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Dáil Éireann debate -
Wednesday, 30 Apr 2025

Ceisteanna ó Cheannairí - Leaders' Questions

My understanding is that the audit into unnecessary hip surgeries carried out on children at CHI hospitals is now complete. Can the Taoiseach confirm for the Dáil that this is the case? If so, can he tell us when that audit will be published? When I raised this scandal of unnecessary hip displasia surgery on children with him four weeks ago, he was unable to shed any light on the matter. He gave me no further information and he certainly gave me no answers. So, a month on, I ask him again, how many children are caught up in this emerging scandal? Are we talking about hundreds or is it more? How many letters have been issued by CHI to parents? What was the reference period for the audit? Is it years or is it decades?

Every single day, our offices receive communication from parents in distress. They are left asking themselves the gut-wrenching questions, was my child one of those operated on unnecessarily, and what are the consequences of this for my child?

In the case of one parent who has been in touch, their child was only three when they had surgery. This is the first parent to tell me that they have now received clinical confirmation that their child did not need the operation performed on them at a CHI hospital three years ago. This parent has now been told by a surgeon, having reviewed the scans from three years ago, that their child's hips were fine. The surgeon says that they would not have performed the surgery. We need to let this sink in - clinical confirmation that this child's surgery was not needed. This parent is absolutely devastated. She told me that she cannot believe what has happened. She describes it as like a horror film. She asks why her child was diagnosed with a condition they did not have and why her child was put through the trauma of surgery if it was not needed. She just keeps asking herself why.

Another of the mothers who reached out after she received the letter tells us that her son had his left hip operated on in 2018 but was told his right hip was fine. He was called back, however, in 2021 and told that the right hip did in fact require surgery, despite displaying no issues. She took the medical advice. She describes this as a devastating decision. She tells us her son's life deteriorated dramatically following this operation. He now suffers serious health development complications and catastrophic consequences from the surgery. The mother is overwhelmed thinking that her child's surgery might not have been needed at all. We have also received confirmation from a parent who received a letter whose child had the surgery in 2010. That is 15 years ago. The child is now a 20-year-old adult. Does this scandal, this issue, go back that far?

Tá scannal na leanaí a ndearnadh obráid gan ghá orthu ag fás gach lá. Tá soiléiriú agus freagraí ag teastáil anois. Cé mhéad leanbh atá i gceist? We have one parent who has clinical confirmation that their child's surgery was not required, and this scandal and stress are growing by the day. It should be remembered that the Taoiseach's former health Minister, Stephen Donnelly, knew about this a year ago and yet he delayed and parents are dealing with this only now. They can no longer be left in the dark. They need answers; they are entitled to that. I ask him again about the reference period of the audit, how many children are affected, whether the audit is complete and when it will be published.

Ar dtús báire, aontaím go bhfuil sé seo an-phráinneach agus gur ábhar buartha é. Is olc an scéal é an rud atá ráite ag an Teachta McDonald. Is é an príomhrud ná go mbeidh an audit cuimsitheach agus go mbeidh sé againn chomh luath agus is féidir. At the outset, this situation is extremely serious and has necessitated an external audit. That is the first point. For any child to go through surgery is in and of itself a trauma. For parents it is also a trauma. If it emerges that children went through surgery that was not required in the first instance, that will not only be very traumatic in itself but a scandal. It is important we await the completion of the audit and its presentation to the Minister. I spoke to the Minister yesterday. She has not received any final draft or the completion of the audit. I have spoken to the Minister and she made that point to me. That then makes it very difficult all around, in terms of commenting in a piecemeal way or on an individual case or a case-by-case basis. I am not in a position to do that until the full, comprehensive audit is finalised, presented to the Minister and the Government and obviously shared with this House, as it will be.

The Deputy is correct that CHI and Cappagh hospital have issued letters in recent weeks to families who may have concerns to provide information and so forth but, ultimately, it is the completion of the report that is key here. I understand there may have been drafts or whatever published, in The Ditch or elsewhere. I do not know. I cannot speak about the provenance of that other than to say the sensible thing for us to do is to enable Mr. Thomas and facilitate them to complete the report as quickly as possible given the anxiety and concerns that are undoubtedly out there. It is accepted those concerns will be there for families whose children will have gone through this particular surgery over a significant period of time.

I understand the audit process is in its final stages. Feedback on the draft report has been received, I understand, by the expert author and is being reviewed. We simply have to assemble all the facts on a comprehensive basis, await the outcomes of the clinical audit and then decide on actions resulting from the outcome of that. The entirety of what took place needs to be understood and laid out fully and transparently. We would then follow through on actions that would be necessary.

There are multidisciplinary teams in place in these hospitals in terms of pre-operative decision-making right across CHI and Cappagh hospital. That process commenced from March onwards. The hospital authorities are obviously taking on board the concerns and so on. It was raised initially via a protected disclosure in September 2023 relating to different thresholds for surgery being applied in CHI and the national orthopaedic hospital in Cappagh. The Department was notified in 2024. The clinical audit, as the Deputy knows, is being conducted by Mr. Simon Thomas, consultant surgeon to the staff of the children’s orthopaedic unit at Bristol Royal Hospital for Children. We simply have to await the completion of that.

Thank you, Taoiseach.

I hope it will be sooner rather than later to help deal with the concerns and anxieties, but also to deal with the issue itself.

Tá an scéal go léir scannalach gan dabht. Tá sé scannalach freisin go bhfuil tuismitheoirí agus páistí fágtha gan freagraí. This thing has dragged on and on. As I said to the Taoiseach, his Minister knew a year ago. Families then received these letters and there is an audit under way. Then there is this unbearable, almost cruel waiting and waiting. I have spoken to a parent who has told me they have clinical confirmation the child underwent surgery that was not needed. That is one. I do not know whether there are more.

The Taoiseach says we have to wait for the process be completed. My information is that the audit is in fact completed. The Taoiseach told me four weeks ago, by the way, that this was in "its final stages". That is not good enough. It is not good enough to issue letters on something of this magnitude that Government knew about for a year and more and leave families in that position. That is unacceptable. Can I ask him again about information he does know or should know?

Thank you, Deputy.

He should clarify, please, the reference period of the audit, how many letters have been issued and how many children are affected. When will we see the audit?

It is regrettable the Deputy would seek to politicise the issue, as she is attempting to do. The first people who should always be contacted in a situation like this are the families who are affected. That is why correspondence goes from the authorities - in this case, the hospital authorities, that is, CHI - to the families. That is as it should be. They should not be hearing about it in a piecemeal way or whatever because, first and foremost, they need full transparency.

Second, the Deputy must know in her heart it would be unacceptable to try to release piecemeal and case by case in this case. The sensible thing to do is wait. It is frustrating that people have to wait, but we have to wait for the full audit. I know the Deputy is well aware of all this, but it does not suit in terms of the politics of it.

Have you spoken to the parents who are waiting?

The bottom line is that a draft report gets sent to all who have been involved.

How many letters issued?

The feedback has come back.

How many letters?

The audit will have all of that information available for everybody.

Thank you, Taoiseach. The time is up.

Does the Taoiseach know how many letters were issued?

That is the proper way to do this.

Last Friday, we learned 15,418 people were recorded as homeless in March, another shameful new high. Nearly 5,000 children are now growing up in Ireland without a home. Each homeless child is a tragedy. There are now 22 more children homeless than there were last month. This is a national scandal. It is the civil rights issue of our generation. As legislators, we must do all we can to see this housing disaster addressed. We must build affordable and social homes, protect renters and tackle vacancy and dereliction, but the Government is not doing enough of any of this.

The Taoiseach's party, Fianna Fáil, has held the housing brief for nearly five years. For most of that period, it has simply doubled down on failed Housing for All policies. More recently, it seems, the party is diversifying. It has not launched anything like the "radical" reset the Government's Housing Commission sought and that we in the Labour Party offered. Instead, Fianna Fáil has adopted a new strategy. It is a flying-by-the-seat-of-your-pants approach to housing, with a series of solo runs, none of them based on evidence. Let us take some examples. This year alone, the Government has said it might get rid of rent pressure zones and might give tax breaks to developers. It is flying kites and no one can keep track. We are trying to figure out what the Government is planning to do on housing. Even the junior coalition partner, Fine Gael, is being kept in the dark. Earlier this month, I think we all read with interest that Fine Gael councillors from Cork as well as Deputy Colm Burke had signed a cross-party letter to the housing Minister calling for urgent funding for the tenant in situ scheme to ensure it is effective to keep renters out of homelessness. Today, Fine Gael Councillor Tom O’Leary from Fingal told the Dublin Inquirer, "I just cannot get over that they didn’t maintain the same level of funding", wondering "Why would you mess with a successful scheme that keeps people from being scattered into the wind?". He is right. The Government's changes to this scheme will render it unworkable. We are hearing from councillors around the country that evictions from the private rented sector are driving the monthly increases in homelessness. With the Government's changes to the scheme, it seems it has given up on it. Has it given up on ending homelessness altogether?

Of course, there is another new policy, shrouded in secrecy so far and announced by the Minister, Deputy Browne, who said he was going to create a new housing "maverick", a fixer-in-chief. The Taoiseach does not like the name "tsar", and nor do I, with its Russian connotations, so he is calling it the new housing activation office. However, it is another new policy that is clearly putting Fine Gael noses out of joint, as the Tánaiste has made clear. It also comes at an extraordinary and unjustifiable price tag. Maybe the Russian name is appropriate because it is a price that might be approved of by a Russian oligarch, but it is not acceptable. What exactly is the housing activation office? What will it do? Will it be underpinned by legislation? All we have been told is it will put boots on the ground and co-ordinate delivery of housing. This is meaningless and already the job of the Minister for housing, the housing Department and the Land Development Agency.

Thank you, Deputy.

This move looks like nothing more than an exercise in the evasion of accountability. What will this body actually do?

I disagree fundamentally with Deputy Bacik's analysis in terms of housing policy more generally. Fianna Fáil and the previous Government did not double down on the policy of the last number of decades. The bottom line is, in 2023, for example, we saw the highest level of delivery of new build social housing since 1975. That is not doubling down on previous policies. It represents a step change in the building of social housing, which has happened over the past three to four years. The Deputy cannot deny that. We have higher targets but you simply cannot deny the fact that 48,000 new social homes is a step change from where we were before 2020. Whatever other hyperbole the Deputy will engage in, we have to deal in facts. The only agenda I as Taoiseach and the Government have is to build as many houses as we possibly can as fast as we can; that is it. I will do everything I can to make that happen across a number of fronts.

The Deputy said we ignored the Housing Commission. We did not but the Labour Party did. The Deputy made a false statement when she said I said we might get rid of RPZs. I never once used those words. Go and check it, please, find the quotation and come back to me. I said a review of RPZ was under way. Guess who suggested there should be a review of the RPZs - the Housing Commission. I knew when the Deputy feigned interest in the Housing Commission's report that she did not really mean it because if she looks at the chapter on the rental market, it criticises the Oireachtas for its approach. It makes clear that we should explore issues with RPZs and so on - not get rid of them but explore the matter - and give certainty to private sector investment. I have said we need private sector investment in addition to public sector investment. Public sector investment this year will certainly go to €7 billion. Others estimate we will need approximately €20 billion. The State cannot do it all. We need private sector investment. Deputy Bacik's party and others have rubbished institutional funds as a vehicle for private sector investment in the housing market. It simply is not credible or sustainable to suggest that the Labour Party has a credible housing policy if it rules that out as a funding option for housing. Yet, that is what the Labour Party, the Social Democrats and others are doing and have been for the past four to five years because it is populist. It is good short-termism but it will not build a house. We need all hands on deck in housing. We need to unblock barriers on the ground. The housing activation office is not a secret; it was in the programme for Government, which was published. There was no secret about it at all.

There is so much to challenge in what the Taoiseach just said, with respect. First, he cannot stand over his Government's figures on delivery of homes when it promised 40,000 homes last year and the actual delivery was 10,000 short, a shocking shortfall. It is utterly indefensible. No one, even in the Government or in Fianna Fáil, will stand over that figure.

Second, the Taoiseach said we would never get rid of the RPZs; I did not say he did.

I hear every day from renters in my constituency-----

Check the record.

-----who are desperately worried because of the review of RPZs announced by the Government. The reason is there are so few homes available to rent. If they cannot afford to pay their rent any longer, they have nowhere else to go. It comes back to delivery of homes. The Government is ignoring the crucial recommendation of the Housing Commission that the Government should introduce a radical reset of housing policy. We in the Labour Party called for the State take a far more active role in direct delivery-----

Thank you, Deputy.

-----of homes through the Land Development Agency, ramped up-----

Thank you. Deputy. Your time is up.

-----to provide State-built homes, as was done in the seventies, which the Taoiseach keeps referring to as the golden age of house building.

In the past three or four years, the then Government, and the Fianna Fáil Minister, Deputy Darragh O'Brien, gave power and resources to the Land Development Agency. Its work is under way.

He promised 40,000 homes.

The Land Development Agency will get more equity and support to build more houses. That will happen but that is not the full story. We have to do much more. The bottom line is we have made a step change in the past three years. From approximately 20,000 houses built in 2019, we are now building approximately 30,000 plus. Housing for All targets were exceeded but everybody said they were not high enough.

You said they were not high enough.

Now, we need to get to 50,000, which the ESRI said. The real challenge for the Opposition and the Government is how to go from 30,000 to 50,000. We will not get there with the populist, popular soundbites I hear every week we come into Dáil Éireann. That will not build 50,000 houses. We need real solutions that can deliver. The Government will do everything it can across all aspects to get solutions. I am not interested in the short-termism-----

Thank you, Taoiseach.

-----that passes in here for housing debate all the time. I am interested in getting real solutions and getting to the 50,000 per annum we need.

Taoiseach, time is up.

Yesterday, the Social Democrats put forward a real solution to increase the finance available to build affordable homes. I hope the Taoiseach will look at that seriously. Not content with creating a new €430,000 post for the housing czar, this Government now wants to increase pay for senior executives in semi-State organisations. Yesterday, the Minister, Deputy Chambers, announced plans to change rules, which will see salaries soar. The heads of 30 semi-State bodies, from Horse Racing Ireland to RTÉ, are now potentially in line for massive increases. This is despite the fact that these CEOs received a combined €75 million in pay and perks over ten years, according to Village magazine.

Strangely, even though I carefully studied the Minister's statement yesterday, I did not see any reference to economic headwinds, tariffs or global volatility. When it comes to gold-plated salaries for those at the top, it seems these concerns are not worth mentioning. Compare that with how people on low pay are treated and the Government's shameful decision to postpone the introduction of a living wage. Improvement in sick leave for ordinary workers has also been put on the chopping block. In a triple whammy, plans to introduce pension auto-enrolment have also been kicked down the road yet again.

While all across the county people are struggling to make ends meet, keep their homes heated, rent paid and bills from piling up, this Government has mounted a despicable attack on low-paid workers. People should be able to live a full and dignified life and not just scrape by day to day. How can someone on the minimum wage afford housing costs that are more than double the EU average? How can they afford bills that have increased by 80% since Russian invaded Ukraine? How are they supposed to put food on the table when prices for goods and services are 42% higher than in other European countries? The cost of living is skyrocketing and the Government expects people to get by on €13.50 an hour. Why does this Government believe those at the top deserve bumper salary increases while low-paid workers are thrown under the bus? How can the Government justify this to low-paid workers struggling to keep a roof over their heads and food on the table?

Over the past three to four years, significant improvements were made to the minimum wage, workers' rights and sick leave pay. In 2022, for the first time, a statutory right was given to employer paid sick leave in the sick leave Act. The Deputy made the exaggerated comment that we are engaging in despicable action against workers. Sick leave has gone from three to five days. That was introduced in January 2024. The minimum wage has been increasing significantly over the past number of years as a result of Government decisions. It will continue to increase. To net out two issues, we decided to delay going from five to seven days and on the minimum wage, there is a delay in respect of matching the living wage. It will be a matter for Low Pay Commission to determine the increase. Those are the only two issues. The Deputy created a narrative around them that somehow there is an enormous undermining of workers' rights about to take place, which is not true.

The Deputy mentioned auto-enrolment.

Is he honestly saying that delaying auto-enrolment from September to January is a trampling of someone's rights? We spent years putting it together. The two main parties in government spent the past three to four years building up what was a very substantive programme in terms of getting auto-enrolment ready.

In the context of the logistics involved, the payroll providers and so on, the view was that it should start with the tax year in January as opposed to in September. That is all. Let us not pretend that this is some massive undermining of workers' rights or anything like that. I am a complete convert to the idea of auto-enrolment. Sorry, I am not a convert; I am a believer. I passionately believe in it, and 800,000 workers will benefit from it. We are going full steam ahead with it as a government. Probably the most significant thing we will do for workers in this generation is auto-enrolment. It has been talked about for 30-odd years, and we are going to do it.

The Deputy understands the context as well because he and his party fought the recent general election. Members on that side came into the House talking about the retail industry, which could not deal with the cumulative costs. Those involved blamed the Government. They had a point, because we did increase costs through improving rights for workers and other things. Many retail and many hospitality SMEs said that the cumulative impact of all of that was damaging both employment and their capacity to continue. We had people in this House talking about the closure of restaurants, etc.

It is always about striking a balance in terms of how fast we go with progressive improvements. We did bring in the pay-related jobseeker's benefit scheme, which is a significant improvement on anything that we had for the past two or three decades. That is a significant additional right for workers and is well deserved.

A living wage is not just good for low-paid workers, it is also good for the local economy. Money that is put in the pocket of workers gets spent in the local economy and boosts local businesses and jobs. There is a very strong economic case for it. Can the Taoiseach not see that it is an absolute kick in the teeth for people on low pay to hear about Government proposals to increase pay for those at the top while excuses relating to tariffs, global headwinds and economic conditions are cited when it comes to delaying promises for low-paid workers in respect of the living wage? Can he not see that this puts people under huge pressure to see that double standard in terms of the talk the Government comes out with? Will the Government reconsider its position-----

-----on the living wage. Will it bring forward the living wage, as it has promised? Why can the Government do it for top-paid workers but not for people on low pay?

I am sorry but we have significantly increased the minimum wage. We have significantly increased it over the past number of years, and it will continue to increase. The Deputy talks about the living wage. The Government does not pay the living wage. He does not pay the living wage. Employers pay the living wage. Shops pay the living wage. The Deputy's local Centra pays the living wage, which is what he is saying. During an election campaign, the Deputy will go into the local Centra, talk to the person there and say "Oh yeah, you're dead right. I'll talk to the Government about that". That is what everyone in the Opposition did in the recent election. They said costs were too high and that we must do something for small businesses and for hospitality. This is an attempt to try to balance how fast and how rapid we make progress. That is it. The Deputy should not try to conflate this with some major agenda that is anti-worker because that is not what this is about, in any shape or form. We are moving ahead with auto-enrolment. The pay-related scheme is a very significant additional benefit that we can improve upon on in time. The State will take on a significant proportion of that, which is important.

In terms of the semi-State sector, rather than the ad hoc approach which has gone on for the past ten or 11 years, it is important to create a framework in terms of how senior executives in that sector are paid.

A few weeks ago, I raised with the Taoiseach some scandalous transactions by a number of financial advisers that have led to genuine investors getting stung for millions. Since raising this issue, I have been contacted by numerous people who have had their honest savings robbed. The last time I spoke on this, I knew of around ten people who were affected. Now, I have at least 60 people who are in this situation. The number is rising.

The regulation of standards and practice is the norm for many areas of work in this State. In healthcare, we have HIQA, which conducts regular inspections of our health service to ensure standards are met and users are safe. In the food and hospitality industry, the Food Safety Authority ensures that standards are met by means of carrying out regular inspections of premises. In the pharmaceutical industry, the European Medicines Agency regulates medicines for human use, ensuring their safety, quality and efficiency. In the financial services sector, regulation is the remit of the Central Bank but regulation of financial advisers appears to be practically non-existent, leaving the ordinary investor at the mercy of some unscrupulous individuals. How can a financial adviser take money from clients for investment in a company that is regulated by the Central Bank, provide loan notes which are not covered by the Central Bank, and put the company into receivership, while the client loses his or her money? That same adviser can then set up another company and start all over again, with no repercussions. Some advisers have done this 11 times already.

I reached out to the Central Bank seeking a meeting but to no avail. That led me to think whether this is a further cover up. The Central Bank is, in my view, equally culpable here. This raises a number of questions for the bank. What is the Central Bank doing in terms of regulation if financial advisers can fleece investors with impunity? How many audits of financial advisers does the Central Bank carry out each year? Will the Central Bank disclose details of these audits? Why are loan notes unregulated? Why does the Central Bank allow financial advisers to behave in this manner without sanction? Many people in my constituency and in many other constituencies face financial ruination having been let down by the Central Bank while the financial advisers, who they trusted and who they understood to be regulated the Central Bank, have run off with their money to another country under the guise of bankruptcy. The amounts for which constituents have been caught include €750,000, €500,000, €350,000, €52,000, €50,000 and much more.

It is now obvious that regulation by the Central Bank does not exist. Does the Government have the power to launch an investigation into the workings of the Central Bank? Will the Taoiseach work with me to get a meeting with the Governor of the Central Bank in order to get answers to the many questions that are out there about Central Bank-regulated advisers who have robbed millions of euro of people's savings?

The Deputy raised this a number of weeks ago. There are laws in place and there is a regulator. The regulator is the Central Bank. There is a tendency in the House to keep asking if we can investigate this and investigate that, but the established regulators have a function and an obligation to investigate if they receive complaints. I am not clear whether the individuals who have been defrauded, as the Deputy asserted, have made formal complaints in respect of the adviser to whom the Deputy refers or the companies in which that adviser was involved in establishing. Have actual complaints been sent to the Central Bank in respect of that? It is important to establish that, particularly as there are Central Bank registers. It is extremely important that customers are aware of the risk of fraud and related scams and that they ensure that the person or entity they are dealing with is registered with the Central Bank of Ireland. Those registers are available free online. The Central Bank also publishes warnings about unauthorised firms and will sometimes list such firms.

I presume this person was a registered broker. I will ask if the Deputy can meet with the Minister for Finance in relation to this, to take him through the details. The Minister has, from policy perspective, some interaction with the Central Bank, which is independent in terms of the conduct of its work. If a business has shut down - and the Deputy has suggested that a business closed down and then another business was established by the same person - any new business would also require authorisation by the Central Bank before it can undertake activities which are regulated by the Central Bank of Ireland. That authorisation process requires and includes a Central Bank fitness and probity review in respect of all of the key roles to lead the business and so forth.

There are individual accountability frameworks within regulation. The Central Bank (Individual Accountability Framework) Act 2023 sets out clearly and fully where responsibility lies in regulated firms and includes conduct standards. If the Central Bank suspects, on reasonable grounds, that a subject has committed a prescribed contravention, it is in a position to hold an inquiry to determine whether the subject has committed such a contravention. There are strong sanctions in relation to individuals.

It would be useful to know more. The Deputy sent me some documents in the past hour but I have not had a chance to go through them. I will read that material. I am not clear why the Central Bank has not engaged.

I do not know if the Deputy has written to the Central Bank to make submissions to it on the people he has spoken about here.

Yes. I wrote to the Central Bank two weeks ago and I have heard nothing back since. There are legal cases being taken at the moment. The fraud squad is also involved. When I raised this question in the Dáil the last time, the fraud squad contacted people immediately afterwards. I sent the Taoiseach and the Minister for Finance two sample cases this morning. I respect that the Taoiseach needs to look at that in his own time.

When I talk about financial advisers, I do not want to tar all of them with the one brush as most are honest in their dealings. I want to talk about those who are scam operators and who, as I said the last time I spoke to the Taoiseach three weeks ago, drive around in top of the range SUVs and are seen drinking champagne outside bars or on the side of the street, laughing at those who now cannot retire or who have retired and who have been robbed of their savings because these despicable people cannot be touched. It is time to hit the untouchables. They have ruined innocent people’s lives. It is time to have these people put behind bars. The only way this can be done is to have a full investigation into the Central Bank's procedures and weed out the reasons how these scam financial advisers were able to play nod-and-wink with the Central Bank and avoid any regulation.

I welcome that the fraud squad seems to be, or is, involved, as the Deputy said. That is good news. It is reprehensible for anybody to defraud another person of funds, particularly their savings, through fraudulent investments. Nobody is untouchable. They can be touched and investigated and there is a process for doing it. We in this country are always going back to investigate the investigator. We do not need an investigation into the Central Bank, I suggest, but an investigation into the individuals whose fraudulent behaviour the Deputy has highlighted in the Dáil. That is what we need. That is why we establish regulators and resource them. We put a lot of funding into regulators. Fundamentally, into the future, the country must use existing regulatory authorities to do the majority of investigations. We love setting up commissions of investigation - inquiries that cost millions of euro, spend years at it and not getting the closure that people want in all cases. There is real law and sanctions here. We should pursue those avenues.

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