who have been granted work permits being refused visas, and there are a lot of them, by the Department of Justice. There seems to be a disconnect between the two regimes. There are two separate statutory regimes and the Government really needs to look at that.

The question I raised is around making sure that there is a plan for areas that are accepting persons seeking international protection and those who have temporary protection, and that plan is clearly communicated to those communities.

The Taoiseach

We have a Cabinet subcommittee on Ukraine and migration. I chair that subcommittee and health is part of that. A pretty regular agenda item we discuss is the health impact and health needs of people who have come here from abroad.

Deputy Michael McNamara

That does not get down to the communities.

The Taoiseach

That is a fair point and something I will follow up on because the situation in each community is different depending on the needs and the capacity of the community and the profile of the people we are bringing into that area. One thing that can help is registering Ukrainian doctors and nurses. They have come to Ireland as well. Making sure their qualifications are recognised, allowing them to work in our health service and getting around the issues of translation is being done. The other work that is being done is bringing together the work permit and visa systems in a single combined system. That is a European law that we have opted in to. I know from experience that we turn around work permits very quickly now, in two or three weeks.

Visas are a little more complicated because we have to check that people are who they say they are. Often, the delay in issuing a visa to somebody is not a delay on our side. It is a delay in the police department in the country they are coming from, because we need to check that they are who they say they are. Nobody would forgive us for issuing visas to people without due diligence.