Mary Lou McDonald
Question:1. Deputy Mary Lou McDonald asked the Taoiseach when the Cabinet committee on social affairs and public services will meet next. [7768/24]
Ceisteanna - Questions
Cabinet Committees
Mick Barry
Question:2. Deputy Mick Barry asked the Taoiseach when the Cabinet committee on social affairs and public services will next meet. [8205/24]
Marc Ó Cathasaigh
Question:3. Deputy Marc Ó Cathasaigh asked the Taoiseach when the Cabinet committee on social affairs and public services will next meet. [8696/24]
Pádraig O'Sullivan
Question:4. Deputy Pádraig O'Sullivan asked the Taoiseach when the Cabinet committee on social affairs and public services will meet next. [9013/24]
Paul McAuliffe
Question:5. Deputy Paul McAuliffe asked the Taoiseach when the Cabinet committee on social affairs and public services will meet next. [9022/24]
Richard Boyd Barrett
Question:6. Deputy Richard Boyd Barrett asked the Taoiseach when the Cabinet committee on social affairs and public services will meet next. [9317/24]
Paul Murphy
Question:7. Deputy Paul Murphy asked the Taoiseach when the Cabinet committee on social affairs and public services will meet next. [9320/24]
Bernard Durkan
Question:8. Deputy Bernard J. Durkan asked the Taoiseach when the Cabinet committee on social affairs and public services will meet next. [10386/24]
Tógfaidh mé Ceisteanna Uimh. 1 go 8, go huile, le chéile.
Déanann an coiste comh-aireachta um ghnóthaí sóisialta agus seirbhísí poiblí maoirsiú ar chur i bhfeidhm ghealltanais chlár an Rialtais i réimsí an bheartais shóisialaí agus seirbhísí poiblí. Clúdaíonn an coiste raon ábhar le béim áirithe ar chomhionannas agus athchóiriú an tseirbhís phoiblí. Mar aon leis sin, tá coiste comh-aireachta ar an bhfreagairt dhaonnúil don Úcráin. Déanann sé maoirsiú ar fhreagairt dhaonnúil an Rialtais do dhaoine ón Úcráin a bhfuil cosaint shealadach á lorg acu anseo.
Other topics covered by Cabinet committee on social affairs and public services include sport, social protection, arts and culture. It also covers justice issues, including policing reform, community safety, and domestic sexual and gender-based violence. The committee met on six occasions last year. Among other items the committee discussed were the proposed referendums on gender equality and implementation of the third domestic sexual and gender-based violence strategy. The Cabinet committee on social affairs and public services last met on 20 November and will meet shortly in the period ahead.
In addition to meetings of the Cabinet I have regular engagements with Ministers at Cabinet and individually to discuss issues relating to their Departments.
There will be seven contributors who will have up to one minute each, starting with Deputy Ó Murchú.
I want to bring up the issue of John Molloy, whom I met with Councillor Pearse McGeough earlier today. John Molloy is the retained station officer in Dunleer fire station and, on 24 May, he turns 60 and will be forced to retire. The crew at Dunleer is at its minimum of five. There is no one who can replace him as fire station officer, so we are in a real predicament. Obviously, it has an impact on him. We know there is an ongoing interdepartmental review on this issue but we need some sort of stopgap solution to this. I will be honest, I have requested a Topical Issue debate on this and hope I will be selected for that. Given its particular importance, both for Mr. Molloy and the wider fire service in Louth and Dunleer, I ask that the Taoiseach would involve himself in trying to bring about a solution. There is an unfairness in the sense that assistant chiefs can be there until they are 70.
Last Sunday the fishing vessel, Ambitious, sank off the Galway coast, thankfully without loss of life. Four of the rescued crew were Ghanaian nationals who approached the International Transport Workers' Federation, ITF, for assistance. The documents provided to the ITF by these fishers showed they had been recruited illegally. They were bogusly given the impression they would be working on UK flagged vessels and were issued UK deckhands contracts promising €1,300 per month. This enabled them to receive a UK seafarers transit visa. However, once they landed in Belfast, they were put working illegally on an Irish flagged vessel. The ITF has reported these and other matters this morning to An Garda Síochána, the Workplace Relations Commission, the Marine Survey Office and the Marine Casualty Investigation Board. However, the vessel owner is attempting to send the four men back to Ghana in quick time before any of these authorities have an opportunity to hear of the men's ordeal. Does the Taoiseach support the call of the ITF that these fishers be permitted to remain in this State so that proper inquiries can be made?
Teastaíonn uaim labhairt leis an Taoiseach maidir leis an caighdeán uisce úir i dtuaisceart chathair Chorcaí. Le timpeall sé mhí anuas, ní féidir le daoine an t-uisce a úsáid le haghaidh iad féin a ghlanadh, chun a gcuid éadaí a ghlanadh nó chun é a ól. I would like to raise with the Taoiseach the issue of water quality on the north side of Cork city, particularly areas right across Ballyvolane, Dillon's Cross, St. Luke's and over towards Blackpool into Deputy Barry's turf.
It is all my turf though.
The Deputy has a bit wider than that, to be fair. People there cannot use the water for washing their clothes, washing themselves or for drinking. It is going on for months with little or no let-up, and in fact I would say things are getting worse. We all get the stock answers from Irish Water about how it is monitoring the situation, working as part of a water quality group, and thanking customers for their patience. However, it is a public service at the end of the day, and people need to have faith in the quality of water they are drinking. It is clear that they cannot drink this water and I urge the Taoiseach to engage with Irish Water to help improve the situation.
Cuirim ceist inniu faoi na rothair scrambler, and I am sure the Taoiseach welcomes the news that across north Dublin, 32 scrambler bikes have been seized following the recent changes in legislation, and the additional powers which that gives to gardaí. Along with the additional powers, it also places an onus to provide additional resources. I ask that the Taoiseach would ensure that the Government would continue to do that for gardaí to allow them to deliver further results. I also note the concerns where gardaí say that these bikes are being used in the sale of illegal drugs, and that not only are scramblers being used but also e-scooters, often by very young children. I thank the Taoiseach for his personal support with regard to the changes on scrambler bikes but I also ask for his continued support on this issue.
The Taoiseach said earlier that with regard to children with special needs, he is open to ideas in addressing the deficiency in services, supports and resources. I will give him one instance where he could intervene. I met this morning with Sallynoggin Killiney Educate Together National School, a school in existence for two years. It has two mainstream classes and one autism class. It has very well-trained and enthusiastic staff who have delivered this autism class. It has 25 people looking to get into that autism class for next year, and you can only have six in a class. It is ready to open a second autism class but the Department of Education's building unit has told the school there is no way it is getting a second class until it moves from the current temporary site to the permanent site in 2027 or 2028. That is crazy because the temporary building is set up to have a second floor with a second autism class. The National Council for Special Education, NCSE, has approved the second class but the Department of Education is saying, "No, we are not giving it to you". I ask the Taoiseach to intervene. This is siloed thinking and those children with autism will have nowhere to go if this second class is not provided.
I do not know if the Taoiseach knows the post office in The Square in Tallaght. It is extraordinarily busy whenever you go there, and it is more than just a post office. It is a community hub for many people, where workers are extremely helpful to those who are coming in, advising them on what to do and so on. Those workers, and those who use the service, are faced with that post office becoming what is known as a contract-run operation. In other words, it is effectively being privatised. The workers are not being given any say in the matter. They are being told that they can either go on working but not directly for An Post anymore or they can be redeployed elsewhere with no guarantee about where that would be in terms of how they are going to get to work, where they currently live and so on. There is no option of redundancy. The best thing here would be that these plans are withdrawn, that these people remain direct employees of An Post, and that the post office is not privatised. Would the Taoiseach agree?
In Celbridge, in my constituency, the local hotel is where refugees have been located for the past number of years. There had never been an incident but unfortunately there was an incident last week, which was totally unrelated to anything happening at the location, and was obviously done deliberately to cause trouble. I have received quite a number of calls from local people who are concerned about the proposal whereby the people located there at the moment have been told that the contract is up, that they must move on, and that they will be replaced by homeless people from Dublin. Both are very pressing issues and equally in need of compassionate response. Would it be possible to postpone the relocation until such time as an alternative accommodation is sourced, so that nobody is displaced in a way that is inconsistent with their needs?
I thank the Deputies for their questions.
Deputy Ó Murchú raised the issue of Mr. John Molloy in Dunleer. A decision was made by Government today to increase the retirement age for those in uniformed services to 62 but I am not 100% sure if that will apply in this gentleman's case or whether it will kick in in time for him. If the Deputy wants to pass me on some details, I can check that out. In principle, we decided today to raise the retirement age for uniformed services to 62, although for the Defence Forces it will be initially 60 rising to 62 because a change has to be made in legislation. Some of the others can be done by ministerial order.
Deputy Barry raised the very real and ongoing issues around the abuse of immigration law and employment law in the fishing industry. I do not know enough about the particular case to comment on it. It is the first I have heard about that case.
Deputy O'Sullivan raised the issue of water quality in the north side of Cork city. I am very much aware of the issue. It has been raised with me by Deputy Colm Burke as well, and the Tánaiste is aware of it too. I have not made direct contact with Irish Water about the situation but I will make inquiries. Perhaps that might prompt a better response than Deputy O'Sullivan has had to date. I will make sure that is done today.
I want to join with Deputy McAuliffe in welcoming the seizure of scramblers. The new laws were a long time coming but I was delighted to see them being used now that they are on the books. I agree that we need more gardaí, Garda staff and Garda reserves. I have to say that I am very encouraged by the fact that 6,000 people applied to join the Garda in the most recent recruitment campaign. That in itself will not turn into 6,000 gardaí but it is encouraging, and the increase in the retirement and entry ages means we will see fewer people leaving and more people joining. That will allow us to get to 14,500 gardaí by the end of the year, which is the target, and 15,000 by the end of next year.
On the issue that Deputy Boyd Barrett brought up regarding Sallynoggin Killiney Educate Together National School, I am glad to hear that it is willing to open a second class. There are some schools that will not. It is great to hear of a school that is willing to do so. I know many are and I will certainly make inquiries with the Minister of State, Deputy Madigan about that and see if there is anything we can do. There may be reasons I am not aware of but I will certainly make inquiries.
Deputy Murphy raised the issue of the post office in The Square in Tallaght, which I do know. I am advised by An Post that there will not be any diminution of service as it moves from direct labour to the franchise model. That is ultimately a matter for An Post rather than Government but I know the Minister of State, Deputy Chambers has met the CEO of An Post to discuss it, given some particular concerns around the loss of iconic buildings in New Ross, Roscommon and some other places.
Deputy Durkan raised the issue of Celbridge, and I am not familiar with the exact plans there but I will make some inquiries about it. Certainly, anyone being asked to move out of accommodation should be treated with respect and given some time to do so and find somewhere else appropriate. I am confident that will be done but I will ask my people to make further inquiries during the day.
National Economic and Social Council
Mary Lou McDonald
Question:9. Deputy Mary Lou McDonald asked the Taoiseach if he will report on the work of the National Economic and Social Council, a statutory agency operating under the aegis of his Department. [7770/24]
Marc Ó Cathasaigh
Question:10. Deputy Marc Ó Cathasaigh asked the Taoiseach if he will report on the work of the National Economic and Social Council, a statutory agency operating under the aegis of his Department. [8697/24]
Peadar Tóibín
Question:11. Deputy Peadar Tóibín asked the Taoiseach if he will report on the work of the National Economic and Social Council, a statutory agency operating under the aegis of his Department. [8796/24]
Brendan Smith
Question:12. Deputy Brendan Smith asked the Taoiseach if he will report on the work of the National Economic and Social Council, a statutory agency operating under the aegis of his Department. [9021/24]
Richard Boyd Barrett
Question:13. Deputy Richard Boyd Barrett asked the Taoiseach if he will report on the work of the National Economic and Social Council, a statutory agency operating under the aegis of his Department. [9318/24]
Paul Murphy
Question:14. Deputy Paul Murphy asked the Taoiseach if he will report on the work of the National Economic and Social Council, a statutory agency operating under the aegis of his Department. [9321/24]
Cian O'Callaghan
Question:15. Deputy Cian O'Callaghan asked the Taoiseach if he will report on the work of the National Economic and Social Council, a statutory agency operating under the aegis of his Department. [10349/24]
Ba mhaith liom Ceisteanna Uimh. 9 go 15, go huile, a thógáil le chéile.
Tugann an Chomhairle Náisiúnta Eacnamaíoch agus Shóisialta comhairle dom ar shaincheisteanna beartais straitéisigh a bhaineann le forbairt inbhuanaithe eacnamaíoch shóisialta agus chomhshaoil in Éirinn.
The National Economic and Social Council, NESC, advises me on strategic policy issues relating to sustainable economic, social and environmental development in Ireland. NESC is currently working on four main areas, the first is which is "A Thriving Ireland: Foundations and Actions". Throughout 2023 NESC engaged in a programme of activities to mark its establishment in 1973. The NESC at 50 programme, culminating in a conference at which I spoke in November to mark its 50th anniversary, focused on the question of how Ireland can thrive. In 2024, the council will produce a special publication to summarise and reflect the wide range of inputs and ideas discussed at the November conference. It is expected that its publication will be finalised in quarter 2 of 2024.
The second area of focus is on good jobs. The programme for Government outlines the need for a concerted policy focus on increasing the number of quality and sustainable jobs in the labour market. The Government has introduced a series of measures designed to improve employees' terms and conditions. This project examines job quality and the range of benefits it can provide for employees, enterprises and wider society. It is also explores what is meant by "good jobs" and the range of public and private sector actions needed to improve job quality. It is expected that the report will be published in quarter 2 of 2024.
The third area of focus is housing. NESC is currently examining options that will help to better realise affordable, integrated and sustainable residential development. It is expected that NESC will publish this work in quarter 2 of 2024.
The fourth area of focus is the just energy transition and the shared island initiative. In Government we are working hard to ensure that Ireland captures the full potential associated with cleaner energy. This NESC project will develop a shared vision and understanding of the role of clean energy and challenges and implications for the economy, society and environment. The project will focus on power and heat services of the energy system on an all-island basis. It will examine energy poverty, the changing relationship between households and the energy system, and the economic benefits and enterprise opportunities arising from investment in clean energy infrastructure. It is expected that this report will be completed in quarter 1 of 2025.
Three weeks ago many of us stood before the House and spoke of the truly historic events taking place in the North following the restoration of political institutions after an agonising delay. A nationalist has been named as First Minister in the Stormont Executive. This represents a watershed moment which presents unprecedented opportunities for progress on our island. . This is no more pronounced than in relation to dealing with climate change. Action on climate change provides a clear and urgent platform for ambitious all-island action and collaboration. Sinn Féin believes that action on climate change should not be grounded in punitive measures that produce deeply inequitable outcomes. Delivery on climate change will be key to achieving an energy-secure and independent Ireland as part of a just transition. This can only be achieved through effective co-ordination and collaboration North and South. We are not the only ones saying this. Many industry experts, including NESC, have urged the Government to do more to make this happen. What decisive action is the Taoiseach taking to further the development of an all-island response to the decarbonisation of our energy system? Will he prioritise a shared approach and work with our colleagues in the North to achieve this? We need to see action on this and we do not need to see more reports on the matter.
The comments in the British command paper prior to the restoration of the Northern Ireland Assembly, the Executive and the North-South Ministerial Council were particularly negative in regard to the all-Ireland economy. Regardless of what British public servants or politicians think, the all-Ireland economy exists, is growing and is being strengthened every day, thankfully, for the benefit of the people throughout this island.
To take one statistic, between 1998, the time of the signing of the Good Friday Agreement, and 2022, cross-Border trade in goods and services increased threefold to well in excess of €11 billion. I note that the figure for 2023 is higher again. We welcome that development because a particularly important element of cross-Border trade is its significance to small and medium-sized enterprises, SMEs. We all know that for many SMEs, their first export market is to the neighbouring jurisdiction, North to South and South to North. The Taoiseach has heard me speak in this House on many occasions about the importance of cross-Border trade for areas like Cavan, Monaghan, Fermanagh, Tyrone and Armagh. This area is thankfully particularly strong in the agrifood sector, construction products and engineering, and it also has a growing tourism industry.
I have mentioned this previously and I would like the Taoiseach's Department and NESC to have a look at it. I refer to the particular challenges and opportunities for the central Border region. We all know that the more densely populated urban centres on the Dublin-Belfast line will grow despite whatever economic challenges arise. We need to prepare and grasp the opportunities and deal with the challenges that will affect the central Border region area.
NESC has done a lot of work on housing in recent years. This fact featured very strongly in its 50th anniversary meeting, which the Taoiseach referred to. I want to raise with the Taoiseach again an area that needs to be examined; namely, the significant and growing deficit in the delivery of three- and four-bedroom homes. I want to update our conversation on this. The Taoiseach said that there are figures to show that the big need is for one- and two-bedroom homes. Certainly there is a big need for one- and two bedroom homes. However, for the Taoiseach's information, in terms of housing need assessment in specific areas, those receiving housing assistance payment, HAP, are not being counted in the figures for housing need because they are on transferred lists. Huge numbers of those people are in larger families, many of whom are ending up homeless in emergency accommodation. We are seeing child and family homelessness growing. Developers do not want to build three- and four-bedroom houses because they can make more profit from one- and two- bedroom houses. We need to do something about this. Even when there is some uptick, albeit not enough, in the delivery in housing - mostly apartments - generally not enough three- and four- bedroom homes are being delivered. We are seeing people being made homeless or couch surfing in all sorts of deplorable situations. I urge the Taoiseach to look at this. Obviously we directly have to deliver more three- and four-bedroom houses in public and affordable housing developments. However, we also need to insist that developers deliver more three- and four-bedroom homes as well.
I want to raise again the huge hikes in childcare fees happening in crèches. Management personnel in many crèches are saying that they cannot afford to stay in the core funding programme any more, and are massively hiking their prices as a result. I have spoken to the Taoiseach previously about Chuckleberries crèche in Firhouse, where fees are being increased by an incredible 35%, which many families are simply not able to afford. From the moment the price increases, they will not be able to stay there. I received an email from someone who said that if this childcare funding issue is not addressed, she "could be left with no option but to leave the workforce and resort to being [a] full-time stay at home mother". Another parent notes:
The 35% increase will result in my childcare increasing by €4877 annually from September 2024, whereas the NCS increase to €2.14 should have provided a €1600 reduction.
The Government has an ambition to reduce childcare prices by half by 2024, but the reality is that many families are facing the opposite - massive fee increases. Does this not prove the failure of the privatised model? We have free, State-provided primary education. Why do we not have free, State-provided childcare and early years education? More immediately, what will the State and the Department do to intervene in the areas where this is happening to ensure that parents actually have somewhat affordable childcare to go to?
I thank the Deputies for their contributions. Deputy Ó Murchú raised the issue of climate action. We are making measurable progress on climate. Emissions are falling and we expect them to fall again this year. This is against the backdrop of a growing economy and increasing population. Our per capita emissions have fallen considerably in the last 20 years, but they are still not falling fast enough. In terms of what we can do on climate when it comes to all-Ireland co-operation, one area is transport. The investment in EV charging across the island is of benefit to all of us.
The decision to go to an hourly service on the Dublin-Belfast rail line is another example of such a benefit. The implementation of aspects of the all-Ireland rail review can be a benefit, too. The other area is electricity, where interconnection is so important, because we have a single grid with connections to France and Britain.
Deputy Brendan Smith spoke very eloquently on the all-island economy. I agree with him; it is real and it is growing. I do not think it should be seen as a threat to trade between Northern Ireland and Great Britain. It is not a case of either-or. Northern Ireland can increase its trade in both directions and with the wider world, in my view, and that is what we want to happen. The Deputy made a strong case for making sure that the central Border region is always on our agenda. We speak a lot about the north west, such as Derry and Donegal, and we speak a lot about the Dublin-Belfast economic corridor. It can be easy to forget about the huge region in between, which also has economic needs and potential.
Deputy Boyd Barrett mentioned housing and the deficit of three- and four-bedroom homes. I accept that there is a deficit of three- and four-bedroom homes in the country. There is a deficit in housing generally. The research and information show us that the greatest need and deficit is in one- and two-bedroom homes. That is a reflection of the fact that we have smaller households, many more single people and many more small families. When we make plans for housing, we should not just look at the developments that are in for planning; we have to look at the developments that are in for planning in the context of the neighbourhood and the area. There may be places where there are already many one- and two-bedroom apartments and it might make sense to have some more three- and four-bedroom homes there. There are also areas where proposals are in to build a lot of one- and two-bedroom apartments in a neighbourhood that is full of three- and four-bedroom homes. People need to look at the neighbourhood and not just the exact development that has been put forward.
Yes, but they are not counting the three- and four-bedroom homes.
On the issue of childcare fees, providers that are in the scheme have reduced their fees by approximately 25% and will reduce them by a further 25% in September. Providers that are outside the scheme are different because we do not control their fees. Even if we had a fully State-run system, I imagine there would still be private crèches and private childcare providers, unless one made them illegal, which I do not think anyone is proposing. I do not have a proper read on the number of childcare providers that are pulling out of the scheme. That is something on which I will have to make inquiries to the Minister, Deputy O'Gorman. It might be a very small number, in which case it would be one type of problem. If it is a very large number, it would be a very different problem.
Cabinet Committees
Alan Dillon
Question:16. Deputy Alan Dillon asked the Taoiseach when the Cabinet committee on health will next meet. [7873/24]
Peadar Tóibín
Question:17. Deputy Peadar Tóibín asked the Taoiseach when the Cabinet committee on health will next meet. [8795/24]
Pádraig O'Sullivan
Question:18. Deputy Pádraig O'Sullivan asked the Taoiseach when the Cabinet committee on health will next meet. [9014/24]
Paul McAuliffe
Question:19. Deputy Paul McAuliffe asked the Taoiseach when the Cabinet committee on health will next meet. [9023/24]
Richard Boyd Barrett
Question:20. Deputy Richard Boyd Barrett asked the Taoiseach when the Cabinet committee on health will next meet. [9319/24]
Paul Murphy
Question:21. Deputy Paul Murphy asked the Taoiseach when the Cabinet committee on health will next meet. [9322/24]
I propose to take Questions Nos. 16 to 21, inclusive, together.
The Cabinet committee on health last met on 12 February 2024 and is due to meet again shortly. Déanann an coiste comh-aireachta ar shláinte maoirseacht ar ghealltanais i gclár an Rialtais a bhaineann le sláinte agus faigheann sé tuarascálacha mionsonraithe ar réimsí beartais aitheanta. Déanann sé breathnú ar dhul chun cinn athchóirithe sláinte lena n-áirítear Sláintecare agus an t-athchóiriú ar sheirbhísí míchumais. Coinníonn an coiste comh-aireachta forléargas ar shláinte an phobail chomh maith. In addition to the meetings of the full Cabinet and Cabinet committees, I meet Ministers on an individual basis to focus on different issues. I meet regularly with the Minister for Health to discuss progress and challenges in the area of health, including the Sláintecare reform programme. Sláintecare is happening with the support and the oversight of the Department of the Taoiseach through the Cabinet committee on health. It is about four main things: making healthcare more affordable; making healthcare more accessible; ensuring better outcomes for patients; and reforming our health service, with a particular focus on integration and IT.
We are committed to expanding the core capacity of our acute hospitals, with more health professionals and more acute hospital beds. We have added more than 1,000 beds since 2020. We have increased the total public health sector workforce by more than 26,000 since the beginning of 2020, which includes 8,000 nurses and midwives, 4,000 extra social care professionals and more than 2,900 extra doctors and dentists, including more than 1,000 extra consultants.
There is a strong pipeline of capital projects, including several new hospitals and significant new facilities for existing hospitals. Our multi-annual approach to waiting lists resulted in an overall reduction of 27% in the number of patients waiting more than ten to 12 weeks to see a specialist or to have an operation, since waiting lists peaked after the pandemic. Waiting lists fell last year for the second year in a row and we are determined to make sure this is the third year in a row in which waiting lists fall.
The figures that matter most are regarding those who are waiting longer than ten to 12 weeks, as recommended in the 2017 Sláintecare report. The core target of achieving a 10% reduction in the number of patients breaching the Sláintecare waiting times was exceeded, with an 11% reduction achieved. The enhanced community care programme continues to improve healthcare at a more local level and alleviate pressure on hospitals. The majority of community healthcare networks, community intervention teams and community support teams are now in place and are providing care closer to home.
We are also making healthcare more affordable, at a time when the cost-of-living crisis is affecting everyone, through the removal of hospital inpatient charges, widened eligibility for the GP card and a reduced drug payment scheme threshold, among other things. Tá níos mó ná €22.8 billiún leithdháilte againn do sheirbhísí sláinte in 2024, rud a éascóidh soláthar agus leathnú leanúnach seirbhísí cúram sláinte inacmhainne agus den scoth. Ina theannta sin, tá maoiniú suntasach á infheistiú chomh maith sna seirbhísí míchumais.
Budget 2024 provides funding of hundreds of millions of euro for waiting lists; action on urgent and emergency care; investments in our workforce such as advanced practice, more college and training places and more hospital consultants; the first full-year programme of publicly funded assisted human reproduction services including IVF; further expansion of the free contraception scheme; additional staffing for CAMHS; €20 million for residential placements for children and adults; €15 million for provision of respite services; nearly €20 million for day services; €8.5 million for children's services, including new therapists; and €11.9 million for other developments, including increased PA hours for people with disabilities.
Our health and social care service has enormous challenges, but our systems are responding and have expanded dramatically in recent years. We are treating more people with better outcomes than ever before. Ireland has the highest self-perceived health status in the EU, with 80% of people rating their health as “good” or “very good”. Our life expectancy is continuing to increase and is above international averages. We are among a small group of countries where life expectancy is above 82. We continue to reduce mortality rates for stroke and certain cancers and are reporting positive trends in preventative health. Our standardised mortality rates have declined for all causes over the past decade by 10.3%.
There are seven contributors who will have one minute each.
I want to raise my concerns in relation to children’s disability network team, CDNT, services in County Mayo. Parents of children with disabilities are in a constant fight to access services, often resorting to private care, which is sometimes oversubscribed to avoid long waiting lists in the public system. The waiting lists continue to grow in Mayo at a pace with which the HSE clearly cannot cope. Children are being left behind when early intervention is of critical importance.
The Minister of State, Deputy Rabbitte, who has responsibility in the area of disability, acknowledges that the Progressing Disability Services for Children and Young People programme is not working. She is trying very hard to fix it and I commend her on that. However, the problem lies not with the disability services, but with accessibility to those services. Our CDNTs are primarily run with a shortage of staff; there is a job vacancy rate of over 25% across the country and of 27% in Mayo. The HSE has continuously stated it is exploring all options available to it to tackle the waiting times. However, it believes that significant population growth has led to an increase in waiting times. Can the Taoiseach confirm what options the HSE is exploring? Has the capacity been evaluated within our private sector? I urge the Government to consider reimbursing patients who have had to pay private practitioners to access services for children with special needs.
It will be of no surprise to the Taoiseach that I will raise the issue of rare diseases again this week. Let us bear in mind that Rare Disease Day was last week. I would like to raise the issue of the Mazars report, which is due to be published shortly. We have spoken about it before and I welcome its publication, but the reality is that the report will not meaningfully reduce the times for which people are waiting for the approval of an orphan drug. When this Government took office, there was an average of more than 900 days for a drug to be approved through the HTA process. When this Government finishes office, which will be any time between now and next year, that approval process will still take more than 900 days. I met a young girl last week who was on her way to the health committee with her mother.
She suffers with epidermolysis bullosa, EB. She was before the committee with Debra Ireland. There is a pharma company promoting the fact that it is ready to go through the HTA process right now with a drug it has developed. I found it very difficult to explain to her mother that the child is going to be waiting 900 days. That is four hours every morning changing her bandages in agony for the next 900 days while they wait for the drug in question to be approved. I urge the Taoiseach to do his best in terms of the Mazars report.
I am also very familiar with the work of Debra Ireland. The HTA process is not just protracted, as Deputy O'Sullivan points out. In 2011, I authored the Irish Platform for Patients Organisations report, which referred to a black hole in decision-making at the end of the process. We have to find a way of striking a balance between value for the taxpayer, which we should pursue without continuously saying "Yes" to pharma companies, and not resorting to patients having to advocate in the way that we do. We have to have a more humane version of the HTA process. The drugs that are put through that process have to be more available to patients while, at the same time, we seek to secure the best value for money for the taxpayer.
An often undervalued and ignored group of workers in our health service are the housekeepers and cleaners without whom our hospitals would not be able to function. As we learned during the pandemic, the need for infection control means that this is a job whereby people have to have many skills, a great deal of training, etc., in order to get things right. I raised this matter with the Taoiseach previously. In the past couple of days, the housekeepers have engaged in a campaign with their union, the Independent Workers Union, over the fact that they have been refused a change in the aftermath of the job evaluation scheme. They have been left on the same band they were on previously and have been denied the right to appeal a decision by the HSE over properly evaluating their work and giving them the value they deserve. They should at least have the right to appeal this decision over their job evaluation, which the HSE is currently denying them. I ask the Taoiseach to intervene with the Minister for Health on their behalf.
I want to ask about a pretty pressing issue for underfunded community drugs projects, namely, the extortionate cost of insurance. I will give a couple of examples from Tallaght to show just what an impact this is having. One project was paying €2,500 six years ago for insurance. That increased to just over €6,000 three years ago. For 2023, the insurance company wanted €21,000. There were no claims against the project and the insurance company blamed the increase on medical malpractice insurance attached to the harm reduction clinic. There were no needle stick injury claims made in Tallaght or in the context of any community programme. In order to get the insurance, in the end they had to suspend the needle exchange service and point clients elsewhere. Another programme got a staggering €7,000 increase on its premium, again having not submitted any claims. I tabled a parliamentary question to the Minister of State, Deputy Naughton, in respect of this matter. I received the regular reply about funding, the level of which is completely inadequate. We need action on this issue.
I still have three contributors. An Teachta Ó Murchú is next.
I brought up an issue that was brought to me by Alison McCabe and was also raised on "Liveline", that of post-mastectomy products for women who have been through breast cancer and mastectomy. There was a plan involving reducing the funding for the scheme. I brought the decision in that regard to the attention of the Taoiseach and the Minister, Deputy Stephen Donnelly, and it was reversed, which is very welcome. However, Alison McCabe has since been back on to me. There are a number of issues which still need to be addressed. There is a proposal about the paper applications that were made previously by the fitters such as Alison. They say that hey are happy to do this and that the women do not need the added stress. They are also talking about the first fitting being in acute hospital settings, sometimes where the women would have had surgery. I do not think that is a particularly good idea. There is also a disparity between certain areas in how much somebody gets for the funding scheme. We need to look at it. The Minister, Deputy Donnelly, stated that this should happen regardless of medical card status and----
I am sorry for interrupting, but we are way over time.
I want to ask about Government and State neglect of the health needs of people with eating disorders. This issue was highlighted on Saturday, with protests taking place in Cork, Limerick and Dublin. Despite the fact that the HSE identifies eating disorders as resulting in the highest morbidity and mortality within the mental health sector, there are only three beds for adults with eating disorders provided within the State's public health system. I asked the young people in Cork who organised the protest last Saturday what their demands were. They explained that they have four demands, namely: counselling to be available in every region; more inpatient beds; more education for carers; and more accurate statistics. It is not known how many people in the State suffer from eating disorders. I would like the Taoiseach to comment on those four demands.
I would like to speak about the children's disability network teams, CDNTs, in Carlow. The biggest issue I have had for the past few months is the lack of occupational therapists and speech and language therapists. For children who are on the waiting list, there is no one to assess them. Children who should be going into classrooms in September do not have school places because they have not been assessed. They and their parents do not know where they are going to go to school. There are major issues in this regard. It is the same with ASD classes. I have been approached by many schools that are trying to get these classes. There are serious issues within the Department. There are waiting lists. I beg the Taoiseach - this is going to become a crisis if we do not get more speech and language therapists and occupational therapists. We need to build more ASD classrooms as a matter of urgency.
I am conscious that quite a number of Deputies raised CAMHS and also CDNTs. I do not information broken down to local or county level. CAMHS receives dedicated funding of approximately €146 million annually, and €110 million of that has been provided to community-based mental health organisations and NGOs this year. A further €10 million was announced in January for mental health, including the clinical programmes and youth mental health. In collaboration with local CAMHS services, a waiting list initiative specifically focused on children and young people who have waited longer than nine months is under way in six areas. The HSE is also receiving funding under the Sláintecare integration and innovation fund to progress a multiphase quality improvement project to manage CAMHS waiting lists. For the first time in the history of the State, we now have a dedicated national office for youth mental health which will provide leadership, operational oversight and management of all service provision and improvements. Both a new HSE national clinical lead for youth mental health and a new assistant national director for child and youth mental health recently took up their posts. Immediate priorities are to improve access to CAMHS and reduce waiting lists.
On CAMHS and therapists, a matter that Deputy Dillon raised specifically, our understanding is that private sector capacity does exist but it is quite limited. Community healthcare organisations can use private sector therapists for those waiting the longest, ensuring they are prioritised.
I acknowledge the difficulty in meeting the demand for children's disability services. We are very much aware of how this impacts on children and their families. The progressing disability services, PDS, roadmap for service improvement was launched last year. This is a targeted service improvement programme to achieve quality, accessible, equitable and timely services for children with complex needs.
On recruitment and retention, in January, the HSE, working with lead agencies, launched a high-profile recruitment campaign for dieticians, occupational therapists, physiotherapists, psychologists, social workers and speech and language therapists. The campaign recently closed and approximately 495 applications were received. Interviews are due to begin in the coming months. Other initiatives include student sponsorship programmes, therapy assistants to help professionals in providing services, and also marketing CDNTs as a workplace of choice and a good place to work.
I again acknowledge Deputies O'Sullivan and McAuliffe for raising issues around rare diseases and orphan medicines. I am not familiar with the particular medicine relating to EB, but I will look into the matter and come back to the Deputies directly.
As Deputy Boyd Barrett said, housekeepers and cleaners do essential work in our hospitals, especially in the context of infection control. I am not familiar with the issue of the appeal on the job specification. If the Deputy passes on some more information to me, I will make sure he gets a proper reply. I am advised that the average business or average community service pays less than €5,000 per year for insurance, but that varies from business to business, from service to service and from risk to risk. It can depend on the different circumstances that may arise.
On the important issue Deputy Ó Murchú raised, I am glad that the decision to restrict some of the services and payments was reversed quickly, certainly once the political system became aware of it. However, I will pass on what he said to the Minister, Deputy Donnelly. The idea is to standardise what is provided. Standardisation is good, but it has to be done correctly. All of us in the House would take the view that if we are standardising such a provision, it should be standardised upwards and not to the average of whatever is provided.
Deputy Barry raised the really important issue of eating disorders, which are far too common and for which the services are far too sparse. From what he said, the four demands seem reasonable. It is easier said than done though, as is often the case, especially given the labour shortages we face. However, I will certainly take them up with the Minister, Deputy Donnelly, to see whether we can respond to them as soon as possible.