Dáil Éireann debate -
Tuesday, 20 Feb 2024

Vol. 1049 No. 7

Ceisteanna ó Cheannairí - Leaders' Questions

Deputy Mary Lou McDonald

The ongoing controversy at RTÉ serves no one well, least of all the members of the public who rely on it as a source of factual and accurate news and current affairs. It is damaging to people's trust in public broadcasting that the fallout from what the Taoiseach has described as a culture of arrogance and entitlement at RTÉ continues to play out. This issue is not going away because it underlines the fact that there is one rule for those in privileged positions and another for ordinary people. We see, on the one hand, that you can be an RTÉ executive, walk away from your job and pocket hundreds of thousands of euros on the way out the door. If you are a nurse, a teacher or if you work in retail or hospitality and you walk off the job, however, you would not be entitled to a penny. Más altra nó múinteoir thú áfach, nó má oibríonn tú i siopa nó óstán agus má fhágann tú do phost, ní gheobhaidh tú pingin. You would not even be entitled to a social welfare payment. If you are a well-connected RTÉ executive, that is a different story.

We have heard a great deal of bluster from the Taoiseach and others in government about accountability, but we have seen none in the eight months during which this debacle has played its way out. Instead of soundbites, what we need to hear from the Government is what accountability looks like. When will there be consequences for those who have breached the public trust and those who have played fast and loose with taxpayers' money? As long as this saga continues, people are voting with their feet. Hundreds of thousands have chosen not to pay the TV licence. Every day that the Taoiseach delays in making a decision on this matter, many more join them, which thousands due to be dragged through the courts. Where is the accountability from those in RTÉ? Every time someone in government is asked about this, they say they are not responsible and that it is someone else's problem. If the Government is not ultimately responsible for cleaning up this mess, who is? Yesterday, we learned that the Minister for media had her first briefing on severance packages at RTÉ, despite the findings of the McCann Fitzgerald report emerging three weeks ago. The Government is behind the curve on every twist and turn of this debacle.

What will be done to ensure that all details of the severance packages paid to top executives at RTÉ are published immediately? What steps will be taken to ensure nothing like this ever happens again?

This is public money, and public money must be accounted for properly. That it RTÉ's job. There must be adequate oversight. That is the Government's job and the Taoiseach's job. RTÉ must be brought back under the remit of the Comptroller and Auditor General, as was the case for many years. Does the Taoiseach support this proposal? Will it happen? The Government has to move on this. It also has to tackle the long-term issue of funding RTÉ and ensuring that those moneys are managed properly. Will the Taoiseach commit to the implementation of all of the recommendations from the Future of Media Commission? Will the Government abolish the TV licence once and for all? We need clarity from the Government on these pressing matters.

The Taoiseach

I thank the Deputy. I take this opportunity to note the passing of Michael O'Regan. I know his friends, colleagues and the people of Kerry, who will be well familiar with the Dáil hour programme on the radio, will mourn his loss. I understand there will be a moment of silence at the end of Leaders' Questions to pay our respects to him and his family and colleagues.

On the Deputy's question, as I said before, we need full information and clarity from RTÉ. The drip-feed of revelations which has been happening for far too long is now seriously damaging an important organisation which has a pivotal role in our democracy and our national cultural identity. The Minister, Deputy Catherine Martin, met the RTÉ chairperson and director general, DG, yesterday to discuss the severance payments, or rather the exit payments. She has been very clear - as have I - that we need maximum possible clarity and transparency on all these matters urgently. In re-emphasising the need for maximum transparency, the Minister has also received assurances from RTÉ that it will reassess the future use of confidentiality agreements and the capping of severance packages for senior executives. While transparency must be lawful and have regard to individuals' employment and privacy rights, the DG has committed to seeking updated legal advice and to making as much information as is permissible publicly available. He is also committed to providing an update in respect of this as soon as possible. I urge him to do so.

While substantive legal advice is awaited, the DG did provide some further clarity with regard to departures of a number of former staff yesterday evening. He has confirmed that he felt a negotiated process to exit an individual from the organisation was needed in the context, that there were no grounds to dismiss the person and that the interests of RTÉ might be best served if the individual concerned was to leave voluntarily. Both parties received legal advice on this matter. The DG has stated his view that there may have had a significantly increased cost to RTÉ were a dismissal to have been attempted.

RTÉ is, in accordance with the provisions of the Broadcasting Act, independent in its pursuit of its statutory objectives and this includes all operational matters such as HR. These severance agreements are not arrangements that required any Government approval or notice and this is standard practice for semi-State bodies as opposed to Departments or State agencies. RTÉ's annual and regular accounts disclose aggregate transactions with regard to senior management but no detail is given. The accounts are published and laid before the Houses of the Oireachtas and are there to be interrogated by Members of both Houses, which, of course, is done by ,the PAC and the media committee.

Two expert advisory committees are going to make recommendations, looking at the governance. We await their recommendations on possible legislative changes that might be necessary and proportionate in order to increase accountability while respecting the principle of the independence of media. I do not intend to pre-empt what these reports might recommend, but I note that the Minister, Deputy Catherine Martin, is committed to implementing the changed recommended in order that we can ensure better governance and greater transparency and try to rebuild trust. What the expert advisory committees have to say about the role of the C and AG will also be important. We will take on board any recommendations in this regard. The Minister expects to receive an update from the expert advisory committees later this week on their progress and on the status of their reports in the context of finalisation and publication.

Deputy Mary Lou McDonald

I join with the Taoiseach in saluting the memory of Michael O'Regan, who was a gentleman and a truly fine and fair professional. Our thoughts are with him and his family. Ar dheis Dé go raibh a anam dílis.

The scandal relating to RTÉ has gone on for months.

It has gone on since last summer, and the Taoiseach still talks about it as if he was some detached, inconsequential observer. He still cannot give straight, concrete answers in respect of accountability and full disclosure of information. It is not, at this point, good enough for the director general of RTÉ or for the Taoiseach, as Head of Government, to continue to dilly-dally and delay on this matter. If RTÉ is guilty of drip-feeding information - which it is and which the Taoiseach has called it out - equally, the Government is guilty of gross indecision, slowness and sometimes an alarming but telling lack of curiosity in the questions it has put to RTÉ.

We now need pace. We need to know from the Government precisely when we will have all of the information required. We also need to know how it intends to ensure that we do not have a repeat of the behaviour we have witnessed. As the Taoiseach awaits another report from another expert committee, I put it to him that there has been one sitting on his desk for the past two years. That report recommends abolition of the television licence. Could the Government please take a decision on that matter without further delay?

The Taoiseach

I thank the Deputy. The Minister, Deputy Catherine Martin, met the director general on the day the McCann report was published. That report dealt with the voluntary redundancy schemes of 2017 and 2020. Yesterday's meeting between the Minister, the DG and the chairperson was in relation to termination packages. We need all transparency on this to the extent that is possible within the law.

There are many recommendations in the report of the Future of Media Commission. These are very good recommendations, and we are implementing them all. There is one outstanding that we still need to make a decision on and that is on the abolition of the TV licence. As the Deputy knows, the Future of Media Commission recommended the use of Exchequer funding. There is a real difficulty with that because the use of Exchequer funding would mean that the Government of the day would control how much money goes to RTÉ and the public service media. I am looking across at somebody who might be the Taoiseach in the next Government, who is currently suing RTÉ and who would have a huge conflict of interests.

Deputy Mary Lou McDonald

I am looking across at members of Government too, and the picture is not pretty.

The Taoiseach

There are people behind her who have sued RTÉ and taken a lot of money out of it, which is ultimately taxpayers' money,as the Deputy has pointed out.

(Interruptions).

The Taoiseach

That is a real concern. We see all over the western world democracies being undermined by governments that want to control the purse strings around the media. I would be really concerned if we were to go down that route.

Deputy Mary Lou McDonald

The Taoiseach is concerned about my influence.

The Taoiseach

Yes.

Deputy Mary Lou McDonald

I suggest that he should be concerned about many things other than that.

Deputy Holly Cairns

I was very saddened to hear of the passing of Michael O'Regan at the weekend. He had a huge love of and interest in politics. On a personal level, he was also very warm, humorous and kind. I extend my condolences to his family, friends and colleagues.

The Children's Rights Alliance, in its annual report card, gave the Government a D-minus for family homelessness. Child homelessness has risen by 55% since this Government took office. We now have nearly 4,000 children growing up in emergency accommodation. There has been a 20% increase in family homelessness in the past year alone. How, four years into the lifetime of this Government, are we still seeing so many lives devastated by homelessness? How is solving this crisis not the primary focus of the Government?

Homelessness has a hugely damaging impact on children's mental and physical health. This can last a lifetime. Children who are homeless are more likely to be bullied, are less likely to see their friends and are twice as likely to be hospitalised. Real and lasting damage is being done to more children every day, month and year. Instead of moving heaven and earth to end child homelessness, the Government withdrew one of the only measures to stop it. It lifted the no-fault eviction ban, knowing what the result would be, namely, more children evicted into homelessness. The Government did it anyway.

I ask the Taoiseach not to tell us that the Government cannot build homes overnight. We have been listening to Fine Gael say that for more than a decade now. When the Government's plan is not working, it needs to change it. First, however, it has to admit that it is not working.

When the Government will not even do that, is it any wonder that people are losing hope.

There are solutions that could be adopted tomorrow if the political will were there: a return of the no-fault eviction ban, a rent freeze and a tax on vacancy that has real teeth. Houses should not be lying idle in the middle of this housing disaster, but they are, all across the country. Instead of solutions to this crisis all we get is constant spin. The Taoiseach says we have turned a corner and we have exceeded our targets. Simultaneously, the Government has failed to meet its social and affordable housing targets every year since it took office. That is the reality. We do not yet know the complete figures for 2023, but the Government had only reached 29% of its social housing targets by September, so it is not looking good.

Did the Government meet its social and affordable housing targets last year? Is there any level of child homelessness that would prompt the Taoiseach to reintroduce the ban on no-fault evictions?

The Taoiseach

The Deputy started the question by referring to the annual report card on Government performance that the Children's Rights Alliance produces. This is an independent body and issues its report card every year. It might be useful for people to know that of the 16 measures the Children's Rights Alliance rates the Government on, our grades are up in four, the same in 12 and not down in any category. It is important to put that fact before the House. The impression the Deputy created would have somebody outside believing that we got a fail grade, which would be dishonest politics. What is here in front of me is not something I am delighted about, but the fact is, of the 16 measures the Children's Rights Alliance looks at, our grades are up in four, the same in 12 and have not gone down in any.

In reform of the childcare system, we have gone from a B to an A. When it comes to the free schoolbook scheme, we have gone from a B to an A. When it comes to children in special education getting an appropriate place, we have gone from a C to a B. When it comes to addressing food poverty in children, we have gone from a C to a B. Overall, looking at it objectively, it is a story of progress, not a story of going backwards. This is not my view. That is the view of the Children's Rights Alliance. As I am sure that group would say, it is not enough and not soon enough and we need to do more. Obviously, I take that on board and agree that we need to do more.

On the issue of child homelessness, as we all know, there are many drivers of homelessness in our society. From the Deputy's question, one would be led to believe that the main cause of homelessness is people being evicted from private rented accommodation. That would be misleading because it is not the case. The main cause of homelessness in Ireland, unfortunately, is family breakdown. No matter who is in government, it is very hard to reduce the number of families that are breaking down at any given time. This happens for all sorts of different reasons. There is also an increasing spillover from migration as well. More than 40% of people now in emergency accommodation are not Irish citizens. This is also something that is not particularly under our control.

Where homelessness occurs, our objective is to make sure it is rare, short lived and is not repeated. We do our best to make sure that if anybody experiences homelessness, it is for less than a few months. In many cases it is less than six months, and in most cases, less than a year. That being said, I appreciate that a few months can be a very long time in a child's life and can stick with them forever. This is why we are redoubling our efforts to reduce family homelessness. We have increased resources for prevention in particular, which is really important, and we are ramping up the amount of social housing being built. More was built last year than any year since the 1970s, before either the Deputy or I were born. We will build even more this year. We do not have the exact numbers for last year yet but we should have them in the next few weeks.

Deputy Holly Cairns

This is the kind of spin I am referring to when I say that people feel that sense of hopelessness, because the Taoiseach is talking about going from an A to a B in all of these different categories. As I said, child homelessness is up by 55% since this Government took office. This is the main figure that needs to be addressed.

On the eviction ban, in almost every single month since the Taoiseach has been in office, child homelessness has increased. The biggest decreases we saw were while the eviction ban was in place. They are the facts and the ban was lifted anyway.

If we look at the numbers for the six months prior to the eviction ban, child homelessness increased by 14.9% and during the eviction ban, child homeless decreased by 0.6%.

A large part of the problem in respect of housing is that the targets have set us up for failure. For a start, they are too low and then the Government is failing to meet them. They are nowhere near what we need to meet demand. According to the leak to The Irish Times, the Housing Commission report states that Ireland needs between 42,000 and 62,000 homes each year. The Minister has had this report since November 2022. Is the Government going to publish that report? I will stick with the one question to try to get an answer to it.

The Taoiseach

I thank the Deputy. It is a little bit of stretch for her to accuse me of spin when she is quite the Social Democrat spinmeister herself. She is the one who brought up the Children's Rights Alliance report, not me, and she did not acknowledge that of the 16 areas under which it assesses us, our grades are up in four and down in none. Of the 16 areas, there are no fail grades but there is one area in which we are deemed unacceptable. That relates to children in adult psychiatric institutions-----

Deputy Gary Gannon

That is okay, so.

The Taoiseach

-----and we absolutely take on board that criticism. In terms of a date for the report, I do not have it but I will check with the Minister, Deputy Ryan, and come back to the Deputy as soon as I can.

Deputy Peter Fitzpatrick

As the Taoiseach knows, a thrombectomy is a surgery to remove a blood clot from an artery or a vein. The procedure can restore bloodflow to vital organs, such as legs, arms, intestines, kidneys, brain or other vital organs. A thrombectomy can also greatly reduce the risk of death or permanent disablement if performed properly. A thrombectomy must be preformed within a matter of hours to prevent life- or limb-threatening complications from occurring. Not all blood clots require intervention. Considering its impact on patients, it would make perfect sense to fund this procedure.

According to the Irish Heart Foundation, most stroke patients will die or suffer severe disabilities if the plug is pulled on a pledge to fund these vital stroke services. This warning comes after the Health Service Executive has done a u-turn on promises for funding to the national stroke strategy, thereby restricting life-saving services, such as thrombectomies, while also increasing the risk of the closures of stroke units.

The Minister for Health said last March that the stroke strategy would provide significant improvement in service delivery and would improve patient flow and efficiency in the delivery of stroke services. However, just months later, it was being defunded, a failure in the whole-of-life strategy that will cost lives without saving the health service a cent. The HSE has been allocated a considerable budget of €23.5 billion for 2024, representing an increase of 4.6% on last year's funding. Will the Taoiseach liaise with the Minister for Health to ensure that adequate funding is provided? It is very important that these services are saved.

The prediction up to 2035 is that strokes are going to increase by 60%. Some 25% of people will survive if they get the proper services. It is important that we invest in these people.

In respect of home care packages, there are many in hospitals who are looking to get rehabilitated but have nowhere to go. Carers are very important.

The Taoiseach, as a doctor, will know, as we all do, that prevention is the best cure. Perhaps I am getting a bit older but the number of people I see having strokes, day to day, is unbelievable. High cholesterol is one of the signs that is out there at the moment and it is very important that the Department of Health lets people know what the indications are. All I am saying is that we need the funding and services. The Taoiseach's Department rang me yesterday and I told his officials exactly what I was going to speak about today. A few weeks ago, I spoke about people having heart attacks. Your health is your wealth. What is the Government's plan, going forward, for the funding of services for strokes?

The Taoiseach

I thank the Deputy for raising the really important issue of stroke on Leaders' Questions. I know the topic has been raised previously but not for a long time. We all know the extent to which stroke affects people and their families. We know people who have died as a result of stroke, people who are surviving with the effects of stroke or who are at risk of stroke. We have a national stroke strategy, which runs to 2027. It aims to modernise and reform our services in line with the Sláintecare policy and to deal with the challenges facing Ireland from population aging and the predicted increase in the total number of strokes across Europe, including Ireland. We are fully committed to making improvements and advances in stroke services.

We have allocated more than €7 million to fund the strategy in the past two budgets. We are making real progress. The recently published Health at a Glance report shows 30-day mortality after admission to hospital for a stroke per 100 admissions for people aged 45 and over in 2021 stood at 6.3. That shows a decrease from 6.8 in 2019 and from 10.1 in 2011. To cut a long story short, a person is almost twice as likely to survive a stroke today than in 2011. That is considerable progress.

We now rank fifth best out of 18 EU member states. A comparison ranking for the same statistic over time shows we were ranked eighth best of the participating EU member states in 2016 and tenth best in 2011. Again, to cut a long story short, we have moved from tenth place to fifth place since 2011. Therefore, there has been very considerable progress in this regard. My particular thanks to all those involved in the stroke programme in primary care and our hospitals for making those very real improvements possible.

The expansion of the GP contract also includes opportunistic case finding of high blood pressure in those over 45 who hold a GMS or GP-visit card. The contract is now in place and the service commenced this year. Opportunistic case finding is one strand of the HSE’s chronic disease management programme and is for patients who GPs suspect may have an undiagnosed chronic disease or those at risk of developing one. High blood pressure is a key risk factor for developing a stroke, and this measure is a significant step towards the full implementation of the prevention pillar of the strategy.

On recruitment, funding for 25 staff was made available in budget 2023 for the recruitment of consultants, nurses and health and social care professionals to implement the strategy. To date, 12 have been recruited, including three consultants in our specialist acute stroke units and our endovascular thrombectomy services. A speech and language therapist has also been recruited, and a total of eight staff across a range of health and social care professions have been recruited to expand our early supported discharge team network, an evidence-based model of care proven to reduce hospital length of stay and provide more care in the community.

Deputy Peter Fitzpatrick

I thank the Taoiseach for his response. What I am asking is that we make sure we have the funding and services going forward. As the Minister for Health knows, Louth County Hospital has a very good stroke unit, and the people from the local area avail of it. My problem is that the prediction for the period up to 2025 is a 60% increase in strokes. Therefore, it is important that we invest more money. Twenty units are already under severe strain and there is talk of some places not having enough staff or funding. Therefore, it is important the Taoiseach consider the current situation.

The number of people I know who got a stroke in recent months is noteworthy. It is important that when they go to accident and emergency or elsewhere, they receive aftercare. The accident and emergency departments have been so overcrowded that it is very important that when a person presents with a suspected stroke, the right people are in the hospitals. The more stroke units and stroke staff, the better to assist people. Will the Taoiseach please ensure the funding and services go to the stroke units?

The Taoiseach

I thank the Deputy. I assure him absolutely that stroke care and treatment form an area in which we will continue to invest. We will invest more this year and indeed in the coming years.

Somebody who has a stroke today in Ireland is 40% more likely to survive it than in 2011. Since 2011, we have gone from tenth place to fifth place in the EU 18. This is one of the many areas where we see patient outcomes improving in Ireland and overtaking those in the rest of the European Union and, in particular, the United Kingdom. We still do not have enough patients accessing stroke care units, notwithstanding the number of additional units around the country. Our target is to have 90% of stroke patients treated in a stroke care unit. The rate is now sitting at about 70%, so there is a 20% gap between where we are and our target. We have to make sure we put the resources behind closing that gap, and we will.

Deputy Michael Healy-Rae

The matter I will raise is a matter of great concern to the Taoiseach, his Minister for Health and all his Government. Currently, St. John of God in Kerry supports adults and children with intellectual disabilities. The breakdown in Kerry is as follows: 230 adults with intellectual disabilities attend residential and day care services throughout County Kerry. They attend 16 day services with facilities in their own communities in towns such as Castleisland, Killorglin, Kenmare, Dingle, Listowel and Tralee. People also travel to attend a day service on the grounds of St. Mary of the Angels. There are also nine group home facilities across Tralee and Killorglin, a further ten apartments where people are supported to live in Tralee and an excellent St. Mary of the Angels facility in Beaufort, where 58 residents live. On services for intellectual disability, five adults attend a respite service in Listowel, 50 children attend respite in Listowel and Beaufort and there is an after-school service in Cahersiveen. In excess of 400 hardworking staff work in various facilities across County Kerry, supporting men, women and children and their families. This is a public service and it is incumbent on the Government to maintain it.

Given that St. John of God Community Services has served notice to transfer, what guarantee can be given to the service users, their families and the staff in those services that their services will be maintained in the current facilities and that staff employment will be secure into the future? This is important because these are the most vulnerable people in our society. These are the people we cherish and we want them to be minded and cared for. No one can say they were surprised, but since this announcement was made by St. John of God, I heard Ministers saying they were shocked. I would love to know what shocked them. We all knew that there was an ongoing dispute about budgeting and that the ongoing negotiations had broken down so I cannot understand how any Minister would be surprised by the announcement by St. John of God.

I do not want to get into an argument over St. John of God or the HSE funding. I do not want to blame the Government or anything like that. I want to hear a caring Taoiseach and a caring Government say that they are concerned about this announcement and that their priority is the service users and their moms, dads, siblings and grandparents, just as they are the priority of everyone in this House. The budget will have to be sorted out, of course, but our main aim is to protect these vulnerable people who have physical or intellectual disabilities. They are our priority.

The Taoiseach

I thank the Deputy for raising the important issue of the St. John of God Community Services and for contacting me about it during the week, as other Deputies did. Everyone here is aware there is a dispute between the HSE on one side and the board of St. John of God on the other. Both sides are putting their best foot forward and negotiating hard so that we can come to a resolution. What happens in that scenario is that service users and their families get caught in the middle. It has caused a huge amount of unnecessary anxiety and worry for service users and their families that should have been avoided. I regret that it was not avoided. I can give an assurance to service users and their families that whatever happens, the services will be protected, even if that means the HSE has to take them over. We would prefer that not to be the case and that we will be able to come to an agreement with St. John of God.

The chief executive of the HSE, Bernard Gloster, met the board of St. John of God on Sunday. Having listened to what its members had to say, he wrote to them yesterday, Monday, setting out the HSE funding that is currently available to the service and how any deficit or gap can be closed. On foot of that, he has asked them to withdraw their notice to quit the service and is awaiting a response. I echo the Deputy's comments. This should not be about the HSE, the board, the Government or politics. It should be about the service users and their families who are now being subjected to unnecessary worry and anxiety.

I am sure this can be resolved quickly between the HSE and the board of St. John of God but in the worst-case scenario, which I hope does not arise, the HSE can take over the services and we can say to them that no matter what happens, those services will continue.

Deputy Michael Healy-Rae

Having studied the financial situation and having got people who would be far better at finance than I am to look at it, this is a no-brainer because if we have to provide that service through the HSE, it will inevitably cost the State a lot more than it would cost to come to an agreement with St. John of God. I am not standing up here today advocating for St. John of God. I am advocating for the service users. The right thing to do is knock the heads of the HSE, the Government and those who hold the purse strings together. St. John of God is poised to be the best option to provide the service because it is giving it as it is. To allow for continuity of service and care, the right thing to do is to negotiate. Yes, we must negotiate as hard as we can because we are trying to protect the State's money but money should not be the priority. The service users should be the priority. I am very grateful for the Taoiseach's response but I plead with him to ensure that heads will be knocked together to give peace of mind to everybody involved.

The Taoiseach

The Deputy can be assured that along with the Minister, Deputy Donnelly, and the Minister of State, Deputy Rabbitte, I am working hard as Taoiseach to make sure this matter is resolved as soon as possible. As I mentioned earlier, the CEO of the HSE met with the board on Sunday. A proposal has been made to St. John of God that includes additional funding and a pathway to deal with legacy deficits incurred by the organisation. The HSE and St. John of God continue to work towards a positive resolution. The significant support on offer provides as pathway to financial stability and removes the need for the board to contemplate actions that could cause unnecessary distress for service users and their families. The HSE indicates that financial projections indicate that St. John of God Community Services will achieve a break-even position this year as it has done every since 2019 and we are, therefore, hopeful that a positive outcome can be achieved in the very near future.